A federal court in Georgia ruled Thursday that employers who categorically exclude gender-affirming medical care from health insurance coverage violate federal law.
Anna Lange, a transgender woman and sheriff’s deputy in Houston County, Georgia, sued in 2019 after she was denied coverage for a vaginoplasty in November 2018.
The Sheriff’s Office provides health care coverage to employees through the county plan, which, beginning in 1998, excluded coverage for talk therapy related to gender dysphoria, gender-affirming hormone therapy and gender-affirming surgeries, according to the opinion released Thursday.
Chief Judge Marc Treadwell, of the U.S. District Court for the Middle District of Georgia, wrote in the opinion that the exclusion “plainly discriminates because of transgender status,” and as a result violates Title VII of the Civil Rights Act of 1964, a federal law that prohibits employment discrimination based on race, sex, religion, national origin and other protected categories.
He pointed to evidence that showed Houston County’s health care plan, provided through Anthem Blue Cross and Blue Shield, would provide hormone therapy for menopause and surgery for breast cancer, but it would not provide the same procedures as treatment for gender dysphoria.
“The undisputed, ultimate point is that the Exclusion applies only to transgender members, and it applies to Lange because she is transgender,” Treadwell wrote, citing a landmark Supreme Court decision in June 2020, which found that Title VII’s protection from discrimination based on sex also includes gender identity and sexual orientation discrimination.
The opinion also noted that, in 2016, Houston County’s insurance broker, who acted as a liaison between the county and Anthem, informed the county that Anthem would no longer categorically exclude coverage for treatments related to gender dysphoria as a result of the Affordable Care Act’s Section 1557, which prohibits discrimination based on sex and other characteristics.
“Despite Anthem’s recommendation to do so, the County chose not to accept the nondiscrimination mandate,” according to the opinion.
A representative for Houston County did not immediately return a request for comment.
Lange, who was represented in part by the Transgender Legal Defense and Education Fund, said in a statement that it’s “a huge relief to know that I can finally receive the medically necessary care that I was repeatedly and unfairly denied.”
“I can confidently move forward with my life knowing that gender affirming care is protected under federal law,” she said. “This decision is not only a personal victory, but a tremendous step forward for all transgender Southerners who are seeking insurance coverage for medically necessary care.”
Sam, a transgender woman who lives in Georgia, said that on Tuesday evening, Reddit users started commenting on a photo of her that she had shared on the platform three months ago.
They told her the photo was being shared on 4chan, a forum website with little moderation, and people were saying that it showed the shooter who killed 19 children and two adults at an elementary school in Uvalde, Texas, on Tuesday. The shooter, identified as 18-year-old Salvador Ramos, was killed on the scene by police.
Sam, 20, started posting photos of herself and her art online to help build up her confidence. Courtesy Sam
Sam, 20, who asked to go by her first name to protect her privacy and safety, told NBC News that the photo and others were taken from her personal Instagram page, and that she’s faced harassment and threats as the image has spread.
“This isn’t the first time I was harassed, but it is the first time I’ve been accused of murder,” she said.The false claims started shortly after news of the shooting first broke. A photo of Sam was posted to 4chan on Tuesday afternoon, in a post that began with “here’s the shooter’s reddit” before linking to her Reddit account and posting a transphobic slur. While some users said they did not believe the photo was of the shooter, other users posted new threads soon afterward, using pictures with fewer details of Sam’s face from her profile.
She said she’s feeling annoyed more than anything: “I’m more worried about the families of the victims of the attack,” she told NBC News.
Social media users and trolls on 4chan, Twitter and Facebook are using Sam’s photos and images of at least two other transgender women to spread the baseless theory that the shooter was transgender. In some cases, they have created collages that place the women’s photos alongside images from an Instagram page believed to have belonged to the shooter.
The claims were spread by some prominent conservatives on Tuesday.
Rep. Paul Gosar, an Arizona Republican, said of the shooter in a since-deleted tweet, “It’s a transsexual leftist illegal alien named Salvatore Ramos.” Gosar has not returned a request for comment.
One of Sam’s photos was shared by the Young Conservatives of Southern Indiana Facebook page, which has more than 4,000 followers.
Alex Jones, the conspiracy theorist who was successfully sued for defamation for falsely claiming the Sandy Hook elementary school shooting was a hoax, also echoed the misinformation that the Uvalde shooting suspect was trans. Representatives for Jones’ website did not immediately respond for comment.
Conservative personality Candace Owens joined in on Wednesday, referencing “cross-dressing” photos she said she’d seen of the suspect. Owens has previously shared misinformation in her feeds and unsuccessfully sued Facebook in 2021 after the company added a fact-checking warning to one of her posts.
The photos that social media users are claiming show the shooter are actually of three different transgender women wearing skirts, including Sam, according to Trans Safety Network, a U.K.-based group that monitors online threats made against the transgender community. The group wrote in a post that all three women have confirmed they are alive.
In an effort to debunk the theory, Sam shared a photo of herself standing in front of a transgender Pride flag on Reddit Tuesday evening and wrote, “It’s not me, I don’t even live in Texas.” In response to a comment on the post, she said she just wants “to live without being attacked when I leave my house.” She also shared another photo of herself holding a piece of paper with the date on it.
Sam on Wednesday.Courtesy Sam
She encouraged people to be careful about what they see online.
“Transphobic people exist and people are quick to blame someone for terrible things instead of looking for the truth about what actually happened,” Sam told NBC News.
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Despite the fact that the posts including Sam’s photos violate Twitter and Facebook’s misinformation policies, the platforms have done little to combat the emerging false narrative.
