How to Navigate Transgender Issues in the Trump Era

It's possible to both condemn the bigotry of the right and reject the excesses of activists.

(Photo by Spencer Platt/Getty Images.)

Even amid all the multifront turmoil of the first weeks of Donald Trump’s second presidency, transgender rights have been a notably acrimonious cultural battlefield. Trump’s barrage of executive orders on trans issues—issues including the legal recognition of gender transition, gender youth medicine, “gender ideology” in schools, transgender athletes in women’s sports, and more—has been decried as a vicious and bigoted attack on a vulnerable population, yet it has also received praise not only from conservatives but from some feminists with little sympathy for Trump or his overall agenda. Meanwhile, in the wake of an election in which Trump almost certainly got a boost from accusing the Biden administration and Kamala Harris of being too radical on transgender issues, Democrats are trying to figure out how to navigate this minefield. Just a few days ago, California governor Gavin Newsom broke with the party line on gender and sports, saying that it’s “deeply unfair” to let transgender athletes play in female sports leagues; other Democrats offered a muted response, suggesting that the issue should be settled at the state and local level.

The broader question of how to deal with the transgender culture wars is a difficult one for opponents of the Trumpist right—Democrats, independents, and centrist anti-Trump Republicans. The idea of sacrificing a minority’s civil rights for political gain is rightly seen as repugnant, and there is no question that the Republican Party is currently engaged in some disgraceful assaults, in words and action, on transgender Americans. But it is also important to acknowledge that some of the issues implicated in this debate are not straightforward matters of civil rights; that concerns about progressive overreach are not simply a right-wing culture war panic; and that such concerns also relate to important questions about harm to the vulnerable.

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It’s a common view among liberals that the right instigated the transgender culture wars circa 2015—the year bills requiring bathroom use congruent with biological sex cropped up in various states—after losing its battle against same-sex marriage. But this claim ignores a vigorous campaign on the left, coinciding with a general surge in social justice activism, to turn transgender advocacy into what a 2014 Time magazine cover story called the “next civil rights frontier.” In the following decade, some of the more controversial ideas associated with transgender activism were mainstreamed to a remarkable degree. For instance: that sex is not identified but “assigned” at birth; that gender transition can be established via self-identification, even without medical or cosmetic interventions; that “nonbinary” or gender neutral identities must be fully accommodated; and that cross-sex identification in children should be presumptively regarded as a sufficient basis for social and (in adolescents) medical transition.

In contrast to the long debate that preceded the legalization of same-sex marriage, all these ideas—most of which would have seemed shocking twelve years ago—rapidly became an undebated liberal consensus, with dissenters routinely vilified as bigots. Partly, this was a result of the triumph of gay equality, codified in the U.S. Supreme Court’s 2015 ruling that made same-sex marriage legal throughout the land: further LGBT victories seemed inevitable, no one wanted to be on the “wrong side of history,” and talk of possible problems was dismissed as similar to the never-materialized dire predictions about the perils of gay rights.

But there are major differences. Perhaps the winning argument for marriage equality was that gays and lesbians simply wanted the legal and social protections for their partnerships as everyone else, and that those partnerships did not tangibly affect others. (Some debates on the margins—for instance, whether florists and bakers with religious objections can refuse service for same-sex weddings—still remain.) The past decade’s transgender activism has gone further than this, and often pursued goals that do encroach on other people’s rights, comfort, and sometimes safety.

Take single-sex facilities. While bathroom stalls afford some privacy, a person of clearly male appearance in a women’s restroom is still likely to cause alarm. Bathrooms are spaces of particular vulnerability due to isolation and intimate functions. With self-ID, there is no ready way to tell a transgender woman from a predatory man, and while there are certainly other places where women can be assaulted by sexual predators, the risk (however small) that a woman could be assaulted in a bathroom by someone claiming to be transgender can’t be dismissed.

In 2021, when a viral video complaining about “a man with a penis” in the women’s nude sauna at a spa in Los Angeles caused an uproar, progressive media initially blamed a “transphobic hoax” (while also insisting that such a person, if female-identifying, had every right to be there). Then, the culprit was identified and eventually charged with indecent exposure: 52-year-old Darren Merager, a registered sex offender who had a record of indecent exposure and voyeurism before legally transitioning in 2019, had already caused at least one similar incident post-transition in a gym locker room in front of several teenage girls. The controversy also revealed that other spas had had problems with customers repeatedly “exposing male genitals in the female pools and lockers”—and that California civil rights law is on their side if they have a legalized female identity.

