For Karen, staging her family’s Austin home to be sold felt like a series of small paper cuts.
Packing up her daughter Jessie’s things particularly stung. Karen boxed up stuffed animals and peeled posters off the walls, including one of Jessie’s favorites: it says “Trans Girls are Girls” in the blue, pink, and white colors of the trans pride flag. Jessie (10 years old) is transgender and had seen it at a protest against the Texas anti-trans rights laws. It was a hit with her, and Karen bought it as a birthday gift for Chris. “As soon as she walked in the door, I heard her shout, ‘Where’s my poster?’” Karen recalls. Jessie could not comprehend why the poster had to be taken down or believe it was an identity judgment.
But it’s to protect that identity that Karen and Chris are rolling up the poster and moving her family out of Texas. Over 30 anti-LGBTQ bills, 13 of which would have specifically affected trans youth, were filed in Texas’ 2021 legislative session, according to a tally by the LGBTQ advocacy group Equality Texas. In January 2022, one bill was passed that would prohibit trans youth from participating in sports teams that are aligned to their gender identity. Then in February, Republican Texas Governor Greg Abbott directed the state’s family protective services agency to investigate parents who may have provided their trans children with gender-affirming care.
Jessie, Karen, and others are also facing an avalanche of attempts by the state to limit or prevent trans rights. According to The Williams Institute, UCLA’s research center on sexual orientation and gender identity policy, 1.4% of U.S. teens aged 13-17 are trans. Many of these young people saw their rights cut in the last two years as conservative state legislators across the country have introduced a flood of legislation that targets LGBTQ youth and their families. A NBC News analysis found that around 240 antiLGBTQ rights bills had been passed by legislators as of March 2022. Half of them specifically targeted trans people. The policies restrict trans youth from playing sports or using a gender-aligned bathroom, and they also limit their ability to study LGBTQ topics in school. According to the American Civil Liberties Union (ACU), at least 22 anti-LGBTQ laws have been passed in this year. Ten such laws that target education in six US states were put into effect July 1.
There is now a growing gap between blue and red states about trans rights. This has led Karen to become a political migrant: trans families are leaving unwelcomed home states in search of better ones that provide explicit protection against discrimination.
Karen’s little girl Jessie assists her in packing as she prepares to move out of their Austin home on June 6, 2022.
TIME by riel SURCHIO
TIME spoke to 10 families in Texas, Arizona and Arkansas who were moving, or are planning on moving, from states that have restricted gender-affirming healthcare for their youth. Others want to move, but cannot due to family obligations, job security or high costs of moving out of state.
Anti-trans rights supporters argue that they are doing what is best for children. Some argue that gender is determined by the sex on a person’s birth certificate, and many anti-trans legislators take the position that offering gender-affirming care to minors is irresponsible.
Chris and Karen are in agreement with the vast majority of American doctors, such as the American Academy of Pediatrics, American Medical Association and American Psychological Association. They believe that gender affirming care can not only be appropriate but also necessary for young trans people. Jessie may not be at an age when her parents can discuss what gender-affirming healthcare is right for her. However, if her parents remained in Texas, they could expose their daughter to child abuse investigations.
“There are no good choices when the situation that these politicians have created is a nightmare,” Karen says. But she knew if they stayed, they’d lose the ability to choose for themselves what’s best for their daughter. And they feared for her safety—TIME is withholding Karen and Chris’ last name and referring to Jessie and her brother Lucas, 9, by pseudonyms because the family has security concerns amid increasing anti-LGBTQ rhetoric in the U.S. On June 6th, Jessie and her brother stood in the driveway, hugged their grandparents goodbye, and began the five day-long drive to their new home in Portland Ore., where gender-affirming care is legal and lawmakers codified LGBTQ inclusive school curricula into law last year. Jessie was sitting amongst boxes and moving supplies in her Portland bedroom, June 19. “I felt safer to move,” she says. “Like, much safer.”
Jessie in Austin at her family’s house on moving day.
TIME riel Sturchio
‘Am I going to die?’
The day Karen realized they had to leave came in early March, shortly after Texas’ Department of Family and Protective Services began investigating families of trans children.
Karen asked Jessie as they drove around Austin if she was interested in joining her at the protest. “I just heard this little 10-year-old voice behind me ask, ‘Am I going to die?’” Karen says. Jessie’s face was swollen with tears. Karen asked why Jessie would say that, and Jessie replied, “Because everybody here hates me,” Karen recalls.
Karen spent three years fighting against state anti-trans laws. By 2021 it had become like an unpaid full-time job, as she met with lawmakers, testified, and protested laws that would restrict Jessie’s rights. One of the bills in the most recent legislative session would have prohibited physicians from providing gender-affirming care to young people—an issue top of mind for Karen and Chris as Jessie nears puberty.