A review of posts on Twitter and Facebook Wednesday morning found numerous tweets and posts using Sam’s image and labeling her as the shooter. In a statement, a Twitter spokesperson said, “In line with our hateful conduct policy, we will require the removal of Tweets that share misleading claims about the identity of the perpetrator with the intent to incite fear or spread fearful stereotypes about a protected category.” Additionally, the spokesperson said, “In line with our synthetic and manipulated media policy, we will require Tweets to be removed if they contain media that present false or misleading context surrounding the identity of the perpetrator.”
A Meta spokesperson said the company is removing content that violates its Bullying & Harassment policy, which forbids content “in which criminal allegations pose off-line harm to the named individual.”
“They’ve been relying on me and others to report the misinformation before doing anything,” Sam said.
Some advocates condemned the basely theory that the shooter was transgender.
“This has GOT to stop,” Erin Reed, a trans advocate, said on Twitter. She went on to reference investigations that Texas opened into the parents of some transgender youths in March following a directive from Gov. Greg Abbott that ordered state agencies to investigate claims of parents providing gender-affirming medical care to minors.
“A sitting congressman just spread a lie about the Texas shooter to pin it on transgender people spread by troll sites, in a state where they are spending more time banning trans kids than they are spending regulating guns,” she said.
Another advocate, Charlotte Clymer, criticized Gosar and said he “owes the public an apology.”
“It’s pathetic that @DrPaulGosar sought to exploit this horrific tragedy for anti-trans propaganda,” she said. “There is zero evidence that the shooter is transgender.”
Reporter and MSNBC contributor Katelyn Burns said this isn’t the first time “right wing liars have tried to falsely claim a mass shooter was trans.” She referenced an article she wrote in April 2018 following a shooting at YouTube’s headquarters in San Bruno, California, in which three people were wounded.
The shooter died by suicide by the time police arrived at the scene, and afterward, some far-right websites and conservative critics speculated, without evidence, that the shooter was transgender.
Similarly, Burns noted that following a 2015 shooting at a Planned Parenthood clinic in Colorado Springs, Colorado, that left three people dead, Sen. Ted Cruz, R-Texas, shared the unsubstantiated theory that the shooter was transgender after a far-right outlet reported that he registered to vote as a woman.
“Well, it’s also been reported that he was registered as an independent and a woman and transgendered leftist activist, if that’s what he is,” Cruz said during a campaign event in 2015, according to audio obtained by the Texas Tribune.
Cruz’s campaign later told news outlets that he was trying to make a point that there were still many unknown details about the shooter.
A federal judge struck down a Tennessee law Tuesday that would have required businesses in the state to post warning notices on their public restrooms if they have policies allowing transgender patrons to use the facilities that match their gender identities.
The American Civil Liberties Union challenged the law in June on behalf of two business owners — the owner of Sanctuary, a performing arts and community center in Chattanooga, and the owner of Fido, a restaurant in Nashville, among other businesses.
The law went into effect on July 1, but U.S. District Judge Aleta A. Trauger issued a preliminary injunction against it a week later. Then on Tuesday, Trauger permanently blocked the law by granting the ACLU’s motion for summary judgment, which asks a court to decide a case without a full trial.
She wrote in a 40-page decision that the law violates the First Amendment of the Constitution because it compels speech that is controversial and with which the plaintiffs disagree.
“It would do a disservice to the First Amendment to judge the Act for anything other than what it is: a brazen attempt to single out trans-inclusive establishments and force them to parrot a message that they reasonably believe would sow fear and misunderstanding about the very transgender Tennesseans whom those establishments are trying to provide with some semblance of a safe and welcoming environment,” Trauger wrote.
Glenn Funk and Neal Pinkston, both district attorneys; Christopher Bainbridge, the state director of code enforcement; and Carter Lawrence, the state fire marshal, are named as defendants. They did not immediately respond to requests for comment. A representative for Gov. Bill Lee has also did not immediately respond to a request for comment.
The law required business owners with even informal policies that allow people to use whichever bathroom they want to post a sign that reads, “This facility maintains a policy of allowing the use of restrooms by either biological sex regardless of the designation on the restroom,” at the entrances of single-sex public restrooms, locker rooms, dressing areas or other facilities that are “designated for a specific biological sex … where a person would have a reasonable expectation of privacy.”
The law said the sign must be at least 8 inches wide and 6 inches tall and use the colors red and yellow, with a boldface typeface, among other requirements.
Representatives for the state argued that the law is a “content-neutral” rule meant to clarify restroom signage and is not meant to be an endorsement of how gender identity should be understood, according to the opinion. The ACLU’s clients, they argued, have “imagined an idiosyncratic, hidden undertone to the [required] signage.”
Trauger, who was appointed to the court by President Bill Clinton, disagreed, noting that the government’s preferred view of how gender works — that it is dictated by “biological sex,” which is assigned at birth and is limited to male or female — is contested.
“The only thing that is imaginary in this case, though, is the imagined consensus on issues of sex and gender on which the defendants seek to rely,” Trauger wrote. “Transgender Tennesseans are real. The businesses and establishments that wish to welcome them are real. And the viewpoints that those individuals and businesses hold are real, even if they differ from the views of some legislators or government officials.”
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“We applaud the court for recognizing that this law violates the First Amendment and harms transgender people,” Hedy Weinberg, the executive director of the ACLU of Tennessee, said in a statement.“Transgender individuals should be able to live their lives free of harassment and discrimination. Today’s decision ensures that the businesses who welcome them are not forced to become instruments for politicians’ discrimination.”
