Election 2024

Does Mike Pence want to ban trans adults from getting gender-affirming care?

Mike Pence, LGBTQ issues, GOP debate, Republican debate
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At last night’s Republican presidential debate, former Vice President Mike Pence said, “We’re going to pass a federal ban on transgender chemical or surgical surgery anywhere in the country.” LGBTQ Nation contacted his campaign asking if he intended to outlaw gender-affirming care for all people, regardless of age. His campaign hadn’t responded by the time of publication.

While Pence’s comment also mentioned “protecting” kids from “radical gender ideology,” his response caught the attention of Alejandra Caraballo, a civil rights attorney and clinical instructor at the Harvard Law School Cyberlaw Clinic. Caraballo posted a video of Pence’s comment on Wednesday night and wrote via Twitter, “They’re going to ban care for trans adults too. It was never about protecting kids.”

“While most anti-transgender healthcare bills in recent years focus on minors, anti-LGBTQ forces ultimately seek to ban all forms of transition-related care, regardless of age,” a recently released report by the Movement Advancement Project (MAP), an organization that tracks policies on LGBTQ+ issues and voting, stated.

“They are pursuing this goal in a variety of ways,” the report added, “including: defining ‘minor’ to include at least some adults; by banning state funds from covering this medical care (e.g., in Medicaid, state employee health plans, and for those in incarceration); explicitly allowing private insurers to refuse to cover this care; and more.”

Three in 10 bills introduced in state legislatures during 2023 sought to ban or restrict medical care for both transgender children and at least some transgender adults, MAP noted. This included bills re-defining a “minor” as including adults up to ages 19, 21, or 26. One in seven bills included provisions that either banned private insurers from covering transition-related medical care, or explicitly allowed them to refuse coverage for such care, regardless of age.

At least nine states explicitly ban Medicaid coverage of trans-related health care, regardless of age. Medicaid is a state health insurance program for low-income individuals. These states include Arizona, Florida, Kentucky, Missouri, Nebraska, Ohio, South Carolina, Tennessee, and Texas.

“These provisions knowingly and intentionally seek to cut off access to this medically necessary care,” MAP wrote. “Without insurance coverage, most forms of health care, including transgender-related health care, are unaffordable to the average person. This is especially true for transgender people, who experience far higher rates of poverty and employment insecurity due to discrimination.”

A graph showing the increase in legislation targeting gender-affirming care for transgender adults
Movement Advancement Project A graph showing the increase in legislation targeting gender-affirming care for transgender adults

Various right-wing politicians have described trans identity as a “delusion” and a “mental illness.” Far-right Daily Wire host Michael Knowles called for eradicating “transgenderism” during this year’s Conservative Political Action Conference. Republican presidential candidate Vivek Ramaswamy and House Republicans have expressed opposition to making bathrooms, workplaces, and the military more inclusive of trans adults.

Other state legislation has also sought to erase trans adults from public life by increasing the difficulty of obtaining accurate identity documents that accurately reflect trans adults’ correct gender identity, banning trans people from using public bathrooms matching their gender identity, and rolling back other existing nondiscrimination protections for transgender people through new or expanded religious exemptions, MAP noted.

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