Trump’s Anti-Trans Orders Are “Ultimately Going to Harm Us All,” Says Expert

HARI SREENIVASAN: Christiane, thanks. Chase Strangio, thanks so much for joining us. Since President Trump took office, he has signed a raft of different executive orders, and we’ll get to some of those in a moment, targeting explicitly the rights of trans people in the United States. I guess my first question to you is kind of a big picture one: What’s the political landscape like right now for trans people in this country and what are your biggest concerns?

CHASE STRANGIO: Well, thank you for having me. And as you, know the last month has really been characterized for trans people by one attack after another from this administration. And we started these attacks during the campaign when the president and the Republican party spent hundreds of millions of dollars focusing on attack as targeting trans people. And now post January 20th, it seems like every day there is some new executive action restricting the rights of trans people and really zeroing in on efforts to prevent us from having jobs, going to the bathroom, going to school, joining the military, accessing healthcare. This is really a full scale assault on trans people being able to really live freely in this, in this country. And so for the trans community, this is a time of great anxiety and fear and concern for the future. For me, in terms of what I am looking at, I am most scared about these continued erosions into our ability to access essential things like healthcare. But that’s also something that many people in this country are worried about. Will Medicaid be cut? Will we continue to see the executive unilaterally, unilaterally try to cut off grant funding that Congress has allocated to institutions,  to the states? So this is a time of significant precarity, and I’m very concerned about the sustainability of our separation of powers in this country, as well as the ability of trans people to survive in the face of these attacks.

SREENIVASAN: Let’s go through some of these orders. On day one, when he came into office, there were a lot of different executive orders that he signed. One of them was, one that said, quote, “It is the policy of the United States to recognize two sexes, male and female. These sexes are not changeable and are grounded in fundamental and incontrovertible reality.” I mean, that seems to be one of the underlying ideas in so many of the other policies that spring from it.

STRANGIO: Yeah, that’s absolutely right. It was a declaration on day one that in essence, from the position of the federal government under President Trump, trans people do not exist. The order refers to a quote “false claim” that an individual can live and identify as a sex different than their sex assigned at birth. And from there, we have seen the president direct federal agencies to do things like prevent trans people from accessing passports and other federal identification that reflects who we are and how we live. To instruct schools to not protect the ability of trans students to protect, participate in activities alongside their peers, to threaten funding to hospitals that allow people to receive medical care consistent with doctor recommendations. So that is sort of one of the underlying premises that trans people don’t exist, and therefore the government is going to take all sorts of actions to try to prevent us from living. Because we plainly do exist. We are here in the world. And so what that actually means is that we’re going to see legal attempts to limit our ability to survive in light of our incontrovertible existence.

SREENIVASAN: On the campaign trail, there were hundreds of millions of dollars spent on making this a central issue to him. Now that he’s in office, he’s of the opinion, that look, the majority of the country, or at least the majority that voted for me, are in favor of these measures. That’s why I’m doing them. This is what helped me get elected. What’s wrong with his thinking there?

STRANGIO: I think there’s a few things wrong with the thinking. It’s not clear that the things that were said on the campaign trail, like ending transgender insanity translate to any particular policy proposal at all. And to the extent the policy proposal is to get rid of transgender people, which is possibly implied in something like end transgender insanity, that is just simply not a moral, ethical or lawful policy proposal. The federal government cannot come in and ignore constitutional strictures for the various branches of government. And then not only that, come in and infringe upon the individual rights of transgender people in the United States. 

SREENIVASAN: I wanna spend a couple minutes on an executive order that is called Protecting Children From Chemical and Surgical Mutilation that bans gender affirming care to children. And I guess just to set the table, for most people who don’t understand what gender affirming care means, explain.

STRANGIO: So what we’re talking about here is an executive order that bans the use of puberty blockers and hormone therapies, and then a small subset of surgeries for transgender people under the age of 19. And I think that that’s important because this is an order that not just bans these treatments for minors, but does so for 18 year olds as well. And though the order is framed as ending so-called “mutilation” of children, there is nothing mutilating about this medical care. This is medical care that is supported and recommended by every major medical association in the United States. It is only provided when the adolescent, the adolescents parents and a doctor recommend the care, or in the case of an 18-year-old, the 18-year-old, and the 18 year old’s doctor. And it’s care that is prescribed – hormone therapy, puberty blockers – routinely to people for many purposes, including purposes like the gender affirming purposes for which transgender people need the treatments. So you could have a non-transgender boy who seeks and needs testosterone because of a delayed puberty. He’s 14 years old, his peers are developing. But a transgender boy who is 14 years old and his peers are developing as boys cannot receive the testosterone treatment for the same reasons to undergo a typical puberty like his male, his male peers. And this order, not only is it attempting to restrict the ability of the federal government to pay for the care. It is far more expansive than that. What it is saying is that it will threaten the funding to any institution in the United States if it provides this care using any funding. So if a state is funding the, its ca, this care in a state hospital, but receives federal funding for other purposes, they are at risk of losing all of their funding just because they’re treating transgender people. And in essence, holding our entire health system hostage and saying, you must stop treating transgender people. And that’s a lot of what we’re seeing, these coercive actions from the Trump administration trying to use President Trump’s policy preferences to shut off essential care and essential services that people need across the country.      