Bob Bernstein, the owner of the Nashville restaurant Fido, has an informal policy that allows customers to use the restroom they feel is most appropriate. He said he has not had any complaints or concerns about the policy, and he objected to the “stigmatizing” message the law required.
“As a former journalist, I believe strongly in free speech,” Bernstein said in a statement. “The government can’t just force people to post discriminatory, inaccurate, and divisive signs in their places of business. I am glad that the court recognized that this law violates the First Amendment.”
A unisex sign and the slogan “We Are Not This” outside a restroom at Bull McCabe’s Irish Pub in Durham, N.C., in May 2016.Sara D. Davis / Getty Images file
Advocates have described the law as a new iteration of “bathroom bills” passed in 2016, such as House Bill 2 in North Carolina, which sought to bar trans people from using the bathrooms that aligned with their gender identities.
The sponsor of Tennessee’s law, Rep. Tim Rudd, R-Murfreesboro, said in legislative debate in May 2021 that the bill is meant to protect women and children “against sexual predators that could be taking advantage of policies, executive orders or legislation that may allow the opposite sex to enter a restroom, shower or locker room,” the Chattanooga Times Free Press reported.
Trauger wrote in her opinion that Rudd “was unable to provide examples or evidence of such a problem,” although he argued that “we shouldn’t wait for people’s rights to be abused” to potentially prevent “an attack.”
The issue is not new, advocates have said, and proponents of bathroom bills passed in 2016 cited similar arguments. A 2018 study from the Williams Institute at UCLA School of Law found there is no evidence that trans-inclusive policies for public facilities increase safety risks.
A federal judge blocked part of a newly enacted Alabama law that made it a felony for doctors to provide certain gender-affirming medical care to minors.
Alabama was the third state to pass restrictions on transgender health care, following Arkansas and Tennessee, but the first to add felony penalties. Doctors and other health care providers who violate the Vulnerable Child Compassion and Protection Act, which took effect May 8 and is partially still in effect, could face up to 10 years in prison or a $15,000 fine, or both.
Civil rights groups and the Justice Department argued against the law on behalf of doctors and transgender minors in the state last week, and in an opinion issued Friday, U.S. District Judge Liles Burke found “substantial likelihood” that part of Alabama’s law was unconstitutional.
He put a temporary block on the portion of the law that bars minors from receivingnonsurgical care such as puberty blockers and hormones, writing that parents “have a fundamental right to direct the medical care of their children.”
“This right includes the more specific right to treat their children with transitioning medications subject to medically accepted standards,” he said. “The Act infringes on that right and, as such, is subject to strict scrutiny. At this stage of litigation, the Act falls short of that standard because it is not narrowly tailored to achieve a compelling government interest.”
Burke allowed other parts of the law to remain in effect, including the ban on gender-affirming surgery for minors. He also allowed two provisions related to education to remain in effect: one that prohibits school officials from keeping information about a child’s gender identity secret from their parents, and another that prohibits school officials from “encouraging or compelling children to keep certain gender-identity information secret from their parents.”
Alabama Attorney General Steve Marshall did not immediately return a request for comment Saturday morning.
Dr. Morissa Ladinsky, a plaintiff in one of the suits challenging the law and a co-lead of UAB Pediatrics’ gender health team, said late Friday that the decision “is a huge relief for transgender children and their families.
“The court’s decision recognizes that this is well established care that has been endorsed by 22 major medical associations,” she said. “This decision will ensure transgender children in Alabama, and beyond, can continue to receive this evidence-based well-known lifesaving care.”
Ladinsky told NBC News after the Legislature passed the bill in March that there were no surgeons in the state who perform gender-affirming surgeries on minors.She said Monday that if thefull law had been allowed to remain in effect, it would’ve forced many of her patients to cease their ongoing treatment, because the law had no grandfather clause for transgender youths who were already receiving care.
“That is one of … the most cruel and ignorant parts of the law,” she said.
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Shay Shelnutt, the bill’s primary sponsor, said during a Senate debate in March that the bill seeks to “protect our children” and “stop these surgeries and these drugs on our children,” local news outlet AL.com reported.
Heather R. who lives in a small town about an hour northwest of Birmingham with her 15-year-old transgender son, Rob, said Saturday that she feels that the decision gives them some “breathing room.” She asked that her last name be withheld for safety and privacy reasons.
“I am worried this is going to increase violence and harassment toward trans people and their families, so I don’t feel we can start celebrating like it’s over,” she said.
Heather created a GoFundMe account so that she could move her family to a more supportive state.
“I don’t think it’s going to get better here, and we’re isolated here,” she said after the law took effect. She had originally planned to move to Maryland but recently decided to move to one of the 19 states that are considering legislation to protect transgender youths.
She said lawmakers who support restrictions on gender-affirming care for minors rely on misinformation to support their views and don’t seem to understand that trans kids are just like other kids. Rob said he likes video games, and when asked how many pets the family has, he said his answer would be “lengthy” before adding, “we have two dogs and a pack of cats.”
Though the part of the law that would affect Rob’s medical care has been blocked, at least temporarily, she said the family still plans to move.
“I do think we need to move somewhere safer so he can have a community of trans and LGBT people to hang out with in his late teens,” she said.
Chris DeSett said the first time he started to feel comfortable with his sexuality was the first night he moved into a dorm at American University in Washington, D.C.
DeSett, 28, moved there ahead of his freshman year in August 2012, from his childhood home near Kansas City, Missouri. He chose the school for its international studies program but also because he wanted to get out of the Midwest to figure out who he was away from his family.
Chris DeSett.Chris Desett
After he moved into his dorm, and everyone’s parents had left, he said other students started banging on doors to gather people to hang out together.
