If You Read the G.O.P.’s Anti-Trans Policies, You’ll See What It Really Wants

In the 2023 legislative session alone, Republican state legislators have introduced more than a hundred bills seeking to restrict transgender people’s freedoms, rights and health care access. To put that in perspective, in the 2018 legislative session, fewer than 20 such bills restricting transgender rights were proposed. Over the weekend, at the Conservative Political Action Conference, the commentator Michael Knowles said that “transgenderism must be eradicated from public life entirely.” These bills have many different aims and often conflicting rationales, but taken together, they reveal the Republican Party’s ambitions to do nothing less than what Knowles suggested. So what are these policies intended to do to the people they target? And why are there so many of them now? Gillian Branstetter is a communications strategist at the American Civil Liberties Union’s Women’s Rights Project and L. G. B. T. Q. and H. I. V. Project. She’s been tracking and studying this wave of legislation, and she guides me through it here. We discuss the attempt by Gov. Greg Abbott of Texas to classify some forms of gender-affirming care as child abuse, why the Republican Party has united around anti-trans policy, how North Carolina’s unsuccessful “bathroom bill” in 2016 transformed the modern right, what gender-affirming care actually is, how Ron DeSantis is trying to build his brand atop this fight, where one might find grounds for hope in trans politics today and much more. Mentioned: “Texas’ Attempt to Tear Parents and Trans Youth Apart, One Year Later” by Brian Klosterboer “What’s so scary about a transgender child?” by Emily St. James “They Paused Puberty, but Is There a Cost?” by Megan Twohey and Christina Jewett “G. O. P. State Lawmakers Push a Growing Wave of Anti-Transgender Bills” by Maggie Astor Book recommendations: Homintern by Gregory Woods Caliban and the Witch by Silvia Federici Can the Monster Speak? by Paul B. Preciado Thoughts? Guest suggestions? Email us at [email protected]. You can find transcripts (posted midday) and more episodes of “The Ezra Klein Show” at nytimes.com/ezra-klein-podcast, and you can find Ezra on Twitter @ezraklein. Book recommendations from all our guests are listed at https://www.nytimes.com/article/ezra-klein-show-book-recs. “The Ezra Klein Show” is produced by Emefa Agawu, Annie Galvin, Jeff Geld, Rogé Karma and Kristin Lin. Fact-checking by Michelle Harris, Mary Marge Locker and Kate Sinclair. Mixing by Efim Shapiro. Original music by Isaac Jones. Audience strategy by Shannon Busta. The executive producer of New York Times Opinion Audio is Annie-Rose Strasser. Special thanks to Dr. Jason Rafferty, Lisa Black, Carole Sabouraud and Kristina Samulewski.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:04Ezra Klein?

  I'm Ezra Klein. This is the Ezra Klein Show.

• 0:23Ezra Klein?

  So the 2023 Conservative Political Action Conference wrapped up this past Saturday. And this conference, if you don't follow it, it's a big deal every year because it is the clearest window into the id of modern conservatism. It brings together its politicians and media figures and influencers. And what we saw at this year's CPAC was it, even as conservatism is on many issues at this moment of unusual internal division, what to do about economic policy and healthcare in Ukraine, about Trump, it is finding unity and purpose in attacking trans people. There is absolutely no subtext here. Michael Knowles, a popular right-wing podcaster at The Daily Wire, said, and I quote, "There can be no middle

• 1:07Ezra Klein?

  way in dealing with transgenderism. It is all or nothing." He went on to say, and again, I quote, "Transgenderism must be eradicated from public life entirely. Eradicated entirely." Tom Fitton, president of Judicial Watch, said gender-affirming care is, quote, "A demonic assault on the innocence of our children." Demonic. It would be one thing if this were all just rhetoric, but it's action. What we're hearing at CPAC is what we're seeing in Republican legislatures and governor's mansions all across the country. Over the past few years, we've seen hundreds, literally hundreds, of bills introduced to regulate, to ban, to criminalize the lives of and the care needed by trans people. And I think

• 1:52Ezra Klein?

  people who follow politics have a sense this is happening, but perhaps not of the scale and cruelty of these policies. I think in a lot of the mainstream press, there's more attention to the hard edge cases. What should be the rules around NCAA swimming meets? What about the rare but real cases where somebody transitions and regrets it? What kind of medical assessment and parental involvement should you need to access this kind of care as a minor? And I don't think those questions are fake, and I don't think they're easy. And I don't pretend to have the answers to them. But I think it's important that we don't lose sight of the overwhelming political and material reality here, which is that trans people already face now terrible discrimination and difficulty,

• 2:36Ezra Klein?

  higher rates of poverty and homelessness and violence, workplace discrimination, just living their lives. And the right is now making trans people their political target. And the most ambitious conservatives are competing, not just in rhetoric, but in policy, to make their lives harder, to try to push them out of the boundaries of public life. Individually, these policies, they have various rationales. A lot of them have conflicting rationales. But I think collectively, if you look at them, you see that what Noel said was true. The right's aim is to use the power of the state to eradicate the ability of trans people to live as themselves in public or to be able to become themselves.

• 3:20Ezra Klein?

  And again, this is policy. It is not just rhetoric. It is not just tweets. And so I wanted to have a conversation looking closely at these policies. Gillian Branstetter is a communications strategist at the ACLU's Women's Rights Project and the LGBTQNHIV Project. And the ACLU has been very involved in tracking and fighting these policies. So Branstadter has an unusually specific and global sense of how all this is coming together on the ground. As always, my email is [email protected].

• 3:54Ezra Klein?

  Gillian Branstetter, welcome to the show.

• 3:56Speaker 01

  Thank you so much for having me.

• 3:58Ezra Klein?

  So I want to begin in Texas, where we've seen Governor Abbott attempt to classify or reclassify certain kinds of gender care as literally child abuse. So tell me about the letter to the Texas Department of Family and Protective Services in February of 2022. What did it say? What was Abbott trying to do there?

