President Donald Trump’s January 28 executive order attempting to limit care for trans youth 18 and younger calls gender-affirming care “chemical and surgical mutilation.” Last Wednesday, Department of Education Secretary Linda McMahon and Representative Dan Crenshaw met with several “detransitioners,” or people who no longer identify as transgender, to mark DeTrans Awareness Day. (The day was created in 2021 during the Biden administration, so, according to HuffPost, this was the first time the federal government has acknowledged it.) Several speakers said they regretted having mastectomies, per The Federalist, or, in their telling, having their “breasts cut off.” Andrew Guernsey, senior adviser to Health and Human Services Secretary Robert F. Kennedy Jr., attended the meeting and referred to gender-affirming care as the “mutilation of kids.”
The Gonzales ruling repeated grisly descriptions of D&X procedures, and Justice Anthony Kennedy wrote that there was “medical uncertainty” over whether the procedure was ever necessary to preserve a woman’s health—the alleged uncertainty arose from doctors saying D&X can be medically necessary, while GOP members of Congress claimed it “never” was. Kennedy also infamously argued that women may regret their choice if they knew how the procedure was really done.
In its document, Students for Life claims that the pills lead to “chemically tainted blood, placenta tissue, and human remains” being flushed into the water system. One of its model bills is the misleadingly named Clean Water for All Act, which would require prescribers of medication abortion to give their patients red medical waste bags that say “biohazard” and instructions for returning the products of conception to them at a follow-up appointment. (This bill bans telemedicine abortion too.) Providers who don’t follow these steps could face up to three years in prison and fines of up to $10,000. The model legislation doesn’t specify what happens if patients don’t return the red bags to their provider. While the “clean water” bills wouldn’t ban mifepristone use outright, they’d make it so risky for providers to continue prescribing the pills that they would simply stop.
The idea here is to try to gross people out to support a law that’s not principally about water but rather is designed to drastically limit access to medication abortion—and to make people afraid of the drugs, as if they’re some kind of dangerous chemical. This scare campaign to give people “the ick” is a bit absurd to Moayedi, who still remembers the first time she saw a C-section in medical school and being shocked at just how much force surgeons use to open the abdominal cavity. The procedure is, to some extent, violent, she said—as are orthopedic surgeries using power tools.
Conservatives are using stigmatizing language as an intentional tactic to demonize the people who need this care and to discredit those who provide it, said Ma’ayan Anafi, senior counsel at the National Women’s Law Center. “This is well-studied care. It’s care that’s provided according to well-established standards,” Anafi said. “The goal of this kind of inflammatory language is to make it sound experimental and dangerous.” Framing abortion and gender-affirming care this way creates a chilling effect that can lead to violence against providers and threats against health care clinics. “This strategy of vilifying providers has a real-world impact,” they said. “It both discourages providers from offering care that they want to provide, and it means that patients need to also be weighing their own safety and their own privacy when they’re trying to access the care they need.”
Just calling medication abortion drugs “chemicals” is itself inflammatory. Recall that Judge Matthew Kacsmaryk wrote in his April 2023 ruling that mifepristone “blocks the hormone progesterone, halts nutrition, and ultimately starves the unborn human until death.” The decision uses the phrase “chemical abortion” 93 times.
To Anafi, the fact that conservatives are looking to the Gonzales ruling to restrict care like medication abortion is telling: Now, as then, medical opinion is not on their side. “Gonzales teaches us that our opponents will often resort to disinformation, to inflammatory rhetoric, to outright lies,” they said. “But what’s more important than the lies is the stories of real people who seek care.” Still, the current media environment and the 6–3 supermajority on the court mean “there is more opportunity for a lot of these false narratives, both about gender-affirming care and about abortion, to lead to really harmful decisions,” Anafi said.
That’s the thing about these bills; they’re not written with a true concern for health and safety but rather reverse-engineered to achieve an ideological outcome. And the engineers typically go after children’s rights first as a kind of testing ground. Conservatives focusing on health care for trans and nonbinary children is “straight out of the anti-abortion playbook,” Moayedi said, pointing to laws requiring parental consent or notification before abortions. The movements are “two heads of the same beast,” she said.
After passing bans for children, they can use the momentum to restrict care for adults and call it protection. “These laws are driven by a lot of that paternalism, by a lot of that belief that people should be protected from themselves,” Anafi said. That framing is implicitly about the specter of regret, which is “belied by the evidence that we have.” A 2021 review of data from nearly 8,000 teens and adults who had gender-affirming surgeries found that an average of 1 percent expressed regret.
But there’s a double standard in the care that’s being restricted. “People also regret knee surgeries. People regret plastic surgery—they regret breast augmentation, and so many people have their breast implants removed,” Moayedi said. There’s no national push to regulate breast augmentation in cisgender women, but lawmakers are acting like it’s a crisis that a small number of trans people could come to regret their breast implants. “The actual percentage of trans people who regret getting medications or surgery is just astronomically lower than people that regret breast augmentation or knee replacement,” Moayedi said. “The math doesn’t math.”
To Anafi, the fact that attacks on abortion and gender-affirming care come from the same groups and lawmakers is an opportunity for solidarity. “They are coming from that same place of trying to take away people’s ability to determine their own futures, decide what happens to their bodies, their access to health care, and to live free from gender stereotypes,” they said. “These principles might bring together the anti-abortion and anti-trans movements, but they also create a basis for the movements that fight for our rights.”
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