“So we’re all rushing down to this meeting area, and we’re talking and we’re playing ‘Never Have I Ever’ and stuff like that,” he said. “It felt very welcoming and felt very affirming, and I kind of dipped my toe in the water and just said, ‘Oh, I think I might be bisexual.’ I didn’t feel that way, but I was just testing the waters for a reaction. And everyone’s like, ‘Oh, my God, that’s so great.’”
After the first semester of his freshman year, he came out as gay. He said that moment on the first night in the dorms had a lasting impact on him.
“The reason why that’s so important to me was I wasn’t met with rejection,” said DeSett, who now works for the federal government. “That affirming environment did give me the confidence to really explore my identity and then land on the conclusion that, ‘No, I am a gay man, and I’m confident that I know that for a fact. I know that I’ll be loved for who I am.’”
New research from the Williams Institute, a think tank at the UCLA School of Law, revealed that LGBTQ people who attended college or graduate school were four times more likely, at 21.5 percent, to report having chosen a university in a different city or state to seek a more welcoming climate than non-LGBTQ people, at 4.8 percent. Nearly one-third, or 32.6 percent, of LGBTQ people reported picking a college elsewhere to get away from their family, compared to 14.1 percent of non-LGBTQ people.
DeSett said he chose a school in Washington, D.C., because he “wanted an experience where I had room to grow and be myself without having to worry about someone calling my parents” and outing him before he was ready.
The Williams Institute found the majority of LGBTQ people surveyed, at 71.9 percent, said they experienced a sense of belonging at their college. That number is slightly lower than non-LGBTQ people, at 83.5 percent.
But, researchers noted, despite some LGBTQ people’s efforts to find more welcoming environments, more of them reported facing bullying, harassment, assault and mental health issues than their non-LGBTQ counterparts. Nearly one-third (32.6 percent) of LGBTQ people who attended a four-year college or graduate school said they experienced bullying, harassment or assault, compared to 18.9 percent of non-LGBTQ people. More than one-third (35.3 percent) reported that their mental health was not good for all or most of the time they were in college, compared to 10.8 percent of non-LGBTQ people.
Majorities of LGBTQ people in four-year colleges (60.4 percent) and graduate school (56.3 percent) also said they were not out as LGBTQ to any faculty or staff.
Adon Cooper said he thought he would feel comfortable being out when he started undergrad in 2004 at the State University of New York at Purchase, a public liberal arts college about a half-hour north of his home in the Bronx borough of New York City.
“Literally, the first time walking on campus, I was greeted by a bunch of drag queens, and I thought, ‘Oh, this is going to be really cool,’ but I realized that I wasn’t really ready to have those kinds of conversations,” Cooper, 35, said.
Adon Cooper.Adon Cooper
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Even though he wasn’t ready to be out, he said he faced peer pressure and verbal abuse from people who tried to force him to come out.
But he said college was still where he found his “footing,” and he started to feel more comfortable with the idea of coming out. One day, his first roommate in college, who was a dancer, went into the bathroom “as his normal self and came out fully in drag,” Cooper recalled.
The two talked about drag and watched “Paris Is Burning,” a 1990 documentary about New York City’s ball scene, a subculture created by LGBTQ people of color where members of different “houses” dress up and compete in elaborate balls. He said they are still friends.
“He started to really educate me on what a queer lifestyle can look like, and it made me feel like maybe if and when I’m ready, I’ll at least have someone I feel comfortable enough to have this conversation with,” he said.
The report found that transgender and gender-nonconforming students face additional issues, including their colleges or universities lacking policies to support them. Resources for transgender students were less commonly reported by participants than general LGBTQ resources. One in four LGBTQ respondents reported that their school had a policy of allowing transgender students to change their gender markers on their school records, and more than half (59.8 percent) were unaware of such policies.
Less than half (44 percent) of LGBTQ respondents reported the presence of at least one gender-neutral bathroom, and less than one-third (29.3 percent) reported that their college had gender-inclusive housing, defined as housing that isn’t segregated into men’s and women’s spaces and welcomes students who identify outside of the gender binary.
JJ Nichols, who uses gender-neutral pronouns, attended Samford University, a private Christian school outside of Birmingham, Alabama, starting in 2013. They said they didn’t come out until two years after they graduated, but, looking back, they said if they had asked to use gender-neutral pronouns at school, it “would be met with a lot of pushback.”
JJ Nichols.JJ Nichols
“It’s still inside Birmingham, which is the major city, so the homophobia was low-lying,” they said. “It was like more of that, ‘Love the sinner, hate the sin.’”
The Williams Institute researchers concluded that their findings show “the need to improve conditions for LGBTQ students, a sizable and heterogeneous minority population.” They recommended that colleges include sexual orientation and gender identity in nondiscrimination policies that protect LGBTQ students, faculty and staff; include LGBTQ content in diversity training for staff; and start a campus climate survey to identify emerging issues, among other suggestions to make campuses safer for LGBTQ students.
Nichols said that, despite the climate at their school, they remember meeting a professor in the school of music who helped them feel a little more comfortable with their identity. The teacher was pregnant, and she made a comment that if she had a son who was gay, it wouldn’t be a problem.
“It was just the note — the knowledge that somebody was OK,” they said.
Just a month ago, Katie, a Texas mom, had no plans to leave her home.
Even after Gov. Greg Abbott urged Texans in February to report cases of minors receiving gender-affirming care, Katie — who has a 15-year-old transgender son and knew she could be investigated — planned to stay and fight.
But things started to change for Katie when the Texas Children’s Hospital announced last month that it would pause gender-affirming services for minors in light of the directive. Her son lost access to his care program for three weeks until a judge paused the state’s investigations.