Similar issues have been reported at hospitals and shelters. In 2019, a transgender person at a women’s shelter in Vancouver, Canada who has an entirely male appearance in selfies bragged on Facebook about walking about the shelter topless, with “a bulge in my pants,” and aggressively rebuffing another resident’s request to “at least dress like a woman.” The shelter backed the trans resident and condemned the criticism as “transphobic.”

Prisons, where women housed with a biological male are literally a captive population, present an even thornier issue. In New Jersey, a 2021 policy of housing inmates on the basis of gender identity was reconsidered two years later after a transgender prisoner in a female facility impregnated two women. In the UK, outrage over a convicted rapist being sent to a women’s prison after legally transitioning while awaiting trial also led to a policy change, so that self-identified trans women who have committed violent sexual offenses and/or retain male genitalia cannot be housed in a women’s prison barring “exceptional circumstances.” What’s more, data from the United States show that as many as half of biologically male prisoners claiming a female identity are sex offenders, compared to some 13 percent of the overall prison population. This reflects less on the population of trans women than on the fact that, when transition is based on self-ID, bad actors can easily abuse the process.

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Women’s athletics is another area where the clash between women’s rights and much transgender advocacy is obvious. While many dismiss the issue due to the very small number of transgender athletes in women’s sports, the fundamental question of fairness remains, and individual stories point to real problems. Proposals to separate athletes by weight and height categories are unworkable, since they ignore the fact that athletes who have gone through male puberty have dramatic advantages over their female counterparts even at similar height and weight (muscle mass, bone density, lung capacity, etc.). Nor does artificial testosterone suppression fully neutralize this male advantage, which is not comparable to the natural advantage outstanding athletes have over others of the same sex. A New York Times/Ipsos poll in January found that nearly 80 percent of Americans—including about two-thirds of Democrats and independents—agreed that “athletes who were male at birth but who currently identify as female” should not be allowed to compete in women’s sports.

A similarly strong consensus exists over youth gender medicine: in the same poll, 71 percent of all Americans (and more than half of Democrats) believe that puberty-blocking medications and hormone therapies should not be available to anyone under age 18. The issue is a fraught one: commentators like science writer Jesse Singal, who has drawn the ire of activists for his criticism of gender transition therapy for minors, have acknowledged that it may be beneficial for children with severe and persistent gender dysphoria. But it’s also a fact that more and more European countries, including socially progressive bastions like Norway and Sweden, have been moving toward drastically restricting access to such therapies for children. England has been the most recent addition to this roster, in the wake of a report by Dr. Hillary Cass, a top pediatrician, who found that the benefits of puberty-blocking and hormonal treatments for minors were extremely uncertain and the possible risks of such interventions were not sufficiently understood.

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Why We Need a Serious Debate About Healthcare For Transgender Youth

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In the United States, political polarization has gotten in the way of finding a reasonable middle ground. Yet reports of gender-dysphoric children being rushed into hormone therapy and other interventions without adequate mental health safeguards, frequently dismissed as scaremongering, have been confirmed by reporting. Clinicians who have long worked in the field of gender medicine, such as child psychologist Laura Edwards-Leeper and clinical psychologist Erica Anderson (herself a transgender woman), have expressed similar concerns. Their observations have also echoed the findings of hotly disputed studies on “rapid onset gender dysphoria,” or ROGD—cases in which children and adolescents, often ones dealing with mental health problems or personal crises, adopt a new gender identity due in part to social influences.

The clash over pediatric gender medicine illustrates another troubling aspect of much transgender advocacy: the politicization, and arguably corruption, of science. Researchers and clinicians who depart from the orthodoxy on youth gender dysphoria have been targeted by intense pressure from activists, leading to severe career repercussions and, in one case, the retraction of a large study of adolescent ROGD on flimsy pretexts. Meanwhile, an influential researcher who advocates for medical transition for adolescents, Dr. Johanna Olson-Kennedy, recently admitted that she did not publish her study showing no mental health benefits from puberty blockers because she was concerned about the political repercussions.

