Last week, the Trevor Project released its 2025 National Survey on the Mental Health of LGBTQ+ Young People this week, finding that 36% of LGBTQ+ youth seriously considered suicide in the past year, that 1 in 10 attempted it, that 90% said anti-LGBTQ+ laws and policies caused them stress or anxiety, and that trans and nonbinary youth denied hormone access were nearly twice as likely to have attempted suicide in the past year as those currently taking hormones — with a dedicated breakdown of the survey's transgender healthcare findings available separately.

Weeks after a federal judge voided the Kennedy Declaration and blocked any similar policy from taking effect, no hospital has yet reopened a trans youth healthcare program it suspended in response to federal pressure. The DOJ's medical records campaign continued to face resistance on multiple fronts: Rhode Island's Office of Child Advocate filed an emergency motion to quash a federal subpoena demanding five years of trans youth patient records from Rhode Island Hospital, while the DOJ separately moved to drop its appeal in the CHOP case, a maneuver CHOP attorneys argued may be an attempt to reroute the fight to the more DOJ-friendly Northern District of Texas.

Children's Minnesota filed a motion to quash its own DOJ subpoena, arguing in court that the demands are "aimed at regulating (and chilling) a particular type of medical care, with the goal of eliminating it nationwide" rather than investigating any specific legal violation. The DOJ is also offering $25,000 signing bonuses to attorneys willing to pursue trans healthcare investigations, part of an apparent effort to rebuild staff capacity after the department's attorney numbers fell from roughly 10,000 to 5,500 under the prior attorney general.

A federal judge in D.C. delivered a pair of major legal victories for WPATH and the Endocrine Society this week, blocking the FTC from enforcing investigative demands against either organization and finding extensive evidence — which the court described as "wafer-thin justifications" for the probes — that they were motivated by hostility to gender-affirming care rather than any legitimate consumer protection purpose.

Tennessee Governor Bill Lee signed HB 754, a law creating what amounts to a public database of trans people, requiring clinicians to file monthly reports on trans patients' medical details, medications, dosages, dates of care, and other diagnoses, all of which will be released publicly in raw, un-aggregated, downloadable form beginning December 2026 — a format researchers say is trivially reversible to identify individual people.

Ohio Rep. Josh Williams — who has already introduced more than 100 bills in the current legislative session — introduced HB 838, which would strip Medicaid coverage for most gender-affirming care and financially penalize cities that maintain trans-inclusive employee health plans, his sixth explicitly anti-LGBTQ+ bill in this session.

A long-stalled New Jersey bill providing criminal and civil protections for gender-affirming care providers and their patients advanced to a Senate committee vote this week, two years after it was first introduced.

Legal scholars at Assigned Media convened a roundtable examining whether the Supreme Court's ruling in Chiles v. Salazar treating conversion therapy as protected speech is legally consistent, with one contributor noting that the majority's reasoning would likely require striking down bans on gender-affirming talk therapy as well.

International

An Alberta judge dismissed an application by Egale Canada and Skipping Stone to amend their court challenge to the province's gender-affirming care ban, ruling that because the law relates to health and safety it falls within provincial jurisdiction — a decision both groups say they plan to appeal, while their original Charter challenge remains on hold pending a Supreme Court of Canada ruling in a parallel Saskatchewan case.

The UK's Department of Health and Social Care has escalated its language further, telling QueerAF that providing puberty blockers to trans children was "appalling," even as the BMA's own report found that the 2024 Cass Review simplified complex findings, downplayed benefits, and that the government's implementation of its recommendations went beyond what the review actually recommended. The British Medical Association reversed its earlier opposition to the Cass Review, with the union's lead reviewer telling The Guardian that Dr. Hilary Cass "has been vindicated" — but the BMA stopped short of endorsing the government's ban on puberty blockers, arguing that prescribing decisions should remain with doctors rather than politicians.

Activist Mpho Buntse wrote in MambaOnline about the resurgence of well-funded anti-gender and anti-queer movements across Africa, tracing their roots to colonial-era laws and describing their relationship to global conservative networks as a direct threat to democratic norms on the continent.

Australia's Medical Board and Ahpra issued a joint statement pushing back against The Australian newspaper's reporting on the disciplinary action against anti-trans psychiatrist Andrew Amos, calling out a pattern of coverage with the potential to undermine public trust in medical regulation. Victoria's Commissioner for LGBTQIA+ Communities Joe Ball delivered a plenary address at the RANZCP 2026 Congress calling on psychiatrists to keep the child at the center of clinical care and resist the pressure to let political noise drive them away from evidence-based practice.

File your FCC comment — by May 22, the Federal Communications Commission is soliciting public input on whether to require warning labels for TV programming featuring transgender and gender-nonbinary characters; GLAAD describes the inquiry as an attempt to pressure networks into compliance with the administration's political agenda, and filing a comment in Proceeding 19-41 is one of the most direct ways to push back right now.

• 'Our Communities Are Literally Dying': Inside a Mexico City Activist's Fight for Liberation — Trans News Network's Mira Lazine interviews Razzia Santillán, an organizer whose collective Clan Mariposas Negras blends mutual aid, legal resistance, and direct action from a multi-year occupation at Mexico City's Cineteca Nacional — and who describes a growing number of trans Americans arriving in Mexico City seeking safety.

• Erin Reed and AlterNet America Tackle Trump's Trans Obsession — A recorded live conversation between Erin Reed and AlterNet America examining the Trump administration's fixation on trans people as a political and policy driver.

• Journal Club: The Joys of Being Trans — Assigned Media's Veronica Esposito reviews a 2024 paper by Matilda Wurm and colleagues on the unique joys, growth, and peace that trans people describe experiencing — from expanded gender perspective and greater critical thinking to the confidence that comes from surviving an immense personal journey.

• The Troubled History of DIY Trans Healthcare — Grace Byron writes in The Nation on the decades-long underground history of hormone access for trans people, and why scholar Jules Gill-Peterson argues that DIY care represents hard-earned resilience rather than a scalable strategic answer to transphobia.

• The Unspoken LGBTQ Youth Mental Health Crisis in Canada — Emma Paidra and Sophie Holland report for Uncloseted Media on the gap between Canada's progressive reputation and the reality facing queer youth, with trans and nonbinary young people facing suicide rates seven times higher than their cisgender straight peers and most unable to access specialized mental health treatment.

At the Pediatric Academic Societies' 2026 annual meeting in Boston, trans youth from Protect Trans Futures and allied clinicians disrupted and protested a panel stacked entirely with SEGM-affiliated speakers — the only panel dedicated to gender care at the conference, and the only one offering CME credits. Despite a 90,000-email campaign, PAS proceeded; the Pediatric Endocrine Society later issued a statement that the panel "was made up entirely of individuals who have espoused views that run counter to the bulk of the primary literature," and doctors attending the conference said they hadn't known about the panel's composition until activists told them. For a full account of how SEGM launders pseudoscience into clinical and legislative spaces, last month's Rx Resist column has the map.

The attacks on adult coverage escalated on multiple fronts this week. The 4th U.S. Circuit Court of Appeals upheld West Virginia's Medicaid ban on gender-affirming surgery for adults in Anderson v. Crouch — the first federal appellate court to apply Skrmetti beyond minors — with legal experts warning it could embolden at least seven other states facing similar lawsuits. Ohio Rep. Josh Williams, now with six anti-LGBTQ+ bills this session, introduced HB 838 to strip gender-affirming surgery from municipal employee insurance coverage.

At the federal level, House Republicans attached five anti-LGBTQ+ riders to the State Department's FY2027 funding bill, including a provision that would defund any organization that provides or promotes healthcare for trans people or "promotes transgenderism" — effectively any organization that acknowledges trans people exist — despite gender-affirming care being endorsed by nearly every major medical association.

Activists rallied at Springfield City Hall after Baystate Health ended gender-affirming care for patients under 18 in February — preemptively, without legal compulsion, and in apparent violation of a 2022 Massachusetts state law — even as a federal court had already ruled those Medicaid threats illegal; the hospital has not reversed course, and state AG Andrea Joy Campbell has yet to compel it. The pattern is doing exactly what it's designed to do: New Mexico's Planned Parenthood clinics have seen a 50% increase in hormonal treatment patients over six months, with half traveling from out of state, as the state becomes a de facto refuge for people abandoned by providers elsewhere.

The federal intimidation campaign against gender-affirming care providers took two significant steps this week. After losing subpoena fights in Massachusetts, Pennsylvania, Washington, and Colorado, the Trump administration filed a new petition in the Northern District of Texas — 1,800 miles from Rhode Island Hospital — exploiting a HIPAA venue provision to land the case before a favorable judge, and a Bush-appointed judge there ordered Brown University Health to hand over patient records within 14 days.

Trump also nominated Fox News contributor Dr. Nicole Saphier as Surgeon General, his third attempt to fill the role; if confirmed, Saphier — who has called trans youth a mental health "national emergency" and falsely equated gender-affirming care with "promoting body dysmorphic disorder" — would have a bully pulpit courts and insurers routinely cite. Tennessee's newly passed HB 754, meanwhile, is being called a registry in everything but name, requiring clinicians and insurers to report patient data on gender-affirming care to the state under the guise of research — and de-identified data in small communities can and does get re-identified.

After the Supreme Court's 8-1 ruling in Chiles v. Salazar effectively legalized conversion therapy nationwide last month, Colorado passed HB26-1322, a new ban using a private right of action — the same legal mechanism behind Texas's abortion bounty hunter law — allowing survivors to sue practitioners directly; the bill now heads to Governor Polis, who has given only lukewarm signals about signing it.

Internationally, the European Parliament voted to back an EU-wide ban on conversion therapy, a non-binding resolution signaling legislative intent across member states at a moment when the U.S. Supreme Court has moved in the opposite direction.

Contribute to Uncloseted Media's investigation into the LGBTQ+ mental health crisis: Over the next two weeks they're publishing on how the American healthcare system is failing trans kids and where Canada is falling short too — work that requires reader support to stay free and ad-free. The numbers they're working from: 39% of LGBTQ+ youth seriously considered suicide last year, over a third of LGBTQ+ people across 31 countries live with depression or anxiety disorders.

Build your answer to "What rights have trans people actually lost?": TransVitae's plain-language guide covers four domains — safety, healthcare access, public participation, and equal legal protection — with model language for the version of that question that comes from a genuinely curious patient, family member, or colleague rather than a bad-faith one.

• Why Masc Survivors of Sexual Assault Feel Invisible — them. — A reported piece on how trans masculine and masc-of-center survivors face compounded erasure in sexual violence support systems built almost entirely around cisgender women's experiences.