“That just really shook me,” said Katie, who asked that her full name not be published to protect her family’s privacy. “The things that you never would think would happen somehow are reality, and I can’t live with the uncertainty. It’s eating us up.”
A spokesperson for the Texas Children’s Hospital said in an email that the hospital “remains deeply committed to our transgender and gender-diverse patients” and will “continue to monitor the ongoing legal proceedings in determining how best to proceed.”
Her son’s initial loss of gender-affirming care was the turning point for Katie and her family. Katie decided that after her son finishes 10th grade this summer, the family would move to Denver.
Her son, N., told NBC News last month that things have been “awful” since the governor’s directive. “It was hard to stay in one piece and not break down on everything,” he said.
Katie said that since the family decided to move, N. has been doing the best he can to stay positive about it.
“But his heart is broken,” she said. “We’re leaving Texas temporarily on our terms with the hope and prayer that come November, we’re going to get to come back home and it will be a joyous homecoming.”
Last month, NBC News spoke to a dozen parents of transgender children, as well as to trans teens, following Abbott’s directive. At the time, only one of those families had planned to move. Now, three, including Katie’s family, have said they will leave the state.
The three families who are departing said they didn’t make their decisions overnight. But they had watched Texas officials become increasingly bold in targeting transgender people in recent years.
In 2015, the state began to consider a “bathroom bill” that would have banned transgender people from using public and school restrooms that aligned with their gender identity.
Since then, the Legislature has ramped up its efforts. Last year, it considered more than 50 bills targeting transgender people. Only one made it to Abbott for a signature: a bill that bars transgender students from playing on school sports teams that aligned with their gender identity.
But one of the other failed bills prompted an opinion from state Attorney General Ken Paxton, who declared on Feb. 21that gender-affirming medical care such as puberty blockers, hormone therapy and surgery cause “irreparable harm” to minors and were child abuse under Texas law. Abbott followed with his directive to the state’s Department of Family and Protective Services the following day.
“I’ll do everything I can to protect against those who take advantage of and harm young Texans,” Paxton said at the time, arguing in his opinion that minors cannot consent to gender-affirming medical care.
He has since taken several actions to defend and double down on his position. He appealed both injunctions issued by judges: a narrow injunction on March 2 that paused one of the state’s investigations into a Child Protective Services employee and a statewide one issued March 11 that paused all investigations. An appeals court reinstated the statewide injunction and it remains in place.
Transgender youths, parents and several Democratic lawmakers rallied at the Texas Capitol on April 28, 2021.Bob Daemmrich / USA Today Network
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Paxton also filed investigative demands on March 24 against two pharmaceutical companies, Endo Pharmaceuticals and AbbVie Inc., alleging that they advertised their products as treatment for gender dysphoria rather than the medical conditions they were approved to treat.
The efforts from Paxton, Abbott and the state Legislature have had widespread effects. The Children’s Medical Center in Dallas removed all references to Genecis, its gender-affirming care program for minors, from its website in November and said the program would no longer take new patients. Last month, 850 doctors, medical students and employees at two Dallas hospitals signed a petition opposing the decision.
Paxton has also tweeted about transgender people, even repeatedly misgendering Dr. Rachel Levine, assistant U.S. health secretary and the first openly transgender Senate-confirmed federal official, prompting Twitter to flag the tweets.
All of it is adding up, and parents and LGBTQ advocates say they are exhausted. The Rev. Remington Johnson, a Presbyterian clergy member and a trans advocate, said she spends her days texting with the parents of trans kids in Texas and doesn’t know of any family who hasn’t considered leaving the state.
Even if advocates continue to defeat anti-trans bills, and even if the courts ultimately shoot down Abbott’s directive, they will leave behind a persistent “climate of terror,” she said.
“This is why there have been doctors that have just stopped treating trans kids,” she said. “It’s not because there’s a law, it’s because this is what terror-inducing bills do. It is the same playbook as the bounty-hunter style abortion bill, where it’s about causing anxiety and fear to stop the thing that you don’t want to be happening.”
She noted that Lt. Gov. Dan Patrick has already signaled support for a bill similar to one recently signed into law by Florida Gov. Ron DeSantis, the Parental Rights in Education Act, which bars discussion of sexual orientation and gender identity in some classrooms. Critics of the bill have dubbed it the “Don’t Say Gay and Trans” bill.
“Texas will work to pass what Florida passed but make it worse,” Johnson said. “It will be harsher, it will be more extreme.”
K., another Austin mom of a 10-year-old trans daughter testified against anti-trans bills at the Capitol last year, when the Legislature held three special sessions to pass the trans athlete restriction. She said that once it was over, she and the other advocates planned to take time off to recover and strategize for the next session.
But then Paxton and Abbott released their letters two months into the new year.
“Here we see that these two extremist politicians circumvented the legal process in order to implement these policies,” she said.
K., who also asked that her full name not be published out of privacy concerns, said that she realized that even though she and the other parents and advocates “followed the rules” and won, they’re still losing. “It makes me uncertain that we would be protected even though our kids have not received gender-affirming medical care at this point,” she said. “And I can’t fight offensively when I’m already down on the ground just trying to fend people off of my kids.”
She plans to move her family to Oregon this summer.
Parents also expect that the next legislative session, which starts in 2023, will be worse than the last. That’s why Heather Crawford, an Austin mom whose 15-year-old is trans, said she plans to move her family to Minnesota this summer.
“I have zero faith that it will stop,” she said. Her 15-year-old, Cass, was born and raised in Texas, but “I cannot ask them to spend the last years of their childhood in a state that wants to criminalize their existence.”
