Now it's time for a breakdown: AG Pam Bondi's anti-trans memo
Buckle up, and grab a snack, this one’s a doozy.
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Amongst the papal chaos, judges getting arrested, and yet another Pete Hegseth signal chat, you might have missed a major memo that was leaked from U.S. Attorney General Pam Bondi’s office outlining the war plan for the Trump administration’s attack on gender affirming care for minors. You can find the memo in its entirety over at Law Dork, and while I have not independently verified the memo, I do feel confident enough in its authenticity to write on it.
The memo, titled “Preventing the Mutilation of American Children” is basically a master class in anti-trans rhetoric, and more specifically the ways that it has evolved recently. Recall that over the past couple of years, we have seen an exponential increase in anti-trans legislation, with bills attacking access to gender affirming care for minors being one of the most prominent categories. I’ve been working very intensely since 2022, and even before then, on fighting these bills in state legislatures across the country, and have seen them all follow a similar framework, which isn’t a coincidence. Bans on gender affirming care have been a major focus area for the Christian nationalist movement, with the primary organizing force behind them being groups like The Alliance Defending Freedom, the Heritage Foundation, Eagle Forum, and other far right Christian organizations. These groups are highly interconnected with political, legal, and “scientific” research groups that have been pushing the anti-trans narrative into the secular world, sharing a large number of staff members and funding sources between them to create a stockpile of pseudoscientific references that can be weaponized against trans people and create mass panic about an already politically marginalized group.
And now we’re seeing the fruits of Christian nationalist labor, with the Attorney General for the entire country announcing its intent to criminalize medical care providers who choose to follow the recommendations of every mainstream medical association over theocratic junk science.
The first section reads like an anti-trans drinking game, going in hard and fast with describing trans affirmation and acceptance as “radical ideology” and adopting the now widely used term “gender ideology” to discredit transgender identity as some kind of modern ideology, and not a well documented, intrinsic part of the human experience. Interestingly, even this language has deep theocratic ties, with the term “gender ideology” having likely originated from the conservative Roman Catholic opposition to same-sex relationships, trans rights, and the rights of women to defy traditional gender roles. The rhetoric in this section, and throughout the memo should frighten anyone with concerns about the normalization of fascism and genocidal ideology.
Bondi compares transgender identity to an infectious disease, claiming that “transgenderism” has “infected an entire generation of children” and calling it a “sociological disease.” Political scientists and historians focused on genocides have long noted that comparing a marginalized community to a disease frequently happens during the fourth step to genocide, “Dehumanization.” I want to be clear here that I am not being hyperbolic or hysterical here. Much of the language about trans people used in this memo, as well as in other parts of the anti-trans movement is indistinguishable from language used in Nazi Germany about trans people and homosexuals, and incredibly similar to the antisemitic and racist rhetoric used as well.
This aligns closely with the use of the “social contagion hypothesis” (also referred to as “Rapid Onset Gender Dysphoria” or ROGD) popular among anti-trans advocates, a widely debunked theory that claims that young people identify as transgender as a part of a social trend in order to fit in with their friends. The study that has proliferated this idea was retracted as it failed to obtain ethics approval from an institutional review board, but it is still widely cited by anti-trans advocates wishing to prey on the widespread scientific illiteracy crisis in the United States and other countries in order to justify anti-trans actions across the country. It’s not just the retraction that delegitimizes the idea that transness is “contagious” however. Studies that support this hypothesis typically survey parents of trans youth, as opposed to the youth themselves, and rarely align with the recorded experiences of trans youth themselves and their medical professionals. There is no standard for what period of time qualifies as “rapid” onset of gender dysphoria, and these studies frequently fail to account for the fact that trans people typically experience dysphoria long before they ever actually come out as trans, but keep it secret due to fear and shame. Instead, the phenomenon recorded in these studies is not that gender dysphoria appears suddenly, causing young people to immediately identify as trans, but that parents learn about their child’s identity when the child is often much further along in the process of understanding and accepting their identity. Medical professionals regularly note that their patients report having experienced gender dysphoria for a year or longer before telling anyone or seeking out medical care, out of fear of parental and social rejection, or simply needing time to understand what they were experiencing.
