Bans on Youth Transgender Affirming Care

When it comes to children, parents almost always have full control over the healthcare received and how its administered. With the exception of some Jehovah’s Witness’s cases, abortion cases, and court-tied decisions, parent’s typically have the final say so when it comes to the healthcare treatment that a child may take on. While at times this level of parental jurisdiction can prove problematic, when there is a discrepancy between what a child wants and what the parents want, this jurisdiction in the case of those aiming to help their children receive gender-affirming care is becoming more difficult.

Older children smile and hug while wearing the Pride flag.
Children smile and hug while wearing the Pride flag. Source: Yahoo Images

Gender-Affirming Care & Gender Dsyphoria

According to the Trevor Project, more than half of trans and non-binary youth consider suicide annually. This striking statistic appears to be remedied by the the reception of gender-affirming care. Gender-affirming care is defined by the World Health Organization as care that “support[s] and affirm[s] an individual’s gender identity” when it conflicts with the gender identity assigned at birth. For those below the age of 18, this care rarely involves the use of surgery. Instead, puberty blockers, which delay the onset of puberty, and hormone therapy, which helps induce physical characteristics that align with their gender identity, are used to help minors work against gender dysphoria. Gender dysphoria is explained by the American Psychology Association to be “psychological distress” rooted in a discrepancy between gender assignment and gender identity. This condition is associated with high rates of mental health conditions and suicide. As such, the reception of gender-affirming care by children has the potential to address gender dysphoria and lead to better health outcomes for trans and non-binary children.

Preventing access to this life-saving care can have dangerous effects, but that’s exactly what proposed and brainstormed bills in several states have the potential to do. The rationale behind such bills varies with voices from Texas likening gender-affirming care to child abuse and with other states claiming that children aren’t ready to make such important decisions regarding their bodies. The interesting part in these bills is where the penalty falls. Both providers and parents are at the mercy of state employees and educators if they seek to either perform or connect the child with gender-affirming care. The irony is that in most cases, parents are needed to consent to medical care and that providers are encouraged to align with parental wishes. Parents have to consent to their children receiving vaccines. If a parent or guardian decides to go against the standards for recommended care, then the pediatrician must oblige. In the case of standards around gender-affirming care, the American Academy of Pediatrics and the American Association of Medical Colleges has made clear that there are criteria to determining whether a child should receive care and that gender-affirming care is the standard of care if these criteria are met.

White board with the words "Hello my pronouns are" followd by two open underlined areas with a slash where two pronouns can fit. The letters are in a variety of birght colors along a rainbow gradient.
Sign where people can fill in their pronouns. Source: Unsplash

Exploring a Right to Healthcare

In this sense, a denial of a child’s access to arguably life-saving and parentally sanctioned treatment goes against a right to health care. Alabama Rep. Neil Rafferty, the singular openly gay member of the Alabama Legislature, spoke to the matter before his state’s bill was ratified. “Y’all sit there and campaign on family being the foundation of our nation … but what this bill is doing is totally undermining that. It’s totally undermining family rights, health rights and access to health care.”

While healthcare as a right remains uncodified in the US, the United States has signed on to multiple international agreements, most recognizably the Universal Declaration for Human Rights, and is held to international suspicion and disfavor should it move towards legislation that hinders a human right and targets minorities. Whether this international judgement holds sway over the United States politically and legislatively is one thing, but for a country viewed to be a global hegemony, a stand against what can be perceived as a violation of fundamental human rights and protections for children is jarring.

Additionally, some bills, like Alabama’s, have enfolded restrictions and impositions on on trans children. For example, under an extension of the bill, students in Alabama must use the restrooms that align with the gender assigned at birth making education an uncomfortable environment for trans children.

Child with a shirt that says "Love who you are." The child has their hands on their hips akin to a superhero pose and has eye makeup on.
Child posing with a t-shirt and position expressing self-love. Source: Unsplash

As such, an attack on healthcare can operate as an entryway into further impositions on trans rights that have been long hard fought and won for years.