• 4:17Speaker 01

  This letter was a directive to the Texas State Child Welfare Agency to begin proceedings to investigate parents with transgender youth who have accessed gender-affirming care. It does not include counseling. It does include puberty blockers, hormone therapy, and surgery. This followed a failure by the state legislator to codify the definition of child abuse by adding gender-affirming care to it. A bill was introduced in the state legislator in Texas in 2021 and ultimately failed. Governor Abbott's primary opponents took him to task for this. So he began sort of a long-rolling process to apply political pressure

• 5:02Speaker 01

  and basically set the tone that this care and its provision in Texas was going to be the next focus of his target. In February 2022, about a week before he and Attorney General Ken Paxton faced a primary, they issued this letter, which was directed to the state's Child Welfare Agency, to begin classifying the provision of age-appropriate gender-affirming care for transgender youth as child abuse. And that does a few things. One, it mobilizes the state family policing agency. So child welfare agencies have a... Advocates have been complaining for quite some time that they have a lot of unchecked power.

• 5:46Speaker 01

  And this power often gets used in very discriminatory ways, in particular against poor, Black, Indigenous, immigrant families. Queer youth especially are overrepresented in our nation's foster care system. The first impact that directive has is in mobilizing that agency to begin investigating. And one of the first people they target is actually a client of ours, who we are representing alongside the Association of Texas and Lambda Legal in one of two challenges to this directive, who is a DFPS employee themselves. This immediately begins terrorizing families across the state of Texas. We're talking about thousands of families who have transgendered youth,

• 6:30Speaker 01

  who are now suddenly faced with the idea that state agents could literally walk in their door and escort their children away from them. And this means young trans people being pulled out of class and interviewed about their health care, or even about their anatomy, and attempting to really nail them down as transgender and build out a case that if we can prove that you've accessed gender-affirming care, we're going to remove you from your parents' custody. The other thing this does is anyone who's ever worked in a field with kids, right? If you've ever been a teacher, or an educator, or childcare provider, you know that you've

• 7:12Speaker 01

  probably signed some paperwork making you a mandatory reporter. Meaning that if you have reason to suspect that a young person is being abused as the law defines it, then you must turn them in. And because of this directive from the governor and the attorney general, attempting to say, you know, "we are interpreting the state's child abuse statute to include this care", that means that nurses, counselors, guidance counselors in schools, teachers, assistant teachers, childcare providers, this entire network of folks who work with youth across the state of Texas are then drafted into Governor Abbott's war on transgender youth.

• 7:57Ezra Klein?

  Well, the term "gender-affirming care" is going to be not just a big part of this conversation, but it's obviously central to a lot of the debate in Texas elsewhere. What is gender-affirming care? And which parts of that care package or structure did Abbott try to get classified as child abuse?

• 8:16Speaker 01

  Sure. So gender-affirming care is an umbrella term for a broad range of medical interventions, which vary greatly based on the age and needs of the person presenting with gender dysphoria. Gender dysphoria is a term for a discomfort felt between your gender identity, your internal sense of your gender, and your gender as it was assigned at birth. And gender-affirming care is an individualized form of health care that includes counseling, sort of talking people through their identities, helping them get a sense of who they are and who it is that they want to be, helping them move past the internalized shame that

• 9:00Speaker 01

  so much of our culture pushes on to transgender people, and assessing whether they might be ready or a good candidate for other medical interventions. So when we're talking about young kids, young prepubescent kids who have maybe started wearing a dress at school or growing their hair out, if they're a transgender girl, young kids like that are never really accessing any sort of permanent health care. When young people start to enter puberty, particularly when they've been presenting as their lived gender for quite some time, they're more likely to access puberty blockers.

• 9:42Speaker 01

  And these are, you know, doctors usually describe them as a pause button, functionally pausing the signals that the body sends to begin developing some of these secondary sexual characteristics, ranging from breasts and wider hips to facial hair and a deeper voice. Then in older adolescents and adults, you begin talking about hormone replacement therapy, which, if you're looking for feminizing effects to reflect your gender identity, will include a testosterone blocker and some form of estrogen. And if you're looking for masculinizing effects, that usually includes testosterone. And then surgical care, which for anyone under 18 tends to be pretty rare and very much based around the needs of that patient.

• 10:26Speaker 01

  It can range from what's often colloquially referred to as top surgery, which are mastectomies, for example, if somebody has breasts that they don't want, or down to bottom surgery, which, while hard to access, is usually a vaginoplasty, so reconstructive surgery, creating a vagina, or a number of surgeries that create a penis. And in this order, under the governor's letter, he bans pretty much everything but counseling, pretty much everything but the idea that somebody could be talking to a therapist and get diagnosed with gender dysphoria.

• 11:06Speaker 01

  Now, what that means, of course, is that all of those healthcare treatments, most people who express a need for them have a very long road ahead before they can actually obtain them. This care is already very difficult to access, and especially in rural areas like those across Texas.

• 11:27Ezra Klein?

  I want to hold on, before we go into that piece of it, on this idea of child abuse. What Abbott is saying, what many in the conservative movement are saying, is that he's very worried about these children, wants to make sure no harm comes to them. What do we know about what happens when children who have been presenting as their lived gender for some time, who want with their doctor and their family to seek care? What do we know about what happens when they don't get it?

• 11:56Speaker 01

  So gender dysphoria carries with it a number of other symptoms, and especially when untreated. And that can range from depression and anxiety to low self-esteem, down to poor academic performance, struggling to build healthy relationships with friends or their family, all the way up to suicidality. And according to a vast array of research, transgender youth have a significantly higher rate of suicidality than their peers.

• 12:26Ezra Klein?

  And just to put some numbers on that. So we saw one study where 56% of transgender youth reported previous suicidal ideation. That was compared to 20% of cisgender youth. 31% of transgender youth reported a previous suicide attempt versus 11% of cisgender youth. And so how does access to care change that?

