- All articles

All articles

- Skrmetti and the Future

- Justice Department Uses Anti-Trans FTC Workshop to Announce Investigations

- TWIBS: PA Punishes Angry Gay Grandpa

- In Washington, Seattle Socialists Marched for Trans Solidarity

- Diagnoses like “Gender Dysphoria” May Not Be Medically Real — But They Sure Are Politically So

JUL 15, 2025, 7:00 AM EDT | ASSIGNED | SOURCE

Skrmetti and the Future

In the wake of the devastating decision in US v Skrmetti, what are the further legal ramifications for other cases centered around the rights of transgender people?

Protesters with Gender Liberation Movement gather in front of the Supreme Court in response to US v Skrmetti. Shortly after, nine protesters were arrested, including author Allison Chapman.

Photo by: Alexa B Wilkinson - @framed.unrest

by Allison Chapman

On June 30th, The Supreme Court of the United States (SCOTUS) released an order vacating three lower court rulings on transgender rights related cases and remanded them back to the lower courts to reconsider in light of US v. Skrmetti. “After any substantive decision, the Supreme Court often takes the procedural step of providing lower courts the opportunity to address whether its decision changes anything about those lower courts’ rulings.” wrote Peter Renn, Senior Counsel at Lambda Legal in a response to emailed questions. While it’s impossible to predict exactly how things will play out, let’s look at the specifics of these court cases to better understand some of the potential outcomes, opportunities, and risks.

Legal Concepts

To understand this analysis you must first understand the legal concepts of equal protection and the different levels of scrutiny the court can apply.

The final sentence of section 1 of the 14th Amendment states “nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.” This is known as the equal protection clause. According to Cornell Law Institute this idea of equal protection means that “the governing body state must treat an individual in the same manner as others in similar conditions and circumstances.” This simple idea has been a core part of constitutional law and the basis of groundbreaking civil rights rulings such as Brown v Board of Education (1954) and Obergefell v Hodges (2015). However, in practice it’s much more complicated.

The 14th Amendment. Source: https://constitution.congress.gov/constitution/amendment-14/

Different methods or levels of scrutiny are applied in cases involving the equal protection clause to determine the constitutionality of a law that allegedly discriminates against a group of people. You might be familiar with the term from the documentary titled Heightened Scrutiny that followed Chase Strangio and US v Skrmetti (2025). There are three distinct methods, strict scrutiny, intermediate scrutiny, and rational basis scrutiny. Each level of scrutiny applies to different groups of people and has increasingly difficult hurdles a law must overcome in order to be ruled as constitutional.

Levels of Scrutiny. Source: https://jdadvising.com/two-minute-mbe-question-constitutional-law-equal-protection/#toggle-id-1

The highest level of scrutiny is strict scrutiny, which comes with the most difficult hurdle to overcome. Strict scrutiny typically applies only to laws that interfere with fundamental rights, laws that discriminate against people based on race and ethnicity, or laws that deal with national origin and alienage. In situations where strict scrutiny is applied it requires that the government that established the law prove that the law was defined in a way that only restricts the group to the level that is necessary to meet a government’s compelling interest. According to the Free Speech Center at MTSU, “An interest is compelling when it is essential or necessary rather than a matter of choice, preference, or discretion.” When you think of strict scrutiny, think about cases like Loving v Virginia (1967) and Brown v Board of Education (1954).

The middle level of scrutiny is intermediate scrutiny, which still has a rather high bar to reach before a law is ruled constitutional. Intermediate scrutiny applies typically to situations where people are discriminated against based on sex/gender (like women’s rights) or legitimacy of children. It requires the government to prove that the law is substantially related to an important government interest. Some examples of situations where the courts have applied intermediate scrutiny are in situations that prevent teen pregnancy, public health issues, and diversity through single-sex education. This was the level of scrutiny that Chase Strangio and the ACLU were arguing to have applied to US v Skrmetti (2025).