By framing trans identity as a “disease” rather than a part of the human experience, AG Bondi is saying that transness is something to be “cured” aka “eliminated.” Bondi also employs the frequent claim that “transgenderism” encourages children to “deny biological reality” and is being pushed by a “radical left wing” agenda that has “politically captured” the medical and academic establishments. Bondi claims that “hard science” should be used to delegitimize transness, and that it’s radical political manipulation silencing dissent, rather than the well established scientific process that has been used to determine the standard of care for trans people over the past century. If you’re familiar with my work you know that I am no stranger to these kinds of claims, with the impetus for launching this blog as an independent venture being my ongoing conflict with anti-trans New Atheist celebrities. But as I’ve written before and will constantly hammer home, no one is “denying biological realities.” Instead we are acknowledging that sex and gender are complex concepts, with different but interrelated meanings in various social, legal, and medical contexts.
This appeal to “hard science” is full of multi-layered irony, which will be a recurring theme in this essay. “Hard science” over the years has become a term that is used more and more frequently to denigrate “softer” fields, like social sciences, humanities, and arts. This glorification of “hard science” has had disastrous consequences in American politics, directly creating the conditions that led to Elon Musk’s attempt to take over every part of the U.S. government. Yes, much of “gender theory” is based on social sciences and humanities, but that does not make it illegitimate, and you should not trust anyone who says that their singular field has the answer for every part of human existence. This appeal also ignores the wealth of mainstream, secular medical science that supports the gender affirming care model, as mentioned before.
Instead of utilizing that information, Bondi repeats another claim that I have frequently heard in state legislatures attempting to ban gender affirming care, that the medical establishment is abandoning so-called “hard science” for profit – the “Big Pharma” argument. This argument claims that pharmaceutical companies and gender clinics have decided to push the gender affirming care model, not out of legitimate medical concern, but because of financial greed. Now I want to be clear before I get into this, as someone who is multiply disabled, I am no fan of Big Pharma and the greed of the American healthcare system. I’m at the intersection of people with chronic pain whose families have also been heavily impacted by the opioid epidemic, and I have intimate first hand knowledge of just how much nuance goes into patient safety and advocacy.
That being said, there is no evidence to support the claim that pharmaceutical companies, doctors, or other parts of the medical establishment are pushing gender affirming care in the same way that opioids were infamously pushed, and certainly not to minors. Gender affirming care is incredibly difficult to access, and while wait times vary depending on geography and medical provider, doctors are typically very cautious with minors in particular, requiring extensive counseling and a social transition that shows “consistent and persistent” gender identification before any medications or surgical interventions are even considered. The number of trans youth receiving gender affirming care is also incredibly small. Researchers looked at the insurance claim data of 5.1 million youth between 2018 and 2022, and found that of those 5.1 million, only 0.017 percent of youth were given puberty blockers as treatment for gender dysphoria, and just 0.037 percent were trans and accessed hormone therapy. The years the researchers looked at are important here, as they predate any state passing a ban on gender affirming care. These are incredibly small numbers in relation to the youth population of the United States. By comparison, 8.4% of children aged 5-17 in the United States around that same time were on some kind of medication for mental health treatment, 6.4% of American adults in 2020-21 filled a prescription for opioid pain medications. Gender affirming care is simply not the Big Pharma cash cow that Bondi and other anti-trans advocates want the public to believe.
This is one of the ironies of Bondi’s appeal to “hard science” — in the same breath that she lambasts the science behind gender affirming care, she makes claims that make no logical or statistical sense.
Bondi then goes on to claim that legal access to gender affirming care leads to wide rates of transition regret, pointing to the story of anti-trans activist and detransitioner Chloe Cole, who has for some time been the poster child of the anti-gender affirming care movement. Cole, who has widely claimed that she was pressured into identifying as trans by friends and social media, transitioned as an older teenager, and later determined that was not the right choice for her. Now I am in no position to judge or verify Cole’s story, and I am sorry that she made choices that she regrets, I’m sure that is very difficult. But again contrary to what Bondi and others want people to believe, her story is not representative of the majority of trans youth, or even the majority of detransitioners.
The most extensive study that examined trans youth using modern diagnostic criteria (more on that in a moment) with the largest sample size to date showed that 97.5 percent of trans youth remain stable in their self-identified gender five years after the start of social transition. Another modern study of trans people not limited to youth shows that only 8 percent of thousands of transgender people ever detransition. Of the 2,000 detransitioners surveyed, 62 percent of respondents said that their detransition was only temporary, and only 0.4 percent stated that their reason for detransition was because they no longer identified as transgender. That’s eight people, by the way, if you don’t want to do the math yourself. By and large the most common reasons cited for detransition was parental pressure and discrimination – not desistance. Those that do experience regret deserve adequate healthcare, no question about it, but that does not mean we should be shaping policy and healthcare law around the experiences of a handful of people.