• 12:48Speaker 01

  Foundationally. So when I sat in a courtroom in Arkansas, where we were challenging that state's ban on gender-affirming care, there was a long line of medical experts and doctors and who work with transgender youth, who took the witness stand and spoke to the efficacy and the impact that this care has on young people's lives. It's very abstract. I think it can be very hard for a lot of cisgender people to understand what dysphoria is and how much it can, you know, impact your life and sort of stunt your emotional development and your emotional growth. And one of the biggest themes that I heard in that testimony was, one, not just that it sort of relieved dysphoria,

• 13:31Speaker 01

  but you also suddenly see that when young trans people do have this degree of bodily autonomy, they begin to improve in many other ways. So, for example, if they're on antidepressants, they find that they can go off of them. If they're on anti-anxiety medications, they find that they can go off of them. They improve in their mental health overall. They improve in oftentimes even just their extroversion, their willingness to participate in the community, their excitement about school. And the number one thing that you hear from a lot of parents with transgender youth and medical professionals who work with transgender youth and from transgender youth themselves is that before accessing this care,

• 14:12Speaker 01

  they really struggle to imagine a future with them in it. They really had zero impulse to sort of plan towards their future or to dream or to have ambitions. And you find that when you give young trans people this degree of autonomy over their own body and help them relieve off this massive weight that they're carrying around, that suddenly they have ambitions. Suddenly, they have goals. Suddenly, they're not just building friendships and being active in their schools and in their family, but they're thinking through, well, gee, what do I want to do with my life? What artistic ambitions do I have? What creative ambitions do I have? What would I want to do professionally?

• 14:56Speaker 01

  What problems does the world have that I could help solve? And I think that sense of possibility is something that any parent would want for their young person. And the at times cartoonishly vile rhetoric around this care is very much meant to obscure that positive impact that it has on people and very much meant to obscure the pain of being denied it, particularly when you know that it's an option that you could pursue. And that is what a lot of young people are facing right now as, you know, the number of these bands grows, is that they actually know a better life is awaiting them and they

• 15:40Speaker 01

  have, you know, politicians who've never met them, politicians who've never talked to anybody like them who's experienced what they're experiencing. Writing and passing laws, taking away this critical aspect of the story they want to write for themselves.

• 15:57Ezra Klein?

  I want to hold on this for a minute because I think there can be, including, I would say for me, a bit of an empathic chasm to clear when it comes to gender dysphoria, that if you don't have it, it's what it means to have it and to feel it is very hard to put yourself in. And my friend Emily St. James, who I worked with back at Vox, she wrote a great piece and she wrote in it something that I always find helpful to think about here. She wrote, "If you are a cis person, imagine for a moment that, all evidence to the contrary, everyone in the world becomes convinced your gender is not what it is. If you're a man, everyone starts using she/her pronouns for you and calling you by a woman's

• 16:42Ezra Klein?

  name. One day, you start insisting to the world you are who you are and the world insists otherwise." And that sense of, for my trans friends, that sense of unbelievable wrongness between how you are seen and how you feel, that...

• 17:01Ezra Klein?

  I don't exactly have a question here, but I just think it's worth stopping for a minute that the intensity of it, from everyone I know who has gone through it, is, I just think, really hard to grasp if it's not something that you've held yourself.

• 17:16Speaker 01

  I think it can be hard. You know, a colleague of mine, Rebecca Clang, has this metaphor of this giant bag of rocks that you're carrying around your entire life. And after a certain point, you kind of tire out. And you either put down the bag of rocks or you stop going forward. And I think the word that comes to mind when I'm usually trying to describe what dysphoria is like to cisgender people is a deep sense of inauthenticity, a deep sense that you were playing a role for other people. And I think that's something that most people can relate to because we all sort of have to do that in one degree or another.

• 18:01Speaker 01

  We all have to navigate and meet people's expectations. And gender, because gender is assigned to you over the course of your entire life, because your family and your friends and strangers and institutions and everything from our economic order to police and our laws are assigning you gender. When that assignment doesn't feel honest to who you are, it is a very inescapable sense. It's an all-consuming sense. And I think a lot of folks, you know, there are a lot of trans folks who, it may be long into adulthood

• 18:45Speaker 01

  before they even begin asking themselves this, right? And I've met trans people who've come out into their 50s, 60s, 70s, 80s, right? And I think it's a bit like if you had lived your entire life next to a waterfall and you heard the roaring, crushing sound of the water your entire life. And the moment you realize that you could up and walk away, that you didn't have to shout over this, suddenly you realize that your entire life, you've been screaming. And you've been begging to be heard. And when a trans person comes out at whatever point in their life that they do.

• 19:28Speaker 01

  It's fundamentally about a demand to be heard. There's an artist that I love, named Girl of Swords on Instagram, who does these sort of like Jenny Holter-style slogans. And one of them she has is that it is a blessing to have a transgender child. And why is it a blessing to have a transgender child? Because I think any parent would agree that it is a blessing to have a child who is strong enough to tell the truth when the whole world wants them to tell a lie.

• 19:56Ezra Klein?

  So how then does Abbott or Paxton, the Attorney General, in these letters and opinions, make the argument? What is the foundation of the argument? That it is child abuse to use puberty blockers or hormone therapy?

• 20:14Speaker 01

  To the degree that there is much logic to it at all. He, and I've seen this in, you know, I saw this in Arkansas too, in their defense of this ban, they're very much hunting for basically any potential risk or any potential excuse, no matter how small, that they can attach to this care. And it's very clear that what a lot of these lawmakers, including Paxton and Abbott, are doing is starting from the position of needing to ban all gender-affirming care and sort of working backwards from there and then looking for justification to do that.

• 20:52Speaker 01

  And certainly, like all forms of health care, gender-affirming health care does carry risks. And I think something that a lot of trans people who access this care know is that those risks tend to loom very large in the cisgender imagination. And one reason is, I think, because they struggle to conceive of that agonizing feeling of being forced to live an authentic life that in fact your own body is betraying you.

• 21:27Ezra Klein?

  So what are some of those risks, speaking not here about the surgical interventions, which are, I think, pretty rare for minors, but the hormone and puberty blockers?

• 21:37Speaker 01

  So some of the risks they cite include, for example, prolonged use of synthetic estrogen, like the kind that many transgender girls and women take, can gradually increase your risk for blood clots or for breast cancer. And as we sort of talk through these risks, it's important to understand, these aren't surprises to anyone that goes on them. They aren't surprises to the parents who sort of talk through them. And there's very much a need to measure the risks of these interventions versus the risks of doing nothing, which for transgender youth with gender dysphoria tend to be very, very grave, as we discussed.