• The Clinical Symposium Where Cisgender Doctors Formed the UK's Gender Identity Clinic — QueerAF — A Trans+ History Week examination of the 1969 First International Symposium on Gender Identity, where the frameworks of the UK's GIC system were built from the start around control and gatekeeping rather than care — with available archival recordings to prove it.

The Trump administration is now arguing in court that gender-affirming care isn't healthcare at all, using its policy denying that care to trans federal prisoners as a vehicle to ban the same treatments for every trans adult. Federal Judge Mustafa Kasubhai's permanent injunction against the Kennedy Declaration was supposed to free hospitals to resume trans youth care, but most of the major systems that capitulated last winter won't say if they'll reopen those programs. California Attorney General Rob Bonta told providers in his state to resume care now and signaled he is prepared to take further legal action against any forthcoming federal rules.

The only transgender care panel at this week's Pediatric Academic Societies meeting in Boston is chaired by HHS Gender Dysphoria Report co-author Moti Gorin and stacked with academics tied to SPLC-designated hate group SEGM, including Riittakerttu Kaltiala. The Southern Poverty Law Center published a Hatewatch tracing how Genspect's "Detrans Awareness Day" pulled in FTC Chair Andrew Ferguson and Assistant Secretary for Health Brian Christine, who reportedly vowed not to stop until gender-affirming care is "eradicated like the plague it is." Days later, the DOJ announced a federal grand jury indictment of SPLC itself over the paid informants the organization once used to infiltrate violent extremist groups.

The FBI dispatched a government plane to Cuba to retrieve a 10-year-old trans girl whose trans mother had taken her there for care during a custody dispute. Texas Tech University adopted a sweeping new policy phasing out all teaching, research, coursework, and degrees touching on gender identity or sexual orientation by June 15. Tennessee Republicans advanced a flurry of bills, including a sex-redefinition statute, a bathroom and shelter ban, an honorifics law, and HB754/SB676, which functions as a de facto registry of trans patients by requiring providers to report demographic and treatment data to the state.

Audit your license plate. A LOOKOUT and Uncloseted Media investigation traces more than $7 million from state specialty plate programs into Alliance Defending Freedom, the Montana Family Foundation, Florida Family Voice, the American Family Association, and the Foundation for Moral Law — the outfits behind state bathroom bans, conversion therapy litigation, "Don't Say Gay" laws, and gender-affirming care bans.

Make publishers answer for harm. A trans teen's mother used the NYT shareholder meeting last week to ask publisher A.G. Sulzberger what accountability the paper has for coverage cited by the Trump administration, Justice Thomas in his Skrmetti concurrence, and SEGM amicus briefs. More of us need to be bringing this kind of accountability to bad actors where it counts — their wallets.

• The surprisingly long history of gender mapping — Eli Erlick, who co-created the Gender Unicorn in 2014, traces visual gender-mapping tools back through Hirschfeld's 1923 diagram, Benjamin's 1966 Sex Orientation Scale, Virginia Prince's 1965 Transvestia chart, and the early-1990s trans umbrella — a useful counter to the "trans people are new" framing driving both the Texas Tech ban and the Texas A&M firing of Melissa McCoul.

• VCU researchers gut the "trans youth desist" number — Catherine Wall and colleagues reanalyzed the 11 studies compiled in the widely cited 2016 blog post (the source of the 60–90% desistance figure that fed into Skrmetti) plus five post-2016 studies, and found that under those studies' actual data, both desistance and persistence rates can be estimated at anywhere from 0% to 100%.

• Talking about trans healthcare — Rachel Saunders, on HRT in the UK for 26 years through informed-consent NHS care, writes about the holistic post-transition healthcare experience for trans women and what gets lost when "trans healthcare" gets flattened to gender-dysphoria management.

Well Beings News turns one year old this week, marking the first issue I sent in preparation for my June 2025 launch. To commemorate the occasion, I revisited some of the pieces I keep coming back to, creating a season-by-season chronicle of what working through a genocide has done to the field, to the people I've interviewed, and to me.

A Happy(?) Birthday to Well Beings News

A season-by-season chronicle of Well Beings News' first twelve months — independent queer trans health journalism with those surviving and thriving in the wake of genocidal institutional and political persecution.

well . beings . NEWS • Baxstar Jonmarie Ferguson

When I published the first issue of Well Beings News in early May 2025 to a basically empty email list, I already had the word. I just couldn't make myself write it. I'd been reporting on LGBTQ+ health for a decade. I knew what I was looking at. But genocide is the kind of word that, the moment you use it, it changes you — not just in the eyes of readers, for whom I might have become someone not to be taken seriously, but for myself. It would mean becoming someone living through a genocide of my own people.

A year later, we have 220 subscribers. Well Beings News has published 52 news roundups, 24 reported stories, and 40+ column installations. I've created multiple premium downloadable resources and earned just under $2000 USD from memberships and donations — enough to keep the lights on. We are creeping closer to sustainability, a goal for which I will be running an intense new subscriber marketing campaign in May and June, followed by a celebratory paid membership drive in July.

This is not a greatest-hits column. It's a chronicle of how the year came at us, and the company I kept while writing through it.

Late spring: launch into the verdict

I started publishing into a world already feeling hostile. I had failed to gain a grant for another project I'd hoped to launch, one focused on queer trans love and joy. Executive Order 14187 had been on the books since January, calling our care "mutilation." On May 1, HHS released its 400-page report claiming gender-affirming care for minors lacked evidence — authored, we'd later learn, by anti-trans activists. By the time I published The LGBTQ+ Health Data Gap is Widening on May 15, federal data infrastructure for LGBTQ+ populations was already being dismantled.

Then, on June 18, the Supreme Court handed down Skrmetti. I launched Queer in Practice that week with Dr. Syd Young, a nonbinary physical therapist in Austin, on radical safety, on refusing to compromise our spaces for bigots, and forging community despite every attempt to tear us down. Two weeks later came the first Peer Reviewed column: sociologist Willow Sipling on SOGICE on conversion therapy, which the same lawmakers were now promoting as a "less invasive alternative" in the wake of the care ban Skrmetti had just upheld.

Summer: infrastructure cracks

June was a wildly nourishing month for me. I celebrated Pride with an incredible group of friends. I had the best birthday party I have ever thrown, and my heart was absolutely overflowing with queer joy. I hold that joy so close to my spirit these days. "I can be so brave for this," I told myself then.

And I have been.

And I will be.

In June, I reported No Safe Space, braiding two threads I hadn't expected to belong together. On one side: Sammy, a Ugandan trans woman displaced to South Sudan. On the other: dozen of trans Americans on Reddit calculating whether they could afford to leave. Some of them became part of the 400,000 trans people who relocated after Trump's second inauguration.

In July, Ohio made it nearly impossible for trans people to access mental health care on Medicaid. And later that month, I sat with Dr. Sean Arayasirikul, who had lost four major NIH grants — including the first training program ever focused on trans population health — to administration cuts. The people best equipped to produce the evidence anti-trans lawmakers claimed to want were the first to lose their funding.

Autumn: erasure as policy

Leaves fall. And so do empires.

In August, I published X Files: the Nonbinary Struggle with Healthcare Data Software, which wasn't really about software — it was about how the architecture of the systems that hold us already encoded the assumption that we don't exist. By November, that architecture would be weaponized into formal federal policy: the administration ordered cancer registries to drop trans options from sex categorization, effectively erasing trans patients from cancer surveillance data.

In late September, I interviewed Lasara Firefox Allen, who had built the first known gender-affirming menopause care certification program out of pocket: 6 Million Genderqueer People Face Menopause Without Adequate Healthcare. I saw in them my own experience of perimenopause, bringing on new questions about gender. Stories of medication shortages began to hit my feeds, impacting cis and trans people alike.

Winter: the doubt-manufacturing machine

The administration was running a single play with two hands: demand better evidence, defund the means to produce it. In November, I published Research in Crisis with psychologist Luke Allen, who spent an unfunded year deliberately replicating his own 2019 study on hormone therapy and suicidality.

In December, I sat with Nicole Gress for Speaking for Ourselves. Gress had quit both her clinical jobs in 2020 after realizing her patients were teaching her techniques from YouTube creators who'd given up on the medical system.

That same month, the HHS report's nine authors were finally named — confirmed paid opponents of the care they'd been asked to evaluate, affiliated with SEGM, the Manhattan Institute, and groups the SPLC has classified as anti-LGBTQ hate organizations.

New year, same story: the word

In January, I had the great pleasure of being able to speak at the Oaxaca Lending Library about gender dysphoria. My YouTube video of the talk doesn't quite capture the energy and joy of being able to share this work in front of a live audience, or the horror and pain of speaking publicly about a genocide happening to people I know and love.

On February 27, Texas Attorney General Ken Paxton issued a legal opinion making any therapist who affirmed a trans youth subject to license revocation, loss of Medicaid, and potential child abuse charges. In mid-March, I published Texas Therapy Rooms Set to Become Crime Scenes. And I knew that I had to keep saying the word. A week later, I published Reclaiming Transsexuality in Trans Genocide.

I'm not naive about how that word lands. Genocide. I know there are people who will close the tab the moment they see it, and people who will read the rest of the piece looking for evidence that I'm being hysterical, and people who will simply roll their eyes. There are days when I wonder if writing any of this matters — whether documenting a thing while it's being done makes any difference at all, if there really is a way to help, to make health and wellness care better for queer and trans people, to fight against what some days feels like an inevitability of rising fascism. Whether I'm just keeping records for a future no one will even be around to read.

But I keep going because the people in this archive keep going. Because you keep going. I am still here, in a year that has tried to convince me over and over of the futility of this fight, because you, my reader, and each of my sources over these last twelve months have shown me what it means to persist and resist.

Thank you, all of you, for sticking with me.

Federal Judge Mustafa T. Kasubhai permanently blocked RFK Jr.'s declaration that gender-affirming care for minors is "neither safe nor effective," writing that "unserious leaders are unsafe" and that Kennedy exceeded his authority and caused "very real harm to very real people." The Colorado Supreme Court heard arguments over whether Children's Hospital Colorado can be forced to resume trans youth care, while families in Wisconsin rallied at the state capitol demanding UW Health do the same. Mother Jones traced the policy infrastructure behind the closures of clinic and hospital programs to Manhattan Institute fellow Leor Sapir and his ties to SEGM. STAT News reported that trans adults in Georgia are being swept up in youth care restrictions as access shrinks across the board.

California's Assembly advanced AB 1930, which would require providers to notify the attorney general before complying with federal subpoenas seeking gender-affirming care records, while Tennessee's Senate advanced SB676, a bill requiring clinics and insurers to compile detailed data on trans patients' prescriptions and treatment timelines, creating a “de facto registry.” The Montana Supreme Court issued a landmark 5-2 ruling declaring transgender discrimination is sex discrimination. Assigned Media reported on squalid conditions at Ace's Place, New York City's trans-focused shelter, while WUNC published a three-part investigation on Black trans women documenting sexual assault and punitive solitary confinement across North Carolina's men's prisons.