 

Though there’s no telling what the future holds for trans children, there are still ways to support them.

1. Donate to LGBTQ+ affirming spaces and support networks like The Trevor Project.

2. Write letters to your state representatives relaying your support of LGBTQ+ children and their ability to have access to quality, life-saving healthcare and urging their reconsideration of a politician’s support for legislation that may prevent said access.

3. Check in with people in your life who may be affected by such a decision.

 

Exploring “Don’t Say Gay” Bills

Pride Month will look different this year. Large corporations have begun their rainbow themed merchandise sales and included short LGBTQ+ focused ad campaigns, but the typical Twitter decries are in short supply.

Seven years have passed since the incredible expansion of human rights, specifically LGBTQ+ rights, within the United States with the Supreme Court ruling in Obergefell v. Hodges. This ruling secured the fundamental right to marry for same-sex couples through the Due Process and the Equal Protection clauses of the Fourteenth Amendment. This case brought in waves of support for the LGBTQ+ population and led to greater well-being and life satisfaction for members of the community.

A small crowd of people gather behind parade barriers. One person with a Pride themed bandana holds up the Pride flag.
People behind blocked off space holding up a Pride flag. Source: Yahoo Images

With the recent leaking of Justice Alito’s opinion on an overturning of Roe v. Wade, there is a panic that Obergefell v. Hodges and Lawrence v. Texas, which determined that criminal punishment for acts of sodomy was unconstitutional, are speculated to be under threat to be overturned. While only time will tell whether there is a reversal of these rulings, a more pressing threat to LGBTQ+ rights is spreading like wildfire.

Bill Content

The emergence of “Don’t Say Gay” bills across roughly a dozen states serves as the new hurdle in the endless marathon of a fight for LGBTQ+ rights. Originating in Florida where it was signed into place by Governor Ron DeSantis under the name of “Parental Rights in Education”, this bill stops discussion of gender and sexual orientation in classrooms ranging from kindergarten to the third grade and also penalizes discussion of sexual orientation and gender is not presented in an age-appropriate manner. Violation of the bill by educators or an educational institution is ultimately determined by the parents and is grounds for a lawsuit. Additionally, parental provisions included in bills similar to Florida’s  require parental notification about any health or support offered to their child, giving parents the right to deny services for their children.

Florida’s bill passage was only the beginning. More states like Alabama, Ohio, Louisiana, and more have made the move towards passing and signing similar bills. Politicians like DeSantis claim that bills like these support parents in determining how they introduce their children to the topics of sex and gender, and facilitate “education, not an indoctrination.” States like Alabama have gone even farther in their measures regarding LGBTQ+ youth, specifically trans youth, aiming to limit healthcare access for individuals seeking gender-affirming care. Much of the debate revolves around this kind of political justification of the bills and where America draws the line between LGBTQ+ discrimination and parental and state control of education.

The reality of the situation is one that educators and those from the LGTBQ+ community have elaborated upon time and again as sister bills have emerged from various states. Succinctly put by Arjee Restar, assistant professor of epidemiology at the University of Washington, to NPR, “The institutionalization of these bills is an overt form of structural transphobia and homophobia, and it goes against all public health evidence in creating a safe and supportive environment for transgender, nonbinary, queer, gay and lesbian youths and teachers to thrive.”

Florida Governor Ron DeSantis signs the "Don't Say Gay" bill. He is seated and surrounded by young children wearing uniforms as well as some adults who stand more in the back.
Florida Governor Ron DeSantis signs the “Don’t Say Gay” bill. Source: Yahoo Images

Potential Bill Effects

LGBTQ+ youths already face relentless stigma and hardship in the process of loving who they are and feeling comfortable sharing that. In fact, according to the Trevor Project, ‘the world’s largest suicide prevention and crisis intervention organization for LGBTQ (lesbian, gay, bisexual, transgender, queer, and questioning) young people’, estimates that roughly one LGBTQ+ youth attempts suicide every 45 seconds. Additionally, due to the intersectional nature of identity, LGBTQ+ POC youth are speculated to face even higher rates of suicide, mental health conditions, and more. When compounded by critical race theory legislation, these “Don’t Say Gay” bills could negatively effect LGBTQ+ people who face intersectional difficulties in existing.