• 22:20Speaker 01

  He also looks into, you know, testosterone is a controlled substance and has some low level risk for misuse and for abuse. In the rare instance that somebody goes on from puberty blockers directly to hormone therapy, it may gradually increase their risks for osteoporosis. As a New York Times report found, it will gradually increase the risk for experiencing osteoporosis in their 50s instead of their 60s. And I think to most trans people, we take these risks seriously. Like, nobody's not attuned to these, right? Like, even in like, the informed consent model of providing this care. So for young transgender people,

• 23:05Speaker 01

  for people under 18, there's sort of a long road of mental health counseling and assessment and making sure this care is right for them. In the space for medical care for transgender adults, there's been an increasing move towards informed consent, which basically means that as long as this person is informed about the risks and effects of this care, we should trust their autonomy to access it. And

• 23:32Speaker 01

  When you really feel like your own personhood is on the line, and somebody says, but wait, you could experience osteoporosis in your 50s instead of your 60s. Like, I'll cross that bridge when I get to it, I guess. Like, I would be, it would be so amazing to live into my 50s. So I think, like I said, a lot of these arguments are generally in bad faith, right? Because all healthcare carries risks, and there's lots of healthcare which these bans don't touch, which carry these or worse risks, and are not the subject of legislation or litigation, or much less, you know, accusations of child abuse.

• 24:14Ezra Klein?

  So when we were working on this episode, we talked with Dr. Jason Rafferty, who authored the American Academy of Pediatrics Guidelines for His Care in 2018. And one point he kept making is that this kind of care is a very, very highly individualized process.

• 24:29Speaker 01

  Yes.

• 24:30Ezra Klein?

  That if you look at the standards for it, you look at the structure and sequencing, it's built on a lot of discussions between the patient, between the doctors, if it's a minor, with their families.

• 24:41Speaker 01

  Yes.

• 24:42Ezra Klein?

  And one thing that is very striking to me about Texas's policy here, but not just their policy, I mean, you see this in a bunch of different states, is they're trying to short circuit, right? They're putting, literally, the government, conservatives putting the government, which I know the charge of hypocrisy here has lost a lot of force over the years, but take it for a minute, into this process that would otherwise be an individualized weighing of risks and questions, and the person's individual needs with the doctor, who knows what they're doing, and possibly mental health professionals and families. And instead, Texas is saying, no, no, no, we know, we don't just know better, we know so much better, that if anybody engages in this in any real way, going down the path

• 25:26Ezra Klein?

  on it towards, you know, puberty blockers or other pharmaceutical interventions, we're going to functionally criminalize it. It's a pretty striking assertion of, yeah, I mean, functionally, government knows best.

• 25:42Speaker 01

  In terms of their willingness to just sort of sweep aside, like, sort of the existing body of evidence and the actual reality of what this care is like, there's a lot to learn here from how the anti-abortion movement has framed abortion care. And you've seen very much the similar process of sort of hunting around for any tail end risk or any hypothetical in which this care might have any kind of negative consequence at all, and then using that to justify banning it. And you can very much see that they're running the same playbook on gender-affirming care. And something to keep in mind is it's very easy to imagine them running this playbook on birth control.

• 26:24Speaker 01

  In fact, you can already sort of see them laying the groundwork. And anyone who's accessed birth control, particularly hormonal birth control, knows that it's very individualized, and it can carry side effects, and it can carry risks. And people, hopefully, trust you to manage those risks and to weigh them against your desire to not to get pregnant, which, depending on who you're talking to, is you rejecting your gender assignment in the same way that a transgender person is. You know, I don't think anyone would describe the process of having an IUD inserted in

• 27:04Speaker 01

  joyful terms, but people still do it because they want that degree of autonomy over their own body and over their own ability to write their life story for themselves.

• 27:18Ezra Klein?

  Well, let me ask you where this particular directive stands now. You mentioned that the ACLU is in court on this, ACLU Texas is, Lambda Legal.

• 27:26Speaker 01

  Right.

• 27:27Ezra Klein?

  What is the current status of the rule?

• 27:30Speaker 01

  There are two lawsuits that were filed against the directive and against DFPS. Both of them were filed jointly by ACLU, ACLU of Texas, and Lambda Legal. We went back and filed a second lawsuit on behalf of yet more families and PFLAG National. For folks who don't know, PFLAG is one of the oldest LGBT rights organizations in the country, and they specifically work with parents of young queer people.

• 28:00Speaker 01

  And they were one of the first organizations to really have to mention gender identity in their official policies to protect transgender youth. And they have hundreds and hundreds of chapters across the country. And I've gone to these and they're usually, a lot like support groups. They're usually parents talking through what it means to have a young queer person, not just sort of protecting them from discrimination and advocating for their rights, but also changing their own expectations for what a life their child is going to lead based on their queer identity. So we file on behalf of PFLAG National and receive an injunction on behalf of PFLAG

• 28:41Speaker 01

  National so that if a family is a member of PFLAG National, they are protected under that injunction, which in Texas, last I heard, was somewhere around 600 families. Now, of course, what that means is that thousands of families are still exposed to this directive. In truth, what we know is that the actual number of cases that have been opened is luckily relatively small. Last I heard, it was under 20. And in each instance that a case was opened, the case was closed. And that's enormously relieving in that it means whatever accusation Greg Abbott wants

• 29:23Speaker 01

  to make against them, these folks are being exonerated by the state agency. That said, even just the process of the investigation is a major invasion into a family's life. And particularly when we're talking about young people who are really, like I said, struggling to imagine a future world with them in it. When the state is threatening them with removal from their family and threatening to put them into a foster care system where, one, transgender youth are already overrepresented? And, two, they're frequently subjected to physical abuse, sexual abuse, and conversion therapy and attempts to make them cisgender.

• 30:08Speaker 01

  That's an extremely threatening blade to hold over these young people's heads.

• 30:44Ezra Klein?