You may see some studies cited that say that up to 80 percent of trans youth desist in trans identity by adulthood. But these studies are flawed for a variety of reasons. First of all, many of these studies are utilizing diagnostic criteria that are no longer in use. The DSM, the diagnostic guidebook for a large number of psychological conditions, including gender dysphoria, underwent a major change in 2013, when the diagnosis associated with transness, “Gender Identity Disorder,” was removed, and “Gender Dysphoria” became the new diagnosis. This was not as simple as a renaming for the same condition, this was a reframing of how medical professionals thought about transness, what it was that they were actually trying to treat, and what they were looking for in diagnosis. Under the guidelines for “Gender Identity Disorder” in children a patient did not even need to identify as a gender different from the one that they were assigned at birth in order to qualify for a diagnosis. GID required that a child fit four of the five following characteristics: desire or insistence to be the other sex, preference for cross-dressing, preference for cross-sex roles in make believe play, a preference for cross-sex games and activities, and a preference for playmates (friends) of the other sex; plus a requirement that the child be “uncomfortable” with the gender role of their assigned sex. (Page 537 of the DSM-IV.) Under this set of diagnostic criteria, a girl who was uncomfortable with feminine stereotypes, preferred boys clothes, preferred to pretend to be a traditionally male role during playtime, likes trucks over dolls, and prefers to play with boys could be diagnosed with GID without ever once expressing a desire to identify as a boy herself.
Recognizing the flaws in this diagnostic approach, the diagnosis of “Gender Dysphoria” came to replace GID, in order to more accurately represent the phenomenon medical providers were treating. Unlike GID, “Gender Dysphoria” requires a desire or insistence to be the opposite sex, in addition to identifying with five out of the following seven criteria: preference for clothing of the identified gender, preference for roles of the identified gender in make believe play, preference for games and activities associated with the identified gender, preference for playmates (friends) of the same identified gender, rejection of games and activities typical of their assigned sex, dislike of their own sexual anatomy, and a desire for sex characteristics that match their experienced gender. (Page 452 of the DSM-V.) This diagnosis is more detailed and specific than GID, and eliminates the misdiagnosis of individuals that simply don’t vibe with the stereotypes associated with their sex assigned at birth.
Gender Identity Disorder was an inherently flawed diagnosis, so studies of desistance using that same criteria are also going to be inherently flawed, and invalid for making policy decisions in 2025. But it’s not just the fact that our understanding of gender dysphoria has changed, the most frequently cited studies for the 80 percent figure had huge methodological flaws, including counting anyone who merely did not return to the clinic as “detransitioning,” or counting anyone who no longer received gender affirming care through Tricare, the health insurer used by U.S. military members and their families, as detransitioning without looking at whether they were getting it through other means like paying out of pocket.
The gender affirming model aligns well with modern diagnostic criteria, and has incredibly low regret rates. Furthermore, recent research indicates a strong likelihood that the more accessible and accepted the gender affirming care model is, the less likely it is that people will experience shame or regret, even if they do choose to detransition for one reason or another. An open, gender exploratory and affirming model includes openness and dismantling of stigma surrounding detransition. When those fears are mitigated, patients are more empowered to be honest with their healthcare providers about their feelings and experiences, even post transition. The greater restrictions that exist, the more likely it is that people who think they might be experiencing gender dysphoria will attempt to stick to a very specific script to obtain treatment, and the less likely it is that they will seek professional assistance if they do detransition at a later point in time. While this is an area in need of further study, it makes logical sense, and very much reflects the lived experience of detransitioners.
Much of the anti-transition rhetoric used throughout the memo intentionally frames trans identity as something that young people will likely “grow out of” and gives off the impression that trans people are “immature” or incapable of making decisions for themselves, with people assigned female at birth depicted as the most mentally incompetent and therefore in need of protection. This is heavily reflected in Bondi’s weaponization of anti-Female Genital Mutilation (FGM) laws.
Bondi claims that she is authorized under these laws to go after healthcare systems that provide gender affirming care, stating: “I am putting medical practitioners, the hospitals, and clinics on notice: In the U.S. it is a felony to perform or attempt to perform Female Genital Mutiliation (“FGM”) on any person under the age of 18.”