The “Don’t Say Gay” bills have the potential to exacerbate societal stigma by formally institutionalizing trans- and homophobia by moving towards educational erasure of this population. They also create the potential for familial discourse that could jeopardize a child’s well-being. According to The Trevor Project, the parental provisions section of bills like Florida’s “appear to undermine LGBTQ support in schools and include vague parental notification requirements, which could effectively require teachers to ‘out’ LGBTQ students to their legal guardians without their consent, regardless of whether they are supportive.”

Furthering the concept of family and what role it has to play in youth education, educators bring to light that while gender and sexual orientation may not often be present in forthcoming ways, family certainly is. And with the ruling of Obergefell v. Hodges, more children come from LGBTQ+ families and may have more than one parent of the same gender. The question this situation produces is to what extent this bill really controls education and where do the boundaries lie in state-control over topics that are are fundamental to a child’s lived experience.

An LGBTQ+ family with a small baby walks through some area that is blurred. One person with long, dark hair carries the baby in a front baby carrier, while the other person has short hair and looks on at the other adult with a smile.
An LGBTQ+ family with a small baby. Source: Yahoo Images

What You

While the effects of these bills is yet to be determined, as of right now, lawsuits and court intervention appear to be the only routes to navigate through undoing this legislation. If you feel called to support the plight of the LGBTQ+ population, please consider the following:

1. Donate to LGBTQ+ affirming spaces and support networks like The Trevor Project.

2. Write letters to your state representatives relaying your support of LGBTQ+ visibility in the classroom and urging for either the prevention of a “Don’t Say Gay” bill or the reconsideration of a politician’s support for one.

3. Check in with people in your life who may be affected by such a decision.

The Realities of Being Homeless in America

An image portraying an encampment under a bridge
Source: Yahoo Images; People experiencing homelessness sleeping under a bridge

The homeless population in America tends to be neglected by the society they live in. They are among the most vulnerable, belonging to already marginalized communities that struggle to meet their day to day needs. As a result, the unhoused have little to no power or influence on social norms and affairs. As someone who has experienced homelessness both in India and in America, I have come to distinguish some of the common misconceptions society holds about the unhoused population. There are a lot of stereotypes and social stigma that surrounds the discussions around homelessness, which often blames the victims of systemic issues, instead of restructuring the conversation around how we as society can best help these marginalized groups realize their basic human rights to shelter. In order to do so, we must first understand what it really means to be homeless in America.

History of Homelessness in America

Homelessness is not an issue unique to the United States, as it can be found in countries all over the world. While homelessness in America can be found as early as the colonial times, modern homelessness rose as a response to the Great Depression, where people experienced high levels of unemployment and poverty. Especially interesting is the relationship between the growth of urban cities and the rise in homelessness. Coupled with low-wages and higher costs of living, people found it more expensive to find places to live in urban centers, such as New York and California. The aftermath of the Great Depression put a lot of people in desperate need of employment, and as the economy took to the service industry, more and more undereducated, impoverished people had no other choice but to turn to these low-income jobs. The country’s shift to a service economy meant that laborers were now being paid lower wages, leaving service industry employees unable to afford the rising costs of housing. Coupled with higher housing costs and lower wages, when people turned to social welfare programs, they found these programs to be lacking in funds as well.

Additionally, there was a campaign to “Deinstitutionalize” people held in mental asylums. While the campaign itself was well-intended, its applications were lacking in structure, and instead of providing patients with proper access to mental health resources, people with mental disabilities were released to fend for themselves. The neglect of these institutions led to the increasing numbers of mental health patients facing housing insecurity. To make matters worse, gentrification policies (made to bring in wealthy real-estate investors and high-income residents to underdeveloped parts of the city) led to the displacement of many low-income families, putting them out of their homes. These policies disproportionately  affect people of color, something that has forced many marginalized communities to fall prey to an endless cycle of poverty and degradation.