Concerns about pediatric transition are frequently dismissed as a “moral panic” on the grounds that such transitions are still fairly rare despite the rise in transgender identification among children—though the critics acknowledge that the actual numbers are unknown. But surely, given that the long-term consequences may include fertility loss and compromised bone density, the issue deserves close attention. It’s worth noting that late last year, Dr. Olson-Kennedy—who, by her own account, has prescribed hormone therapy for children as young as 12 and approved double mastectomies for transgender-identifying 13-year-olds—was sued by a 20-year-old former patient who has detransitioned and says that her transition-related medical procedures were approved without adequate assessment.

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The gender revolution of the past ten years has also gone far beyond the “classic” model of a gender-dysphoric person transitioning to live as the other sex. Many of the new “queer” activists challenge the basic classification of humans as male or female (the “gender binary”), claiming that sexual dimorphism is a myth, promoting the idea of a huge number of gender identities, and seeking to upend universal norms of interaction such as assuming sex based on appearance. Mainstream culture has accommodated these demands to a remarkable degree.

But these trends have encountered pushback not only from conservatives but from a number of feminists and gay activists. Aside from the complexities of transgender inclusion in sports and single-sex spaces, many feminists are concerned that the new activist language of gender perversely validates regressive stereotypes (discussions of nonbinary identities, for instance, often seem to suggest the notion that you’re neither male nor female if you like sports and pink dresses), while many gays and lesbians bristle at the notion that it’s bigoted to reject a partner who shares your gender identity but has an opposite-sex body. “Gender-critical” feminists have been targets of some extremely ugly rhetoric.

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At the same time, the anti-trans backlash has also taken ugly forms. Some critics of transgender advocacy insist that there must be no recognition of gender transition at all, whether on the legal level or the personal level of using preferred pronouns. (Science writer Ben Ryan, who has been attacked by transgender activists for writing critically about pediatric gender medicine, has been assailed by gender-critical activists for referring to transgender women as “she.”) Trump’s executive orders also reflect or explicitly state this position—for instance, mandating that passports have gender markers based on biological sex and not transitioned gender, which could create problems at the border for a person with a female appearance but an “M” in the passport or vice versa. The executive order banning transgender people from the military not only cites medical burdens but asserts that “a gender identity inconsistent with an individual’s sex conflicts with a soldier’s commitment to an honorable, truthful, and disciplined lifestyle,” going as far as to classify a transgender identity as a “falsehood.”

In the same vein, some Republicans in Congress have made a point of referring to transgender House member Sarah McBride as “Mr. McBride” and “the gentleman from Delaware,” while Representative Nancy Mace pushed through a bill in November to bar McBride from using women’s bathrooms in the Capitol. Yet, aside from the fact that McBride has a personal bathroom in her office, transgender women like her who have transitioned and who live and present in accordance with their legal identity have been using women’s bathrooms for decades with no fuss. Current Republican initiatives aim not simply to reverse some of the excesses of the past decade but to deny transgender people the level of acceptance they had 40 or 50 years ago.

In today’s polarized atmosphere, hoping for a return to a sane middle seems futile. But Democrats and other Trump critics should aim for such a middle rather than die on the hill of an extremism that alienates ordinary Americans—as transgender dissidents like Democratic activist Brianna Wu have been pointing out. Compassion is important, but it should also extend to the rape survivor who doesn’t want a male-presenting person in her all-female support group or to parents who believe their gender-distressed child would benefit from therapy that does not encourage transition.

What would a sane middle look like? It would certainly not look like bullying, dehumanizing or mocking transgender people, or subjecting them to a blanket military ban. It wouldn’t look like winding back the clock on decades of recognition of transgender people’s ability to live as they wish and enjoy basic respect: America is a free country in which the presumption should be that everyone decides for themselves on their version of the good life.

But a sane middle would also (as in countries like the United Kingdom and Sweden) move towards stringent safeguards for any gender transition interventions for underage patients. Such a movement would recognize the need to protect single-sex female sports while creating equitable options for transgender people to participate in athletics. It would mean a return to some objective medical criteria for legal transition for adults rather than self-ID, and a pulling back from rhetoric that denies biological sex or demands unquestioning recognition for any self-declared gender identity. And, above all, it would involve open debate rather than dogma in an area of human life that is still so little understood.

Cathy Young is a writer at The Bulwark, a columnist for Newsday, and a contributing editor to Reason.

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