Internationally, India's president signed the Transgender Persons Amendment Bill, 2026, stripping self-identification and adding a new offense punishable by up to life in prison for "forcing" someone to assume a transgender identity, while a Mexican court delivered a landmark conviction for the attempted transfemicide of trans activist Natalia Lane — the first time a sex worker obtained a femicide conviction in Mexico while still alive. South Africa's only state gender-affirming surgery clinic can serve just four surgical patients a year against ten new monthly referrals, with waiting times projected at 20 to 30 years, and MambaOnline's March rights watch documented the murder of queer Hammanskraal resident Tshepang Phokobye, a Grindr-gang robbery in Johannesburg, and a delayed "corrective rape" trial in the Eastern Cape.

Learn about the HRT underground. However you feel about DIY HRT, it is the only way some trans people survive in this world, and you should understand it so you can adequately treat patients who are accessing it. Lucy in Naarm reports that HRTCafe.net went dark last month after the anti-DEI group Do No Harm pressured the FDA, but argues the underground pharmacies supplying trans women with estrogen have financial incentives far beyond HRT to stay operational.

• Gender-Affirming Hormone Cycling: Can You Feel More Like a Woman? — Amethysta Herrick, Ph.D. makes the case for HRT cycling protocols that simulate natural hormonal rhythms — exploring whether mimicking cyclical estrogen and progesterone patterns could accelerate feminization and offer trans women more of the physiological experience of cisgender womanhood.

• Trans Victories at the State Level — An episode examining where trans rights advocates are actually winning at the state level, even as the federal picture deteriorates.

• 150 Homes in 10 Years: How the Foster Care System Fails Trans Kids — Uncloseted Media's Sam Donndelinger reports on Hayden Dawson, a 20-year-old nonbinary person who cycled through more than 150 foster homes from ages 8 to 18, roughly 80% of them non-affirming; the piece maps the patchwork of state protections (and non-protections) that leave trans foster youth dependent on the luck of placement.

• Post-Op Vaginal Biology — A personal essay from writer and researcher Rachel Saunders exploring the biological realities of post-vaginoplasty anatomy.

• Unpacking the Manosphere's Secret Obsession with Trans Women — A trans woman writer for Prism & Pen reflects on being algorithmically fed both red-pill content and queer media simultaneously, using that vantage point to analyze why pre-op trans women occupy a particular fixation in manosphere spaces.

I am so excited to share this month’s Buy the Book column. This book not only made me cry with hope for a better future but also gave me several ideas for reported features, and I’m very excited to bring them to you in the coming months.

Stay tuned for pieces unpacking trans medication "noncompliance," the shared playbook behind "social contagion" and "drug-seeking" rhetoric, how medicine codes queer and trans identities as risk factors rather than vulnerabilities, and the uneasy analogy between medical and sexual consent.

Weekend Column

Consented: A Doctor's Call to End Medical Violence and Reclaim Patient Autonomy

Dr. Zed Zha names medicine's consent problem for what it is — a system designed to override patient autonomy, not protect it — and imagines what we could build instead.

well . beings . NEWS • Baxstar Jonmarie Ferguson

Consented: A Doctor's Call to End Medical Violence and Reclaim Patient Autonomy is a book about consent in medicine, which means it is a book about power. Dr. Zed Zha, a rural family physician, spent three years writing it in the wee hours between shifts, and the result is clear, specific, and — in ways I did not expect — genuinely hopeful about what healthcare could become. Out this month, Consented joins Dr. Vanessa Grubbs' Negligent by Design on my shelf of great books from North Atlantic Press that you should check out.

Consented: A Doctor's Call to End Medical Violence and Reclaim Patient Autonomy

A physician’s bold critique of medical rape culture—and her call for a new model of care that centers consent and empowers patients

Medical culture has a problem with consent—and it’s not just a few bad doctors. That’s the conclusion of Dr. Zed Zha in Consented, a groundbreaking look at how the healthcare industry ignores patients’ agency and perpetuates violence.

Bookshop.org

The Kaltiala study I covered in the latest Well Beings News Rx Resist column is continuing to make waves, with Erin Reed at Erin in the Morning breaking down why its headline finding is a textbook case of surveillance bias, immortal time bias, and a binary outcome measure that cannot distinguish a routine monitoring referral from a psychiatric hospitalization. Evan Urquhart at Assigned Media makes the case that the study reflects the failures of Finland's own hostile clinical model — not gender-affirming care as practiced elsewhere — and that allowing Finnish researchers to present their findings without that context is a mistake with real policy consequences.

There's a small but significant clinical win to note: Children's Minnesota has reinstated gender-affirming care for trans youth after pausing it in February, following a federal court ruling that found RFK Jr.'s HHS declaration exceeded his legal and scientific authority.

The surveillance picture is grimmer. Prism Reports documents how Kansas, Texas, Indiana, Tennessee, and other states are quietly building lists of trans people, tracking who changed gender markers on documents and who sought gender-affirming care. Tennessee's SB 676/HB 754 passed the state Senate today and heads to Gov. Bill Lee, requiring providers and insurers to report the number and nature of gender-affirming treatments to a public state website, while also blocking local governments from prohibiting talk therapy as a treatment for gender dysphoria.

Idaho Gov. Brad Little has signed the Pediatric Secretive Transitions Parental Rights Act, requiring teachers and health care providers to notify parents within 72 hours if a minor uses a different name, pronouns, or facilities — with no safety assessment mechanism and civil penalties of up to $100,000 per violation. Oklahoma's SB 904 advanced through committee, prohibiting the use of public funds for any entity or individual that provides gender transition procedures and barring the use of state property for that purpose.

New York State Senator James Skoufis has introduced S9817, legislation that would allow survivors of conversion therapy to sue practitioners for civil damages — a direct response to the Supreme Court's recent ruling striking down state enforcement bans.

India

The Kerala High Court has allowed two transgender petitioners to continue hormone replacement therapy while their challenge to India's Transgender Persons (Protection of Rights) Amendment Act, 2026 proceeds, after hospitals stopped treating them following the law's enactment.

Writing in Outlook India, scholar Anand Teltumbde argues that the 2026 amendment — which removes self-identification, mandates state certification, and requires hospitals to report gender-related surgeries to district magistrates — is not merely flawed legislation but the legal expression of a project of social discipline that treats trans identity as a problem to be managed rather than a right to be protected.

Register for Beyond the Rainbow: Health Equity for Lesbian and Queer Women, a free virtual event from the Curve Foundation focused on health disparities and access gaps for lesbian and queer women — general admission is free, with optional pay-it-forward donation tiers to support Curve's programming.

• How HRT Affects Fertility for Trans Women: Point of Pride, in collaboration with Dr. Izzy Lowell of QueerMed, breaks down how estrogen affects sperm production, what timing looks like for fertility preservation before and after starting HRT, and how to have these conversations with patients who haven't yet decided what they want.

• A Guide to PTO, FMLA, and Disability Leave for Gender-Affirming Care: Also from Point of Pride, a practical breakdown of workplace leave options for patients navigating time off for gender-affirming procedures — including ready-to-use scripts for approaching HR without disclosing more than necessary.

• For trans San Diegans, lack of public restroom access is causing lasting medical harm: Mission Times Courier reports on how bathroom inaccessibility is directly contributing to pelvic floor dysfunction, kidney damage, and incontinence among trans San Diegans — grounding in local stories what Well Beings News has covered as a growing public health crisis.

• Journal Club: A Genuine Broad Study of the Effects of HRT: Assigned Media's Veronica Esposito digs into a new Australian study of over 30,000 people that uses a difference-in-differences design to show that access to HRT led to sustained reductions in mental health service utilization — with trans men falling below their baseline within the first year, and trans women within five.

• The Laundering: How Western Media Built the Permission Structure for Anti-Gender Authoritarianism: Alejandra Caraballo at The Dissident argues that the American press has consistently reached for UK and Nordic comparators when covering restrictions on gender-affirming care — when the honest comparators are Russia, Hungary, Georgia, and Turkey, where crackdowns on trans rights have tracked precisely with democratic backsliding.

No original reporting or column this week — the news cycle had other plans. Coming up for next week, though, I have two columns in the queue, and I'll be back to regularly scheduled reporting before the end of April. I'm also deep in development on the first Rx Resist course material, which will be available to paid subscribers — if you've been thinking about upgrading, now is a good time to do it so you don't miss what's coming.

The Supreme Court ruled 8-1 that state bans on conversion therapy likely violate the First Amendment, holding that talk-based professional conduct is protected speech — a decision that could invalidate protections in more than 23 states. Justice Jackson warned in her lone dissent that the ruling could make speech-based medical treatments broadly unregulatable.

A new Kaltiala study claims gender-affirming care worsens youth mental health. Still, Erin Reed's fact-check identifies fatal methodological flaws, including massive surveillance bias from a system that counts mandatory quarterly psychiatric check-ins as evidence of decline. I covered how this disinformation pipeline works in last week's Rx Resist — this study is already following the same trajectory.

Children's Minnesota has resumed all Gender Health services after a federal court ruling vacated the Trump administration's care restrictions. Vanderbilt's decision to cease gender-affirming surgeries for adults has left zero surgical options in Tennessee, forcing patients to travel to Atlanta or Chicago. A federal judge in Maryland refused to lift the nationwide injunction blocking the administration from conditioning federal funding on whether providers offer gender-affirming care to minors.

Idaho is requiring teachers, therapists, and counselors to report any suspected gender non-conformity in children to parents within 72 hours, with no safety exception and penalties up to $100,000.

In the UK, the NHS published its new service specification for children and young people's gender services: no gender-affirming medical treatment for under-18s, safeguarding interventions if families seek care elsewhere, and training run by the Cass Review network.

And a transgender woman's allegations of mistreatment at a Free State hospital in South Africa underscore systemic barriers to gender-affirming care in the public health system. Senegal's president signed a sweeping anti-LGBTQ+ law doubling prison sentences for same-sex relations to ten years and criminalizing the "promotion" of homosexuality, bisexuality, and trans identities. India's president signed amendments to the country's transgender rights law that strip self-identification, narrow the legal definition of trans to specific socio-cultural groups, and mandate that hospitals report gender-affirming surgeries to authorities.

Support trans healthcare funds as institutional options continue to disappear — direct mutual aid is keeping people in care right now.

Read the first Rx Resist column on the anti-trans disinformation pipeline and upgrade to paid to improve your media literacy alongside us.