SREENIVASAN: You know, a part of that executive order also kind of gets into, a little bit to this idea that there are children who soon regret this. The phrase that the administration used is that “countless children soon regret that they have been” quote “mutilated.” Now, there was a study in the Journal of the American Medical Association back in 2024 that showed only 4% of transgender teens pursuing this type of medical care expressed any regret. Yet there’s also a study out there that revealed that 30% of adults who begin gender related hormone treatments ultimately discontinue it. Can both of those kind of realities coexist?

STRANGIO: Yeah, absolutely, because they’re asking different questions. The first question is about whether people regret treatment. And every single study to study this question found that the, has found that the rate of regret of this treatment is not only extremely low, it is also comparatively much lower than many other forms of medical treatment that are provided in the pediatric and in adult context. The other study you referenced, which is the 30% of adults, and again, these are, that’s just one study, discontinue hormone treatment. Discontinuing treatment is not the same as regretting treatment. There are many reasons that people will stop receiving hormone treatment. One of which is that they’re wholly satisfied with the way in which the transition has progressed. They don’t have a medical need for treatment. They very likely continue to identify as transgender and do not regret the treatment at all. There are other people who discontinue treatment because they can no longer afford it because they don’t have access to health insurance. We live in a country that is consistently making it difficult for people to access medical care. So those two things are looking at different questions, but the government in these executive orders made a lot of allegations about what is true about this care. But we’re in court right now. They had every opportunity to defend the executive orders, and they put in exactly no evidence. No evidence to show that there is a high rate of regret, that these medical treatments are ineffective. 

SREENIVASAN: You know, there was a recent study that looked at how many children are actually getting this, and it was less than one in a thousand, one tenth of one percent. Right. And it is an incredibly minute population. Yet you are very well aware that there’s what, 26 states now that have laws on the books that are banning gender affirming care. Why do you think that is?

STRANGIO: Because I think what’s happening here, and you see it with respect to the extraordinarily small numbers of people who receive this care, the extraordinarily small number of transgender athletes that exist in the world, in some, in the country, in some states it’s zero. In the NCAA, we heard from Charlie Baker that it’s less than 10, and that includes trans women and trans men out of 510,000 athletes in the NCAA schools. So what we’re talking about here is an outsized fixation on an exceedingly small population in order, that is being used in order to stoke fear, if people who do not know trans people, who do not understand trans people. And that fear is causing people to then react in support of discriminatory policies. And at the end of the day, these discriminatory policies, as harmful as they are for trans people, and they are very harmful for us, they’re ultimately going to open the door to discrimination against so many other groups of people.

SREENIVASAN: I came across something that kind of startled me and that I hadn’t really heard about, which was a study showing a causal link between increased rates of suicide attempts among trans and non-binary children in states after those states passed sort of anti-trans laws. And yet, and I bring this up because there seems to be an open question on whether or not this category of people are living through any sort of immeasurable harm. And you know, this is something that even came up, and I guess this is to burnish your legal credentials, when you were arguing in front of the Supreme Court in a recent case about Tennessee, and that was a group of families and a medical provider, I guess, you know, what’s at stake in that case and what’s at stake kind of in that question that some of the justices were sort of posing?