The lowest level of scrutiny that can be applied is rational basis scrutiny. It includes any groups of people not included in intermediate or strict scrutiny. Rational basis scrutiny requires the plaintiff, the person challenging the law, to prove that the law being challenged is not rationally related to legitimate government interest. In other words, this shifts the burden of proof onto the plaintiff to prove the government is in the wrong, compared to the other two levels of scrutiny which requires the government to prove that it is not wrong. The bar is also substantially lower than intermediate scrutiny in that it also requires that there be some legitimate justification for enacting the law. This is the level of scrutiny that was applied to US v Skrmetti (2025).

Fowler v Stitt (2023): A Case About Identity Documents

In Fowler v Stitt (2023), the 10th Circuit Court of Appeals overturned a lower court ruling and decided that an executive order and policy issued by the Governor of Okalahoma was in violation of the 14th Amendment in regards to sex discrimination under intermediate scrutiny. The executive order and policy prohibited gender marker changes for transgender people on state birth certificates. Additionally, It held that the policy had no rational relation with any legitimate government interest, meaning it also failed under rational basis scrutiny.

As you may recall, the Supreme Court determined that in U.S. v Skrmetti (2025), that the gender affirming care ban for minors in the State of Tennessee did not meet the threshold of intermediate scrutiny under the 14th Amendment. If you apply the logic that the Supreme Court applied in Skrmetti to this case, it quickly undermines the 10th Circuit's reasoning for considering this under intermediate scrutiny. In fact, this exact logic was already applied to the case by Justice Hartz in his dissent of the 10th Circuit’s ruling! Justice Hartz lamented “No person, either male (at birth or at present) or female (at birth or at present) can obtain an amended birth certificate changing gender. As I asked at the outset of this partial dissent, which sex is discriminated against?” His dissent ends with the statement “Perhaps one day we will get clarification from the Supreme Court.” Unfortunately, that day did indeed come.

However, the organization leading this case still appears confident that the case will see a positive outcome. Peter Renn, Senior Counsel at Lambda Legal told Assigned Media, “The Supreme Court held in Skrmetti that Tennessee’s law merely regulated medical treatment and thus did not discriminate against transgender people. That argument ultimately has no relevance here, where medical treatment is not at issue.” He went on to explain, “Oklahoma stripped transgender people of their ability to access basic identity documents, which are critical to their ability to safely navigate through modern life, simply because they are transgender. There is thus no question that the government has engaged in discrimination here.” In the end, the fact that this case has already been determined to fail even under rational basis scrutiny may prove to be a well needed safety net. However, that can’t be necessarily said about the other cases remanded by SCOTUS.

Kadel v Folwell (2022) and M.H. v Magni Hamso (2022): Gender Affirming Care and Insurance Coverage

The Supreme Court vacated and remanded two other decisions back to their respective lower courts, a combined decision referred to as Kadel v Folwell (2022) but also includes an additional case Anderson v Crouch (2022), and M.H. v Magni Hamso (2022). Both of these cases concern prohibitions on insurance coverage including gender affirming care on healthcare plans.

The 4th Circuit Court of Appeals ruled in Kadel v Folwell (2022) and Anderson v Crouch (2022) that banning coverage for gender affirming care is a violation of transgender people’s 14th Amendment rights and ruled that “in this case, discriminating on the basis of diagnosis is discriminating on the basis of gender identity and sex” and thus subject to intermediate scrutiny. This is nearly identical to the logic rejected in U.S. v Skrmetti when they determined that gender affirming healthcare for minors was not subject to intermediate scrutiny! The combination of this decision not making any determinations under rational basis scrutiny along with a large amount of the opinion based upon logic that was rejected by SCOTUS is concerning and leaves this case potentially vulnerable to being overturned.

However, the 4th Circuit Court further held that in Anderson v Crouch (2022) West Virginia exclusions of gender affirming care in its state’s medicaid program was in violation of the Medicaid Act and Affordable Care Act. This is a situation that was not considered by the Supreme Court in Skrmetti and thus it may increase the chances of it being upheld after it is reconsidered by the court.