• Transitics' Comprehensive Anti-Trans Policy and Litigation Map 2.0 — The updated state-by-state tracker now includes policy ratings, risk projections for bathroom bans and identity documents, and a new color-coded scoring system from "Most Progressive" to "Most Restrictive."

• Every Trans Suicide Is a Murder — Alejandra Caraballo applies Friedrich Engels' framework of social murder to the current legislative landscape, arguing that the sustained campaign to strip trans people of healthcare, legal recognition, and public existence meets every element of the definition.

• She Spoke with Eight Trans Women in Prison — Uncloseted Media's Hope Pisoni investigated how the Bureau of Prisons is still denying trans women gender-affirming care despite a court injunction blocking Trump's executive order, and found retaliation against those who pushed back.

• The Trans Panic Clickbait Economy — Cool Zone Media’s It Could Happen Here investigates a series of frightening claims: that ICE can detain people for ‘looking trans,’ the creation of a transgender public registry, and that an adult gender-affirming healthcare ban is imminent.

• Reconstruction and the Criminalization of Transition in the 1870s — Jules Gill-Peterson traces the roots of anti-crossdressing laws to Reconstruction-era policing and Jim Crow, revealing a 150-year lineage of anti-trans criminalization that puts today's legislative attacks in sharp historical context. (Part IV in a series)

• The Idaho Legislature Isn't Governing. It's Hunting Transgender People — An Advocate opinion piece on Idaho's proposed felony bathroom bill, which would carry jail time for each offense and effectively banish trans people from public restrooms.

Weekend Column

This Is What a Disinformation Campaign Looks Like

How an anti-LGBTQ+ pseudoscience network launders its lies for the mainstream media, from science to socials, to statutes and standards of care.

well . beings . NEWS • Baxstar Jonmarie Ferguson

On Saturday, April 4, a new study landed in Acta Paediatrica. By Sunday morning, the "Society for Evidence-Based Gender Medicine" (SEGM) — a known hub of the "anti-LGBTQ+ pseudoscience network" according to the Southern Poverty Law Center — had posted about it on X. By Monday, it had 446,000 views. Conservative news outlets like The Federalist have already published on the study entirely without criticism, and it quickly made its way into the hands of centrist and anti-trans liberal journalists like Matt Yglesias and Benjamin Ryan.

It hasn't been covered by the New York Times or the Washington Post... yet. But it will be. And when it is, they will undoubtedly use their reputation among liberals to launder this latest installment of the anti-trans agenda into something more respectable. SEGM's own 2024 year-in-review boasts that New York Times columnist Pamela Paul described them as "one of the most reliable nonpartisan organizations dedicated to the field" of anti-trans lobbying. We know what's happening.

"Every time one of these studies drops, it gets laundered through policy bodies and court filings as settled science. It isn't," writes Alejandra Caraballo, a clinical law professor who provided a thorough analysis of the study on Bluesky, which forms the basis for much of what follows. (Be sure to subscribe to her journalism at The Dissident.)

In this installment of Rx Resist, I'll walk you through this pipeline, so we can start to learn how to analyze both science journalism and its underlying studies, to explore potential political bias, to demonstrate how this bias finds its way into mainstream media — how a politically motivated paper moves from a right-wing network through centrist amplifiers toward mainstream coverage.

Normally, this is where I would drop a paywall break! Today, you are getting this story for free, so be sure to subscribe and upgrade to paid to access the rest of this skill-building series and the media literacy course at The Well, launching in June!

First, let's break down everything wrong with this study; then we'll look at how it has progressed from funding through publication to the feeds of right-wing, centrist, and liberal media members.

The study misrepresents its own results

Caraballo's analysis identifies three distinct ways the data was misrepresented.

1) They're not measuring what they claim. The headline metric — contact with specialist psychiatric services — is a proxy, not a direct measure of morbidity. Kids in gender clinics are under intensive clinical surveillance. Controls are not. Caraballo: "You are measuring detection, not disease. This is epidemiology 101."

2) The comparison groups are rigged by design. In Finland, severe psychiatric morbidity disqualifies patients from gender-affirming care. The treatment group was pre-selected for low baseline psychiatric contact. Any apparent increase afterward is at least partly an artifact of that selection and the subsequent monitoring. The dramatic numbers hide this comparison entirely.

3) The authors buried their own exculpatory finding. Once you control for prior psychiatric treatment, care status has no independent effect on outcomes. That finding is in the paper, in Tables 4 and 5. It is not in the authors' conclusions. Caraballo: "The authors intentionally chose the opposite frame to mislead people."

What the data actually supports. Trans youth carry an elevated psychiatric burden regardless of treatment pathway. That's an argument for integrated care, not against affirming care.

And that's how the science gets made

"Conflict of interest" is one of many factors to consider when looking at what biases researchers are bringing with them into a study: what assumptions, incentives, and institutional pressures did this researcher bring to the work before they collected a single data point? Funding sources, organizational affiliations, prior published positions, history of speaking engagements, and other public relationships all shape which questions get asked, how studies are designed, and which findings are foregrounded.

The senior author of this paper, Dr. Riittakerttu Kaltiala, is a SEGM keynote speaker. She also presented findings to the Observatoire la Petite Sirène — a French psychoanalyst collective that lobbied to exclude gender identity from France's conversion therapy ban and co-organized a 2024 conference with SEGM — and CAN-SG, a British-Irish clinician group whose videos YouTube has designated as conversion therapy content.

She served on the Cass Review advisory board, another publication that has misrepresented data. She testified before the DeSantis-appointed Florida Board of Medicine to ban gender-affirming care for minors. She is a regular at Genspect, which opposes gender-affirming care for people under 25. She has previously published highly criticized and politicized work on gender-affirming care, which she also presented to SEGM and which was used by the organization to push its agenda.

Speaking of their agenda, SEGM's money runs through donor-advised funds shared with the Heritage Foundation, the Alliance Defending Freedom, and the Family Research Council — all Project 2025 signatories. Donors Trust, described as the right wing's ATM for dark money in Mother Jones, gave tens of millions to these various hate groups, right-wing think tanks, and lobbyist organizations, including SEGM.

Kaltiala has also supported and defended practices that should put her medical expertise into question, if not putting her license at risk. Former patients at her Tampere clinic have described years of "assessment" with no therapeutic support, repeated misgendering, and one patient claims to have been assigned masturbation as homework by a nurse there. (Kaltiala has defended these interactions.) Erin Reed has documented her conversion therapy ties and clinic practices in detail.

"Peer-reviewed" is not a quality guarantee

Acta Paediatrica is a legitimate journal — it was founded in 1921 and is published by Wiley-Blackwell at the Karolinska Institute. Unfortunately, peer review is not a guarantee that research is well-designed, well-executed, and well-analyzed. In this case, it failed to catch what Caraballo identified in a single afternoon.

We know that peer reviewers often miss mistakes thanks to a former BMJ editor who tested peer review by inserting deliberate errors into papers and sending them to reviewers. No single reviewer caught all the errors. Most caught about a quarter. He concluded that peer review is "almost useless for detecting fraud" and that it works primarily on trust.

Peer review functions primarily as a credibility signifier rather than a quality guarantee. This raises an issue I've discussed before here: the meaning of "quality data" in scientific inquiry. To confuse the discourse, conservatives often conflate two distinct issues: studies like this one that are poorly-designed, poorly-executed, poorly-analyzed, and poorly-summarized with a specific agenda in mind; and studies like I discussed with Dr. Luke Allen in my Peer Reviewed column about his work, where a term like "low quality data" is not a judgement of his work, but a description of how reliably his results could be used to predict future outcomes for other people.

In the former instance, with Kaltiala's work, the data can be interpreted to show the exact opposite of what she claims it demonstrates. In the case of Allen's work, his interpretation is sound, suggesting that his study should be replicated on a larger scale to improve its predictive quality. These are not comparable critiques, though the right would have you believe they are.

How it gets laundered

The network that produces this research is the same network that distributes it. Within hours of publication, SEGM and other connected anti-trans groups have posted it to their social media. Within 48 hours, these posts have collectively received at least half a million views, and from there the spread continues.

The centrist gateway. Matt Yglesias shared the SEGM post almost immediately and without any criticism, moving it from partisan media into the mainstream consideration set. He's not a scientist. He didn't evaluate the methodology. He shared a post from a designated hate group, and on it goes.

The credibility bridge. Benjamin Ryan — an independent journalist who has been widely criticized for his anti-trans writing and who contributes to the New York Times, The Guardian, and NBC News — published a piece on his Substack that largely presents the study's conclusions at face value. He noted the selection bias in one sentence. He did not mention Tables 4 and 5, which explicitly counter the analysis being presented to the public. He also has a prior relationship with Kaltiala. Here, the study gains the veneer of respectable science journalism before it reaches major editors.

Why this works. A new study published in Political Communication argues that disinformation doesn't travel as discrete incorrect facts. It travels as an emotionally resonant narrative. The stories that spread are the ones that affirm what an audience already believes and feels. The paper found that journalists are much more likely to repeat disinformation uncritically when it coheres with preexisting frames that resonate with their audience. The frame here is 'maybe we moved too fast on trans youth care,' all the while moving at a literal snail's pace, doing everything possible to prevent trans youth from actually getting that care.

This playbook has run before. SEGM funds open-access fees for journal articles and commission systematic reviews. Between 2021 and 2024, they paid McMaster University's Gordon Guyatt $250,000 to conduct systematic reviews, and they chose the research questions. After the reviews were published in 2025, Guyatt wrote to every outlet that cited them, saying they were misconstruing his work. Each refused to publish his letters. His team later called the use of reviews to deny care "a gross misuse of our work and is unconscionable."

What to do with this

When a new study comes across your desk — whether on social media, in mainstream news, or brought up by a patient or colleague — ask these questions before engaging with the findings.

CASP Checklists - Critical Appraisal Skills Programme

View or download our range of critical appraisal tools & checklists for free including our RCT, qualitative and quantitative checklists.

CASP - Critical Appraisal Skills Programme

Check who funded it and who's amplifying it. Conflicts of interest are disclosed in every published paper. Read them. Look at who immediately launches into praise for the work. The network distributing a study sometimes has a hand in its creation as well.

Ask what the study actually measured. Headline claims and outcome variables are frequently not the same thing. Identify what was measured before accepting what was concluded.

Read past the abstract. Authors' conclusions don't always reflect their own data. The full results section sometimes tells a different story. Get comfortable in the weeds.

Translate the findings accurately. Ask what the data actually supports — which is often more nuanced, and sometimes the opposite of what's being claimed.

Distinguish design failure from data limitations. A study can be poorly designed, poorly executed, and politically motivated — or it can be rigorously conducted with transparently acknowledged limitations. These are not the same critique, even when critics treat them as interchangeable.

