For transgender youth and their families, the upcoming presidential election in November will be one of the most significant in history.
A second term for Donald Trump would pose a severe threat to vulnerable young transgender people, many of whom are already facing challenges from their state and local governments. As outlined in his campaign promises, Trump plans to ban gender-affirming care for minors in all 50 states, along with cutting Medicaid and Medicare funding for any hospital that provides treatments like puberty blockers and hormone replacement therapy to young patients. Trump has also pledged to pass a federal law that recognizes only “male” and “female” genders assigned at birth, effectively erasing the existence of transgender people.
The real and potential dangers of a Trump presidency are what motivated me to spend nearly a year traveling across the United States to speak with transgender youth and their families about their daily lives. I ultimately spoke to seven transgender families in seven different states, which became the basis for my book, American Teenager. Through my conversations, it became clear that transgender children often have little in common except for their desire for their elected leaders to allow them to live in peace.
For transgender kids from conservative states, this peace has been hard to find. Wyatt, who was 15 when I visited his family in South Dakota, spent his entire childhood attending state Capitol building sessions in hopes of preventing Republicans from hindering his right to exist, sadly to no avail. Despite his efforts to lobby against a gender-affirming care ban, testifying at public hearings and meeting personally with lawmakers, the legislation was passed in February 2023. By then, Wyatt was already planning to pursue ballet school in another state, realizing that South Dakota would never reciprocate his love for his home state. He couldn’t endure another heartbreak after years of watching South Dakota continually betray his affection.
In the hundreds of hours of interviews I conducted, transgender youth expressed a common sentiment: They feel as if their childhoods were stolen from them. All they want is the ability to spend time with their friends, play video games, and go to the mall without worrying that their rights might be taken away. But this is exactly what conservative politicians have denied them.
Growing up in the shadow of anti-transgender legislation, to say the least, is not an ideal adolescence. Jack, who was 19 when we spoke, temporarily lost access to her hormone medication after Florida banned Medicaid coverage for transgender youth healthcare, which was her primary source of medication. For five months, until her 18th birthday, she watched helplessly as the girl she had come to know faded away, unable to stop it. Jack was deprived not only of the final days of her childhood but also of her very body.
Transgender kids and their families are keenly aware that these seemingly unimaginable nightmare scenarios are precisely what they will be fighting to prevent if Trump is allowed to return to the presidency. This is one of the many reasons transgender Americans have moved to one of the 14 states that have laws protecting gender-affirming medical care. A survey from the liberal think tank Data for Progress found that 40% of transgender respondents had considered moving due to anti-transgender legislation, with 26 states now imposing restrictions on transgender youth medical care; at least 8% had already done so. Some transgender people, fearing that nowhere is safe for them, especially under a Trump presidency, are considering moving to more progressive countries like Canada and New Zealand.
The question is not whether these harms would be exacerbated under a Trump presidency, but rather, to what extent. His running mate, Ohio Sen. J.D. Vance, has proposed making it illegal for doctors to provide gender-affirming care to minors. If enacted, the “Protect Children’s Innocence Act” would make it a class C felony, punishable by up to 15 years in prison, for a doctor in any state to offer gender-affirming surgery to a patient under the age of 18. This is despite the fact that transition surgeries are rarely performed and typically only in cases of acute medical need. When New Hampshire passed a bill earlier this year banning gender-affirming surgeries for minors, supporters of the measure claimed that such an operation had never been performed in the state.
But Trump, empowered by the Supreme Court’s expansion of executive authority, would likely not limit his efforts to restricting gender-affirming care. His platform suggests that his administration would push a “Don’t Say Gay” law prohibiting teachers from discussing LGBTQ+ topics in schools, risking the loss of federal funding. According to his campaign website, Trump also intends to limit the participation of transgender youth in sports, force schools to reveal the identities of transgender students to their parents, and push a national law declaring that there are “male and female—and they are assigned at birth.” The latter policy would be a repetition of his first term, during which his Department of Education issued guidance advising K-12 schools to allow students to use restrooms that align with their identities and respect their pronouns and chosen names in class. Demonstrating his willingness to go further, even then, Trump declined to issue an executive order legalizing broad discrimination against LGBTQ+ people.
These policies would make America an unbearable place for transgender kids, many of whom already feel unsafe in their own communities. It’s no coincidence that, after my book was published, both Wyatt and Jack were compelled to make a similar decision: moving away from states that do not represent their best interests. They appear happier—even lighter—in their new environments, and Jack now has a boyfriend and a new job. But the reality is that, depending on who is president in January, there may be no safe haven left to move to. There may be nowhere for them to experience the only thing they’ve ever truly desired: the ability to simply be themselves.
The choice, therefore, seems clear: We can either vote for an America where transgender kids thrive or one that continues to turn children into refugees in their own country.