The legal world is built upon years of precedent and rulings. When a case like Kadel is overturned it can have a cascading effect across the entire country. This is something Alejandra Caraballo, a civil-rights attorney and nationally recognized LGBTQ+ rights advocate knows all too well, “...we're about to see decades of precedent carefully built up be dismantled in the next year. Everything from healthcare access to gender marker changes to non-discrimination laws and bathroom access. SCOTUS just declared open season on us,” she wrote in a post on Bluesky.

In a similar fashion, M.H. v Magni Hamso (2022) held that intermediate scrutiny applied to Idaho Medicaid’s ban on gender affirming care. “As alleged, the policy of treating certain surgeries as “cosmetic” only when treating gender dysphoria creates a classification on the basis of transgender status and sex, which was clearly subject to heightened scrutiny under binding circuit precedent.” Here again, we find that the court relies on logic in conflict with the logic presented in Skrmetti in regards to the level of scrutiny to apply in this scenario. However, the court could still find that their original logic still applies given that Skrmetti dealt with healthcare for minors whereas this case deals with adult gender affirming healthcare.

Additional Cases and Where This Leaves Us

Unfortunately but unsurprisingly, these are far from the only cases potentially affected by Skrmetti. “Those opposed to equality for transgender people are already busy at work trying to stretch Skrmetti beyond its four corners” said Renn. Additional cases challenging gender affirming care bans all the way to the military ban on transgender people are already seeing briefings filed from both sides attempting to show how Skrmetti affects or does not affect their case. In fact, there are over a dozen cases currently being watched closely to see how courts rule now in light of Skrmetti.

According to Renn, “the Supreme Court was clear that its narrow decision was tied to the specific context of medical treatment for transgender adolescents.” However, it has yet to be seen whether the lower courts will agree. As with most legal matters, the devil is in the details. Transgender rights are in the most immediate danger in cases involving healthcare and reliance on the definition of gender dysphoria.

A few days after vacating the rulings in these three cases the Supreme Court also agreed to hear Little v. Hecox (2023), to potentially determine if transgender sports bans are a violation of transgender people’s equal rights under the 14th Amendment. It’s clear the Supreme Court isn’t finished assisting the Trump regime in tipping the scales by stripping the rights of the most vulnerable.

Where does this leave the trans community? Skrmetti was a stinging blow to transgender rights that will continue to have lasting and rippling impacts throughout the legal field. It’s also likely that more rights will be lost in the coming months and years. However, we will not go down without a fight. Lawyers like Chase Strangio of the ACLU and the attorneys at Lambda Legal will continue to fight tirelessly in the courts to defend transgender rights. Outside of the courts, it is the duty and right of those living under an oppressive government to rise up and resist oppression. We must stand together for ourselves and our neighbors. The fight is not over, in fact, it can be the beginning. That’s up to you. How are you going to respond?

Allison Chapman (she/her) is a LGBTQ+ Legislative Researcher and Transgender Advocate. Her work has been featured in publications such as Reuters, Washington Post, Slate, Truthout, and more. To learn more about her work you can visit her website https://allisonchapman.lgbt

This article was downloaded from https://www.assignedmedia.org/breaking-news/skrmetti-and-the-future at Jul 15, 2025, 7:23 PM EDT.

JUL 14, 2025, 7:00 AM EDT | ASSIGNED | SOURCE

Justice Department Uses Anti-Trans FTC Workshop to Announce Investigations

Leading Off: The DOJ launches investigations into gender-affirming care providers. ICE erases the numbers of transgender people in custody. And the EOCC resumes processing discrimination complaints by trans workers. The top story lines as the week begins.

by Assigned Media

The Justice Department is aggressively targeting gender-affirming care providers and snooping through the medical records of trans patients in the process.

