As Arizona lawmakers voted to advance a bill banning trans youth from receiving gender-affirming surgery, a legislative aide approached Skyler Morrison and handed her a note. Morrison, a trans teen who lives in Phoenix, warned in a testimony delivered to the House Judiciary Committee earlier the same day that Senate Bill 1138 is a “pointless and harmful solution to a non-existent issue.” At 13 years old, she is years away from being able to surgically transition, and in her speech, she told committee members that the legislation is “just an excuse to discriminate.”
“I still have a good four or five years before I start worrying about it, but it’s so scary because it’s really not about protecting kids,” Skyler told HuffPost over the phone. “It’s about stripping our rights away. That’s all they care about.”
Among those present for her March 9 testimony was the note’s author, state Rep. Walter Blackman. That day, his aide handed Skyler an Arizona Department of Corrections medal inscribed with words like “integrity” and “professionalism,” along with a message handwritten on a torn piece of notepad paper. In it, Blackman thanked her for being “brave.” The GOP lawmaker personally met with Skyler in his office 12 days later, and, during that meeting, he told her he wanted to “be a better legislator for all people,” according to Skyler’s father, Andrew.
Although she said it was a “really weird gift,” Skyler hoped the gold medallion was a sign she had gotten through to Blackman. She’d succeeded in swaying conservatives before. After Skyler testified in February against a sweeping bill banning all forms of gender-affirming medical care for trans youth, including puberty blockers and hormone replacement therapy, state Sen. Tyler Pace broke with his party to oppose it.
Unfortunately, Skyler was not able to reach across the aisle a second time. Just minutes after writing his message to Skyler, Blackman cast the deciding vote to advance the bill out of committee. He backed the legislation yet again when it came up for a full vote in the Arizona House on March 24, with the bill passing 31-26 in its final hurdle before reaching Gov. Doug Ducey’s desk. The state Senate had already greenlighted the legislation a month prior in an even narrower 16-12 vote.
Andrew said the bill’s passage was a “slap in the face,” especially after Blackman gave a speech to his fellow House representatives urging them to listen to youth like Skyler and hear what they have to say. Andrew said he sent Blackman a “respectful but pointed email” following the final vote, and the lawmaker didn’t write back. (Blackman’s office did not reply to a HuffPost request for comment.)
“I won’t get a response,” Andrew told HuffPost. “That’s how it works. They tell you what you want to hear and then do whatever they were already going to do when it comes time to vote.”
Ducey signed SB 1138 into law on March 31, making Arizona just the third U.S. state to limit the kinds of medical treatments trans youth can receive, after Arkansas and Tennessee last year. In a statement accompanying the decision, the GOP governor referred to the new law as “common sense” and claimed it would “ensure that individuals undergoing irreversible gender reassignment surgery are of adult age.”
The law is set to go into effect in April 2023. Although surgical interventions for trans youth are relatively rare, many families worry the statute could prevent children who do need these lifesaving procedures from getting treatment. It also sets a dangerous precedent as other states push even harsher restrictions on trans health care. On Friday, Alabama Gov. Kay Ivey signed the first law in U.S. history to criminalize doctors who treat trans youth. Medical providers face up to 10 years in prison and a fine of $10,000 for providing gender-affirming medication or surgery to minors under 19.
Many families, including the Morrisons, would be forced to move away if Arizona were to pass a stricter trans youth medical care ban in the future. What makes that reality particularly devastating for their household is that they already had to relocate once to keep Skyler safe: They left Texas in 2017 after lawmakers attempted to force through a bill banning trans youth from using the school restroom that matches their lived gender. The Morrisons hoped Arizona would be a chance to start over.
Having dealt with attacks on her daughter’s right to exist for years with no end in sight, Skyler’s mother, Chelsa, compared the experience to the movie “Groundhog Day.”
“I’m constantly worrying about everything,” she told HuffPost. “It’s hard to be a good mom, a friend, or a wife because I’m just constantly sick with fear. Whenever we feel like we get a breath or a moment that’s beautiful, there’s something right behind that takes it away and makes it awful. I don’t feel like we’re ever going to get a break.”
A Ticking Clock
SB 1138 was one of two anti-trans bills enacted in Arizona last month. The other, SB 1165, bars trans girls from participating on sports teams in alignment with their gender identity at all public and private schools, including at the collegiate level. Known as the “Save Women’s Sports Act,” the legislation allows parents of cisgender students to sue if their child is forced to compete against a trans athlete.