This is a radical and dangerous legal conflation, and a slap in the face to the women and girls who have been victims of actual FGM practices. FGM is a cultural tradition practiced in many parts of the world, justified by the stigmatization of women’s sexuality. According to UNICEF, FGM “refers to all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons[,]” and impacts over 230 million girls and women world wide. The term FGM has never been used to refer to gender affirming care, which is widely understood to be done for medical reasons, and there is no universe in which any anti-FGM law passed by Congress was done so with the intention of preventing gender affirming care. Contrary to what textualists would want you to believe, congressional intent does matter when interpreting the law, and even under a more textualist interpretation, the term “Female Genital Mutilation” would not be defined by the experts and materials referenced by Congress at the time to refer to gender affirming care.
I believe there is also a reason why Bondi focuses on female genital mutilation here beyond mere convenience of highjacking anti-FGM legislation. After all, if the concern is about “protecting children,” shouldn’t it be about protecting all children, not just the female ones?
When you watch the anti-trans space for long enough, you begin to notice some particularly misogynistic patterns, especially regarding the characterization of trans men and boys compared to trans women and girls. Trans women and girls are always depicted as sexual predators and sports cheaters, lying in wait to harm “biological” women. The laws in place that make things like sexual assault illegal aren’t enough, and instead a whole other layer of “protection” needs to exist. Trans men and boys, on the other hand, are typically presented as “confused” victims of a “radical social agenda.” There is a strong implication in this kind of rhetoric that by nature of being assigned female at birth, these individuals are biologically inferior, and more susceptible to social pressure and manipulation, especially by other afab trans people, because “girls” follow trends. They are victims because they are intellectually less competent than people assigned male at birth, whose transness is then conversely a sign of political manipulation and predatory behavior.
This type of misogyny is rampant in conservative Christian theological circles, as well as in other conservative religious spaces, and is a key part of the Christo-fascist project. Much of the justification for the subjugation of women in conservative Christian spaces has been based around the idea that Eve was somehow singularly responsible for the fall of man in the Garden of Eden. (I’m focusing on conservative Christianity here as it is the dominant political force behind the rhetoric in this memo.) In this particular strain of theological thinking, women must be kept under the thumb protection of their husbands because Eve was too easily manipulated by the serpent to eat from the Tree of Knowledge of Good and Evil. Conversely, women must submit to their husband because they were able to convince Adam to eat from it as well. Under this line of thinking, women are more akin to children than intellectually capable adults. They are both the manipulated and the manipulator, though they are incapable of knowing what they are actually doing, so it is in humanity’s best interest for their independence to be limited.
This is what leads to the pattern of highjacking legal structures designed to protect women from systemic harm and abuse to attack trans people, no more heavily typified than in this highjacking of anti-FGM laws. There is real, systemic abuse that happens to women every day, and we should be rightly horrified by it, but trans rights and existence are not the cause of said abuse. Anti-FGM laws also activate strong emotions – again, rightfully so – but those strong emotions are being intentionally and actively manipulated in order to attack a marginalized group, and reinforce a misogynistic idea of women’s inherent inferiority to men.
Bondi then moves on in the memo to the next section, titled “Investigations of Violations of the Food, Drug and Cosmetic Act and False Claims Act.”
Bondi, using the wealth of healthcare legislation that has been promulgated to protect patients, states that she will “investigate and hold accountable medical providers and pharmaceutical companies that mislead the public about the long term side-effects of chemical and surgical mutilations.”
Yeah that sounds like it is going to be a fair and unbiased investigation by someone who is “just asking questions” for the safety of America’s children. Please note the sarcasm there, I am begging you. This is going to be a sham investigation, with a predetermined outcome. It operates under the assumption that the public is, in fact, being misled about gender affirming care, which simply isn’t true. The informed consent process for gender affirming care is extensive, and provided by every member of a trans person’s care team. The amount of paperwork you have to sign and the education you receive as a patient is staggering, and speaking from personal experience, more than I have received for any other type of healthcare. I was given essentially a novel on all of the potential side effects of testosterone therapy, and was not permitted to proceed until my doctor was confident that I understood what I was getting into. The informed consent process has also only gotten more stringent, especially for youth healthcare, as doctors try to cover more and more of their bases from the political attacks on this type of healthcare.
Bondi says she will also be investigating both the on and off label usage of medications like puberty blockers and hormone replacement therapy, targeting pharmaceutical companies that offer continuing education for doctors that present gender affirming care an a viable and appropriate treatment option for gender dysphoria, and under the False Claims Act, go after healthcare providers who prescribe these treatments for “illegitimate” reasons (meaning gender affirming ones) and billing it to insurance under a “legitimate” diagnosis like precocious puberty.
