Legislation Undermines Trans Medical Access



Virginia Reader, 72, of Lake Orion, Michigan, takes one Prometrium pill, left, each night and wears a Vivelle-Dot patch, right, continually, changing patches on Sundays and Wednesday, as part of her Hormone Replacement Therapy. (Patricia Beck/Detroit Free Press/MCT)

Jack Portman

On Jan. 27, the Republican controlled South Dakota House of Representatives voted 46-23 to pass legislation which will effectively criminalize hormone treatment for trangender teens under the age of 16. The insincerely titled Vulnerable Child Protection Act will prevent medical practitioners from performing gender re-alignment surgeries or administering hormones or puberty-blockers by classifying such procedures as class-1 misdemeanors. The legislation’s passage in the House is an affront to the rich scientific literature affirming trans medical care as a necessary, even life-saving practice.

The gender binary is a social institution which works to bifurcate gender roles, experiences and expectations on the basis of sex-at-birth. That gender is generally concieved in this cultural milieue as being both binary and inherently connected to sex-at-birth does not reflect the historical and cultural variants of this mode. Many human societies have institutionalized non-sex-detrerminant gender identities; the binary and sex-affiliated system which is presently salient cannot be considered an innate or inherently right system. Thus, in a gender-binary society, when an individual is circumstanced such that their natural gender faculties do not align with their culturally assigned gender, individuals are forced to embody and perform a gender with which they do not identify. For many, this inexorable non-compliance with a prominent social institution causes quantifiable adversities such as poor health outcomes, employment insecurity and social detachment. Depression and suicidal behaviors are repeatedly shown to stem from this tension between social expectations of gender and individual identity. In this sense, revoking the rights of trans teens to pursue medical procedures, which could affirm their gender identity and help ease the stress and anxiety associated with non-confirmation to the gender binary, only exacerbates the preexisting adversities facing the trans community.

That this absurd parody of child-protection legislation has thus far succeeded does not bode well for trans people in other red states”

The philosopher John Rawls’s book A Theory of Justice suggests that it is the charge of a just society to ensure that lesser-advantaged citizens lead the best lives possible. It would seem that a citizen cannot reasonably be said to lead a best-possible-life when they are forced to adopt a gender other than that with which they identify. The tangible health outcomes facing trans teens who are prohibited from seeking out hormone therapies and gender realignment surgeries, such as depression and suicidal behavior, arguably limit their capacity to operate in professional and academic settings, further exacerbating their circumstantial inability to lead a best-possible-life.

South Dakota’s legislation, which will soon be considered by its Republican controlled Senate, will have tangibly negative health effects for the very population it claims to protect and categorically fails to recognize the tenants proffered by Rawls’ utopic just-society. That this absurd parody of child-protection legislation has thus far succeeded does not bode well for trans people in other red states; South Dakota has come to serve as a litmus test for the political viability of socially conservative legislation, owing to its peculiar policy ensuring every bill introduced to the legislature receives a public hearing.

The Vulnerable Child Protection Act − a title so insultingly disingenuous that it pains me to refer to it as such − constitutes an unjust erasure of the rights of trans teens to seek critical medical treatment, undermines the tenets of justice which ostensibly permeate our democratic institutions and emboldens future legislative abuses of the rights of trans people.