The LGBTQ+ community has garnered significant progress in the last several decades, but many argue that recent laws and harmful rhetoric pushed largely by Republican politicians are eroding that progress.
That argument is valid: A poll by Gallup found that in 2023, 15% fewer Republicans viewed same-sex relationships as morally acceptable compared to 2022 -- the lowest number since 2014.
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Some states, including Michigan, have laws in place to protect LGBTQ+ individuals from discrimination. But, while Michigan law dictates that employers can’t fire a worker because of their gender identity or sexual orientation, employers still can fire an employee for those reasons and claim the firing was for something else.
To the dismay of many, the harmful messages shared by politicians who oppose the LGBTQ+ community are more than just words. Several states have targeted the LGBTQ+ community by imposing restrictive laws and eliminating their legal protections, claiming such actions are required for “safety,” though research shows LBGTQ+ individuals are several times more likely to be victims of violent crimes and sexual assault.
Restrictive and dangerous laws are being enacted across the U.S. -- including in Florida, whose Republican Gov. Ron DeSantis recently announced he’s running for president.
During his time as governor, DeSantis has denounced education and care relating to sexual orientation and gender identity, and has pushed to outlaw it. By vilifying gender-affirming care, LGBTQ+ people are being kept from accessing such gender-affirming care that has been associated with lower suicide rates, experts say. Many are concerned about the national effects of DeSantis’ strategy.
What is gender-affirming care?
Gender-affirming care is not one specific type of treatment; it can include various social, psychological, behavioral and medical interventions “designed to support and affirm an individual’s gender identity” when it conflicts with the gender they were assigned at birth, the World Health Organization says.
“Gender interacts with but is different from sex, which refers to the different biological and physiological characteristics of females, males and intersex people, such as chromosomes, hormones and reproductive organs,” the WHO said. “Gender and sex are related to but different from gender identity. Gender identity refers to a person’s internal and individual experience of gender, which may or may not correspond to their sex at birth.”
Gender-affirming care can help people create a more comfortable living environment and experience that better reflects their identity. Such care doesn’t always include surgeries: Only about one in four trans and nonbinary people choose gender-affirming surgery.
Down in Florida, DeSantis approved legislation seeking to ban gender-affirming care for children, and to further limit such care for adults. For example, Florida recently passed House Bill 254 to outlaw reversible puberty blockers, surgeries and the like.
But surgical treatment is not the goal for treating minors, pediatrician and child psychiatrist Jason Rafferty told the Association of American Medical Colleges. The U.S. Office of the Assistant Secretary for Health says surgical treatments among children are rare, and are not listed as treatment options for minors; they are “typically used in adulthood or case-by-case in adolescence.”
Instead, when it comes to children in the U.S., the most common gender-affirming treatment includes social affirmation, which involves adopting various “hairstyles, clothing, names, pronouns, and using certain restrooms and other facilities.” The next most common form of care for children involves puberty blockers, which have been used to treat other conditions for decades, and are described as “reversible.”
In Michigan, any individual seeking hormone therapy must provide a referral from a mental health provider that meets the criteria of the World Professional Association for Transgender Health, according to Michigan Medicine at the University of Michigan. The hospital would then review the documents to see if a patient could receive treatment.
For minors, the most common form of gender-affirming care is just “calling them by the name they want to be called by,” said Sam Srauy, inequality scholar and associate professor of communication at Oakland University.
Srauy also said phrases like “gender-affirming care” are often used by those who oppose the LGBTQ+ community to scare people about things they may not understand. Republican politicians in particular, including DeSantis, have made their opposition to gender-affirming care and other LGBTQ+ related topics a large part of their platform and messaging.
“It’s concerning to see any candidate for any office who relies on disinformation and scare tactics regarding the trans community as part of their campaign strategy,” said Blake Bonkowski, coordinator of Oakland University’s Gender and Sexuality Center. “Believing those falsehoods about the trans community has been a long-held justification for discrimination and violence.”
One way the scare tactic-violence connection manifests is through the “gay/trans panic” defense, Bonkowski says. This defense is used as a legal strategy, in which the defense attempts to criminalize a victim’s sexual orientation or gender identity by arguing that identity is to blame for the defendant’s violent actions, including murder, according to the American Bar Association. The defense, which the bar calls a “legally sanctioned discrimination against one’s sexual orientation and gender identity,” has been used in cases to lessen the offenses of defendants convicted of killing a person who identified as LGBTQ+.