Let’s break all of that down. First, let’s talk about “off-label” usage, which has become a buzzword in the anti-trans community. “Off-label” refers to the usage of medications for reasons other than what the FDA has approved them for, quite literally for reasons other than the label used in the packaging. Now this sounds scary, but remember that legally the FDA does not regulate the practice of medicine. Off-label usage is an incredibly common practice, based on scientific studies regarding the effectiveness of various medications, as it is simply not practicable for the FDA to approve every single possible use for a medication, particularly as applied to groups less likely to be represented in clinical trials such as children, pregnant people, and people with psychological disorders.
Some examples of common off-label usage include: Benadryl to treat anxiety or nausea; Gabapentin to treat bipolar disorder, essential tremor, hot flashes, migraine prophylaxis, neuropathic pain syndromes, phantom limb syndrome, and restless leg syndrome; Magnesium Sulfate for premature labor and preeclampsia; and Zoloft to treat premature ejaculation. The term doesn’t just refer to treating different conditions though – those of you who are familiar with anti-abortion tactics will recognize this fear mongering as identical to that used to restrict misoprostol, which is approved to be taken in office, but is frequently used off-label by clinics allowing women to take it in their own homes. Yet another stark reminder that the fight for gender affirming care and the fight for reproductive rights are deeply and intrinsically tied.
“Investigating continuing education efforts” by pharmaceutical companies is also suspect. Now, do I think that overall allowing the people who profit from the sale of medications to educate doctors on its uses is the best idea? No, not really. But it is how the system works for all kinds of medications, and again I refer you to earlier in this essay when I discussed that gender affirming care simply is not a major cash cow for Big Pharma. It’s also not illegal. This could also lead to hospitals and clinics ceasing any education measures that are supportive of the gender affirming model of care for fear of investigation.
Now using the False Claims Act is a newer tactic, and one that will have disastrous consequences for not only trans youth, but cis youth with precocious puberty conditions, intersex conditions, or other healthcare needs that are typically met with the types of medications being targeted here. The FCA exists to address Medicare/Medicaid fraud and the manipulation of the insurance billing system through coding certain conditions as something else in order to get reimbursements and coverage, or higher reimbursements. Things like therapy appointments might be billed as a 45-minute session instead of the actual 30-minute session, as just one example.
We’ve seen this tactic and its consequences before in the overcorrection by health care providers in the wake of the opioid crisis. While opioid prescriptions have gone down thanks to investigations under the FCA, and that is a good thing when it comes to actual cases of overprescription, it has also caused doctors to become more overly cautious when it comes to prescribing pain medication for fear of triggering an investigation, causing legitimate pain patients massive amounts of suffering.
I’m calling the shot now: we will see cis children being denied medical care at a much higher rate than ever before out of fear of investigation. Go back and look over that section more closely. Bondi has made it clear that she’s not only going to be looking at the use of these treatments for gender affirming purposes, but every possible use of them. Any time a doctor prescribes puberty blockers or hormones, even for the reasons that the anti-trans movement has deemed “legitimate” they will be at risk for investigation. A large number of healthcare providers are not going to be willing to open themselves up to that risk.
This is also going to lead to witch hunts in healthcare facilities, as evidenced by Bondi’s emphasis that the public should be informed that her office is open and willing to work closely with qui tam whistleblowers, and highly emphasizing the attached financial incentives for being one.
Qui tam is an abbreviation for the Latin phrase “qui tam pro domino rege pro se ipso in hac parte sequitur” which translates to “Who sues on behalf of the King as well as himself.” A moment for applause for the combination of Catholic and law school education that has led to my Latin capabilities. Basically this means that private citizens can bring about certain legal actions on behalf of the government, something that is common in FCA litigation and helps with efficiency in enforcement. While the private citizen is the one bringing the action, they are not the actual petitioner in these cases, which remains the government. But that does not mean that qui tam relators don’t get any benefit for their role. In fact, in successful actions they’re typically entitled to 30% of the financial recovery received by the government. Bondi makes a huge point of this, emphasizing that “[i]n 2024 alone, qui tam relators received a $344 million share of victories won by the Department.”
Now we are already in an era of anti-trans witch hunts, which I’ve written about before over on Freethought Now. Gender McCarthyism, as I’ve come to call it, is infecting every part of everyday life, from government to healthcare to Irish dancing and professional billiards. And now the government is tacking on a major financial incentive to engage in these witch hunts. Many Americans are already very financially motivated, and when you combine that with the disintegration of the American economy and the major cost of living crisis caused by this administration, you create a perfect storm for metaphorical witch hangings. Witch hunts never find witches, but they do find the politically marginalized and force people into hiding, which is exactly what all of this will do.