Last Wednesday, at a Federal Trade Commission event, the Department of Justice Chief of Staff announced that the DOJ had filed more than twenty subpoenas for records from clinics providing gender-affirming care for minors; a press release later that day confirmed this. The DOJ is claiming potential fraud and false statements are the reasons for these investigations, but the move is largely seen as an escalation of the ideologically-motivated attacks on transgender healthcare.

This marks a new angle in the administration’s attacks on trans healthcare. Gender affirming care is widely recognised as safe and effective.

The FTC event featured an array of speakers and panelists from known anti-trans activist organizations such as Do No Harm, the Manhattan Institute, and the LGB Courage Coalition. Notably one of the panelists was Ethan Haim, a doctor who in 2024 was charged with accessing and leaking the medical records of transgender children to Chris Rufo, who would go on to publish the data to Twitter.

ICE has stopped recording the numbers of transgender people that it has in immigration detention. This erasure has complicated the efforts of advocates and has them concerned for the safety of transgender people in custody.

This is just one of many instances of the Trump Administration going to the effort of erasing the records and existence of trans people. Shortly after Trump took office, mentions of trans and intersex people were removed from numerous government pages and resources.

Later that same month, trans and queer were removed from the Stonewall National Monument website, prompting a number of protests and rallies in opposition to the changes. Recently, mentions of bisexual people were removed from the Stonewall National Monument page as well, as reported by Erin Reed.

While some of the latest changes were quietly reversed, they serve as a chilling indication of an intention to systematically erase records of LGBTQ+ people entirely as a way of removing us from the public consciousness.

The Equal Employment Opportunity Commission earlier this week resumed processing discrimination complaints by transgender workers, coming as a surprise after they stopped processing these claims shortly after Trump took office.

While these claims will be under higher scrutiny, this change comes as a welcome one, despite it not being clear as to what prompted it. This will allow at least some transgender workers to pursue compensation for cases of discrimination in the workplace

Assigned Media is your transgender news source.

This article was downloaded from https://www.assignedmedia.org/breaking-news/leading-off-doj-anti-trans-ftc-workshop-investigations at Jul 15, 2025, 7:23 PM EDT.

JUL 11, 2025, 6:00 AM EDT | ALYSSA STEINSIEK | SOURCE

TWIBS: PA Punishes Angry Gay Grandpa

Last year, activist James Lantz, known online as Angry Gay Grandpa, was arrested for a demonstration in PA. Now, they want to take thousands of dollars from a man with terminal cancer for the sin of… caring about trans kids?

Humor by Alyssa Steinsiek

This Week in Barrel Scraping (TWIBS) is Assigned Media’s oldest column! Every Friday, Alyssa Steinsiek digs deep from the well of transphobia and finds the most obnoxious, goofy thing transphobes have said or obsessed over during the week and tears it to shreds.

Sometimes, when I’m cruising headlines to find a story worth looking into for this column, I come across an event that exists in the strange purgatory zone between so unpleasant it couldn’t possibly be funny and so absurd that it’s hysterical how evil these people are. These are often the most interesting stories I get to talk about, and I’m happy to report that this week we’ve achieved the absolute perfect equilibrium between those two states by discussing the story of James Lantz, the gay grandpa with terminal cancer who was fined thousands of dollars by the state of Pennsylvania for protesting on behalf of trans kids.

I’m not particularly religious, but I have to say… my God!

A little background: Lantz is an activist who is best known for bringing attention to a spate of suicides among trans youth in Pennsylvania, which he talks about in a video on his website where he alleges that former Republican State Senator Ryan Aument is culpable for these deaths as a result of his frequent promotion of anti-LGBTQ+ legislation. He likens conservatives’ spreading of toxic rhetoric against queer people to the sort of damage a corporation does to the environment in the film Erin Brockovich, as well as the delayed negative repercussions of his own exposure to radiation that caused his own cancer.

There are other videos on Lantz’s website explaining his desire to fight against figures like Aument. While he focuses chiefly on this specific state senator, he also speaks broadly against the culture of fear, hatred and toxicity that conservative politicians are introducing into the world. He draws a direct line between those evils done to the queer community, and the tragic loss of queer lives to suicide.