Gender-affirming care is a model of care that can include a spectrum of social, psychological, behavioral, or medical interventions designed to support and affirm a person’s gender identity, according to the World Health Organization. It can support youth experiencing gender dysphoria, which is the feeling of discomfort or distress that might occur when a person’s gender identity is inconsistent with the sex they were assigned at birth. What care looks like can vary; in young children, gender dysphoria can be treated with non-medical social and behavioral interventions, like changing one’s name, pronouns, or clothing. During puberty, a young person experiencing gender dysphoria may also begin receiving gonadotropin-releasing hormone (GnRH) analogues—known as “puberty blockers”—that can pause the continued development of a puberty incongruent with their gender identity. Some adolescents might start taking hormones that affirm gender, like testosterone and estradiol, as they grow older. It is rare for a person under 18 to undergo surgical intervention, but some may decide to pursue “top surgery”—surgery to change the appearance of one’s chest—while they are still teenagers.
There is broad consensus among providers and major U.S. medical associations—including the American Medical Association, American Academy of Pediatrics, the Endocrine Society, American Psychological Association, American Psychiatric Association, and the World Professional Association for Transgender Health—about the medical necessity and appropriateness of gender affirming care for youth. There is much debate in the field over when to start different interventions, but providers and experts agree that they are necessary. Expert organizations have reported harmful consequences of depriving youth access to such services. Kaiser Family Foundation (KFF)
As Karen and her family leave Austin, boxes are waiting to be moved by the movers.
TIME riel Sturchio
Peer-reviewed research published in The Journal of Adolescent Health Researchers from the LGBTQ suicide prevention organization The Trevor Project found that gender-affirming hormone therapy is associated with an almost 40% reduction in suicide attempts and recent depression among nonbinary transgender youth aged 13-17. A peer-reviewed study, published in PLOS one on January 12, showed that having access to gender-affirming hormonal therapy as an adolescent was linked with improved mental health for trans adults. It is based upon data from the 2015 U.S. Transgender Survey, conducted by the National Center for Transgender Equality and involving over 27,000 transgender Americans.
Texas GOP lawmakers and representatives from 20 states passed laws that would ban physicians from providing minors with gender-affirming healthcare in 2021. Arkansas passed the first such law in April. The next year, at most 15 states would introduce 25 other bills to restrict youth’s access to the same gender-affirming services. Alabama passed the harshest anti-trans legislation yet in April, making it a crime to provide young women with gender-affirming services.
The American Academy of Pediatrics strongly condemns the February legal opinion by Texas Attorney General Ken Paxton that stated gender affirming care is child abuse. Abbott’s directive came a week later, which the Biden Administration said put “children’s lives at risk.” LGBTQ advocates argued the move was political, pointing out that it came shortly before the state’s Republican primary, where both Paxton and Abbott faced challengers. Both incumbents prevailed.
Paxton’s and Abbott’s offices did not respond to requests for comment on this story.
Karen and Chris were affected by the directive in their assessment of their risks for their trans-daughter raising her in Texas. They sat together in the kitchen, talking circles in circles, after Jessie had asked if she would die. It was safe to continue living here. They could pick up the pieces and move on. They could afford it. What would it take to get health insurance for them? They sent the kids upstairs so they wouldn’t listen, but of course they eavesdropped. Eventually Jessie came back downstairs and handed her mom a card she’d drawn. “Super mom!” The card was read with Karen wearing a cape superhero costume. “We can fight this together.”
“It should not be something she has to fight,” Karen says, her voice catching. Chris and Karen decided to meet that evening.
Karen and Jessie are now resting in Portland, their new home on June 20, 2022.
Ricardo Nagaoka for TIME
Portland was chosen by Chris because he knew Portland had good friends and strong policies and laws for LGBTQ people. Chris made arrangements with his architect firm to work remotely. They sold the house and staged it. Three months of waiting was intense as they waited for the date. Each day, the children went to school with a paper stating that they didn’t consent to being interviewed. They were instructed to give it to child protective service agents who may approach them.
‘Our rights shouldn’t depend on our zip code’
When Paxton’s office issued the February opinion stating that gender-affirming care constitutes child abuse, it conflated puberty blockers and hormone therapy with surgical procedures—which major medical associations say are rarely performed on minors—and said the opinion addressed the mixing of medicine and “misguided ideology.” Days later, Abbott called on “licensed professionals” and “members of the general public” to report the parents of trans youth to family protective services if it appears their children had received gender-affirming care.
Texas’ Department of Family and Protective Services (DFPS) never opened an investigation into Jessie’s family. TIME received confirmation from DFPS that they opened investigations into at least eleven families in February. (Some investigations are currently suspended while the litigation is ongoing.
The Briggles—Amber, Adam, and their 14-year-old trans son and his sibling—are one of those families. The DFPS informed them that the investigation had been closed. Amber says they’ve considered moving out of Texas, but it would be extremely difficult for them. She’s a small business owner and Adam is a tenured college professor—if they left, they’d lose their jobs and health insurance. It worries her that she will have to pull her children out of crucial years of social and emotional development in high school and middle schools. “We shouldn’t have to leave,” Amber says. “Our rights shouldn’t depend on our zip code.”
Cardelia Howell Diamond is a Cumberland Presbyterian Church minister. Her three sons are both transgender and she feels exactly the same. They’ve built a support network in their home state. “The thought of having to recreate that somewhere else is terrifying,” she says.