The recent rise of negative rhetoric aimed at the LGBTQ+ community has a serious impact on youth mental health and their relationships with their families, experts say.
“We are seeing more and more students whose parents hold strong negative beliefs about trans and nonbinary people, leading to distancing between youth and their families, and increased violence against trans and nonbinary youth,” Bonkowski said. “Last year I had about one student per month that [said] they were being kicked out of their parents’ house -- almost all for being trans or nonbinary. Anti-trans politicians encourage this type of abuse.”
DeSantis restricts, bans ‘lifesaving’ gender-affirming care
Under Florida’s new laws, adults must provide consent for a child to receive gender-affirming care. That care can only come from what the bill defines as a “physician,” even though certain care can come from nurses, and care like social affirmation can come from friends, family, teachers and others.
By limiting who can administer such care, experts say fewer children will be able to access potentially life-saving treatment -- including non-medical treatment like using preferred names, pronouns and other forms of social affirmation.
The Human Rights Campaign calls gender-affirming care “lifesaving” because, as a study published in medical journal JAMA found, “gender-affirming medical interventions were associated with lower odds of depression and suicidality over 12 months.” People who identify as LGBTQ+ are also more likely to experience discrimination and have higher rates of anxiety, depression, and substance use disorders.
According to Srauy, the transgender community’s relationship with suicide is related to a trans person’s ability, or inability, to feel accepted in their social space. In that way, Srauy said gender-affirming care acts as a form of suicide prevention.
“[Any] anti-trans legislation is always an attempt to shove trans people out of public life and to discourage us from coming out and being our authentic selves,” Bonkowski said. “That has never worked. It has only caused us to be abused, discriminated against, and … suffer negative mental health outcomes.
“Anti-trans politicians know they’re making trans lives more difficult with these bills -- and that is what they want. It’s horrific, cruel, and a direct contradiction for any politician who claims to value human life in any form.”
Despite research showing the importance of gender-affirming care, Florida law mandates that health care professionals can be arrested for providing gender-affirming care, including reversible puberty blockers, to patients younger than 18 years old. Children who receive such care can be removed from their guardians’ custody and placed in the state’s custody.
Non-physicians can also be arrested for providing any gender-affirming procedures or prescriptions under Florida law. Adults there can no longer receive gender-related treatment from medical professionals like nurses, even if the patient consents to the treatment.
How does this impact the rest of the country?
In his presidential announcement in May, DeSantis reiterated his stance against the LGBTQ+ community, calling those supporting the community a “mob.”
On May 15, DeSantis signed a bill that blocks public Florida universities from using government funds on diversity, equity and inclusion programs. Such programs seek to create welcoming environments for marginalized communities, and broaden people’s perspectives and tolerance of these communities and the hardships they face.
If elected President, DeSantis said he would use Florida as a blueprint for the rest of the nation. Americans who support and identify with the LGBTQ+ community worry what their future may look like with DeSantis in charge.
DeSantis’ blueprint includes banning gender-affirming care that has helped decrease suicide and depression rates, spreading incorrect information about that care, and creating laws that foster messages of exclusion. These actions increase anxiety and depression within the LGBTQ+ community, and increase violence against that community, research shows.
His most prominent Republican opponent, former President Donald Trump, also said he would ban gender-affirming care for minors, despite the fact that gender-affirming care is not common among minors, and that surgical treatment is already extremely uncommon and difficult to receive for adults, let alone children. If reelected, Trump also said he would impose “severe consequences” for teachers who support trans rights or speak about trans experiences.
In addition to DeSantis and Trump, at least six Republican presidential candidates running in the 2024 election have said they would ban gender-affirming care for minors. So far, other states like Utah, Missouri, Alabama, Arkansas, Louisiana and Texas have either proposed, advanced or approved similar bills.
“It’s more important than ever for folks like myself to be models of happy, successful, openly trans adults,” Bonkowski said. “The trans and nonbinary youth who will be impacted most by anti-trans rhetoric need to see that we’ve survived this before, we will survive this again, and that there is support available.”
Related: Michigan LGBTQ+ resource guide: How to find support, healthcare and legal resources