Now there’s something else here you might have noticed I haven’t brought up yet, and that’s because I wanted to get through the actual practical consequences of these sections before making this next point.
Providing gender affirming care is not a federal offense.
Let me say that again for you to really hammer it home.
Providing gender affirming care is not a federal offense.
Yes, more than half of states have banned gender affirming care for minors at this point in time. And Congress has been contemplating a federal ban. But this memo does not have the same force of law and is not legislation. The entire reason Bondi has to abuse laws like anti-FGM laws and the False Claims is because if you practice medicine in a state where gender affirming care is legal, neither your state or federal government can actually come after you for it. This is a scare tactic with more practical consequences than traditional legal ones. Bondi’s office, under the direction of the Trump administration and political manipulations of the Christian nationalist movement. And Bondi knows this. Skipping briefly ahead to the very end of the memo because it is extremely short, Bondi states that she has instructed the Office of Legislative Affairs “to draft legislation creating a private right of action for children and the parents of children whose healthy body parts have been damaged by medical professionals through chemical and surgical mutilation.” This in itself is not a full ban either, as medical professionals can still provide these treatments under the law, but they are liable if the patient or their parents later regret the decision, meaning it will massively chill the practice of gender affirming medicine, again through scare tactics and an abundance of caution. And even then, just because this legislation is being drafted does not make it an inevitability. Congress is currently massively divided, and while there is a Republican majority, it is not likely going to be enough for this type of legislation to pass. Keep in mind that while we are still in a moment of struggling with Democrats abandoning trans people, the majority of Americans were more supportive of pro-trans candidates than anti-trans ones in the weeks leading up to the Presidential election. A gender affirming care ban would be political folly of the highest order going into a midterm election where Dems are poised to be able to take back some measure of power by leveraging the disaster show that has been the second Trump presidency. And while I certainly would never accuse the Democratic Party of political genius, it seems just likely enough to me that the bare minimum will be done to keep this type of legislation from moving forward, at least until after the midterms.
Bondi knows that the likelihood of this legislation passing on the federal level is low, which is why she also announced that her office will be partnering with politically aligned states to establish the “Attorney General’s Coalition Against Child Mutilation.” This section was also short, so I’ll copy the key point here for you directly:
“I will partner with state attorneys general to identify leads, share intelligence, and build cases against hospitals and practitioners violating federal or state laws banning female genital mutilation and other, related practices. The Department will support the state-level prosecution of medical professionals who violate state laws that protect children, such as Alabama's Vulnerable Child Compassion and Protection Act, which makes it a felony for doctors to treat children with puberty blockers or hormones to affirm a gender identity inconsistent with biological sex.”
Bondi knows that as of right now her only effective legal pathway to attacking gender affirming care is through state legislation. It’s important to note that this coalition destroys the less brought up buts still prevalent argument that gender affirming care should be left to the individual states. By throwing its weight behind the states that have banned gender affirming care for minors, Bondi, and by extension the AG’s office and the federal government as a whole has declared its position on the topic. Now this isn’t actually anything new, but it is yet another damning piece of evidence that there is no political neutrality going into this issue.
What this is also going to do is exacerbate the growing internal transgender refugee crisis in the United States, as well as push it into the international sphere. I’ve been tracking over the past couple of years the rising rates in transgender people, their families, and their healthcare providers that have left states with healthcare bans for safer states. This phenomenon isn’t just impacting trans people, for the record, but also teachers, people capable of getting pregnant, victims of natural disasters, climate scientists, and any number of other people who have not bowed to the ideological and legal attacks of the conservative movement.
I myself am among the number of trans adults who have moved out of their home states due to increasing political hostility and fear of losing healthcare access. I live seven hours away from my family because it is no longer safe for me to live in Indiana. I’m likely not going to be able to leave the country – my other health conditions separate from my gender identity make the immigration process to countries that do have legal protections for trans people far more expensive and complicated. But I also don’t want to. I want to stay and keep fighting for as long as I possibly can. But I cannot, will not, and do not judge anyone who does choose to leave, because I am making that cost-benefit analysis basically every day. There are going to be increasing shifts in where people choose to live in the coming months and years, and blue states and foreign countries are going to need to prepare to meet those peoples’ needs.
