Mommy, I’m scared,” my daughter said from the backseat of our SUV, surrounded by her backpack, a sleeping bag and some other odds and ends that never made it into her duffel bags. We were still about an hour away from camp and other than “why can’t I just stay home this summer?” these were the only words she’d muttered in the past 90 minutes.
“I know, *Gabby,” I said, empathizing. “It can be scary going to a new camp. But I’m sure that once you get settled in, you’ll make friends and have fun!”
“You don’t get it, Mom,” she said. “No one wants to be friends with the new kid.” And then a few seconds later: “Especially the new trans kid.”
I honestly didn’t think being transgender would prevent her from making friends. Hell, I hoped it wouldn’t. Regardless, I knew she was feeling anxious. And even though I loved my camp experience (eight summers as a camper, four as a counselor, and I still sing color war cheers and alma maters in the shower), I could only imagine the anxiety she was feeling.
Privacy at sleepaway camp is minimal, often nonexistent. Picture an old-school Loehmann’s dressing room — add some beds, cubbies and a multi-stall bathroom/shower area, and you’re looking at a traditional bunk. Yes, things had gotten a little awkward one summer at my old sleepaway camp when my boobs started growing before some of my bunkmates, and when my friend sprouted pubic hair when the rest of us hadn’t, but for the most part, all of us girls were in the same boat. Breasts and bushes aside, we all looked similar and had few qualms about dressing or undressing in a crowd.
But how would my penis-bearing daughter feel changing in a room full of vaginas, I often wondered when the topic of camp arose. And how would the vagina-bearing girls — and let’s be honest, their parents — feel about their kids changing, let alone living in the same bunk as a girl with a penis?
When we first began researching camps, my husband and I weren’t even sure sleepaway camp would be possible for our daughter. Especially after Gabby told us vehemently, “I’m not going to trans camp,” which was a decision we respected. While there are a handful of incredible camps for gender-nonconforming and transgender kids, our daughter wanted a traditional sleepaway experience where she could simply be “one of the girls.”
“Why can’t I go to cousin Amanda’s camp?” Gabby asked for about the fifteenth time a week before camp was slated to begin. We were sitting outside, just the two of us, eating dinner at a neighborhood café.
“Honestly,” I replied, setting down my glass of cabernet, “for a few reasons. One, Amanda’s camp is a little over the top for my and Daddy’s taste. Let’s just say it’s a bit fancier than I’d expect a camp to be. And most of the girls seem to be wearing the same outfits” — expensive outfits, I thought but didn’t say — “in all the pictures I’ve seen. It seems a bit much to me.
“And besides,” I started to say, but then stopped.
“Besides what?” Gabby asked.
I sighed.
“Just tell me, Mom!”
“I’m not sure they’d let you go to that camp,” I admitted softly.
“Let me go?”
“Yes,” I said, and paused again, trying to buy some time before having a conversation I’d been dreading since my son Gideon became my daughter, Gabriella. “Not all camps accept transgender campers.”
“Oh,” she said dejectedly. “Well, did you ask Amanda’s camp?”
“No, we didn’t. Because again, it’s not a camp we’d consider for you.”
“Did you ask other camps that said no? Is that why I’m going to this new camp?”
Texas leaders have targeted trans youth, their families and gender-affirming care practices for months. It’s exacerbated feelings of anxiety and fear in trans youth, who already experience higher rates of depression, anxiety and suicide than their cis peers. Mental health practitioners can help navigate these feelings, but finding and accessing an affirming therapist in Texas can be a challenge.
For resources and support, call Trans Lifeline at 877-565-8860, The Trevor Project at 866-488-7386 or the National Suicide Prevention Lifeline at 800-273-8255.
Roswell Gray, 17, has seen a lot of different therapists’ offices. They’re always some variation of black and white and gray, the muted tones matching the monotony of having to explain everything over and over again to a new person, in the hopes they’ll be the right fit.
But Gray said walking into a new office, about an hour away from their home in Sherman, felt different.
“It was really simplistic, but there was a lot of beautiful art, a lot of different colors and stuff that made me smile,” Gray said. “She had a little mini fridge with snacks and drinks. And it was just like, super welcoming and inviting.”
But beyond the fully-stocked fridge and the décor, Gray’s therapist used their pronouns and asked about their gender identity. Their previous therapist “wasn’t great in many aspects,” and they had been looking for a provider who was trans-affirming and could talk about their Mormon faith.
“I was partially nervous because a lot of people of faith aren’t as accepting as I would like them to be,” said Gray. “It was really nice to hear her talk about how she’s dealt with other clients like me, who are also queer.”
Because of the drive to the office outside of Grayson County, gas prices and the pandemic, Gray hasn’t gone to therapy as often as they’d like. And it’s been hard to navigate the past few months, they said, as gender-affirming care has been caught up in a legal back-and-forth.