Stay ahead of the coverage cycle. By the time a study reaches mainstream media, it has often already been framed for the general public. Educating yourself on the full context gives you a heads-up in countering harmful talking points that rely on that framing.

Knowing how this pipeline works isn't just professional due diligence; it's part of what it means to show up for patients in this moment. The disinformation doesn't stop at the lobbyist, the researcher, or the media covering them — it walks into your office. This column exists to make sure you're ready when it does.

The physician behind the ASPS anti-trans position statement pushed the same resolution at New York's largest medical society this past weekend, with outcomes still pending. An investigation revealed that the same dark money behind Project 2025 is bankrolling a Northwestern University study recruiting trans kids through the Gender Dysphoria Institute. The Ohio Supreme Court heard oral arguments in the ACLU's challenge to the state's ban on gender-affirming care for trans youth, with a written opinion expected in the coming months.

The New York Times denied that the AMA requested a correction to a story characterizing the organization as having backed limitations on youth gender surgeries, despite an AMA board newsletter stating the language attributed to them was neither a policy change nor an endorsement. A 16-year-old's breast reduction was cancelled hours before surgery by Novant Health after staff determined it was geared toward "transgender intent." Separately, a contract dispute between Mount Sinai and Anthem Blue Cross Blue Shield has led to the cancellation of hundreds of trans surgeries, leaving patients facing bills exceeding $100,000.

Idaho passed the most extreme bathroom ban in the nation, applying to public buildings and private businesses with penalties escalating to life in prison under the state's persistent violator (ie. “three strikes) statute. Given that we know the Trump administration admits to medically experimenting on trans people in federal prisons every layer of criminalization matters. Trans West Virginians asked the full Fourth Circuit to revisit an alarming ruling in their Medicaid coverage case, warning the panel's reasoning could amount to judicially-endorsed regulation of trans people's liberty to exist.

Tennessee's House passed a bill to track transgender patients seeking gender-affirming care, with the sponsor comparing transition care to frontal lobotomies. Ohio's House passed a drag ban that criminalizes gender nonconformity in public, backed by a GOP lawmaker accused of child sex abuse, with Republicans voting down an amendment to strip the anti-trans language. Given that we know Republicans are expanding the asylum state and criminalizing homelessness by targeting "the mentally ill," Kentucky Republicans are quietly moving to ban trans teachers while forcing doctors to reclassify being trans as a mental disorder, mirroring the anti-gay movement of the 1970s.

Attend “From the Statehouse to the Streets: Taking Action for Trans Rights” tomorrow for Transgender Day of Visibility!

Support ETSI, a trans-led HIV clinic in Portsmouth, Virginia that is struggling to stay open amid funding cuts and DEI rollbacks.

Make sure your trans clients know their rights. UK / US / Canada

Help your clients, your community, and yourself to be more resilient.

A year after the Trump administration took aim at transgender Americans, a doctor continues her fight — a profile of one provider’s sustained resistance against federal pressure to abandon trans patients.

Ten notes on gender-critical complaint — how two cases pursued by nurses misguide the public about trans healthcare. (Opinion)

Trans kids in limbo as Trump takes ‘unprecedented’ actions to limit health care — on the ground impact in communities where care access is disappearing.

Trans kids need rights, whether or not their parents or doctors agree — of the approximately 300,000 trans kids in the US between ages 13-17, only about 1,000 of them access medical interventions.

How this ‘out and proud trans woman’ navigates Missouri men’s prisons — Lexie Handlang writes about resilience inside a system designed to break people.

Transgender Quebecers face surgery delays while out-of-province patients get faster care — on the structural barriers in Canada’s surgical care pipeline for trans patients.

How the UK media has wrongly shaped knowledge about some of the country’s most important trans legal cases for for Transgender Day of Visibility.

Emotional quality-of-life after chest masculinizing surgery among transgender persons aged under versus over 18 years

This French multicenter study (n=49) found no significant difference in emotional quality of life between young trans men who had chest masculinizing surgery before versus after age 18, with a median follow-up of 3.5 years. Postoperative satisfaction was high across both groups — 100% satisfied with chest appearance while dressed, 95% unclothed springer — and scores didn't decline over time.

link.springer.com/article/10.1186/s41687-026-01046-9

Just Ask! The Primary Care Pediatrician’s Role in Adolescent Disclosure of Gender Identity and Sexual Orientation

A survey of adolescents at a pediatric primary care practice found that the single biggest factor in whether young people disclosed their sexual orientation or gender identity was whether their provider asked — patients who were directly asked were significantly more likely to disclose both their sexual orientation (98% vs 22%) and gender identity (86% vs 15%).

journals.sagepub.com/doi/abs/10.1177/00099228261431412

Very excited to share the first story in my collaboration with Madisyn Parisi at The Backbone, just in time for Trans Day of Visibility. Madisyn will be over here on Well Beings News with their own story soon!

Original Reporting

Seen But Not Heard: The Cost of Trans Hypervisibility

In The Backbone's first ever guest story, Baxstar Jonmarie Ferguson reports on how media visibility is weaponized against trans people, personally and politically.

the-backbone.beehiiv.com/p/trans-hypervisibility

Weekend Column

Peer Reviewed: What Today's Adults Learned About Sex

A Kinsey Institute study finds massive gaps in sex education—and the downstream effects on relationships, identity, and clinical care

well.beings.news/p/peer-reviewed-what-today-s-adults-learned-about-sex

Only one topic out of sixteen cleared 50% when researchers asked nearly 4,000 single American adults what they'd actually learned about in school: reproduction. Not consent. Not healthy relationships. Not sexual orientation or gender identity. Just the basic mechanics of how someone gets pregnant.

That's the headline finding from "If I Only Knew Then," a study published last fall in the International Journal of Sexual Health by Jessica Hille, Justin Garcia, and Amanda Gesselman at Indiana University's Kinsey Institute.

A federal judge ruled that the Trump administration overstepped in trying to ban trans care federally and pressure providers to stop offering it. A federal court in Connecticut ordered preliminary relief for trans plaintiffs in a class action against Aetna, blocking the insurer from enforcing its categorical exclusion of gender-affirming facial surgeries while the case proceeds.

Dr. Oz tried to pressure major medical societies into opposing trans youth care, though most groups defended their support for medical intervention. The Trans News Network reports on the human toll of the Catholic Church's trans healthcare ban, which affects one in seven hospital patients in the US. In brighter news, the Connie Norman Transgender Health Care Clinic opened in Los Angeles, offering full-service health care at the community center that is "open for all."

Idaho's House passed a trans bathroom ban carrying a five-year prison sentence, one of the harshest bills criminalizing trans people in the nation. In Colorado, anti-trans ballot measures have been certified with backing from evangelicals and the archdiocese, and voters will decide whether to ban trans kids from gendered sports and gender-affirming surgery for children, along with three other states. A Missouri poll found that a ban on transgender care is the strongest selling point in a ballot measure that would outlaw abortion.

Despite the right doing everything in their power to spread their anti-trans agenda globally, a US attempt to define gender in the UN with the binary terms of man and woman alone has failed. Unfortunately, a sweeping anti-trans bill is advancing in Portugal, built on the template constructed by the US far-right. Another in India. Similarly, anti-trans legislation is spreading in the Canadian prairies, where the Canadian Medical Association has applied to intervene against the Saskatchewan government's "parental rights" bill barring trans youth from changing the name or pronouns they use at school without parental permission.

Healthcare news for decision-makers

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Fight forced conversion "therapy." This is urgent: forced conversion "therapy" on trans people in prisons is under way. Later this month I'll be reviewing a pair of books that reveal the long history of the US prison system as a site of medical experimentation.

Warn your clients. This is your regular reminder that not all people who study trans health actually care about trans people's health. The scientists behind the "Social Contagion" myth of gender and the pseudoscience of "Rapid Onset Gender Dysphoria" are recruiting trans youth for the AYAGDOS project.

Defy quietly — or loudly. Florida professors are refusing to alter syllabi on race and gender, even as the state targets how inequality is taught.

Support parents to support their trans kids. Whether that means helping to create third spaces where trans kids can be themselves, connecting to vital networks of mutual aid and community care, or assisting families with relocating to another state or country, parents of trans kids need your help.

Back lawsuits and help parents fight. Denver Health is backing Children's Hospital Colorado in a gender-affirming care lawsuit filed by parents arguing that losing access to care is both dangerous and discriminatory. How can you advocate for hospitals, major clinics, and medical organizations to which you belong to participate in and support these efforts?

• The Ratchet — A data-driven analysis of anti-trans legislation documenting the most sustained legislative assault on a minority population in modern American history, mapping the architecture of a coordinated campaign of elimination.

• Trans Kansans Sue for Their Rights — Imara Jones highlights trans Kansans who filed a lawsuit after a state law revoked their driver's licenses, covers four anti-trans Democrats in North Carolina losing their primaries, and shares how New York AG Letitia James mandated hospitals resume gender-affirming treatment for trans youth.

• Blue States Retreat on Trans Youth Health Care — Imara Jones examines the wave of hospital networks in blue states abruptly ending gender-affirming care programs despite legal mandates, speaks with GLAD Law's Jennifer Levi about legal implications, and talks resistance strategies with Kei Williams of New Pride Agenda.

• As a trans therapist, my trans clients teach me how to build a better future — Therapist Leigh Hendrix writes about holding space for trans clients while sharing their fears, finding antidotes to despair in trans resilience, and why believing in a collective trans future is part of the work.

• On Hold — Photographer Prins de Vos documents people waiting for gender-affirming care in the Netherlands, where average wait times have reached three years. The ongoing photo series continues until trans and nonbinary people have the right to self-determination.

Scheduling mishaps with sources this week means no weekend column, so instead you get a bonus article sourced from an argument I needed to stop having on Facebook, ha. We’re talking about how trans people use the words “transgender” and “transsexual” and how this usage features in transmedicalism.

Original Reporting

Reclaiming Transsexuality in Trans Genocide

On the words transgender and transsexual, the legacy of transmedicalism in queer discourse, and how the hottest trans in-fight has more than two sides.

well.beings.news/p/reclaiming-transsexuality-in-trans-genocide

New on YouTube

The word transsexual starts fights.

I know this from experience. I use the word to describe myself — I'm a transsexual person, by which I mean that I have medically transitioned, due to physical dysphoria, specifically to change my primary and secondary sex characteristics. And I have been called transphobic, by other trans people, for saying so. Not for gatekeeping anyone else's identity. Not for claiming my experience is more valid than theirs. Just for using the word.

This happens because transsexual sits at the center of one of the most heated intracommunity arguments in transgender life right now.

