The Washington PostDemocracy Dies in Darkness

Opinion Kentucky’s new anti-trans horror signals a need for blue-state havens

Kentucky House Speaker David Osborne (R). (Timothy D. Easley/AP)
4 min

If 2022 was the year of the “abortion refugee,” the term some used to describe women from red states seeking abortions in blue ones, then 2023 might well prove to be the year of the “transgender care refugee.”

After numerous GOP-controlled states were liberated by the Supreme Court to ban abortion, untold numbers of women sought the procedure mostly in blue states, generating powerful media reports. Now red-state bans on transgender care for adolescents may force families across state lines, possibly shifting how Americans see the transgender cause.

This week, the GOP-controlled state legislature in Kentucky overrode the veto of Democratic Gov. Andy Beshear to pass extraordinarily onerous restrictions on trans care. Starting this summer, hormone therapy and puberty blockers for trans youths — which doctors say create developmental “pauses” — will be illegal, as will gender-assignment surgery.

Parents in Kentucky who want to initiate such care for their children will not be able to find it. And in cases where gender-affirming care is underway, doctors will have to end it (with limited exceptions), under penalty of losing their licenses.

In the past couple of months, legislatures have passed similar laws limiting or outlawing gender-affirming care in 10 other red states. But Kentucky’s law represents an acceleration. Not only is it arguably more stringent than most of the others, but Republicans also rolled over a Democratic governor to pass it.

And more is coming. Other GOP-run states — including Kansas, Missouri and Texas — are on their way to passing similarly restrictive bills. And others are likely to seize on the momentum generated in Kentucky to pass their own restrictions.

Although the overall picture is hard to predict, given ongoing court challenges, the reality is stark: Untold numbers of red-state families are about to find themselves without options for kids experiencing gender dysphoria and in need of treatment.

“There is no infrastructure in place to support thousands of people who are going to be deprived of care almost instantaneously when some of these laws go into effect,” Chase Strangio, deputy director for transgender justice at the American Civil Liberties Union, told us. “Parents are absolutely panicking about what to do.”

Strangio noted that in states that have passed laws, ACLU affiliates are receiving “dozens of calls a day.” National LGBTQ advocacy organizations are already contemplating a future in which desperate families seek care in other states.

“We’re going to see more organizing around how to create safe spaces for these families,” Jean-Marie Navetta, director of learning and inclusion at the advocacy group PFLAG, told us. Such organizations, Navetta said, might have to create “a structure in which people can connect across state lines and understand what options might be available to them.”

Or as Jennifer Levi, a senior official at GLBTQ Legal Advocates and Defenders, bluntly put it: “Blue states will have to take on more of the responsibilities for providing care.”

This emerging geography of cruelty is already visible. Doctors in states facing bans are reporting a reluctance to treat new patients. Families are contemplating moving out of state to maintain their kids’ gender-affirming care, care that is endorsed by major medical organizations.

The drumbeat of abortion horror stories last year — the 10-year-old rape victim who had to travel for an abortion, the woman who almost died from sepsis because she couldn’t get the procedure — had surprising emotional force. They surely persuaded many Americans to see the gravity of taking away abortion rights in a jarring new light.

So what will happen when the national media starts telling stories about the family that drove 24 hours to seek gender-affirming care for their kid? Or about the family that couldn’t afford to take their kid to another state at all?

The culture is far more evolved on abortion than on trans rights. Many Americans now personally know someone who has had the procedure or are familiar with cultural lore about “coat hanger” treatments. But transgender people are a small portion of the population. Far fewer Americans have had direct contact with them.

Reactionary opponents of trans rights understand this. So they constantly manufacture the impression that lurking behind advocacy for trans kids are nefarious “elites” who want to erase natural gender identities or sexualize innocent children. But stories about families desperately seeking care might drive home the reality that there is genuine demand for this kind of treatment because parents want it for the good of their kids.

Far-right state lawmakers know this demand is real. That’s why they’re using state power to suppress it. And the ugly reality is that they’re likely to enjoy plenty of success in this mission.

But if anything can effect a meaningful change in the culture about this ongoing tragedy, cruel and heavy-handed government overreach — and the tales of human suffering it unleashes — might be it.