Lawmakers in Texas have increasingly tried to prevent access to gender-affirming mental health and medical care for trans youth since last year. Attorney General Ken Paxton and Gov. Greg Abbott have both targeted families providing medical care to their children. In addition, a bill the Texas legislature passed last year bans trans athletes from sports in school.
Repeated exposure to negative messages on trans identity in the media and from political leaders can lead to increased “depression, anxiety, PTSD and psychological distress” for trans people, as researchers found in a study in the journal of LGBT Health earlier this year. The Trevor Project, a national LGBTQ youth crisis services, advocacy and research organization, reported back in January that 85% of transgender and nonbinary youth surveyed said their mental health was negatively impacted by hearing state lawmakers debate trans rights.
“Navigating Texas, with all the changes in laws and policies, has been really hard,” said Gray. “Especially when I would go on to social media, and everything I would would see is like, the state is banning trans youth from playing sports. So I spend less time on social media just to distance myself from all of the negative things.”
As Texas leaders target gender-affirming care, psychologists’ work is caught in a legal back-and-forth
Mental health providers like Beck Munsey in North Texas are worried what statements from state leaders could mean for their work. Munsey is a clinician and educator who sees LGBTQ+ youth and adults. Part of Paxton and Abbott’s directives were that the Texas Department of Family and Protective Services, plus mandated reporters like physicians, mental health counselors like Munsey, and teachers, investigate and report families to the state.
“It is scary, because there may come a time where Texas law says that I’m not allowed to provide affirming care,” Munsey said. “And so I’ll have to make a moral decision on what I do with that.”
But clinicians and families are pushing back. Several families of trans youth, along with the Texas branch of the national advocacy organization PFLAG, filed a lawsuit to stop the state’s investigations. Doctors at UT Southwestern and Children’s Medical Center Dallas, which quietly closed its trans youth program GENECIS last winter due to political pressure and fear of lawsuits, are also currently in litigation to provide services to new patients.
The highest ranking transgender official in U.S. history will give a speech in Texas Saturday, urging physicians-in-training to fight political attacks against young trans people and their families.
In prepared remarks shared exclusively with NPR, she writes: “Trans youth in particular are being hounded in public and driven to deaths of despair at an alarming rate. Fifty-two percent of all transgender and nonbinary young people in the U.S. seriously contemplated killing themselves in 2020. Think about how many of them thought it was better to die than to put up with any more harassment, scapegoating and intentional abuse.”
Political attacks against trans young people are on the rise across the country. Over 100 anti-trans bills have been introduced in state houses this year, according to an analysis by Freedom for All Americans and the Guardian. Many of these legislative attacks use scientific language to justify their political aims, she says. In her prepared remarks, she concludes: “The language of medicine and science is being used to drive people to suicide.”
Levine is a pediatrician and adolescent medicine specialist by training. “I’m not a political person,” she tells NPR. But in this context, she says, when young trans people are being attacked by their own governments, she thinks medical professionals “need to stand up and be more vocal — and that’s exactly what I’m going to do.”
NPR spoke to Levine before she flew to Texas about what many Americans still don’t understand about sex and gender, how federal policy can counterbalance anti-trans legislation in the states, and how she sublimates personal attacks to drive her advocacy.
This interview has been edited and condensed for length and clarity.
You will be speaking at Texas Christian University on Saturday at the Out For Health Conference, which was founded and organized by medical students. Why this event and what is the message of your speech?
I think it’s a tremendous opportunity to speak with young professionals about health equity, diversity and inclusion.
One of the biggest messages I have at this time is really to speak about the challenges that the LGBTQI+ community face, particularly youth. The challenges come from very disturbing – and frankly discriminatory – laws and actions that many states are taking that are potentially dangerous, and costing the lives of young people. I think it’s a very important message to give young physicians in training.
In your prepared remarks, you write, “Anyone who believes that words are not the same as actions, who believe that LGBTQI people should just toughen up, should walk a mile in our shoes.” What would people learn from walking a mile in your shoes?
For some people, I think that these issues of gender identity are beyond their experience. They don’t understand it, and so they fear it, and that fear can lead to negative feelings and emotions. My goal is to educate about the LGBTQ+ community in general, and to educate about the trans community – that we are people just like everyone else.
We are doctors, we are lawyers, we are business people, we are teachers, we function in every part of society and we’re all just doing our part and living our lives and working towards the common good. And that might help dispel some of this fear and some of this discrimination.
“To walk in our shoes” is to have empathy for other people. I am such a big fan of diversity in all of its different aspects. I think diversity helps society. It helps any community. It helps any business, school, governmental agency. We have this beautiful tapestry of diversity in the United States. And so I think that it really is incumbent upon us to have empathy and compassion for those that are different from us.