I’ll be real—the news this week is about as bad as could be expected. I know that, behind the scenes, we are all resisting in our own ways. More and more, this resistance is happening offline in private spaces, or in closed groups and encrypted servers, especially in response to recent news that the UK’s biggest DIY HRT website was shut down, stirring concern that other resources could be next.

So remember as this genocide against queer trans folks continues to make headlines, that the resistance may not be as widely covered, but that doesn’t mean we aren’t there, doing the work however we can. This is also your regular reminder to consider your digital privacy and security before diving in headfirst to the resistance.

In the news… the 4th Circuit became the first federal appeals court to uphold a state Medicaid ban on gender-affirming care for adults, with Erin Reed breaking down the ruling's most alarming implications — including language explicitly endorsing states' interest in compelling trans people to "appreciate their sex."

A new State Department rule has given ICE the legal rationale to treat any trans person's documents as fraudulent, effectively opening trans people to immigration enforcement regardless of citizenship status. Anti-trans hate groups have petitioned the FDA to create a mandatory registry of trans women using estrogen and impose sweeping prescribing restrictions — all achievable through existing regulatory authority, without new legislation. The Bureau of Prisons is ordering the tapering and discontinuation of hormone therapy for incarcerated trans people, which physicians say will cause serious, potentially irreversible harm.

On the wins side: a federal judge ruled that Aetna's blanket denial of facial feminization surgery for trans women constitutes sex discrimination under the Affordable Care Act, a landmark first.

In Idaho, Republicans passed a bill requiring medical providers to out trans minors to their parents. And In Texas, AG Ken Paxton has extended the state's youth care ban to mental health providers, meaning therapists and social workers now risk their licenses for delivering any care to trans minors affirming their identity. The ban is already cutting off hormone treatments for cisgender kids with unrelated medical conditions. A Texas court also issued a restraining order barring a New York retailer from selling chest binders in the state, based solely on Paxton's arguments that these count as “medical devices” and with no opportunity for the defendant to respond.

In the UK, NHS England banned new hormone prescriptions for trans youth under 18 — and the evidence reviews used to justify the ban excluded 97% of all relevant studies, through criteria specifically designed to guarantee that result. The ripple effects are already reaching adults, with GPs refusing to continue prescriptions for trans women who have been stable on hormones for years, and a policy expert warning that the NHS is capitulating to a small group of well-funded anti-trans campaigners.

Oppose a registry of trans women and transfeminine people on estrogen by submitting a comment to the FDA.

Beef up your OpSec. Work with your communities to be sure no one is spying on you when you engage in resistance.

• The GOP's Anti-Trans Crusade Already Forced Me to Move My Family. I'm Still Not Sure We're Safe. — A trans clinician and parent writes in Slate about fleeing Iowa after the state's care ban, relocating to Colorado, and now watching the same warning signs appear in a state they hoped would be a haven.

• How parents in the South are organizing to support their trans kids — TransLash's Lewis Raven Wallace profiles the growing movement of Southern parents who are showing up for their trans children in the face of hostile legislation, from Houston families flying queer flags to South Carolina parents welcoming kids who need safer space.

• The Normative Mask — Harvard Law clinical instructor Alejandra Caraballo delivers a rigorous and devastating analysis of how the Supreme Court and federal judiciary have spent the last 18 months constructing an interlocking legal architecture — through the shadow docket, selective case selection, and deliberately neutral-sounding doctrine — designed to eliminate trans people from every dimension of public life.

• A brief history of how the UK's broken trans healthcare system only serves its cisgender doctors — QueerAF's Ludovic Parsons traces the UK's NHS gender clinic system from its 19th-century psychiatric roots to the present day, making the case that the system was never designed to serve trans people — it was designed to control who gets to be one.

Queer in Practice is a bit delayed, so we’ve got another Buy the Book up this week, going back into the archives to a vital 2018 text, Histories of the Transgender Child by Jules Gill-Peterson. But first, therapists respond to the Texas AG outlawing affirming talk therapy.

Original Reporting

Texas Therapy Rooms Are Set to Become Crime Scenes

Where affirming care becomes a crime, and conversion therapy becomes free speech, therapists in the US South are choosing to stay and fight.

well.beings.news/p/texas-therapy-rooms-set-to-become-crime-scenes

Weekend Column

Histories of the Transgender Child: Gatekeeping, Erasure, and the Racial Plasticity of Gender

In the archives of the institutions that built American transgender medicine, Jules Gill-Peterson found the children they'd rather we forgot.

well.beings.news/p/histories-of-the-transgender-child-gatekeeping-erasure-and-the-racial-plasticity-of-gender

There is a popular narrative about trans kids among anti-trans lobbyists that I bet most of you reading have heard: that they are new. That this generation is the first. That we are in uncharted territory and nobody knows what will happen. That the science isn't settled. That caution is warranted. That children can't possibly know.

Jules Gill-Peterson wrote an entire book proving that every word of that is a lie.

Histories of the Transgender Child, first published in 2018, is an academic monograph that should be mandatory reading for every provider working in gender-affirming care, every advocate defending the existence of trans children, and every person who has been told that what's happening now is unprecedented. It is not.

Last July, I wrote about how Ohio's budget language — specifically Section 333.13 of HB96 — would inevitably be used to target any therapy that affirmed trans people's genders, including talk therapy. Several people responded to tell me that such a law would be unenforceable. Several therapists I interviewed in the weeks after insisted that affirming someone's identity in talk therapy doesn’t count as "gender-affirming care."

Unfortunately, they were wrong.

On March 2, Texas Attorney General Ken Paxton issued a legal opinion declaring that the state's existing ban on gender-affirming care for minors — SB 14, passed in 2023 — applies very broadly, even including underwear retailers. All mental health professionals licensed by the Texas Behavioral Health Executive Council are subject to these laws, according to Paxton: professional counselors, psychologists, marriage and family therapists, and social workers. Under his interpretation, any therapist who affirms a trans youth's gender identity is "facilitating" illegal treatment and committing child abuse. Therapists who violate the opinion risk losing their licenses, losing Medicaid funding, and facing criminal penalties. The opinion also invokes mandatory reporting requirements, meaning therapists could be legally obligated to report colleagues — and potentially parents — for supporting a child's gender identity.

The opinion doesn't just prohibit affirming care. It effectively mandates conversion therapy. Paxton's memo cites professional ethics rules requiring therapists to help clients with "stabilizing," "alleviating," or "overcoming" underlying conditions — while simultaneously declaring that affirming a child's gender identity is illegal. As Aleksandra Vaca at Transitics wrote, "Under Paxton's opinion, doing anything other than push a child to accept being their assigned sex at birth will result in providers losing their license and/or being imprisoned. This is conversion therapy, which is recognized by the United Nations as being tantamount to torture."

The Texas Behavioral Health Executive Council has issued formal guidance confirming that licensed therapists are prohibited from providing care that affirms a minor's gender identity when it is intended to facilitate medical transition — while leaving deliberately vague the line between affirmation that "facilitates" medical transition and affirmation that doesn't. As Sebastian Barr notes, the guidance also endorses "exploratory therapy" as permissible, quietly confirming what advocates have long argued: that so-called exploratory approaches are defined precisely by their exclusion of affirming outcomes.

Paxton's opinions aren't technically legally binding. But they carry enormous weight. In 2022, he issued a similar opinion declaring parents of trans youth guilty of child abuse, which Governor Greg Abbott used to direct the Department of Family and Protective Services to investigate families across the state. That directive terrorized parents and threatened to remove children from their homes before a state court blocked it. Paxton has also leveraged SB 14 to go after physicians directly — Dallas pediatrician May Lau surrendered her medical license last year after becoming the first doctor he sued under the law. The timing of this latest opinion — released one day before the Texas Republican primary for U.S. Senate, in which Paxton is running — tells you everything about the political calculations at work.

And Texas isn't the only front. Nine days later, the Fourth Circuit Court of Appeals ruled that West Virginia can exclude gender-affirming surgery from Medicaid coverage — and in doing so, became the first federal appeals court to extend the Supreme Court's Skrmetti framework from minors to adults. The all-Republican, mostly Trump-appointed panel went further than any court before it, writing that it is constitutional for a state to restrict care in order to "encourage citizens to appreciate their sex." The ruling effectively provides a legal roadmap for outright adult care bans, arriving just weeks after Heritage Foundation president Kevin Roberts declared on a podcast that eliminating transgender adult care was the organization's next target.

Meanwhile, the Supreme Court is still deliberating Chiles v. Salazar, a case that could determine whether states can regulate conversion therapy bans at all. During oral arguments last October, the court's conservative majority appeared sympathetic to the argument that conversion therapy is protected speech under the First Amendment. A decision is expected by June. If the court rules in favor of Chiles, it could gut conversion therapy bans in more than 20 states — while states like Texas are simultaneously moving to make affirming care the thing that's illegal.

Read that again: one arm of the legal system is working to protect SOGICE (sexual orientation and gender identity change efforts) as free speech while another is criminalizing the act of using a trans kids pronouns.

The question for therapists on the ground is no longer theoretical. What do you do when the state tells you that evidence-based care and professional ethics are a crime?

"Some laws are unjust and should not be followed"

When I put out a call for therapists willing to speak about what these developments mean for their practice, the responses, while few, were striking — not for their fear, but for their clarity.

Cherise Miles is a licensed professional counselor in New Braunfels, Texas. They specialize in trauma and LGBTQ+ care, and run a pay-what-you-can practice. They are, in other words, exactly the kind of provider trans Texans depend on. Their response to Paxton's opinion was unequivocal.

"I will continue to follow my code of ethics and the WPATH standards of care. It will not change how I care for my clients," Miles told me on Threads. "Some laws are unjust and should not be followed."

This is a calculated ethical position from someone who could face license revocation, loss of support and funding, or even criminal liability for continuing to do what every major medical and psychological professional association says is the standard of care.

Joel Blackstock sees the same fight from Alabama. Blackstock is a licensed clinical social work supervisor and the founder and Clinical Director of Taproot Therapy Collective in Hoover, a complex trauma-focused practice just outside Birmingham. He reached out to me directly, concerned that Alabama is running the same playbook. "When a state declares that basic, affirming talk therapy is illegal, they aren't just policing language; they are actively weaponizing the therapy room," Blackstock told me.

His framing is neurobiological, and it's worth sitting with. Trans youth, he explains, already live in a state of chronic minority stress — their nervous systems stuck in fight-or-flight because their environment is constantly signaling danger. The therapy room is for many the one place where that armor can come down. It's a space for what clinicians call co-regulation: a safe, validating professional helping a client's nervous system out of panic and into processing.