Cass, who uses “he” and “they” pronouns, said the idea of moving to a state with a number of pro-LGBTQ laws — and was the first to outlaw discrimination based on sexual orientation and gender identity in 1993 — is a huge relief. He said Paxton’s and Abbott’s efforts will put trans people in danger. “It’s saying that people can get away with transphobia towards everyone in the community, including kids,” he said.
Rue Dickey, who lives in Corvallis, Oregon, said that as a transgender person, they felt helpless watching Texas officials begin to investigate parents of trans children.
Dickey, who uses “they” and “he” pronouns, said they were “having a bit of a crisis” at their day job in marketing when Texas Gov. Greg Abbott ordered the state child protective services agency to pursue child abuse investigations into the parents of transgender children who are suspected of receiving gender-affirming medical care. (Those investigations have since been blocked by a judge.)
Dickey, 25, wanted to do something to help trans youth and their families in the state.
Rue Dickey.Ashley Brianna
“The lack of things that I can do as a single person was super overwhelming,” they said. That’s when Dickey, who also designs tabletop role-playing games, remembered that Itch.io, a website that sells independent games, held fundraisers for racial justice, Palestinian relief and, more recently, people in Ukraine.
Tabletop role-playing games, such as Dungeons and Dragons, a popular game released in the 1970s, are interactive; players sit around a table and describe their characters’ actions, which affect the rest of the game. One player, usually designated the game master, describes the setting of the game and uses a set of rules to give players some structure and guidance.
The bundle they created includes 493 games from 300 designers, and it’s on sale until April 3. It’s valued at more than $2,700 but is available through the fundraiser for $5.
The bundle went live March 2, and Dickey said they initially set the fundraising goal at $1,000.
Just 45 minutes later, the fund met that goal. So they increased the goal to $5,000, and it was quickly surpassed again.
They went to bed, and the next morning the fund hit $11,000. Since then, they have increased the goal seven more times to $420,000. As of Friday evening, that had raised nearly $394,000.
“I’ve cried probably a dozen times at this point,” Dickey said. They said representatives from both of the organizations have been “super excited” about it.
“When I first reached out to them, I was like, ‘Hey, we’re hoping to give you at least like $5K each,’ and now every time I email them, I’m like, ‘Hey, just an update, you’re getting $170,000 each now,’” they said, laughing.
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Dickey said both groups have been talking about what they’ll do with the funds, and they have been especially happy to hear what a difference it will make for Organización Latina de Trans en Texas. The trans immigrant-led group runs shelters in cities across Texas and also provides legal support for name changes and navigating the immigration process.
A representative for the organization told Dickey that the donation will be one of the largest that it has ever received, they said. “It’s going to be enough money for them to do a lot of renovations and revamps to the shelters and things like that, which I’m super excited about.”
Tabletop role-playing games have become increasingly popular among the queer community as the games have become more inclusive. Dickey said that they have two answers for why role-playing games are so popular among trans people in particular.
“My joking answer is that almost all tabletop games have werewolves, vampires, changelings or magic users, and I’ve never met a trans person who doesn’t identify with one of those,” they said.
On a more serious note, they said that “tabletop role-playing games, at their heart, are about storytelling.” Often, trans people’s stories are told by cisgender people, who identify with their assigned sexes at birth, and are “portrayed by cis actors who don’t understand us and don’t know what we live,” Dickey said.
Tabletop role-playing games give trans people “the ability to be at our own table and centering ourselves in our stories and getting to play trans characters who the whole through line of their character isn’t that they’re trans, it’s just a part of who they are, and they still have dreams and goals and ambitions, and they’re a part of an adventuring party, they make a difference in the world,” they said.
“How empowering it is to tell your own story and be a part of a narrative that centers you and your experiences, I think is a lot of what draws at least me and a lot of other trans folks that I know to tabletop games,” they said.
Rue Dickey
There are a few games in the bundle that Dickey recommends, including their own — “not to toot my own horn,” they joked — called “I Want Your Bite.” The game is based off “The Bachelor,” the dating TV show, “but instead of the bachelor just being a normal person, the bachelor is a vampire,” Dickey said. “So you’re not only competing for their hand, you’re also competing for immortal love.”
They said one of the “big ticket items” in the bundle is a game called “Thirsty Sword Lesbians,” which they described as a “rivals-to-lovers,” high-drama game. They also recommend “Wanderhome,” a fantasy game in which the characters are small animals who defend their home from various threats.
Dickey said creating the bundle, and now selling 40,000 of them, has brought them a lot of joy amid what’s happening in Texas and the dozens of other states that are considering bills targeting transgender people.
They hope that trans youth in Texas know that they’re not alone.
“It’s super important to know that there will always be somewhere that you belong and that the world is duller without you in it,” they said to trans youth. “So don’t let them try to put out the light that is so important that you bring to all the spaces that you’re in.”
An increasing number of child welfare workers in Texas are quitting because of a directive from Gov. Greg Abbott that requires them to investigate child abuse claims against parents suspected of providing gender-affirming care to their transgender children.
Morgan Davis, a transgender man, put in his two-week notice with the Child Protective Services office in Travis County this month because he “couldn’t morally continue” his job after investigating the family of a trans teen, he told KXAN-TV, an NBC affiliate in Austin.
Davis is reportedly not alone. More than a half dozen Child Protective Services employees in the state told The Texas Tribunethis month that they have either resigned or were looking for new jobs as a result of Abbott’s directive.
Last year, the Texas Legislature failed to pass a bill that would’ve changed the state’s definition of child abuse to include providing gender-affirming medical care, such as puberty blockers and hormones, to minors.