Pew did a survey in 2021 that found that most Americans think that whether someone is a man or woman is fixed at birth. Most Americans also say they don’t know anyone who is trans. There’s a gap of understanding. Is there a role for the federal government in closing that gap?
I think there’s a role for community, medical and public health organizations to educate the public about these issues.
[Most people’s] experience might be that there is a simple binary of male and female, but it is actually much more complicated.
There is sex. You might think that that is simple, but it is not. There’s chromosomal sex, there are [primary] sex characteristics, secondary sexual characteristics. Of course, there are individuals as part of our LGBTQ+ community who are intersex. And so it is multi-dimensional.
Then there’s gender. Gender is really that self-concept in terms of your gender that is also multidimensional. There are sex roles, which have changed tremendously in our society over the last 50 to 70 years. And then there’s sexual orientation – whom one is attracted to and wants to have intimate relations with – and that is also multidimensional. We want to educate people about those somewhat complex features and help them understand our rainbow family.
Texas has been one of the loudest states in going after trans kids and families. The state has investigated the parents of trans kids for child abuse. Families have moved out of the state because they felt unsafe, and the state attorney general attacked you recently on Twitter. As a trans person, how are you thinking of all that as you head to Texas?
I use all of those challenges and sublimate that into my work. Those egregious actions, one might say insidious actions, that are politically motivated and really harm trans and gender-diverse youth and their families – I take my feelings about that and I put it into my advocacy and our policy work to support trans youth and their families.
We have a president, President Biden, who sees us and supports us. We have a vice president, Vice President Harris, who sees us and supports us. Secretary Becerra of the Department of Health and Human Services, Secretary Cardona of the Department of Education – really across the administration in the federal government, it is just remarkable how supportive they are to the LGBTQ+ community.
But we are seeing in many states – including Texas – laws and actions which are discriminatory, politically motivated and they need to be fought against.
People who feel that they are being discriminated against can contact the Office for Civil Rights, and they will open a case and investigate. And so we encourage trans and gender-diverse youth and their families [who] are feeling they are being discriminated against in Texas or any other state [to] contact our office.
In addition, [federal agencies] are looking at Title IX – particularly in the Department of Education and the Department of Health – in terms of support for sexual and gender minorities. We are going to be looking – throughout the administration – at policies that, again, support, affirm and empower our community.
Prior to this role, you were the secretary of health in Pennsylvania. A lot of people might not realize that you in HHS are not in charge of, say, the Florida Department of Health. That’s not how it works. Do you think that is a problem in the case of trans youth?
We have a republic in which the states have a lot of individual power. One thing we learned through the pandemic is how important it is to coordinate between local, state and federal public health authorities. When they’re not coordinated, that makes our work very difficult.
These negative and discriminatory actions and laws are politically based. It’s not public health-based. It’s not medically based in any way.
[In medicine], there is an evidence-based standard of care for the evaluation and treatment of trans individuals, whether they’re youth or adults. That standard is set by the World Professional Association for Transgender Health, or WPATH. The last formal standards of care were [released] in 2011, and we expect the new standards of care in 2022.
There are many other standards set by organized medicine, for example, the Endocrine Society, which is an international organization of hormone specialists – endocrinologists – has a standard of care. There have been comments from the American Academy of Pediatrics, the Society for Adolescent Health and Medicine, from the [American Medical Association], from the American Psychiatric Association, the American Psychological Association – [all] in support of evidence-based standards of care for [gender-affirming] treatment.
So when, for example, the surgeon general of Florida puts out a statement based upon political considerations, that is not appropriate. We need to stand against that both from a medical and public health point of view.
I will disagree that there are many studies cited in the Florida statement – there are a few studies. I’ve looked at them. A lot of them say that we need more research. We agree. This is no different from any other medical field in which there’s a research base that might inform a standard of care for treatment of other conditions, whether that’s diabetes or hypothyroidism or other hormonal endocrine conditions – those change over time as the research changes.
When you look at the forthcoming WPATH standards of care and you see the hundreds and hundreds of articles, you will be able to see the difference between the research base for the standards of care and the few studies cited by Florida.
There is no argument among medical professionals – pediatricians, pediatric endocrinologists, adolescent medicine physicians, adolescent psychiatrists, psychologists, etc. – about the value and the importance of gender-affirming care.
Idaho, Alabama, Arizona and other states have introduced more than 100 bills related to trans kids this year. There are bills about what can be taught in schools related to sexuality and gender – the so-called “Don’t Say Gay” bills. Some limit gender-affirming treatment to young trans people. Others limit trans kids’ participation in sports. What do you think is happening in these states with all of these bills?
I think that they’re all related in terms of their political motivation, and trying to stigmatize a vulnerable community — and particularly to stigmatize LGBTQ+ youth. We have a mental health crisis in this country, particularly among our young people, with increasing rates of depression, anxiety, suicidal thoughts, suicidal behavior. Our surgeon general, Vice Admiral Vivek Murthy, highlighted that in a surgeon general’s advisory in December of 2021.