We’re also going to need to be prepared to help people who cannot leave their home states for any number of reasons, rather than politically abandoning conservative states. Trans people have always existed, and we’ve always had ways to ensure we are getting our healthcare, financial, and social needs met. And while no one wants to go back to the old days of DIY transitions, we need to be prepared to build non-governmental social aid and safety programs to support our siblings across the country.
Finally, returning to the other section of the memo that I skipped, we’re going to end our analysis on the section titled “Ending Reliance on Junk Science,” a statement that caused me to legitimately and publicly laugh out loud when I read it. Apologies to the barista I startled.
Now the “junk science” in question is not the aforementioned massive network of Christo-fascist pseudoscience that has been well documented by the Southern Poverty Law Center. No no no, instead, the “junk science” Bondi is referring to is the work of the World Professional Association for Transgender Healthcare (WPATH), one of the major sources for mainstream, evidence based healthcare information regarding the best practice medical procedures for trans people globally. The WPATH Standard of Care (SOC) is relied upon by mainstream medical associations globally, and is developed and edited through rigorous scientific processes in order to make sure that they are aligned with the most recent scientific information. The SOC is currently on its eighth version, and WPATH has done an excellent job documenting how it has come to its conclusions, its past versions, and why certain recommendations have changed over time. The anti-trans movement despises WPATH because they are incredibly transparent, and as a result are incredibly hard to delegitimize through actual scientific means. The biggest boogie man that Bondi brings forward to frighten people of the SOC is WPATH’s recent shift to recommend that, instead of a hard and fast age limit for gender affirming surgeries, there be some discretion given to doctors, care teams, patients, and parents addressing extreme cases of gender dysphoria to move forward with surgical interventions if all parties agree that the patient is mature enough to provide the requisite level of informed consent. These types of cases are rare and would pretty much apply only to 16 or 17-year-olds where the mental health benefits outweigh the potential physical risks (the same cost-benefit analysis that happens for any gender affirming surgery, regardless of age for the record.)
Access to a level of individualized discretion is a far cry from Bondi’s characterization of this shift being open season on “genital mutilation.” It is merely the recognition that this is a nuanced issue, and that there are a limited number of extreme cases where this type of action would be in the best interest of the patient.
It’s important to note here that cisgender minors get similar cosmetic surgeries at a much higher rate than their transgender peers.
Somewhere in the ballpark of 300 youth receive gender affirming surgeries each year in the United States, based on an analysis of health insurance claims. Of those surgeries, the overwhelming majority of them were mastectomies or breast reductions, followed by breast augmentation, and the data set found claims for somewhere around 18 genital surgeries a year in minors ages 13-17 with a prior gender dysphoria diagnosis.
Meanwhile a review of statistics from the American Society of Plastic Surgeons shows that roughly 7,000 cisgender patients ages 13-19 in the U.S. receive the same type of health care each year for primarily cosmetic purposes, encompassing mastectomies, breast reductions and breast augmentation. That’s a 2233.33 percent difference between the two demographics. This doesn’t include other types of cosmetic surgeries like rhinoplasty,
If we really had concerns about the removal or change of “healthy body parts” why are we not also concerning ourselves with the cisgender minors in plastic surgeons offices? I’ll tell you why, it’s because their gender affirming care brings them more in line with their gender assigned at birth, and therefore is “normal” and not a threat to the Christo-fascist project.
Transness and gender nonconformity in general are some of the greatest threats to the growing theocratic order, because conservative and fundamentalist Christianity rely on strict gender hierarchies to function. Pick any fundamentalist family and you’ll see this in practice, with the father being the ultimate authority over the family, his wife expected to be fully submissive to him, and the children’s education centering around becoming “biblical men and women.” In addition to aiding the general logistics of the home, the strict insistence on these sex-based gender roles also serves as a form of psychological control within these communities, creating binaries that limit a person’s ability to question authority and stifle their ability to see the world complexly.
Fascist regimes, religious or otherwise, use the exact same tactics of logistical and psychological control on a much larger scale through the strict enforcement of gender, race and class-based hierarchies. But like any political structure, it can only last as long as the people under it buy into those hierarchies. Trans and gender nonconforming people directly contradict this system, making their arbitrary nature increasingly obvious, even to people who are comfortable with their assigned social roles. Bondi’s rhetoric throughout this memo to delegitimize best practice trans healthcare is intentionally frightening to push the American public into buying into the hierarchies necessary to implement widespread Christo-fascism throughout the United States.