"When you legally mandate that a therapist cannot affirm a child's identity, you completely destroy that safety," Blackstock said. "You turn the therapist into an agent of the state. The child's brain immediately registers the clinic as a biological threat. The therapy not only stops working, but it actively causes trauma. You cannot treat depression or suicidality in a teenager when you are legally required to gaslight their lived reality."

For clinicians, Blackstock describes the impact as "profound moral injury." Therapists are trained to provide unconditional positive regard and safety. Being legislated into causing clinical harm to the most vulnerable patients in their caseload, he says, "completely dysregulates the clinician and accelerates massive burnout in the field."

But Blackstock, like Miles, isn't leaving.

"We stay. In Alabama, we fight this by focusing heavily on nervous system regulation," he said. "The state might try to police the exact words we use, but they cannot police the physiological safety, empathy, and somatic trauma processing we provide. We bypass the cognitive, legislated language and focus on regulating the biological hardware to keep these kids alive. It makes the job infinitely harder, but abandoning the most vulnerable patients in our state isn't an option."

What Comes Next

There are legal arguments to be made that Paxton's opinion won't hold up. Will Francis, executive director of the Texas chapter of the National Association of Social Workers, told the Texas Tribune that mental health workers don't have to stop treating trans youth because counseling has long been considered protected speech under the First Amendment. Lambda Legal senior counsel Karen Loewy called the opinion "baseless and overreaching," adding that it goes "far beyond" what the Texas Legislature approved. Equality Texas CEO Brad Pritchett said Paxton "misrepresents the law."

But the legal arguments and the lived reality are two different things. Paxton has full enforcement power over SB 14. Even if his opinion is eventually struck down by a court, the chilling effect is immediate and intentional. Therapists who cannot afford legal risk — especially those in solo practice, those who depend on Medicaid reimbursement, those who are themselves trans — must now weigh every clinical decision against the possibility of prosecution. Some will stop seeing trans youth altogether, not because they agree with the opinion, but because they cannot afford to fight it. And with the AG going after networks like PFLAG mailing lists, these risks are more real than ever.

Unfortunately, a First Amendment argument that affirming care advocates are counting on could cut both ways. If the Supreme Court rules in Chiles v. Salazar that talk therapy is protected speech — a finding many legal observers expect — it will serve to protect conversion therapists from state bans. But whether it would equally protect affirming therapists from state mandates to practice conversion therapy is an open and deeply unsettling question. The legal landscape is one in which blue states may lose the power to ban conversion therapy while red states gain the power to require it.

For providers reading this, the practical calculus is grim but not hopeless. Blackstock's approach — focusing on somatic and neurobiological interventions that don't rely on the specific language the state is trying to police — represents one model of resistance. Miles' approach — continuing to follow professional ethics and WPATH standards regardless of what the state says — represents another. Both models, finding a balance between legal risk and moral clarity, share a common foundation: staying for the fight.

The pattern I identified in Ohio last year is now playing out across multiple states, backed by an increasingly receptive federal judiciary. Therapists who affirm their trans clients' identities are being systematically reclassified from healthcare providers into criminals, while therapists who practice conversion therapy are being reclassified from discredited religious ideologues into defenders of free speech.

Some therapists, like many other health and wellness professionals who serve queer trans patients, are definitely leaving for other states and even other countries. But many others are having necessary conversations about adapting, resisting, and staying. Providers around the US and in other nations need to start thinking about contingency plans.

How are you thinking about protecting yourself and the queer trans people you serve?

Trans in the USA

The U.S. Supreme Court issued its fifth anti-trans decision in less than a year, reinstating an injunction that could mandate forced outing of trans youth across California and undermine school confidentiality policies nationwide. The DOJ is meanwhile appealing federal judges' orders blocking subpoenas for gender-affirming care patient records, with the first oral arguments heard Friday in the Ninth Circuit in the case against telehealth company QueerDoc. And eight trans inmates say the Bureau of Prisons is illegally denying them gender-affirming care despite a federal court order last June to restore accommodations, with legal filings documenting noncompliance at 19 different facilities.

At the state level, Tennessee lawmakers are targeting trans people's access to health care with a wave of anti-LGBTQ+ bills that would bar TennCare from covering gender-affirming care, prohibit providers from asking minors about gender identity without parental permission, and expand state reporting requirements. The Colorado Supreme Court will hear an appeal over gender-affirming care for minors after Children's Hospital Colorado paused care over Medicaid funding concerns and a lower court denied parents' request to restore it. Experts are echoing what I reported back in September: bathroom bans are likely to harm mental health and increase risks for trans people, and Kansas's new law—which includes a bounty-style provision allowing individuals to sue for $1,000 per incident—has no evidence backing its proponents' safety claims.

The APA released an update on policies affecting gender-diverse populations, highlighting ethical dilemmas for psychologists caught between restrictive federal regulations and evidence-based care. On the protective side, a bill expanding Oregon's shield laws to protect providers of abortions and gender-affirming care to out-of-state patients has passed both chambers, creating additional privacy rights and making court petitions for a legal sex change confidential.

Florida has deemed all existing intro to sociology textbooks illegal and produced its own, with the Board of Governors overseeing the new curricula including roofing contractors and insurance execs, but no educators.

Trans Globally

NHS England paused new prescriptions of gender-affirming hormones for 16- and 17-year-olds effective today, launching a 90-day consultation after an evidence review concluded data does not support continued use—while Gender Plus, the only CQC Outstanding-rated private provider, called the decision contrary to every reputable expert body in the field. An NHS pilot targeting trans kids under 10 has been revealed to rely on research from the 1960s while ignoring all modern literature on trans children, with no risk assessment for potential harm to the 12 children and families who would participate.

QueerAF published a deep explainer on Goodwin v UK, the 2002 European Court of Human Rights case whose significance is being erased in the wake of the For Women Scotland ruling. A TransActual report found 99% of trans people in the UK say anti-trans media coverage has harmed their mental health, with the hostile environment actively deterring trans people from seeking healthcare. And the Trans Advocacy and Complaints Collective filed supplemental evidence with GANHRI questioning the EHRC's compliance with the Paris Principles, concluding that the commission has become one of the most significant risks to the safety and equal treatment of trans people in the UK.

Australia's health regulator AHPRA ordered psychiatrist Andrew Amos to stop making online statements about gender and barred him from direct clinical contact, after complaints about social media posts claiming trans identification cannot be differentiated from psychosis.

A Malaysian government minister called on the public and media to replace the term "LGBT" with "deviant culture" to prevent normalization, drawing condemnation from human rights groups who say the remarks violate constitutional protections and fuel violence.

Protect your patients' data. If you're in the UK, the Gender Recognition (Disclosure of Information) Order 2026 creates a new legal gateway for an NHS data linkage study; share this guide on how to opt out of NHS data being used for research with your privacy-concerned patients before the order takes effect on March 20.

Support trans community spaces. Southern Oregon's first dedicated transgender community center is opening in Ashland this spring, offering peer support, free clothing, career assistance, and weekly programming for gender-diverse individuals and their families. What could you help build in your community?

Show up like you mean it. Parents are putting their freedom on the line to protest the dismantling of youth gender-affirming care programs, with 25 arrested last month blocking the entrance to HHS headquarters. What are you willing to risk?

• How you word a poll question can swing opinion by 20-60 points – A majority opposes "gender-affirming care for minors" but a plurality supports "parental rights to pursue doctor-recommended treatment" for kids with gender dysphoria. About 64% of respondents gave contradictory answers on trans rights depending on framing.

• Making sense of a non-binary world – Philosopher Kevin Richardson on why humans default to binary thinking, and why reality—from biology to identity—refuses to cooperate.

• The Bad Science Behind Sex Tests in Women's Sports – Sex testing is framed as objective science, but the policies ignore biological complexity, misread athletes with intersex traits, and reinforce a broader campaign to exclude trans women from competition.

• Devastating report into trans lives shows we are 'stronger together' – Green leader Zack Polanski responds to the TransActual report with a hopeful take on community resilience despite 99% of trans people in the UK reporting harm from anti-trans media.

• Gender critical smoke and mirrors – On why fighting for trans rights requires understanding the full diversity of trans identities, and how the gender critical movement obscures who funds and benefits from anti-trans lawmaking.

A bloodless menstrual cycle? The perceived and hormonal menstrual cycle-like experiences of transgender women in the United States

Finally, solid research into transgender women's menstrual cycles! A mixed-methods study from Columbia University interviewed 20 transgender women, tracked their daily symptoms, and analyzed 30 days of urine samples for 24 hormone metabolites. Half reported cyclical symptoms including cramps, breast tenderness, and mood swings—and the hormonal data backed them up: PMS-like symptoms consistently occurred when estradiol dipped below personal averages. Notably, symptoms tracked with estrogen rather than progesterone (the typical driver in cisgender women), pointing to potentially distinct hormonal mechanisms.

www.tandfonline.com/doi/full/10.1080/26895269.2026.2636663

PTP Pink Paper - 2SLGBTQIA+ Health Disparities In Canada

This paper found that 40% of 2SLGBTQIA+ individuals reported a diagnosed mental health condition (twice the general rate), satisfaction with mental health services was as low as 3% among genderfluid and Two-Spirit respondents, and up to 77% of Two-Spirit respondents reported healthcare discrimination. The report recommends integrating queer and trans health into provider education, expanding culturally competent mental health services, and standardizing inclusive data collection nationally.

www.pinktrianglepress.com/advocacy/ptp-pink-paper

Later this week I’ll have an article about the impact of the Texas ban on affirming talk therapy, and the next edition of Peer Reviewed.

Rx Resist

Good Intentions Don't Change Systems

What providers actually need to close the gap between inclusion statements, affirming care, and the advocacy of an accomplice — and a new column built to help

well.beings.news/p/good-intentions-don-t-change-systems

Most providers reading this already know something is wrong. You've seen the headlines — care bans, FBI probes into pediatric hospitals, an anonymously authored HHS report endorsing conversion therapy by another name. You know the political environment is hostile to your trans and gender-diverse patients. You probably know it's hostile to you, too, if you're providing affirming care.

What's less clear is what to do about it.

Not in the abstract. In the concrete. In the day-to-day reality of running a practice, managing an intake process, navigating institutional culture, talking to a journalist, or pushing back when your employer's public commitment to inclusion doesn't match the experience your patients are actually having. The conviction is there. The toolkit often isn't.

Fae Johnstone has spent over a decade working in that gap — the space between knowing better and doing better. Johnstone is the executive director and co-founder of Queer Momentum, a national 2SLGBTQIA+ advocacy organization in Canada, and a former DEI consultant who worked directly with health and social service organizations on inclusion through Wisdom2Action consulting. She's also a trans woman who has been on the receiving end of international hate campaigns for her public visibility, and who has testified before Canadian Parliament on the rise of anti-LGBTQ+ hate.

