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Sept. 1 (UPI) -- Growing efforts to enact laws restricting transgender rights across the United States have largely been orchestrated by national conservative organizations determined to dismantle "gender ideology." Few of the proposals originate within the states' borders as a result of concerns from constituents. Instead, many come from a playbook that includes advice on how to write the laws so they will hold up in court.
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Representatives from the American Principles Project and the Alliance Defending Freedom -- two organizations pushing anti-transgender legislation in states including South Dakota, Iowa, Nebraska, Texas, Montana, Florida and Tennessee -- told UPI in interviews about the overarching goal of their concerted effort: to block transgender people from protections under civil rights law.
APP policy director Jon Schweppe opposes "gender ideology," which he describes as "the belief that sex and gender are different. That gender is not immutable, it is something that you can determine for yourself."
"Ultimately, we believe this gender identity stuff is delusional," he said.
In contrast, a study from the University of Melbourne found gender-affirming therapy to be potentially lifesaving. Endocrinologist Brendan Nolan said people who begin hormone therapy earlier experienced significant reductions in gender dysphoria, depression and suicidal ideation.
The number of patients in the study that experienced suicidal ideation prior to the therapy was cut in half within the first three months after starting.
Outside influences
Among the first laws to target transgender youth in multiple states was a ban on transgender girls from women's sports.
South Dakota, where the GOP holds 94 of 105 legislative seats, has been a testing ground for such restrictions, said state Rep. Kadyn Wittman, D-Sioux Falls, becoming one of the first states to enact the women's sports laws in 2022.
Though Wittman was aware of the uphill battle she and her 10 Democratic colleagues faced in resisting a persistent wave of bills focused on banning items like gender-affirming healthcare, she was surprised to learn how much her Republican colleagues were coordinating with forces outside the state.
In March, more than 2,600 emails between state Rep. Fred Deutsch, R-Florence, other Republican lawmakers across the country and a slew of anti-transgender activists and organizations were leaked to Mother Jones.
"I was surprised by the breadth of the impact Rep. Deutsch had been having," Wittman told UPI. "The conversations he was having with individuals who could not be less connected to South Dakota. It read like a decades-long playbook on how to strip trans community members of their rights."
Wittman said these types of conversations between lawmakers and out-of-state organizations are "absolutely not" common.
The whistleblower in the email chain, former anti-transgender activist Elisa Rae Shupe, exposed the coordinated effort to enact copycat laws throughout the United States.
"When all of that came out, more people realized this is not coming from South Dakota," Rachel Polan, newly elected president of Sioux Falls Pride, told UPI.
"People in South Dakota really value individual liberty. That is fair to say no matter where they are on the political spectrum. Were it left up to a simple majority, I don't think South Dakota would be voting to ban trans people from sports or to make trans people use the bathroom of their assigned gender at birth."
Matt Sharp, director of legislative advocacy for the ADF, is one of the reported 18 people that Deutsch was coordinating with in 2019, mostly on efforts to keep transgender athletes out of women's sports.
His group was one of the first legal organizations to be involved in litigation on this issue, specifically in Soule vs. Connecticut Association of Schools in which four female high school track athletes challenged the state's policy to allow transgender girls to compete in girls' sports. The case was dismissed in 2021 and the court of appeals upheld that judgment.
"Since then, we have been receiving inquiries from legislatures that have wanted to see what we could do to protect fairness in their states," Sharp said.
The ADF uses its litigation expertise to advise state and federal lawmakers on bills, evaluate their viability and ensure the laws would hold up in court.
APP was also active on the transgender sports issue in South Dakota. The group found that it was important for Republicans to carefully frame their stance as "for women" rather than "against transgender athletes," Schweppe said.
South Dakota first attempted to pass a bill in 2021, but it was vetoed by Gov. Kristi Noem. She advised the legislature to rework the language to avoid conflict between the state's public universities and the NCAA. The following year, a reworked version of the bill was signed into law.
"I would point to South Dakota as a state we have had wild success in," Schweppe said.
Gender-affirming care
Sharp said the ADF has worked closely with many of the 22 states that have gender-affirming healthcare bans in effect.
"Alliance Defending Freedom is committed to protecting children from harmful and unnecessary medical procedures being pushed by politicized medical associations and interest groups," he said. "We look forward to even more states joining the effort to protect vulnerable children in their states."
ADF and similar organizations often cite Dutch research to support their claims that gender-affirming healthcare is harmful, particularly to children. Sharp cited a study from the Endocrine Society, which states that gender dysphoria resolves for 85% of youth who go through puberty without gender-affirming care.
This study was also cited in an expert opinion by James Cantor in the case of Boe vs. Marshall in Alabama. In that case, the court ruled against the state's law that would have imposed criminal penalties on parents and healthcare providers who facilitated gender-affirming care for minors.
Researchers from Emory University, led by Dr. Vin Tangpricha, dispute the assertion that gender dysphoria resolves at such a high rate naturally. The research team tracked 82 transgender and gender-non-conforming teens over the course of several years.
"The vast majority of transgender and gender diverse people seeking gender-affirming hormone therapy continue on these therapies. This indicates that these gender identities are persistent and sustained," Tangpricha said.
According to the Trevor Project, LGBTQ+ youth are four times more likely to attempt suicide and are at much greater risk to have suicidal ideation. About 20% of transgender and nonbinary youth attempted suicide, according to the organization's 2022 National Survey on LGBTQ Youth Mental Health.
Sharp said his group is working with people who have "detransitioned."
"They sadly went through these procedures and now regret it."
Shupe once worked to oppose gender-affirming care alongside organizations like ADF. She has since renounced such organizations for using her as a "pawn."
"That fact should serve as a cautionary tale for others who may choose to get involved with these groups at their own peril," Shupe wrote in a 2022 blog. "By doing so, you will simply become a useful idiot: a pawn in their injurious war against the transgender population."
Shupe, a U.S. Army veteran, became the first legally recognized non-binary person in the United States in 2016.
House Bill 1080, called the "Help Not Harm" law, went into effect in South Dakota on July 1. It bars healthcare providers from administering surgery, prescribing drugs that delay or stop puberty and prescribing hormones at amounts "greater than would be normally produced" to anyone under age 18.
'NRA for families'
The APP has been billed as the "NRA for families," Schweppe said, as the organization runs ad campaigns and works on bills that "defend the family."
"We run ads to show Republican politicians that these are winning issues," Schweppe said. "We also worked with lawmakers to push bills across the finish line."
What would be described as winning issues changed in the eyes of Republicans for a time, Schweppe said. After a failed "bathroom bill" in North Carolina in 2016, he saw Republicans turn away from such legislation.
"We frankly lost that issue. What we did was we wanted to counter gender ideology. That was the long-term goal of ours," he said.
Women's sports bills became the next target. Then, bans on gender-affirming healthcare.
APP had also worked against same-sex marriage. Schweppe said he still "institutionally opposes" it, but the issue has fallen to the wayside because the organization is focused on "where we can actually win," like bans on gender-affirming care for kids.
Its next battle is to prevent the Equality Act from becoming federal law. The act would codify gender identity into civil rights law, protecting transgender and non-binary people from discrimination.
The bill has passed the U.S. House but has died in committee in the Senate in 2015, 2017, 2019 and 2021.
If you or someone you know is suicidal, call the National Suicide Prevention Lifeline at 988.
