Donald Trump’s HHS & the British Supreme Court: the triumph of transnational transphobia
by Pauline Park
2025 will be remembered as a banner year for transphobia on both sides of the Atlantic. Donald Trump’s (re) election in November 2024 brought the return of a president who probably personally could not care less about transgender issues but whose far right-wing coalition includes Christian fundamentalists deeply committed to undoing what limited rights members of the transgender community enjoy at the federal, state and local level in the United States. In theory, the British Labour Party is more liberal than either Trump’s Republican Party or the British Conservative Party; but since leading Labour to a landslide victory in 2024, Sir Keir Starmer has been anything but an ally to the transgender community in the United Kingdom.
To begin with the report issued by Donald Trump’s Department of Health & Human Services (HHS) (“HHS Releases Comprehensive Review of Medical Interventions for Children & Adolescents with Gender Dysphoria,” 1 May 2025), entitled “Treatment for Pediatric Gender Dysphoria: Review of Evidence & Best Practices,” 1 May 2025). The ‘report’ is not so much a report as an ideological attack on the very notion of medical intervention for transgendered children and adolescents, concluding that “The evidence for benefit of pediatric medical transition is very uncertain, while the evidence for harm is less uncertain,” even going so far as to assert that “There is evidence that some medical and medical health associations have suppressed dissent and stifled debate about this issue among their members” (executive summary, p. 9).
The response to the HHS ‘report’ from actual medical professionals has been almost uniformly negative.
“Today’s report is propaganda aiming to delegitimize the perfectly safe, effective, and evidence-based health care that transgender people access to be who they are. Being transgender, just like being cisgender, is not a choice nor can it be reversed by any medical or social method. The same way cisgender people know who they are, so do trans people. The same way cis people receive gender-affirming care, so do trans people. This report is clearly trying to build a case for conversion therapy. Conversion therapy is dangerous, discredited, and opposed by every major medical and mental health association including the American Academy of Pediatrics, American Medical Association, and the National Association of Social Workers. Conversion therapy only causes harm. There is no healing in trying to force someone to be someone they are not,” wrote Dr. Aisha Mays, adolescent medicine physician in California and board member with Physicians for Reproductive Health on behalf of the organization. Make no mistake, gender-affirming care is safe, it is effective at treating the dangerous reality of gender dysphoria, and as a result, it is lifesaving. Transgender and queer people, no matter their age, deserve to be trusted and affirmed. I am proud to be in a community of physician advocates committed to listening to the needs of all young people, including transgender youth. Uplifting and embracing trans youth is the only long-term solution that will allow all young people to live whole, healthy, and safe lives.
(“New HHS Report is Dangerous for Transgender Patients,” 1 May 2025).
The truth about the absurd assertions made in the HHS ‘report’ is to be found in another report: a thousand-page report required by a bill signed into law by Republican Utah Gov. Spencer Cox, which concluded,
“The consensus of the evidence supports that the treatments are effective in terms of mental health, psychosocial outcomes, and the induction of body
changes consistent with the affirmed gender in pediatric [gender dysphoria] patients. The evidence also supports that the treatments are safe in terms of changes to bone density, cardiovascular risk factors, metabolic changes, and cancer…
“It is our expert opinion that policies to prevent access to and use of [gender-affirming hormone therapy] for treatment of [gender dysphoria] in pediatric patients cannot be justified based on the quantity or quality of medical science findings or concerns about potential regret in the future, and that high-quality guidelines are available to guide qualified providers in treating pediatric patients who meet diagnostic criteria…”
“Overall, there were positive mental health and psychosocial functioning outcomes. While gender affirming treatment showed a possibly protective effect in prostate cancer in transgender men and breast cancer in transgender women, there was an increase in some specific types of benign brain tumors. There were increased mortality risks in both transgender men and women treated with hormonal therapy, but more so in transgender women. Increase risk of mortality was consistently due to increase in suicide, non-natural causes, and HIV/AIDS. Patients that were seen at the gender clinic before the age of 18 had a lower risk of suicide compared to those referred as an adult…” (Madison Pauly, “Utah Study on Trans Youth Care Extremely Inconvenient for Politicians Who Ordered It,” Mother Jones, 24 May 2025)
Perhaps not surprisingly, the right-wing Republicans who pushed the transphobic ban on puberty blockers and hormones for legal minors in Utah rejected the very report they commissioned, with co-sponsor Rep. Katy Hall issuing a joint statement with Rep. Bridger Bolinder telling the Salt Lake Tribune, “We intend to keep the moratorium in place. Young kids and teenagers should not be making life-altering medical decisions based on weak evidence.” In other words, if the overwhelming evidence shows positive health outcomes for medical interventions, simply reject the evidence and call it ‘weak evidence.’
But the right-wing Republican Party is hardly unique in undermining transgender rights: in the United Kingdom, the ostensibly progressive British Labour Party has been undermining the UK’s transgender community.
After 14 years of Conservative Party misrule by a series of increasingly incompetent prime ministers, the British public became fed up with the terrible Tories and tossed them out. In a general election on 4 July 2024, Labour won 63% of the seats (411 seats) in the House of Commons — based on 33.7% of the popular vote — itself an indictment of the British electoral system. Starmer appointed the first openly gay health minister in British history after campaigning on a platform of full access to gender-affirming care for trans people but West Streeting’s first act as health minister was to affirm the outgoing Conservative government of Rishi Sunak’s ban on puberty blockers — a ban subsequently confirmed by the British Supreme Court; established on 1 October 2009, the Supreme Court replaced the House of Lords as the highest in the United Kingdom (Kaz Self, “What Wes Streeting gets wrong about puberty blockers,” Labour List, 17 July 2024).
On 16 April 2025, the UK Supreme Court ruled in favor of For Women Scotland Lt. v. the Scottish Ministers, unanimously declaring that terms ‘woman’ and ‘sex’ in the Equality Act of 2010 should refer to biological sex assigned at birth (Gender GP, “UK Supreme Court Ruling: What It Means for Transgender Rights in Britain,” 24 April 2025); it was a devastating blow to the British transgender community and based on a complete misunderstanding of the relationship between sex and gender and the socially constructed character of sex itself. Many in the community fear that the ruling has seriously undermined the Gender Recognition Act of 2004, though the full impact of the Supreme Court decision will only become clear over time. The ruling addresses single-sex occupancy facilities but does not explicitly address public restrooms, which are a big flash point for transphobic reactionaries attempting to fuel a ‘gender panic’ with visions of predatory men lurking in women’s rooms.
“It’s worth noting that this ruling places the UK increasingly at odds with international best practices regarding transgender rights. Countries like Ireland, Portugal, and Argentina have implemented more progressive gender recognition systems based on self-determination rather than medical diagnosis or biological definitions. The European Court of Human Rights has also previously emphasised the importance of legal gender recognition as a fundamental aspect of the right to private life. This divergence raises questions about whether challenges to the UK position might eventually reach European human rights courts,” notes Gender GP (Gender GP, “UK Supreme Court Ruling: What It Means for Transgender Rights in Britain,” 24 April 2025).