Bodies over Minds: Restricting Gender-Affirming Care, Challenging Medical Expertise

Cal Garrett, Wake Forest University
Kylie Jones, Wake Forest University
Maya Roth, Wake Forest University

Until recently, there was a growing consensus among medical experts in the United States that gender-affirming care is a necessary and legitimate form of health care for young people based on evidence that this care improves long-term mental health outcomes for queer and trans people. However, state-level restrictions on the provision of gender-affirming care that have proliferated since 2022 run counter to this consensus, asserting that normative sex and gender development of the body should takes precedence over mental health outcomes. This assertion, championed by activists and policymakers to restrict gender-affirming care, while running counter to current medical expertise, often enjoy popular support from the public at-large. Why has the emerging professional consensus on gender diverged from popular understandings such that medical experts’ authority sex and gender is now in question? Based on a qualitative archival analysis of three distinct cases of state-level policies (Georgia, North Carolina, and Virginia) that have been proposed to restrict access to gender-affirming care for minors, and resistance to those policies, this paper finds that the rejection of expert consensus hinges, in part, on two questions that underpin gender-affirming care provision that have been bracketed by experts but remain salient in public debate: (1) whether gender variation is a ‘normal’ part of human development and (2) whether mental health outcomes can justify biomedical treatments or interventions. In other words, while there has been growing expert consensus in support of providing gender-affirming care as an ethical standard of practice, because this move has not been accompanied by explicit arguments that queer and trans people are a ‘normal’ outcome of human development and that mental health concerns are an appropriate basis for medical interventions or procedures, expert acceptance of gender-affirming care has not been followed by the public at-large.

No extended abstract or paper available

 Presented in Session 22. Health, Medicine and Body