Ducey claimed the law would “protect participation and fairness for female athletes,” citing similar reasoning to the 13 other governors who have signed trans sports bans into law. Iterations of the legislation put forward in previous years were criticized for requiring students to undergo invasive physical exams or submit to DNA testing to verify the sex they were assigned at birth, leading opponents to dub the legislation a “show me your genitals” bill. This year’s version does not explicitly include those provisions.
LGBTQ and civil rights organizations condemned both Arizona measures after Ducey signed them into law on March 30. The American Civil Liberties Union and National Center for Lesbian Rights vowed to sue Arizona and referred to the laws as “harmful and discriminatory.” In a statement, ACLU of Arizona campaign strategist K.M. Bell accused Ducey of attempting to “score points with extremist lawmakers and hateful groups” by signing the legislation.
Although advocacy groups have not yet filed a lawsuit to overturn SB 1138, Arizona has already been met with legal action for denying gender-affirming medical care. In 2020, NCLR sued on behalf of two anonymous plaintiffs who have been unable to receive surgical treatment for gender dysphoria under the state’s Medicaid program, which categorically excludes transition care for coverage.
Those who would be most directly affected by Arizona’s trans youth surgery ban are trans teenage boys, according to NCLR staff attorney Asaf Orr. Although the vast majority of surgical interventions take place after trans youth reach the age of 18, one exception is top surgery, a term referring to a double mastectomy performed on a trans male patient. These operations are performed on a “case-by-case basis,” Orr said, for youth who have already been receiving other forms of gender-affirming care for years.
John Doe, one of the plaintiffs in NCLR’s lawsuit, is a trans minor who has been unable to receive top surgery despite the fact that his doctors have deemed it medically necessary. Orr said his client’s gender dysphoria “affects him very significantly on a day-to-day basis” and that not getting the treatment he needs forces him to “hide his body in large sweatshirts, which are extremely hot in the Arizona heat.”
While it’s unclear how often surgery is performed on trans boys under 18, leading U.S. groups like the American Medical Association have broadly supported the use of gender-affirming care in treating patients’ gender dysphoria. Numerous studies have also shown that surgical interventions have positive impacts in the lives of trans adults. A 2021 study conducted by researchers from Harvard Medical School and Boston health nonprofit The Fenway Institute found that surgery reduced suicidal ideation by 44% and psychological distress by 42%.
“It’s hard to understate the benefits of surgical care to treat gender dysphoria because it has such a significant effect on every aspect of a transgender person’s life,” Orr said. “It has a universally positive impact.”
Kristin Downing, the mother of a trans 15-year-old, said SB 1138 is forcing her family to make hasty decisions regarding her child’s health care. Downing said he is still in the “middle of this whole journey,” having come out as nonbinary in 2019 and switching to he/him pronouns a month ago. Her child has less than a year before SB 1138 becomes official policy, and Downing said it feels as if he suddenly has a “time clock over his head to make big decisions before then.”
“It should be on his timeline,” Downing told HuffPost. “It shouldn’t be rushed. It shouldn’t be pulled off the table, especially because in Arizona, a minor can have breast augmentation or reduction surgery with parental consent, as long as they’re not trans. That’s just so insane to me that those parents have that right, but I don’t have the right to allow my child to do that.”
Although Downing said her child isn’t sure what decision he’s going to make yet, their family has discussed the possibility of moving out of state to ensure that he can receive whatever care he requires. She said he has expressed on numerous occasions that he “wouldn’t be here today” if not for the doctors who have affirmed his gender identity over the years. Having the support of medical professionals, she added, has been a lifeline for the whole family: It’s offered them a space where they don’t feel judged or like they need to educate anyone.
Preserving that resource would be worth uprooting their lives if the time came, Downing asserted, because of the difference it has made in her child’s life. She said he walks straighter and smiles a little easier now that he has been allowed to be himself. With every step of his journey of self-discovery, she described him as being “more comfortable in his own skin.”
Regardless of whether the family stays in the state, Downing affirmed that she will keep advocating for his right to continue down the path he has chosen for himself. “It puts a fire in my belly,” she said. “It makes me dig in. I don’t think they realize that: None of us are running scared. They’re just making us angrier and more determined.”
The Anti-Equality Playbook
The vast majority of trans girls under 18 would not immediately be impacted by SB 1138, as health care providers generally recommend delaying genital surgeries until what the World Professional Association for Transgender Health refers to as the “age of majority.” But LGBTQ advocates and parents of trans youth worry Arizona legislators will attempt to expand the scope of the law in the coming years.
