Last month in the Montana statehouse, Democratic State Representative Zooey Zephyr stood up to oppose a bill that bans gender-affirming care for the Montana’s transgender youth. “If you vote yes on this bill and yes on these amendments, I hope the next time there’s an invocation, when you bow your heads in prayer, you see the blood on your hands,” said Zephyr, the first transgender woman elected to the state’s legislature. The conservative Montana Freedom Caucus called for the “immediate censure of transgender Rep. Zooey Zephyr,” and Republicans voted to bar her from the Montana House floor. The American Civil Liberties Union of Montana is now suing the state to reinstate Zephyr.

Zephyr is one of many legislators and transgender advocates nationwide who are leading the charge to protect access to gender-affirming care. So far this year, 49 states have introduced a total of more than 500 antitrans bills, according to the data collection website Trans Legislation Tracker. Like the antiabortion movement, “a lot of this is just moral panic,” says Alejandra Caraballo, a clinical instructor Harvard Law School’s Cyberlaw Clinic, who has been tracking antitrans legislation. It involves “tons of distortion of the medical evidence, straight-up lying [and] manipulation.”

In contrast, states such as California, Colorado and Minnesota have passed legislation that protects trans people who are seeking gender-affirming care and their families. The bill in Colorado, for example, allows people from other states to travel to Colorado and receive this care without fear of prosecution.

Many parents of trans children agree that gender-affirming care is essential. “This is literally lifesaving medical care for children,” says Amber Briggle, who is the mother of a trans kid in Texas and involved in an ongoing lawsuit against Governor Greg Abbott. Briggle’s family is one of at least 15 who were investigated by the state’s Department of Family and Protective Services after Abbott directed the agency to open child abuse investigations into families who provide gender-affirming care to their children. “I’m fighting not just for my kid and my rights but for all families” with trans children, Briggle says.

A wealth of studies has shown that gender-affirming care is vital for trans people’s health and mental well-being. A study at the Gender Clinic at Seattle Children’s Hospital found that in trans youth who are 13 to 20 years old, such care leads to 60 percent lower odds of depression and 73 percent lower odds of suicidal thoughts. Another study published in PLOS ONE showed that trans people who received hormone therapy during adolescence were far less likely to have experienced severe psychological distress in the past month than those who didn’t take hormones until they were adults.

Along with reducing negative mental health outcomes, this care allows trans people to live as their true selves, which brings incredible joy. “Being trans is hard sometimes, but it is a relief every single day I do not have to live as a man...,” tweeted Ari Drennan, LGBTQ program director at Media Matters for America. “I see my life so clearly, and what it might have been in a crueler era. I’m so grateful to have had a choice.”

Briggle’s son is also thriving. Now 15 years old, he is one of the most popular kids in school and a talented musician who plays the cello, ukulele and piano, according to Adam Briggle, the teen’s father and Amber Briggle’s husband. His son’s biggest passion, however, is creative writing. “Everything about him is flourishing,” Adam Briggle says. “I can’t even imagine if we had said, ‘No, you aren’t who you say you are.’”

These benefits are the reason major medical associations in the U.S., including the American Medical Association, the American Academy of Pediatrics and the American Psychological Association, support access to gender-affirming care.

Continuing to publish studies on the benefits of such care is a necessary step in having evidence-based public policy, says Jack Turban, director of the Gender Psychiatry Program at the University of California, San Francisco. Turban has co-authored multiple studies that show the significant psychological benefits of gender-affirming care, including the paper in PLOS ONE.

But publishing data is only part of the battle because most people don’t spend their time reading dense academic journals, he says. Another key element is to talk to journalists who can break down misinformation about trans people and health care—or, as Turban has done, write about the dangers and falsehoods of antitrans rhetoric. His work has appeared in publications that include the Washington Post, the New York Times and Scientific American. “These Republicans have simply repackaged old anti-gay rhetoric and scaremongering to target transgender people,” he wrote in his most recent opinion piece for CNN.

The number of antitrans bills has more than doubled since 2022, and much of the battle to protect access to gender-affirming care has been happening inside state capitol buildings. Democratic State Senator Machaela Cavanaugh of Nebraska spent months filibustering a bill that would bar physicians from providing gender-affirming procedures and medical care to anyone under 19 years old; Republicans ultimately passed the bill.* “It is not the role of government to be in the doctor’s office,” Cavanaugh says. “I don’t think it is appropriate for the legislature to target a minority population and try to prohibit them from getting medical care.”

And antitrans legislation is not stopping at trans children. Lawmakers are now targeting health care for trans adults through bills that would prohibit state funds from being used for health benefits that cover gender-affirming care for people of any age—or that ban such care for minors and specifically call out Planned Parenthood clinics in Tennessee as one of the “largest administrators in this state” for adult gender-affirming hormone therapy and other treatments. “I fear this will be an issue in upcoming presidential campaigns unless we push back hard,” Amber Briggle says. “Trans kids are just the canary in the coal mine.”

She would rather spend her time doing ordinary things such as learning how to grow the best heirloom tomatoes than continually fighting against the unprecedented flood of antitrans bills. But she is not going to rest until transgender care is secure. Adam Briggle hopes for a day when trans people are just seen as normal, joyful people.

Caraballo, however, believes that “it’s going to be a decade-long fight.” She compares the situation to the onslaught of gay marriage bans that passed in 2004, 11 years before the Supreme Court made same-sex marriage a right nationwide. But ultimately she thinks it will be successful. “We’re going to win out in the end,” Caraballo says.

*Editors Note (5/17/23): This sentence has been updated after posting because the bill in question has been passed.