Unfortunately, one of the most concerning additions to the homeless population is the disproportionate number of youths that identify as being part of the LGBTQ+ community. According to a recent study conducted by Chapin Hall at the University of Chicago, LGBTQ+ youth had a 120% higher risk of experiencing homelessness. These members who already belong to an ostracized community can become more vulnerable to harassment, violence and hate crimes.

Additionally, unable to find jobs after returning home from military service, many veterans end up homeless with nowhere else to go. Although places do exist to support veterans who experience homelessness, many are either unaware of the resources at hand, or too ashamed to use these resources. As a result of the social stigma surrounding the topic, people experiencing homelessness often become withdrawn from society.

Society’s Attitudes Toward the Homeless

A bench that has armrests in-between to prevent laying down
Source: Yahoo Images; An example of hostile architecture that prevents the unhoused from sleeping on benches

Homelessness is received with wildly different attitudes among different cultures. America is a very diverse country, with people that share hundreds of different cultures and traditions, and these cultural attitudes can carry over in the way they respond to contemporary social issues. Different cultures share a varying definition of what a “home” means, and even more distinctions in their approach toward people experiencing homelessness. What the dominant White culture might consider to be a home, (an individual unit of space for nuclear families), might not be what someone who belongs to the Indigenous population believes. They might argue that a home is where you can interact with your community, a place to feel safe and share with friends and family. Even the attitudes toward helping people who are unhoused have strict cultural implications. As described in Islam, it is part of the every-day religious ritual of a Muslim to give alms and help the poor in their community. In Hinduism, while helping the poor with food and shelter is allowed, certain castes are not allowed to eat alongside with or sit beside  people of lower castes. People experiencing homelessness have their own unique culture, where certain skills or strategies for survival on the streets are shared amongst each other.

Along with all these complexities, the unhoused also undergo various types of stigmas, including social stigma, and cultural stigma. Social stigma can be discrimination and harassment directed toward the homeless population by the institutions, systems and people that make up society. Cultural stigma can refer to the stigma expressed by friends and family members or other religious or cultural institutions that may shame and blame the victims for being homeless.

Unhoused people also have a hard time finding employment. This is partly due to the fact that the job application requires a home address for the application process to be completed. As a result, people who are dispossessed also experience difficulties when finding housing. The applications for apartments include a proof of income/employment section and applying for government housing takes months to be processed and reviewed. Many states have long and complicated application processes, and even then, it is not a guaranteed housing option. Nevertheless, applicants can be denied, and they would still need a place to stay while awaiting their application to be approved.

Adding to these difficulties, people in the homeless community are constantly harassed with wild stares or abuse, (both verbal and physical), from members of society. The law enforcement agency, an institution designed to serve and protect people of the community, may make matters worse by deteriorating the situation further. Without proper training, police approach the homeless defensively, ready to attack at the slightest “abnormal” reactions. What they haven’t been trained to realize is that many people experiencing homelessness are also at high-risk of developing mental health issues due to the stress and realities of being homeless. These altercations can turn deadly, and unfortunately, many people of the homeless community have either been locked up or even killed by officers of the law. Many of these instances were even caught on camera, yet these officers faced little to no accountability or legal punishment.

People experiencing homelessness are also easy targets to getting their possessions robbed, and many times, police will raid their camps and confiscate what few belongings they might acquire, including sleeping tents and toiletries. Society also treats the homeless population as a burden and blames them for being “lazy” or “druggies” or “criminals/suspicious,” without any provocation from the homeless community. It can be especially insulting for the people experiencing homelessness to be judged for their situation while society simultaneously fails to criticize the state’s inability to protect peoples’ fundamental human rights to food, shelter, and other basic needs.