Jessie and Lucas, their brother, hang from a tree in front of their new home.
Ricardo Nagaoka for TIME
Heather is keeping her name secret out of fear of harassing her children. She says that she values families who are willing to fight for their rights, but feels she must leave Alabama to be with her trans-son Robert, 15 years old. “The atmosphere here is already tense,” she says. “Could you imagine what it will be like closer to the election?” They’re planning to move to Illinois, and have turned to GoFundMe to ease the financial burden.
Kimberly Shappley, whose 11-year-old daughter is trans, says she decided to leave Texas in May when a leaked Supreme Court draft opinion signaled the high court was poised to overturn 1973’s landmark abortion decision Roe V. Wade While her daughter’s rights might be under attack in Texas, she’d figured they’d be upheld if litigation reached the Supreme Court. Now, she’s unsure. A registered nurse, she’s looking at states where she can keep her license that are also friendly to trans kids. She’d been planning on New Hampshire, until she saw a state lawmaker had introduced its own bill in March that would classify gender-affirming care as child abuse.
This isn’t even the first time Shappley has moved for her daughter; she and her family moved from Pearland, Texas, to Austin in 2018 after her daughter’s previous school refused to let her use the girl’s bathroom. They thought the city’s progressive reputation would help protect them. “But the city of Austin isn’t going to be able to save us,” Shappley says. “I just don’t see Texas being better for trans kids anytime soon.”
Jessie & Lucas are together at their new house.
Ricardo Nagaoka for TIME
Families with trans kids who’ve already left their state don’t know when they’ll be able to go back. GoFundMe was used by Emily Spurrier (right) and George Spurrier (left), in April 2021, to enable them to move quickly from Arkansas to New Mexico. The family was concerned that their trans 17-year old son would be stopped from receiving the gender-affirming care he needed. Camille Rey moved with her transgender children from Texas to Maryland after the initial gender-affirming care ban in Maryland was passed in 2021. Mike Taylor and his twins aged 10 years, one transgender, moved from Texas to Hawaii when anti-trans laws began to collapse.
“My heart’s in Texas,” says Taylor, who has continued his job as a South Texas radio host remotely. “I would love to go home at some point for good… I feel I was forced to [become an] expat from my own state, and that’s heartbreaking.”
‘It made me feel safer’
When Karen’s family reached Oregon in early June, they all felt some sense of relief. They blasted “Edge of Town” by Middle Kids as they crossed the state line after five days of driving.
“It made me feel safer, but also sad,” Jessie says about the move. Although emotions may not be the most pleasant, both children are trying to focus on the good things. Jessie loves Oregon and says that she feels safer. Her brother Lucas can’t wait for a cold winter.
Karen’s family has found a haven, but the battle over the rights of trans youth is far from over, in the political arena or the legal one. As right-wing candidates use the issue to gain support, more bans could come down on gender affirming care. American Principles Project, a conservative advocacy group, claims it has raised as much as $9,000,000 to fund a midterm campaign that will target gender-affirming minors’ care and other issues that impact trans children.
Karen and her kids play with balloons at Portland’s Pride festival on June 19, 2022.
Ricardo Nagaoka for TIME
Alabama and Arkansas’ gender-affirming care bans are currently blocked and tied up in litigation, but the issue is not settled. In a brief filed June 27, Alabama’s Attorney General cited the Supreme Court’s recent overturn ofRoe V. Wade in defense of its felony ban, arguing that gender-affirming care is not “deeply rooted in our history or traditions”—as Justice Samuel Alito wrote about the right to an abortion—so the state has the legal authority to ban it. In Florida, where teaching about LGBTQ issues in primary school is now banned, The Department of Health issued guidance in April advising against any gender-affirming care for young people, even social transition like changing one’s name or pronouns, and has proposed a rule change that would ban Medicaid from covering gender-affirming care for people of any age. In response to the wave of anti-trans policies, President Joe Biden issued an executive order on June 15 directing the U.S. Department of Health and Human Services to “work with states to promote expanded access to gender-affirming care,” which could tee up even more litigation in the future.
In the meantime, Karen’s family is settling into their new home, free for now from the burden of battling their state government. They’re in the process of unpacking, slowly unwrapping pieces of their old life. In the basement is a stack of what still needs to be hung on the bare walls: Karen and Chris’ wedding portraits, a Kurt Vonnegut poster, drawings by the kids, and Jessie’s blue, pink, and white poster that says “Trans Girls Are Girls.”
On June 19, the family went to Portland’s Pride festival on the waterfront in their first outing together in the new city. The family held hands as they squelched through the rain-soaked mud and weaved their way through the crowd of rainbow-clad people. They approached the booth of the TransActive Gender Project, which works to support trans youth in Oregon, and Karen introduced Jessie, sharing that they’d just moved from Texas.
“Welcome,” the staff member said, addressing Jessie. “We’re so glad you’re here.”
Karen, Chris and their kids attend Portland’s Pride festival, as they settle into their new home town.
Ricardo Nagaoka for TIME
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