This type of social-psychological manipulation is quickly becoming the bread and butter of the Trump administration. Across the country scientific research that does not align with the administration’s ideological goals is being targeted and defunded. Graduate schools have had to rescind admissions offers due to funding cuts. The National Institute of Health is facing major funding cuts for research on developing new and effective vaccines, addressing healthcare inequities faced by marginalized communities, HIV/AIDS research, the actual effectiveness of gender affirming care and ways to improve it, and more. When the federal government was forced by the courts to restore the web pages that acknowledge trans existence that were deleted in a mass censorship effort earlier this year, a disclaimer was added, reading:
“Per a court order, HHS is required to restore this website as of 11:59 PM on February 11, 2025. Any information on this page promoting gender ideology is extremely inaccurate and disconnected from the immutable biological reality that there are two sexes, male and female. The Trump Administration rejects gender ideology and condemns the harms it causes to children, by promoting their chemical and surgical mutilation, and to women, by depriving them of their dignity, safety, well-being, and opportunities. This page does not reflect biological reality and therefore the Administration and this Department reject it.”
The only metric being used by this administration to determine what is and is not “junk science” is whether or not it aligns with a Christian nationalist political agenda. Methodology, funding source, conflicts of interest, none of that matter now. The only thing that makes scientific research “legitimate” in the eyes of the Trump government is if it aligns with its predetermined conclusions. Yet another layer to the irony I mentioned earlier.
In many ways, this memo does not represent anything new. If you had asked me to make a bingo card of what was in this memo before I read it, I probably would have ended up with a full sweep across the board. Vertical, diagonal, four corners, any configuration would have been it.
That being said, this level of war planning, this level of sheer vitriol towards trans people, this level of legitimately genocidal rhetoric coming from the Attorney General’s office still fills me with an intense sense of dread for what the next few years are going to look like. The rapid escalation towards mass criminalization of trans people, our families, and our healthcare providers is particularly frightening as we’re watching our immigrant siblings being shipped off to El Salvadoran prisons without due process and Trump has said that he is trying to determine how he can send “homegrown criminals” i.e. U.S. citizens, out of the country as well. Every incarcerated person is a political prisoner because who does and does not get jailed is a political decision. Who is and is not the most “violent” of offenders is a political decision. And this memo, which concludes by equating transgender healthcare with the violence and harms of terrorists and drug cartels, shows that this administration wants to label anyone who supports trans existence as a violent threat to American children. And that certainly would put us on the list to be deported and incarcerated in foreign prisons, likely with little to no due process, and no real way to contact our friends and family members. If you care about the rise of fascism in this country, this memo should absolutely terrify you, even if you aren’t trans, because it demonstrates how quickly the powers that be can cast a small, highly marginalized group in a violent light. This government is not going to stop with immigrants. It’s not going to stop with trans people. And it’s not going to stop until every person who does not meet the Christo-fascist standard is eliminated from American soil.
So it’s up to us to stop them. Yes, the government is powerful. Yes, we are in a critical historical moment. But that does not mean all is lost. To the contrary, it is now more important than ever to work together to push back against this mass repression. That can look like any number of different things depending on where you are and who you are. In a state that’s attacking trans people, that can look like going to provide testimony at your statehouse, or even at your school and library board meetings, and voicing your opposition to this type of legislation. It might look like community fundraising to help your most vulnerable neighbors move, or access legal representation. In a state where trans rights are more secure, it might look like pushing your elected representatives to fight harder for our rights, and to utilize their political capital to bring their colleagues on board. It might look like donating to and volunteering with organizations fighting for your rights. It might be sending support to the organizers in high risk states. Regardless of where you are, it might look like attending protests, but it also might look like packing water bottles and snack bags and first aid supplies before the protests to be distributed. It might look like organizing community food and healthcare drives. It might look like running for office yourself. There are a ton of ways you can engage in this fight. This blog is one of my more public facing ones, but there are plenty of other things you don’t see.
We are not helpless.
The fight is not over.
In fact, we’re only getting started.
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Kat (they/them) is a queer lawyer, activist, and theorist focusing on the intersections of law, queerness, religion, and politics, with the occasional bit of theology, political theory, and legal theory thrown in for good measure. Originally from rural southern Indiana, Kat earned their B.A. in Political Science in 2019 before continuing on to earn their J.D. in 2022, both from Indiana University- Bloomington. A former Equal Justice Works Fellow for the Freedom From Religion Foundation, Kat has spent their professional career fighting for the separation of church and state and LGBTQIA+ rights. Outside of work you can find them at a ballet or contemporary dance class, sipping on dirty shirleys at their local gay bar, or playing video games with their cat, Merlin.