The Legal Response to Homelessness in America

Spikes under bridges
Source: Yahoo Images; An example of hostile architecture to deter the homeless from sleeping under bridges

The legal response to the homelessness crisis in America has not been a heartwarming one either. Urban cities all over the United States have put in place anti-homelessness measures, otherwise known as hostile architecture. These include slanted benches, benches divided by armrests, spiked and rocky pavements to prevent people from sleeping there, and even boulders under bridges. Not only are these measures inhumane, they also cost the tax-payers a lot of money. These atrocious tactics are put in place to discourage homelessness, attempting to connect rising numbers of homelessness to increased crime rates. As recently as July of this year, Los Angeles even went so far as to make homelessness downright illegal, restricting homeless encampments in majority of the city. The city has even  prohibited the homeless from sitting, sleeping, or laying in public.  Due to the fact that homelessness overwhelmingly affects people who belong to already marginalized communities, a rights-based approach is necessary, one that addresses the existing systemic issues which need to be fixed first.

Covid-19 and How it Continues to Impact the Homeless Population

An image of a crowded homeless shelter
Source: Yahoo Images; Homeless shelters can be crowded, without proper social distancing measures in place

The Covid-19 pandemic continues to impact many different communities in a variety of ways. The pandemic hit especially hard among the homeless population, where access to hygienic products are often slim, if not non-existent. People experiencing homelessness may not have the ability to continuously wash and sanitize their hands, with limited access to clean water and soap products. They also been experience complications with social distancing measures, forced to be in crowded spaces like homeless shelters, which has only increased their risks of getting infected. Furthermore, even when infected, or exposed to the disease, the homeless population has very limited ability to quarantine, further allowing the spread of the disease to others in close proximity. The unhoused population has limited access to healthcare and medicinal treatments, and many are already immunocompromised or have pre-existing conditions, which increases their vulnerability of catching the disease. Stereotypes geared toward the homeless population labeling them as “junkies” or “druggies” has influenced the care they receive, leading to many cases of misdiagnoses or mistreatment as a result of biases held by healthcare professionals and others in the health care industry. Due to the rise in unemployment numbers during the economic shutdown as a response to the pandemic, millions of people who did not qualify for unemployment benefits, and could not make ends meet, also became homeless as a result.

Some Successful Approaches to Ending Homelessness

A person sitting next to a hostile architecture with a sign reading, "Homes Not Spikes"
source: yahoo images; An unhoused person advocating against hostile architecture

There have been some successful attempts at ending homelessness in America as well as in other nations. Utah attempted to decrease its rates of homelessness back in 2015, which successfully reduced its homelessness by 91%. They executed a policy known as “Housing First,” which gave their chronically homeless populations free housing, a decision that cost the state less money than alternative anti-homelessness measures. This program unfortunately has not been a complete success, as people experiencing homelessness in other states have been migrating to Utah, making it too expensive for Utah alone to pay for the country’s increasing homelessness crisis. A national policy, on the other hand, that could implement the Housing First approach taken by Utah, may be the easiest, and essentially cheapest option to ending the homelessness crisis in America. This is essentially what Finland did. In 2019, Finland approached the homelessness issue with the most obvious of answers, by providing housing for all those who are unhoused. Like Utah, they applied the “Housing First” policy, (which came with no strings attached), recognizing that housing is an essential human right that should be protected and promoted. They also understand that in the long run, providing the homeless population with housing is the cheaper option to society. Also, as examined earlier, if applied in America, this Housing First policy will inevitably save more lives, with fewer interactions between the homeless and the police.

While homelessness is not something people are normally born into, the unhoused face discrimination, stigmatization, and marginalization from society just as much as any other group. Although people’s socioeconomic status is a major factor in determining who is most vulnerable to experiencing homelessness, as we’ve seen in the case of the LGBTQ+ youth, and older veterans as well, homelessness can impact people of any and all races, at various age levels, and at any given time. The pandemic itself has expanded the homeless population as people are unable to pay their backed-up rent or mortgage payments. While alternative approaches can assist to eradicate levels of homelessness in our society as implemented in Finland and Utah, it is crucial that we also continue to destigmatize being homeless in American society and take a rights-based approach to finding long-term solutions to end their suffering.