STRANGIO: Yeah. So this is a case that in essence asked whether or not a state can constitutionally ban this gender affirming medical care for transgender people under the age of 18. And the real question in the case was whether such a ban, which was defined as a ban on medical treatment inconsistent with a person’s sex is a form of sex discrimination. That’s really the central question in the case. And the harms at issue in the case are the harms that extend to the hundreds of transgender people in Tennessee, but also around the country who rely on this medical care. And as our clients in that case testified, and as our clients in many other cases have testified, it has only been through the provision of this care that these young people have been able to thrive and see a future for themselves. And it is only through the provision of this care that their parents have been able to finally see their children happy, joyful, and hopeful about the future. And the government has come in and overridden the decisions of these kids and their parents in order to ban this medical treatment. And the data shows that taking away this medical care is harmful, it causes increased distress, anxiety, depression, and suicidality. Now, our opponents fixate on this argument that they make, which is that the studies themselves do not show an increased rate in completed suicide. And that is true. The studies do not show an increased rate in completed suicide. Now, the reason for that is because completed suicide is generally rare, and that when you have a study of whether it’s 50 people or 300 people, the hope is that nobody has a completed suicide in any group within that study. But what the studies do show consistently is that the medical treatment decreases incidents of suicidality. And independent research shows that decreases in suicidality decrease completed suicides. But the fact that we’re even getting into that debate whether or not completed suicide is the only metric of whether something works or not, is in and of itself a horrible place to be. 

SREENIVASAN: I wanna point to a couple things that Justice Kavanaugh said during the oral arguments that you were at. He said, while there were “forceful” arguments to allow the medical treatments, 20 plus states put forward arguments on the other side. Looking at the Constitution, he said, “doesn’t take sides on how to resolve that medical and policy debate. The constitution’s neutral on the question.” He goes on to say, it should be left to the Democratic process. What do you say to that?

STRANGIO: Well, the Constitution is not neutral on the question of whether or not it is permissible to discriminate against a group of people based on a protected characteristic. The equal protection clause could not be clear that the government you know, that when, that each person is equally protected under the law. That the government cannot discriminate on, against someone based on a protected characteristic like their race, like their sex. So certainly the Constitution isn’t neutral. And any time there is a robust policy debate, if that is how it wants to be, you know, how, how the justices or others wanna frame the current conversation about trans people as access to medical care. That policy debate cannot proceed in ways that treat people unequally. That is what the Constitution tells us. That there is strong protections for democratic process for that to be. It is limited by the individual rights that the Constitution enumerates and makes very, very clear. And that has always been the way things, the way things work. You, that you could equally say, well, there was a robust debate about whether it should be lawful to ban interracial marriage. There was a robust policy debate over whether or not women should be bartenders. All of those things were subject of democratic debate. The question was whether those debates used classifications that the courts thought suspect and impermissible in the end.

SREENIVASAN: Recently the president also signed an executive order Keeping Men out of Women’s Sports at an event surrounded by young female athletes. He said that men are “posing” as women. And as we discussed in this conversation, it’s an incredibly small number of athletes out of the half a million or so that participate in the NCAA. But the NCAA changed their policy as a result almost the next day. And I’m wondering, was the NCAA wrong to comply with this order?

STRANGIO: Well, certainly the NCAA was wrong to change their policy. I don’t even think that they were necessarily complying with the order because the order at that time had no, had no legal effect. Certainly it may have in the future, but the NCAA was wrong. The policies that are claiming that transgender women in sports are men are wrong. The president is lying when he says that there are men impersonating women and participating in women’s sports. There are no examples of men impersonating women that I am aware of. And it is incorrect to refer to transgender women and girls as men and and boys. And what these executive orders do, what these laws do is open the door to sex-based policing that cannot be enforced without subjecting everyone to some sort of scrutiny to some sort of invasive process that is ultimately gonna harm us all.

SREENIVASAN: There was a recent New York Times Ipsos poll that was asking and found that 80% of Americans think trans female athletes should not be allowed to compete in women’s sports. What do you say to those who argue that the president is listening to the population and right on this?

STRANGIO: Well, I would say two things. And the first is that, you know, when I was in my twenties, that’s how many people thought that gay people shouldn’t get married. And if you pose that question now, it’s vastly different. And what changed was that people were exposed to accurate information about, about gay people, not Anita Bryant style campaigns about gay people harming children, but real stories of gay people living their lives. And then the second thing I would say is that even if that is true, even if 80% of the country believes something, if it is unconstitutional, if it is wrongly discriminatory, that is the, that is the guarantee, that is the promise of this country, that we have a system of checks and balances that ensures that those who are facing majoritarian discrimination have a recourse in the courts. There were a lot of people who were in support of preventing women from holding certain jobs. There were a lot of people that were in support of making it a crime to marry outside of your race. And yet the courts have stepped in in order to ensure that the cons, the promise of the constitution is actualized. And so I would say we want that system, I want that system.

SREENIVASAN: Chase Strangio of the ACLU. Thanks so much.

STRANGIO: Thank you so much.