Bridget Sharpe, Arizona state director for the Human Rights Campaign, said the law represents a tactic from the “anti-equality playbook” of chipping away at LGBTQ rights “piece by piece.” After Tennessee enacted an extremely narrow law in 2021 banning puberty blockers for “pre-pubertal minors,” lawmakers introduced at least four bills this year outlawing all forms of gender-affirming medical care. Two of those proposals — House Bill 578 and its companion bill, Senate Bill 657 — threaten Tennessee doctors that treat trans youth with up to 11 months in jail and loss of their license.
“We see that incremental change year after year,” Sharpe told HuffPost. “We’ve seen such a sweeping movement this year of anti-trans legislation, and it just doesn’t come out of nowhere. If we have states like ours who weren’t able to get the full bill that they wanted to see passed, they’ll just keep going until they continue to take away the rights of our community.”
About 240 bills targeting LGBTQ people have been introduced in states in 2022, according to NBC News. At least 17 of those proposals were put forward in Arizona, and parents of trans youth said yet another wave of legislation in 2023 would severely threaten their children’s lives. Elizabeth, who asked not to be identified by her real name to protect her privacy, said the “only reason” her son is thriving is because of the gender-affirming care he’s been receiving. When Arizona debated the comprehensive youth medical care ban earlier this year, she cried in the shower for hours every day.
Elizabeth’s family just moved to Arizona from Oklahoma in 2020, and they would struggle to be able to move again. It cost them more than $30,000 to move during the pandemic, she said, and she is hoping to put a modest down payment on a house in Arizona and then flip and sell it if they need to to fund a move out of the state. But as her voice quivered, Elizabeth said she has made offers on 14 properties and viewed over 100. She’s beginning to lose hope of that plan working.
“We’re constantly waiting for the other shoe to drop and know that we have to leave again,” she told HuffPost. “My husband was a veteran and sacrificed greatly for our country. He put his life on the line, and we’re unwilling to sacrifice our son’s life for this state or for lawmakers that don’t even do their due diligence and let medical providers make these decisions.”
Parents like Elizabeth said they feel trapped in limbo as they await what is coming next. Ai Bin Ho, the mother of a 4-year-old trans girl, said she has been having flashbacks to leaving Vietnam with her parents. Her mother was imprisoned for trying to escape following the war, forcing Ho’s father to go into hiding. They were finally able to get out after the U.S. lifted its embargo on Vietnam in 1994, and Ho recalled that her family took shelter in a warehouse until the day their plane took off.
“When the time comes, I won’t be cupping my daughter’s mouth and sneaking her off in the middle of the night, but I will be taking her hand to another state where she can be safe,” Ho said. “It creates this internal domestic migration based on the lives of our children.”
The mass exodus is not unique to Arizona: Some families in Arkansas and Texas have also been forced out of their states by decisions they argue threaten their children’s right to exist. Last year, Arkansas became the first state in the U.S. to pass a law prohibiting all forms of gender-affirming medical care for youth, after a bill was forced through by legislators over the veto of its governor, Asa Hutchinson (R). In February, Texas Gov. Greg Abbott (R) ordered the state’s child welfare services agency to investigate affirming parents of trans kids for “abuse.”
Both policies have been blocked by courts as lawsuits against them proceed through the legal system, but parents of trans kids across the U.S. remain fearful that more states will join Arkansas and Texas. Chelsa Morrison said it doesn’t “feel like any state is safe” for her daughter anymore, especially now that Skyler has become a public voice in opposition to legislation targeting trans kids.
Families of trans youth said they have essentially been left with no good options. Even if the Morrisons were to leave Arizona, Chelsa said, the trauma of having your family in the crosshairs stays with you. After they moved away from Texas five years ago, Chelsa cut off all her hair in case she was ever forced to literally fight for her daughter’s life. She said Skyler still has recurring nightmares of being kidnapped and taken away by strangers, and Chelsa struggles with the fear she wouldn’t be able to stop them.
Having spent so much of her childhood living in terror, Skyler said the fact is that she shouldn’t have to think about any of this at such a young age. “I don’t want to have to worry about what state I feel safe in,” she lamented. “I don’t want to worry about moving out of a space that I’ve just barely got adjusted to. I just want to live my life as a regular kid, but I can’t.”