  So what you often hear is this is just about children. We're trying to protect children as a special class. Maybe they don't know who they are yet. Maybe they're influenced by something they saw on TikTok. But but a bunch of these bills target adults, too. And in fact, there's one that has been introduced in the Texas Senate, SB 1029. They would effectively ban these treatments for minors, but it would also effectively ban gender-affirming hormone therapy and surgery for adults. So tell me a bit about the relationship between the legislation targeting children and the legislation we've seen in a bunch of different jurisdictions that includes adults.

• 31:18Speaker 01

  So one thing that I think is important to understand is that these bills aren't really responding to any sort of like grassroots demand for these bills. They are coming at the behest of a group of organizations within the right wing that have at the core of their worldview, this very binary and rigid understanding of gender. And one of them is the American Principles Project. And over the course of the last few years, has tried to warm politicians on the right up to the idea of going after transgender people. And there was a report that Maggie Astor in the New York Times did, where she called up Terry Schilling, this group's president.

• 32:03Speaker 01

  And he said, we do, in fact, want to ban this care for anyone of any age. And in his words, the purpose in going towards young people was, quote, "going where the consensus is." Now, one, I would challenge the idea that there is a consensus. And, two, I think that belies just how sort of bad faith a lot of these discussions are, that most of these groups, ALEC, these organizations that are really well-known in right-wing circles for basically acting as bill mills, for sort of printing off this legislation and distributing them across states. They are not going to tolerate medical transition at all.

• 32:48Ezra Klein?

  So tell me about how intersex people play into this. Can you say what intersex means and where these conservative groups and some of these bills tend to stand on healthcare for that population?

• 32:59Speaker 01

  Intersex people are those born with non-normative sexual characteristics. Intersex conditions can range from hormonal sensitivities down to people born with what might be called anomalous sexual characteristics, or maybe the presentation of sexual material that is associated with one sex right next to sexual material that is associated with another sex. And often, when an infant is born and is presenting as intersex, the doctors will go to the parents and say, well, we can create a, quote, "normal genitalia" for them.

• 33:44Speaker 01

  And we find it's best to do it now because later in life, who would want to grow up with a non-normative body? And a big target of human rights activists and of the intersex rights movement is getting hospitals to drop that default setting of launching towards performing these surgeries on literal infants. Laurie's Children's Hospital dropped this default. There's been sort of growing inclusion amongst the American Medical Association and other groups. There is an exemption for those surgeries forced onto literal infants with very little

• 34:24Speaker 01

  concern for who they may grow up to be, very little concern for their long-term well-being, but strictly about making sure that they look normal.

• 34:36Speaker 01

  And I became very curious, how is it possible that all of these lawmakers and all of these legislators came to agree on the need to force intersex children into these surgeries? So I began looking around for how the right wing has encountered intersex people. Because think about it, if you are telling people that there is a biological binary and these roles are inevitable, they're complementary, they are designed for these explicit purposes and for providing these explicit forms of labor.

• 35:10Ezra Klein?

  In some tellings, they're godly.

• 35:12Speaker 01

  Right, exactly. And I found the bill that was passed into law in Arkansas banning gender-affirming care for transgendered youth that we have sued and blocked in federal court. And you find that across, not just in folks on the family, but across how the right wing regards intersex folks. They say, well, of course, we want to show them compassion, but really, these children are the result of a fallen society. That something about the amoral condition of modern life is producing intersex children, which has extremely dark echoes across the history of not just medicine, but theology

• 35:56Speaker 01

  and what was often referred to as monstrous births. These were a major focus of the witch hunts of the Middle Ages and the Renaissance, a sort of targeting mothers who gave birth to, quote, "monstrous births." It's very shocking to see that in modern political language. And it's even more shocking to realize that what they're looking for in these bills is not to end these treatments. They are trying to end these treatments for everybody. They're specifically trying to end them for people who are seeking them

• 36:37Speaker 01

  in order to rewrite their gender assignment, in order to actually make sure their gender assignment reflects who they know themselves to be. And yet, they're protecting these other treatments.

• 36:52Ezra Klein?

  So I want to go back to something you were saying about the politics of this a minute ago, which is that the way I've been thinking about the increasing centrality of anti-trans bills and rhetoric to the right, because it's something that you're seeing in the 2024 primary field for Republicans, it's a big issue for DeSantis, it's of course now a big issue for Donald Trump, and we can talk about his administration on this, which is very telling. But it's also every right-wing legislature, more or less across the country, is now full of these bills. And it's been a pretty quick move to the center of their agenda. And one of the ways I understand politics in this era is that

• 37:33Ezra Klein?

  we've been watching or living through this transition from, because politics is always changing as to what the core cleavages really are, what people will compromise on and what they won't. And I think the broad understanding of the Republican Party 15 years ago, and I think it was true, is that they talked to social conservatives, they talked to social conservatism, but they governed economic conservatism. The actual non-negotiable was tax cuts for corporations. And then they would tell the evangelicals what they needed to hear to turn out the vote. And that, over this period, that's more or less flipping. And you now have the post-Trump Republican Party, a lot of people who are

• 38:18Ezra Klein?

  kind of confused and often opportunistic on economics. But these questions of, I would call it sort of social gender hierarchical change, right, this question of the traditional hierarchies of American society have become really fundamental. And there's been a search for what is the issue that cracks this open. And I think that there was a view that it was immigration, right? That was Donald Trump's sort of initial play, and it worked for him to a degree, but it's actually not popular to be highly anti-immigrant in this country. And then particularly post-George Floyd, when there were the protests that had riot elements in them, you had a kind of backlash on Black Lives Matter, and then that failed

• 39:02Ezra Klein?

  in 2020, Joe Biden wins the election. And it seems since then that the idea is to crack open the sort of progressive coalition around trans issues, that this has become the kind of edge of the sphere. In the Republican Party's backlash to social change. That's been my working theory of it. But I'm curious, because you're obviously much more read in on this than I am, and think about it much more, how you've understood this transition to the center of the Republican agenda for this set of issues.

