Democrats Should Stand Strong Against Anti-Trans Attacks in 2024 and Codify Medical Care Protections the Next Chance They Get

By Data for Progress’ LGBTQ+ Issues Working Group

The 2023 election results gave us further evidence for what was already pretty clear: Americans are not happy about the Supreme Court’s decision to overturn Roe v. Wade. It also reaffirmed once more that Republicans’ attacks on the transgender community are a political loser.

In 2024, Democrats should unapologetically champion bodily autonomy and reclaim being the party of personal freedom. And the next chance they get, they must codify basic protections for accessing abortion and gender-affirming medical care nationwide. 

Leading up to Election Day, Republicans leveled vicious, transphobic attacks at Democrats, in yet another attempt to turn demonizing the transgender community into an electoral wedge issue. In Kentucky, Democratic Governor Andy Beshear won reelection comfortably after being consistently lambasted and targeted with more than $2 million in attack ads for vetoing a sweeping anti-trans bill. In Ohio, opponents of the proposed amendment to establish a state constitutional right to abortion spent tens of millions of dollars on misleading ads, saying that the amendment would allow minors to get a “sex change” without parental consent or notification. Voters passed the amendment by more than a +13-point margin. 

In Virginia, Republican Gov. Glenn Youngkin once again campaigned hard on “parents’ rights,” trumpeting his anti-transgender policies related to schools and sports — and he will now have to work with a Democrat-controlled legislature for the remainder of his term. Democrats also won key school board races in swing districts across the country, including Virginia, Pennsylvania, and Ohio, defeating Moms for Liberty and other conservative candidates who campaigned on banning “woke” books and censoring LGBTQ-inclusive curriculums.

Do these results mean that running on transgender issues is a surefire way for Democrats to win elections? Not necessarily. But they are a source of hope. Transgender issues are not the winning background issue that Republicans surely thought they would be — even with a far-reaching, right-wing media apparatus that constantly spews anti-transgender talking points to millions of American households each night. 

However, Republican threats to bodily autonomy continue to emerge. Since Roe was overturned in 2022, 21 Republican-led states have taken action to ban or restrict access to abortion. At the same time, at least 22 Republican-led states have passed laws restricting gender-affirming medical care for transgender young people — care that has shown promise in reducing feelings of gender dysphoria and suicide risk. 

As the ACLU notes, these attacks are intertwined, as “the same lawmakers that don’t want people to be able to make decisions about their pregnancies also don’t want transgender people to be able to make decisions about their medical care.” Earlier this month, the ACLU asked the Supreme Court to review a September decision handed down by the 6th U.S. Circuit Court of Appeals, in which the court cited Dobbs in reinstating transgender medical care bans in Tennessee and Kentucky.

There’s no good reason to believe that the conservative Supreme Court will protect transgender people’s access to gender-affirming care given its unpopular decisions in Dobbs and 303 Creative. The danger these bans pose to public health is a good enough reason alone for Democrats to prioritize passing federal protections the next time they have a government trifecta. And as we’ve seen in recent elections, protecting trans rights is not the political liability that many pundits would have you believe it is.

New Data for Progress polling finds that voters support Congress passing a Transgender Bill of Rights — to protect the rights of transgender and nonbinary people under the law by ensuring their access to medical care, shelter, safety, and economic security — by a +5-point margin, including a +52-point margin among Democrats and a +10-point margin among Independents. To be clear, there has been no proactive media or communications strategy to win support for a Transgender Bill of Rights, and it still polls above water against the seemingly endless barrage of anti-trans attacks coming from the right.

When asked about recent state-level efforts to ban both abortion and gender-affirming medical care, a majority of voters (55%), including 76% of Democrats and 56% of Independents, think that state lawmakers should not be allowed to implement full bans on abortion and gender-affirming medical care, or place criminal penalties on physicians who provide this care. 

Our polling also finds that voters trust medical and mental health associations more than seven times more than elected state lawmakers to develop policies and regulations regarding transgender minors accessing gender-affirming medical care. Leading medical and mental health associations in the United States, including the American Medical Association, American Academy of Pediatrics, American Psychiatric Association, American Psychological Association, and the American Foundation for Suicide Prevention, have endorsed gender-affirming medical care as best practice and voiced public opposition to the blanket bans pushed by Republicans. 

When asked who should be able to make the final decision about whether or not a transgender minor can access gender-affirming medical care, a majority of voters (54%) choose the minor’s parents, followed by the minor’s doctor (22%) — while only 12% choose the elected state lawmakers where the minor lives.

In nearly all cases, minors need parental consent to receive gender-affirming medical care, as is the case for the vast majority of health care in the United States. Ironically, Republicans’ blanket bans on best-practice, evidence-based medical care are an actual threat to “parents’ rights.” Democrats should flip the script on this issue and make clear that these types of private health decisions should rest with parents, patients, and doctors — not politicians.

It can be hard to understand transgender issues for those who have never met someone who is transgender, and that is probably true of many elected officials. It’s also entirely possible that Democrats won’t win another government trifecta anytime soon, and passing federal protections won’t be possible in this polarized climate.

But this issue is worth fighting for. State bans on gender-affirming medical care, like state bans on abortion, threaten public health and personal freedom. Democrats must address this crisis by defending bodily autonomy and the right of families to make decisions about their medical care, without interference from politicians. The ongoing success of reproductive rights — and failure of anti-trans attacks — at the ballot box should give them the political courage to do so.