"Cultural competency isn't about memorizing a tip sheet," Johnstone told me. When the work becomes about categorizing every identity into a neat box, "we risk losing sight of people's shared humanity, of the nuances that all of us bring to every facet of our lives." What actually closes the gap, she argues, is a model built on "compassion, care, and humility at the core, meeting people where they're at."

That might sound simple. It isn't — not because providers lack compassion, but because the systems they work within aren't often designed to support it. Johnstone describes the gap between organizational statements of inclusion and the on-the-ground experience of trans people accessing care as a cart-and-horse problem. Public commitments matter — they signal values, shift culture, open internal dialogue. But they lose that value very quickly with follow-through.

She's not dismissing the flags and the statements. She's saying they're the beginning, not the destination. "I'm not a fan of window dressing," she said. "It's less about having a pride flag on every window or in every doorway. It's more making sure that our folks get good care when they show up in our spaces." That means doing the structural work: the training, the community partnerships, the policy changes. "If you're only doing one but I'm not seeing the other, that's where I have cause for concern."

The good news is that the foundation is already there. "We don't need you to be perfect," Johnstone said. "We need you to do your best to meet clients where they're at. These are core values already spoken about in our health and social service systems." Getting to know a patient — really know them, the same way providers are trained to with every patient — matters more than memorizing a list of key terms. "We're not just one story," Johnstone said. "We are a lovely mosaic of different things. And we have a lot in common with just about anybody else."

And here's the part that should matter to every provider reading this, regardless of patient population: this work doesn't only serve queer and trans people. "Homophobia and transphobia also lead to worse health outcomes for straight people," Johnstone points out. "By tackling health inequity facing queer and trans people, we actually build better systems that better serve people of all kinds." Fixing the system for the most underserved fixes it for everyone.

That's the premise of this column.

Rx Resist is a new monthly feature at Well Beings News built on one idea: that providers who want to do better deserve more than good intentions and hope. Each season, this column will rotate through a core area of tactical education — media literacy, provider activism, systems literacy, and collective care.

We'll start on Trans Day of Visibility, March 31, with media literacy: how to evaluate the coverage shaping public perception of your work, how to talk to journalists, and how to recognize when misinformation is being laundered through legitimate-looking sources. Future seasons will tackle how to advocate within and beyond your institution, how to read and push back on policy, and how to sustain yourself and your colleagues through the long fight for queer trans rights.

Anti-trans policy-makers and lobbyists have decided that they know better than physicians do, as Johnstone puts it. They're counting on providers being too scared, too busy, or too unsupported to push back. This column is here to make sure that's not true.

If you want to be sure you have access to all the future installments, get 20% off your upgrade to a Professional Membership today!

Straight up: I'm writing this from bed. I've been one of three kinds of ick 5 / 7 days this past week, and I'm incredibly grateful to have this laptop so I can keep working from the somewhat horizontal position. There's a particular irony in coming back from time off feeling worse than when you left—you finally give your body permission to rest and it takes that as its cue to completely shut down.

Pictured: my bedside kit and desk for getting stuff done on sick days.

But at least it afforded me plenty of quiet time to read and review Starre Vartan’s investigation into the science and culture of female strength, The Stronger Sex, which Professional members can check out in February’s Buy the Book? column.

Despite the enforced rest (or maybe because of it), this has been a productive week behind the scenes. I have some exciting collaborations in the works for Trans Day of Visibility at the end of the month, I'm developing new material for the Resources section—including a free media literacy course for Professional members.

And the recording of my "Understanding Gender Dysphoria" presentation will be available next week for anyone who wants an evidence-based primer to share with colleagues, students, or really anyone in your life who could use one. It’s fun and full of science and personal stories, so keep an eye out!

Upgrade

In the meantime, this week's news is as heavy as ever. From federal prison torture experiments to hospital systems voluntarily surrendering care they know saves lives, it’s all still happening. And so we resist—in courtrooms, in communities, in the growing chorus of providers and professionals who refuse to comply. That's what we're here for. Let's get into it.

Federal Policy: Prisons, Data, Schools

The Bureau of Prisons prohibits gender-affirming care in federal prisons, but it goes further than just denying care—the Trump administration is effectively testing conversion therapy on approximately 2,200 trans people in federal custody, forcing detransition through psychotherapy and psychotropic medication aimed at "resolving" gender dysphoria. The administration has also scrubbed LGBTQ+ questions from hundreds of federal surveys, according to a new Williams Institute report.

I've added a book to my recommendation list that I think everyone appalled by this move should read: Tip of the Spear: Black Radicalism, Prison Repression, and the Long Attica Revolt by Dr. Orisanmi Burton.

Tip of the Spear: Black Radicalism, Prison Repression, and the Long Attica Revolt

Orisanmi Burton explores what he terms the Long Attica Revolt, a criminalized tradition of Black radicalism that propelled rebellions in New York prisons during the 1970s. The reaction to this revolt illuminates what Burton calls prison pacification: the coordinated tactics of violence, isolation, sexual terror, propaganda, reform, and white supremacist science and technology that state actors use to eliminate Black resistance within and beyond prison walls.

bookshop.org/a/116889/9780520396326

Hours after Trump's State of the Union rant against trans kids, House Republicans introduced H.R. 7661, a nationwide "Don't Say Trans" and book ban bill that defines anything involving "gender dysphoria" or "transgenderism" as "sexually explicit."

More broadly, 21 states now have bathroom bans in place, with criminal penalties in two of them. While I do think it matters that these bans will absolutely be weaponized against any gender-nonconforming person, these bills would be a dangerous and growing public health crisis even if they didn’t also impact cisgender people.

Care Access: Hospitals, Providers, and Professional Organizations

Vanderbilt University Medical Center in Nashville has stopped all gender-affirming plastic surgeries for adults, citing the departure of its senior surgeon, leaving patients facing referrals to hospitals hundreds of miles away. Mount Sinai has cut off services for trans kids ahead of new federal rules, and protestors gathered outside NYU Langone on Saturday in response to that hospital's earlier closure of its Transgender Youth Health Program. Today, the New York AG ordered NYU Langone to immediately resume trans youth care, warning of an investigation if the hospital fails to comply.

ASPS members are demanding answers after the organization released a position statement recommending gender-affirming surgeries be delayed until age 19—a statement that bypassed its own Gender Surgery Task Force and appears to have been developed in coordination with Trump administration officials. On a more encouraging note, the American Psychological Association reaffirmed its support for trans youth care, pushing back against a New York Times piece that mischaracterized the organization's position.

State-Level Attacks, Violence and Safety

Texas AG Ken Paxton declared that therapists who affirm trans youth are committing child abuse, extending the state's care ban to mental health providers and threatening license revocation and criminal penalties. In other words, Texas is trying to force healthcare providers to engage in SOGICE—because the only option Paxton's interpretation leaves is to help trans kids "overcome" being transgender.

Kansas is sending letters to trans residents demanding the immediate surrender of their driver's licenses with no grace period. In so many interviews I've conducted, transportation has come up as a major factor in whether or not transgender people have access to even basic healthcare, let alone gender-affirming services. This is especially true in somewhere like rural Kansas. This move was made possible because Kansas secretly spent years building a list of trans residents that Republicans are now weaponizing.

Finally, a report finds that many alleged suicides of Black trans women are likely murders—modern-day lynchings misclassified by law enforcement.

Apply for lesbian health research funding. GLMA's Lesbian Health Fund provides grants for research on the health needs of lesbians and bisexual women—if you're doing research that serves this community, apply.

Push to reconsider the UK puberty blockers trial. A UK Parliament debate on ending the (flawed) puberty blockers trial is happening—both anti-trans actors and researchers want the study cancelled, but for very different reasons. Contact your MP and demand kids get access to real care without being needlessly experimented on!

Support the fight against criminalized trans healthcare. A North Dakota physician is appealing a ruling that upholds the criminal ban on gender-affirming care for youth, arguing it violates the state constitution's freedom protections. You could too!

Learn how to effectively advocate to Congress. TransVitae's guide to advocating for transgender rights walks through finding your representatives, making effective calls, writing persuasive emails, and organizing responsibly.

• What Makes Sexual Healthcare Culturally Safe for Two-Spirit People? Two-Spirit research coordinator Jaylene Mcrae talks to Canadian trans health publication Script about what culturally competent care looks like for Indigenous and Indigiqueer patients—and how providers can begin to repair harm.
  

• Michigan's LGBTQ+ Commission Turns Community Stories Into State Policy: How a 15-member unpaid advisory body helped shape Michigan's unprecedented $10 million investment in LGBTQ+ health disparities and continues to connect community voices to state resources.
  

• Veiled in Secrecy, Anti-Trans Extremist Group Deceives Public: Know your hate groups. A new organization calling itself "Democrats for an Informed Approach to Gender" claims to represent liberals while promoting conspiracy theories, anti-trans slurs, and medical falsehoods. Assigned Media investigates its opaque funding, pseudonymous leadership, and ties to right-wing legal infrastructure.
  

• Anti-ICE Protest Safety for Trans People: The TransLash Podcast talks with Gender Justice legal director Jess Braverman and therapist/organizer Seal Dwyer about what safety looks like for trans people opposing ICE enforcement operations—timely listening as immigration raids continue to put queer and trans community members at risk of violent detention and retraumatization.

I don’t normally include Letters to the Editor in the Research section, but this week’s is a good one, advocating for the normalization of non-flat top surgery techniques!

This week for our Professional members, we’ve got a killer book review of Starre Vartan’s The Stronger Sex, an incredible look at the physical and cultural influences that have led both to our understanding of “strength” as a concept, and the designation of women as the “weaker” sex. This book will absolutely change how you think about sexed bodies.

Weekend Column

Buy the Book? Starre Vartan on Proof, Politics, Possibility for Mixed‐Gender Sports

A critical look at the book The Stronger Sex, the cultural choke points that keep women "weaker" and a roadmap for truly inclusive athletics.

well.beings.news/p/the-stronger-sex-proof-politics-and-the-possibility-of-mixed-gender-sports

What if everything you've been taught about physical strength and weakness has been filtered through a lens of sexism, predicated on faulty logic, and reinforced through cultural norms and societal biases against women? This is the question that led author and science journalist Starre Vartan to write The Stronger Sex, an investigation built on a deceptively simple premise.

The Stronger Sex: What Science Tells Us about the Power of the Female Body

A myth-busting vindication of women's physical strengths that's "fun, rooted in science, and a strong pitch for a stronger sex" (Cat Bohannon). For decades, Starre Vartan--like most women--was told that having a woman's body meant being weaker than men. Like many women, she mostly believed it. Not anymore.

bookshop.org/a/116889/9781541604421