• 39:36Speaker 01

  It's interesting that you tease out this existing divide in the right between more economic concerns versus social conservative concerns. One, I think they have more similarities than they differ. Conservative economics tend to produce socially conservative outcomes. Two, there's been an interesting turn in right wing politics over the course of just about the last decade, where there's been a lot of motivation and energy around the social conservative wing, this wing that's devoted towards an explicit construction of what it means to be American along racial, gender, and class lines.

• 40:18Speaker 01

  And one of the dividing points for this was in 2016 in North Carolina, where you had the state legislator and Pat McCrory pass one of the first bathroom bills, so basically a law requiring transgender people to use the bathroom that aligns with what was on their original birth certificate. And this was really one of the first major tests for transgender rights in the political sphere. There were some previous fights around like HERO, and we could talk through that history if you want, but this was definitely the largest conflagration that transgender rights had had in some time.

• 40:56Speaker 01

  And the bill was signed into law, and you quickly saw a number of corporations and large institutions like the NBA and performers like Bruce Springsteen begin polling events out of North Carolina and begin saying, well, we're not going to spend money in a state that would endorse this hate. And according to one analysis, this cost the state of North Carolina's economy around $3 billion. In no small measure, Pat McCrory lost reelection because he decided to focus on this issue at the expense of the rest of the state.

• 41:36Speaker 01

  And this caused a deep sense of frustration within the conservative movement. And I think it was the dawning of what you often hear now described as woke capitalism. The idea that the culture has left our values and they've taken corporations with them. So therefore, we can no longer trust the Chamber of Commerce crowd to act in defense of socially conservative actions. It was almost the end of what has been called fusionism. This idea of the libertarian-minded economic right and its ties to often more evangelical, more socially concerned right.

• 42:21Speaker 01

  And over the course of the Trump administration, you see this frustration begin to grow. Because while the Trump administration leaves no stone unturned when it comes to rolling back transgender rights, whether rolling back protections for transgender students, rolling back protections for transgender people accessing healthcare, really repealing what has occasionally been called like the quiet trans revolution of the second Obama term. Social conservatives begin to feel a bit left behind. And particularly because the legislative agenda of the Trump administration was pretty much dominated by the Trump tax cuts, which as far as they're concerned, don't move them towards their goals of sort of rewiring the backends of American culture

• 43:05Speaker 01

  to reflect these deeply conservative values. And an inflection point for this comes in 2020. 2020 was a busy year, you might remember it. But I remember in June of 2020, the Supreme Court issued a decision in Bostock v. Clayton County, which is actually a trio of cases on behalf of LGBT people who had been fired because of their sexual orientation or gender identity. The ACLU represented Amy Stephens. She was a transgender woman in her 50s. She worked at a Michigan funeral home. She came out as transgender. She wrote this impassioned letter explaining that this is very important for her. And the funeral home turned around and fired her two weeks later. And what was up for debate in this case

• 43:49Speaker 01

  was not whether they were discriminated against because Amy was trans or the other workers were gay. What was up for debate is whether by discriminating against these employees on that basis, the workplaces were in violation of Title VII of the 1964 Civil Rights Act, which prohibits sex discrimination. And really, since the Civil Rights Act has been passed, sex discrimination has been expanded as a definition. So it now covers lots of pregnancy discrimination, it covers lots of sexual harassment, it covers what's called sex stereotyping, and basically judgments that you make based upon how you think somebody should behave based on their "biological sex."

• 44:32Speaker 01

  And the Supreme Court finds, in a 6-3 decision in June of 2020, that these protections extend to queer workers, that if you fire somebody because they're transgender or because they are queer, then you are exhibiting sex discrimination, you are in violation of the Civil Rights Act. This is greeted as an apocalyptic event in right-wing spaces. You know, I find in liberal and progressive spaces, I often have to remind folks that this happened. I remember seeing a poll before that case was issued that some 80% of the country thought it was already illegal to fire somebody because they're gay or transgender. So I often have to remind, like, people in sort of liberal, progressive spaces that

• 45:17Speaker 01

  this case even happened. But soon after that, you have folks like Josh Hawley thumping their fist on the table and saying, "This represents the end of the conservative legal movement." That if an employer can't fire somebody because they're transgender, that this represents an existential threat. And I think one of the reasons you see this massive reaction is because a lot of the legal victories on behalf of LGBT rights up to this point had very much hinged on the private life. So Obergefell and the right to marry, for example. As much as you're running into the issues of, like, does a baker need to make a wedding

• 46:01Speaker 01

  cake, or does a website need to make a website for a gay couple that's getting married, the foundational right to marry is about a right to privacy. And as well as just, you know, equal protection clause under the 14th amendment. And likewise, before that, in 2004, in Lawrence v. Texas, when the Supreme Court found that the state could not criminalize same-sexual relations, that was very much also founded in this private life, in this private space. It's about making sure the government isn't looking in on what consenting adults are doing behind closed doors. In contrast, Bostock was very much about your public life. Now, suddenly, we're in the workplace.

• 46:44Speaker 01

  Now, suddenly, somebody has the right to be trans in the workplace, around other people, even, Ezra. And there is the logic that the opinion, which was written by conservative golden boy, Justice Neil Gorsuch, the logic of his opinion, it doesn't take a whole lot of thinking to then apply it to all other laws which prohibit sex discrimination, including Title IX, which prohibits sex discrimination in education, or Section 1557 of the Affordable Care Act, which prohibits sex discrimination in health care. So the right-wing legal movement walks away from this case with an enormous amount of egg on their face, and I think a lot of outrage, because they just walked away from

• 47:28Speaker 01

  four years of a Trump administration where they didn't feel like any of their needs were being met, which is laughable, as somebody who was working in trans advocacy at that time. And they are feeling cheated even by the Supreme Court itself. And it's the legislative session right after that case, so the 2021 legislative session, where you really start to see the total number of these bills take off.

• 47:55Ezra Klein?