One of the most vulnerable groups of young people are LGBTQI+ youth, and particularly – the focus of many of these issues – trans youth. We need to affirm them. We need to empower them because they are at risk, and they have a very high rate of suicidal thought and we have to act to prevent them from harming themselves. [We have] to support those young people and their families.
You said on a podcast recently that “being trans doesn’t have to define who I am.” I’ve heard from trans friends and colleagues that it can be exhausting to have to explain your personal experience and talk about gender all the time. How do you think about this part of your job and your role?
I am honored to be the assistant secretary for health, and a four star admiral and the leader of the United States Public Health Service Commissioned Corps. I recognize that I am the first openly transgender person to be confirmed by the Senate and to have these roles. It is a privilege. I want to use that – how fortunate I am to be in these roles – to work toward the common good in all of the different medical and public health issues that we’ve been discussing and more.
I understand the significance of my role to stand up and be counted as a very open and proud LGBTQ+ individual and openly transgender woman. And to use that to support more of our vulnerable LGBTQ+ community in all ways that I can.
[Talking about it] doesn’t bother me. I mean, I’ve been in these [public] positions for seven, eight years now, and so it doesn’t surprise me. I’m used to it.
Sarah McBride, national press secretary of Human Rights Collation, speaks on the introduction of the Equality Act, a comprehensive LGBTQ nondiscrimination bill at the US Capitol on April 01, 2019, in Washington, DC.
Jennifer Williams is a former New Jersey Republican Assembly candidate and was the first openly transgender delegate to the Republican National Convention in 2016. She currently serves as a member of the Conservatives Against Discrimination Leadership Council and as chair of the Trenton Zoning Board of Adjustment in New Jersey. The views expressed in this commentary are her own. View more opinion on CNN.
(CNN)Five years ago, my wife, children and I planned an Easter week trip to Charlotte, North Carolina, to visit some of our relatives. What should have been a relatively smooth road trip from New Jersey to North Carolina, however, soon turned into a highly precarious situation.
Just a few weeks before our trip, North Carolina passed House Bill 2, which required everyone in the state to use public restrooms based on the sex assigned to them at birth. What that meant for me — an American transgender woman — was that I would have to break this law in order to use the women’s restroom at any of the stops we visited in the state.
Jennifer Williams
As we crossed the border from Virginia, my wife and I both grew uneasy. We still had several hours of interstate driving in North Carolina ahead of us. Knowing that I could be arrested if I used a women’s restroom, my wife found a downloadable Google Map called “Safe Bathrooms,” which the spouse of a transgender person created so other transgender people could find a safe restroom to use in a supportive, private business.
Thankfully, we found one for me to use in downtown Greensboro at a small independent bookstore. After entering the bookstore, I explained to an employee that I was transgender and would like to use the restroom. The employee graciously showed me where it was.
As safe as my family and I felt at that moment, the sting of state-sanctioned discrimination was sharp. It felt especially poignant for my family to find refuge in the same city where four brave North Carolina A&T students staged a sit-in to integrate the F.W. Woolworth store nearly 60 years earlier.
Though North Carolina has since repealed this discriminatory restroom law, many LGBTQ Americans continue to face similarly agonizing decisions each day. According to the Human Rights Campaign, 2021 has been a record-breaking year for anti-LGBTQ laws in state legislatures — many of them targeting transgender youth seeking medical care or wanting to compete in sports.
The FBI is investigating claims that Congresswoman Debbie Wasserman Shultz’s car was the target.
A quickly accelerating pickup truck ran over two men at the Wilton Manors Florida Pride parade killing one and injuring another. According to reports the two victims and the driver of the truck were members of the Fort Lauderdale gay men’s chorus and participants in the parade.
The Fort Lauderdale mayor said that the incident was “intentional” and a ‘terrorist attack’ against the LGBT community. The FBI is investigating claims that Congresswoman Debbie Wasserman Shultz’s car was the target.
Some witnesses said the crash appeared to be an intentional act, but Fort Lauderdale Police Detective Ali Adamson told reporters that authorities were investigating all possibilities.
The driver and the victims were a part of the Fort Lauderdale Gay Men’s Chorus family, according to a statement reported by news outlets from the group’s president, Justin Knight.
“To my knowledge, it was an accident. This was not an attack on the LGBTQ community,” Knight said in the statement. “We anticipate more details to follow and ask for the community’s love and support.”
Recent studies have tried to quantify the impact of Hormone Replacement Therapy (HRT) on the cardiovascular system, by measuring the risk of blood clots. This is also one way the risks of taking birth control contraception has been measured. 2 recent studies reveal that HRT is nearly as safe (if not more so) as birth control medications when it comes to forming blood clots.