As a result, Attorney General Ken Paxton issued a legal opinion in February that said providing gender-affirming medical care to minors, including puberty blockers and hormones, constitutes child abuse under state law. Abbott issued his directive to the Texas Department of Family and Protective Services, the state agency that investigates child abuse reports, shortly after.
One of the first cases under Abbott’s order landed on Davis’ desk. He said he could have recused himself, but he wanted the family being investigated to see a friendly face.
“In my case, it was an exemplary family. Exemplary. The kind of family you wish and pray that every case we had would have,” Davis said.
He didn’t find any abuse or neglect, but said the agency didn’t drop the case.
“All we do is protect children. That’s all we’re supposed to do,” he told KXAN. “And then we’re genuinely in a path to hurt and, or terrify families. To tell them anything else other than to walk into that home and applaud them is unthinkable.”
Davis told The Texas Tribune that he decided to resign after speaking with the lawyer of the family he had investigated.
“She said, ‘I know your intentions are good. But by walking in that door, as a representative for the state, you are saying in a sense that you condone this, that you agree with it,’” Davis told the paper.
The lawyer’s comment “hit me like a thunderbolt,” he said. “It’s true. By me being there, for even a split second, a child could think they’ve done something wrong.”
The Department of Family and Protective Services declined to comment on the resignations. In regards to the investigations, Marissa Gonzales, the agency’s director of media relations, said “DFPS has and continues to comply with Texas law.”
Davis told KXAN that turnover at the agency is already high, adding that caseworkers, who usually manage about 15 cases at one time, have recently been overseeing about 35 to 45.
“You have caseworkers calling in sick just because they need a break,” he explained.
Charlie Sprinkman traveled to 42 of the 50 states for work as a representative of an organic beverage company in 2019 and kept Googling “queer hangouts here” when he would arrive in a new town. But he would often come up empty.
“I couldn’t find a resource for it,” Sprinkman, 25, said of a centralized directory of LGBTQ-owned businesses.
Charlie Sprinkman, creator of Everywhere Is Queer.Katie Hope / The Wild Within Us
Then, in the summer of 2021, he was a counselor at a queer leadership camp for 12- to 18-year-olds outside Los Angeles, and he said being surrounded by 100 LGBTQ people for 11 days was “euphoric.”
“I was like, ‘How do I create this space?’ Maybe not as grand as a camp, but like a space where people can feel this energy and not be judged for who they are,” said Sprinkman, who currently lives in Bend, Oregon, and works in customer service.
On the long drive back from the camp to his then-home in Colorado, Sprinkman said the phrase “Everywhere is queer” came to his mind. A few months later, in January of this year, it became the name of his LLC.
Everywhere Is Queer consists of both a website that houses a worldwide map of LGBTQ-owned businesses and an Instagram page that shines a spotlight on some of these companies. Three months after the launch, the map has more than 500 businesses listed, and the Instagram page has nearly 5,000 followers.
The Everywhere Is Queer map.Everywhere Is Queer / Google maps
Sprinkman said the project is personal for him, not just as a queer traveler but as someone who didn’t know of any LGBTQ-friendly spaces in his small suburban hometown about 30 miles west of Milwaukee.
“I didn’t have any out cousins, aunts, uncles, anyone as like an influence, so I didn’t really have a space as a child to find queer spaces around my hometown,” he said. “As I was building Everywhere Is Queer, I was thinking about youth, my hometown, trying to find and build spaces for them to just, even if they’re not out, just sit in a queer-owned coffee shop and just see queer people. You know, that subconscious layer of just like seeing queer people is what I hope Everywhere Is Queer will provide for so many.”
Charlotte Tegen
So far, Sprinkman said most of the LGBTQ-owned businesses on the map are concentrated in the U.S., and that there are only four states that don’t have an LGBTQ-owned business listed yet. He said there are also businesses listed in Germany, Spain, South Africa, the United Kingdom, Costa Rica and Mexico.
One business owner listed on the map said she has seen more queer people come into her restaurants. Mel McMillan is the owner of Sammich in Oregon, which sells sandwiches made with house-smoked meats. Both of her Sammich locations, in Portland and Ashland, are listed on the map, as is her food truck, also in Portland.
“If you Google ‘lesbian meat maker,’ you’ll get a real touch of what’s going on with me,” McMillan said. (It’s true: An article about her is the first thing that comes up in the search results for that phrase.)
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McMillan, 39, said that one of the things she loves about Everywhere Is Queer is that it’s bringing together queer people from different generations.
Last month, Sprinkman and McMillan invited about 20 people to Sammich’s Portland location.
“The first thing that I thought was so cool about this was it’s bridging the gap between older queers and younger queers,” McMillan said. “That was really cool, because there were 20-somethings and 40-somethings, and there’s not even a place really for that either.”
Sprinkman said he’s also building a job board that allows businesses that are on the map to share job opportunities.
“I also have been searching for a queer-owned business job board, and I cannot find one, so we’re building one,” he said.
In the future, he said, he hopes to build an app to house the map and travel around to visit many of the LGBTQ-owned places listed.
“I would love to hit the road and visit and really hear the authentic stories of these queer-owned businesses,” he said, adding that “uplifting” the voices of queer business owners is a dream of his.
He said he also hopes that it helps LGBTQ travelers feel safer — and some have told him that it already has. He’s received hundreds of messages from people who have thanked him for filling a void.