  I want to get at something that you touched on there, which is that as part of what has changed in the politics of this one, in a way that maybe progressives don't realize or admit, you mentioned this sort of quiet revolution here in the Obama administration, where policy became much more equal in this area. You mentioned some very, very important cases that pushed forward sort of nondiscrimination. And some of the backlash actually was a response to the fact that the sort of equilibrium on this was being pushed forward. It was being pushed towards justice, and that created a kind of opposite counterreaction. And there's also the feeling that many people have, and I think as to the extent

• 48:36Ezra Klein?

  we have data on it seen as true, that we are seeing a rise, whether it's because more people are coming out as trans and they would have suppressed it and not told anybody at another point, or because something is changing, but that we are seeing a rise in the number particularly of trans kids. And so the other way of thinking about the sort of centrality of it in our politics is that it's a response to, on the one hand, actual progressive victories on this point, and on the other hand, an actual change in the sort of on-the-ground reality of particularly how many trans children we're seeing. How do you think about those as explanations?

• 49:14Speaker 01

  In your book, Why We're Polarized, available in stores now, you reflect on how polarization is not inherently a negative thing, that in fact polarization is a necessity when moving forward on important progressive issues. And in fact, over the course of American history, when there's been consensus around an issue, it's usually around an issue based in discrimination, or an issue that we now look back on and are very glad that we had a controversy on and changed.

• 49:44Speaker 01

  And I think one way to think about the second term of the Obama administration, and what has often been referred to as the trans tipping point, right, Laverne Cox, it's a cliche in writing on this topic, that within the first two paragraphs, you have to mention Laverne Cox on the cover of Time Magazine in 2014. And I think a good way to think about that is as the end of the consensus that was regarding trans rights as ludicrous and unnecessary, that there was a cultural and political consensus regarding trans life as unlivable, regarding trans bodies as unlovable, and regarding trans people as untrustworthy.

• 50:32Speaker 01

  And over the course of decades of advocacy and public education campaigns and meeting with lawmakers, sort of building a degree of power, you begin to see that slowly creak open over the course of the early 2010s. And it's one reason why, if you're over 30, you were raised in a culture which saw our existence as, if not an avid threat, then as pathetic. In a culture which portrayed us as, alternately, as sickly eunuchs or decadent perverts. And I know that because I'm over 30.

• 51:17Speaker 01

  And I was raised to believe those things about myself. And transgender people are taught how to hate ourselves. I think that there is a lot of institutional memory that still exists within a lot of even nominally liberal institutions in American life that still try to tell that exact same story about trans lives as unlivable and still rely on a lot of the same tropes. And, you know, I'm a New York Times subscriber. And that sort of gives me access to the New York Times archive.

• 52:00Speaker 01

  And one thing I've been doing over the last few months is looking across the media coverage of an institution like the New York Times and finding the history of how the paper has regarded transgender people. And not just using the language of today of transgender and sort of finding these early examples in the 1990s you can find and things like that, but using the old language, transvestite and transsexual.

• 52:30Speaker 01

  And what you find is not very pretty. And I don't think that's specific to The New York Times at all. I think a lot of institutions across American life, including mainstream political organizations, have that same history.

• 53:16Ezra Klein?

  I want to go back then also to something else that happened in this period that you kind of touched on right around North Carolina, which is the North Carolina bathroom bill was not the only bill and not the only kind of social justice question. But I do think it was one of the first that began to open a sort of wedge that is still not at all closed between the Republican Party and particularly like major parts of corporate America.

• 53:46Speaker 01

  Yeah.

• 53:47Ezra Klein?

  So I mean, we're talking in a week where Governor DeSantis sort of succeeded in taking away some sort of special autonomous privileges that Disney had in Florida. I mean, Disney, which is one of the big namesake Florida employers.

• 54:01Speaker 01

  Sure.

• 54:02Ezra Klein?

  And that was over Disney's criticism response to what gets called the Don't Say Gay bill, which among other things is very targeted, I think it's fair to say, at trans people. And I think there's been a particular important dimension in our politics right here at this line where you've had the sort of woke corporations fight around Black Lives Matter, but in an ongoing way, you really have it around these issues. And it does seem to me to be forcing a weird sort of realignment in the Republican Party, where a party that was known very much as the big business party, now at least in some cases, right, obviously not in every, and there's still plenty of deregulatory efforts

• 54:45Ezra Klein?

  and corporate tax cuts and all the rest of it swirling around the Republican agenda. But Ron DeSantis is going to run for president bragging. About how he used the power of the state to punish a corporation.

• 54:58Speaker 01

  Sure.

• 54:59Ezra Klein?

  For its speech. One, I think it goes to show sort of how intense the commitment on this set of issues is in the Republican Party right now. But two, I'd just be curious to hear you reflect on the way it is slightly altering some of the Republican Party's traditional alignments and forcing members of it within it to choose sides.

• 55:22Speaker 01

  Sure. So the Don't Say Gay law, as it's properly known, the Parental Rights in Education Bill, prohibits discussion of sexual orientation or gender identity in kindergarten through the third grade. Although, as we're talking, a version was just introduced in the Florida Bill House that would extend it up to the eighth grade. It's funny how that happens. And this has resulted in queer teachers feeling like they need to hide who they are at school, to the pulling down of just basic symbols of LGBT pride, like the rainbow flag, right down to the banning of books that mention queer people. So Tethers Two Mommies or And Tango Makes Three, which is literally a book about gay penguins.

• 56:03Speaker 01

  And it very much is part and parcel with this goal of sort of regarding queer identities as an ideology that's being forced onto people. I think the right recognizes that most people don't know a transgender person in their daily life. The numbers I see usually float between like a quarter to like a third of people know, actually know somebody who is transgender. So when you're railing against transgender people every day from your bully pulpit or on Fox News or wherever else, they don't have an actual person to conceive of that you're talking about. All they have is the abstract or whatever cartoonist caricature you're painting for them.

• 56:45Speaker 01

  So that means that the realities of transgender life are being mediated through these institutions, which range from either hostile or indifferent to our existence.

• 56:57Speaker 01

  And I think one of the reasons that he begins to pick this fight with Disney is that it allows him to keep telling that story. So instead of the young queer kids he's demonizing, or the parents who are now afraid their kid might mention that they have two moms and will get them in trouble, or the teachers that you've read about who now feel like they have to leave this state altogether. Instead of those real people who are being scared, now the story is Ron DeSantis takes on woke capital and Disney forcing its ideology on our children.

• 57:42Speaker 01

  And I think by picking that fight, DeSantis is sort of selecting the frame for himself. And he's sort of positioning himself as the David against this Goliath, when it is in fact, he himself, who is the empty-headed bully wandering around the playground and smashing kids' face into the dirt.

• 58:04Ezra Klein?

  One question I have about it is whether or not it's getting worse and better at the same time, which is to say, we've been talking about particularly red states, where a lot of, I think, quite terrible legislation is being proposed, and where the rhetoric has gotten very vicious, and I don't think that can be discounted. But there are also blue states that have been, I think, and some of them trying to move in the opposite direction. So are there places that are brighter to you, that at the same time, we're seeing not just backsliding, but actual literal demonization and scapegoating? Are there places that are looking more like there's no bottom, that there's also, you can look up towards, I don't exactly want to say no top, I'm not sure that metaphor

• 58:49Ezra Klein?

  works, but a different kind of future? Are there places that are more hopeful to you right now, that if you're just following the places things are getting worse, you might not see?

• 59:02Speaker 01

  So you referenced that the number of openly trans people, and the word openly is important here, has been rising, and particularly in younger generations. One, I think that matches the rise in LGBT identification over the decades. People are fond of citing this tart around left-handedness, and that once public schools stopped hitting children for writing with their left hand, suddenly, there was a huge surge in left-handedness identification. I see a lot of encouragement in that, because it means that more trans people feel safe, that they feel that they will, at the very least, find a community of people like them.

• 59:46Speaker 01

  When you talk with transgender people over a certain age, you hear a similar refrain, that "I thought I was the only one," that they had no concept that there were other people in the world who felt like they did.

• 1:00:01Speaker 01

  And when you start to see this crack is really with the introduction of mass media, and the sort of peering curiosity into transgender lies. And it's one reason why, over the course of the history of mass media, including the news media, there was this consistent demonization of transgender people, because it was very much telling closeted trans people, "Well, you can't come out, because look how grim your future will be, or we will make sure you are punished for rejecting your gender assignment. We will mock you, we will shame you, we will put you on reality TV and make you a laughing stock." Then, as the internet grows and social media grows, I know that there's a lot of anxiety

• 1:00:46Speaker 01

  that there are young people sort of like self-diagnosing themselves with gender dysphoria, and rushing off, and getting their breasts removed because they saw it on a TikTok video or whatever else, right? That's not what I see when I see trans people gathering online. I see the breaking of geographic boundaries that used to separate us, that trans people are, of course, very naturally gravitating towards people who are like-minded, who have similar experiences.

• 1:01:15Speaker 01

  Because, believe it or not, the world still doesn't greet transgendered people with absolute joy. And it's very hard to find people who share that experience, especially in a lot of rural areas across the country. And the internet has this interesting place in trans history as this ultimate gathering space, where we can share experiences, share wisdom. Because one of the ways that trans life is deemed unlivable and impossible is we are all isolated from one another.

• 1:01:57Speaker 01

  And I think that's what really threatens a lot of folks, is that suddenly trans life is looking a little possible. And the fact that the number of people who are willing to be openly trans is increasing is a really good sign for that reason, at least for my work.

• 1:02:15Ezra Klein?

  I think that's a good place to begin to come to an end. So always our final question, what are three books you'd recommend to the audience?

• 1:02:22Speaker 01

  Sure, anyone who knows me knows this was an exceedingly impossible question to answer. I'm going to start with a book by Gregory Woods called Hum and Turn. And it is a history of queer life and culture pre-Stonewall, from the trial of Oscar Wilde up to just really right before the sexual revolution. And it is this incredibly rich, entertaining, vibrant history of people making space for themselves when, as many people who grew up queer did, they thought they were the only one, including finding community before they even really had the language to describe queer identities.

• 1:03:08Speaker 01

  And it's a fantastic history told through, I mean, love notes and cocktail napkins and police reports and gossip. And it's very juicy in parts. And it's just fascinating to think like, how did the arrest of Oscar Wilde, one of the world's most famous playwrights, change how the media and politics regarded gay people? What was Josephine Baker learning from the drag queens of Harlem and Washington? How did George Orwell reckon with his own homophobia? The second book is Caliban and the Witch by Silvia Federici. Silvia Federici is a really seminal feminist thinker, was a major figure in the wages for housework movement. And Caliban and the Witch is about a pandemic,

• 1:03:52Speaker 01

  followed by a labor shortage, followed by a revanchist movement to assign rigidly strict gender norms onto people that targets queer people and women especially. And the pandemic was the Black Death. And the movement to enforce these rigid gender norms were the witch hunts, this long period of time in Europe when women and queer people were hunted and killed because they did things like offer abortions or offer contraceptives or cross-dressed. And then third, I'm going to recommend a little book called, Can the Monsters Speak? by Paul Perschato. He's a transgender man.

• 1:04:36Speaker 01

  And this book, Can the Monsters Speak? is a lecture he gave in front of this esteemed group of psychoanalysts. And what he's asserting in this book is he's trying to illustrate and challenge all the ways in which transgender people's voices are not taken seriously by the medical establishment, by the media, by the culture. That what we demand, that what we challenge in this world is so threatening to some of the foundational myths of this world that we are told we must be confused. Or we are told to wait and pass a million tests and go through all these levels of gatekeeping

• 1:05:20Speaker 01

  because who knows, we might regret it later.

• 1:05:24Ezra Klein?

  Gillian Branstetter, thank you very much.

• 1:05:27Speaker 01

  Thank you so much, Ezra.

• 1:05:39Ezra Klein?

  The Isaklant was produced by Emma Fagau, Annie Galvin, Jeff Geld, Rajesh Karma, and Kristen Lynn. Fact checking by Michelle Harris, Mary Marge Locker, and Kate Sinclair. Mixing by Afim Shapiro. Original music by Isaac Jones. Audience strategy by Shannon Busta. The executive producer of New York Times Opinion Audio is Andy Ross Strasser. And special thanks to Dr. Jason Rafferty, Lisa Black, Carol Sabaro, and Christina Samuelowsky.