States across the U.S. have a variety of laws regarding whether businesses can refuse service to LGBTQ people. Twenty-one states and Washington, D.C., have laws that explicitly prohibit discrimination based on sexual orientation and gender identity in public accommodations, such as businesses, according to the Movement Advancement Project, a nonprofit think tank. Eight states interpret their laws to protect LGBTQ people or provide partial protection. The remaining 21 states and five territories don’t provide any protection based on LGBTQ status.
From left, Mel McMillan, Charlie Sprinkman and the owners of catering company Two Spoons PDX, Laura Taki and Rachel Arenas.Charlie Sprinkman
As of this month, the map has been viewed more than 100,000 times, and Sprinkman doesn’t make any money off it.
“I’m building this just out of my own little queer heart,” he said.
He hopes that the map can ultimately just help people find the spaces that allow them to be themselves.
“I hope that a queer-owned business that was maybe unknown before can provide a space and a little bit more confidence, less judgment for anyone that’s struggling with figuring out their most authentic self,” Sprinkman said. “We’re always constantly on a journey, all of us.”
The Texas Department of Health and Human Services appears to have removed resources for LGBTQ youths from its suicide prevention webpage.
On Feb. 1, the webpage included a subhead for the Trevor Project, describing it as “the leading national organization providing crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender, queer and questioning young people under 25.” The section provided the organization’s website, phone number and text line.
A few days later, on Feb. 5, the section was gone. Of the four suicide prevention phone or text lines, only The Trevor Project was removed.
Now, there are three crisis lines listed: the Suicide Prevention Lifeline, the Veterans Crisis Line and the Crisis Text line. The Trevor Project’s phone number is still included in a PDF of resources under “Parent and Youth Suicide Prevention” as it was previously, but it isn’t as easily accessible as the section that was removed was, and doesn’t state that The Trevor Project is an LGBTQ-specific organization.
The Health and Human Services Department has not returned a request for comment.
Sam Ames, director of advocacy and government affairs at The Trevor Project, said mental health is not a partisan issue, and removing suicide prevention resources from a government website “because they are specific to LGBTQ youth is not only offensive and wrong, it’s dangerous.”
“We’re talking about a group of young people who are more than four times as likely to attempt suicide compared to their peers,” Ames said, citing Trevor Project research. In another survey, the group found that more than 80 percent of LGBTQ youths said it was important that a crisis line include a focus on young LGBTQ people.
“Especially during this time of unprecedented political attacks against LGBTQ youth, we encourage all youth-serving organizations and government agencies to learn more about The Trevor Project’s lifesaving crisis services and to publicize them to the youth and families who most need support,” Ames said.
This isn’t the first time Texas officials have removed suicide prevention resources for LGBTQ youths — and The Trevor Project, specifically — from state websites.
In August, following criticism from one of Gov. Greg Abbott’s Republican primary challengers, Texas officials removed a webpagetitled “gender identity and sexual orientation” and a page devoted to Texas Youth Connection, a program run by the Department of Family and Protective Services, which included a link to The Trevor Project.
The page on sexual orientation and gender identity still shows an error message. The Texas Youth Connection website also displays the same message that it did in October: “The Texas Youth Connection website has been temporarily disabled for a comprehensive review of its content,” the website says. “This is being done to ensure that its information, resources, and referrals are current.”
Patrick Crimmins, the director of communications for the Texas Department of Family and Protective Services, said in October that the review of the webpages “is still ongoing” and would not provide further comment about why the pages were removed. He has not responded to a request regarding when or whether the pages will be restored.
Cameron Samuels, a senior at Seven Lakes High School in Katy, near Houston, and an activist, said the removal of LGBTQ-specific resources from state websites is “part of this larger attack on LGBTQ youth in Texas.”
As an example of this “larger attack” — which Samuels, who uses gender neutral pronouns, said is causing widespread fear among trans people in Texas — they cited a directive issued last week by Abbott that called on the state’s child protective services agency to investigate the parents of minors who are receiving gender-affirming medical care for child abuse. Abbott’s directive also called on “licensed professionals” and the general public to report the parents of trans minors if it appears that they are receiving gender-affirming medical care.
Samuels has also fought censorship of LGBTQ websites within their school district, the Katy Independent School District.
After student activism, they said the district removed its block on the website for the Montrose Center, a local LGBTQ group in the state, in December. In January, it removed restrictions on websites for three national organizations: the Human Rights Campaign, the largest LGBTQ advocacy group in the country; GLSEN, which advocates for LGBTQ students; and PFLAG, which supports LGBTQ people and their families, among other sites.
Samuels said the district has “remained insistent” that The Trevor Project continue to be blocked due to its chat function. But they noted that the chat feature is what allows students to message a trained counselor.
The district has not returned a request for comment, but an official told the Houston Chronicle in January that the Children’s Internet Protection Act has a requirement of “ensuring safe communications including electronic mail, chat rooms and other forms of direct electronic communications.”
“The Trevor Project website has a community space to ‘get advice and support within an international community for LGBTQ young people ages 13-24,’ which is available to anyone who chooses to ‘join now,’” said Maria Corrales DiPetta, manager of media relations for the district. “Minors communicating with adults, unmonitored, online is an area of concern for communication and chat rooms as outline in CIPA.”
Samuels said it’s disappointing to see Health and Human Services officials making decisions that “are very harmful to students and youth who they represent.”
“And this is in addition to the governor’s efforts to investigate parents of trans youth for child abuse and to remove LGBTQ books from school libraries,” they said. “It’s really concerning and disturbing to see this.”
CORRECTION (March 2, 2022, 3:50 p.m. ET): A previous version of this article misstated the month that the Texas Department of Family and Protective Services removed two webpages with resources for LGBTQ youths. It was August, not October.