In other words, Lantz recognizes the patterns members of our communities have been seeing develop over the last decade, and he’s trying to create a platform to fight back against the people perpetuating so much harm against us.

Lantz’s most recent protest was, of course, in Pennsylvania, where he glued his hand to a Pennsylvania Capitol railing on the fourth floor of the visitors’ gallery to protest lawmakers like Ryan Aument and their indifference towards trans youth.

“I felt that if the cycle could be interrupted, even by one voice, one story, we might save a life, here or nationally,” Lantz told Dauphin County Judge William Tully. “Time, I believed, was of the essence. I knew I had to act. I also knew my time was limited. I have stage 4 cancer … I remember what I endured as a closeted teen in the 1970s. I don’t want to see another LGBTQ kid die by suicide. Our kids are suffering physically, mentally and emotionally. And I did what I felt I had to do. I just wanted to be heard peacefully.”

Unfortunately, prosecutors from the Dauphin County District Attorney’s office disagreed that damaging public property constituted peaceful protest, and tried to charge Lantz with felonies related to institutional vandalism and criminal mischief in April of last year, as well as a misdemeanor offense for obstructing an official proceeding. Lantz pleaded guilty to criminal mischief on Tuesday as part of a plea deal that stipulates he must pay $16,575 for the damage done to the railing he glued his hand to.

Lantz called the fees associated with his demonstration “politically punitive and grossly inflated,” and it’s hard to argue with him when the county is charging him $3,775 for removing glue from the railing, $11,250 for carpet replacement, and $1,550 repairs to the wood trim finish. The county argues that the high costs associated with the repairs are due to the historic antiquity of the materials. I would argue that they’re being ripped off by their contractors.

Regardless, Lantz’s courage is commendable, and his message should be heard far and loud. Like just about any other queer community elder, he recognizes the parallels between the horrors of living in the closet generations ago and the fear and hatred conservatives are fomenting today, particularly for trans people.

Here’s hoping the folks who need to hear Lantz’s message receive it loud and clear.

Alyssa Steinsiek is a trans woman journalist who reports on news relevant to the queer community and occasionally posts on BlueSky.

This article was downloaded from https://www.assignedmedia.org/breaking-news/twibs-pa-punishes-angry-gay-grandpa at Jul 15, 2025, 7:23 PM EDT.

JUL 10, 2025, 8:27 AM EDT | ASSIGNED | SOURCE

In Washington, Seattle Socialists Marched for Trans Solidarity

A peaceful march on June 27th showed the deep support for trans rights that still exists in much of America.A peaceful march shows the deep support for trans rights that still exists in much of America.

all photos by Arin Waller

by Arin Waller

Throughout the U. S. protests are happening. Assigned welcome’s reports from local reporters who want to share some of the flavor of trans rights protests from their neck of the woods.

On June 27th at 4:30 P.M., dozens gathered at Cal Anderson Park for a march towards a Trans Pride Seattle event in nearby Volunteer Park to the north as a public display of trans solidarity.

This public park in the historical gayborhood of Capitol Hill was named after Washington State's first openly gay state legislator, Calvin B. Anderson, in 2003, who died 8 years prior in 1995 after losing his battle with AIDS. Recently, the park has become a gathering place for many protests and marches against the Trump administration. Notably, a May counter-protest against an anti-trans Christian group drew arrests and police violence, sparking criticism from the community due to the perception of bias in the way police handled the situation.

This event was hosted by Socialist Alternative, a political organization promoting the Democratic Socialist Party in the United States. A major figure for the branch in Seattle, Washington, is Kshama Sawant, an Indian-American politician who successfully ran for Seattle’s city council as a member of the Socialist Party.

I was at the event early to scout out locations for photography. There I saw organizers with bottled water and premade signs with slogans such as “No compromises on trans rights! An injury to one is an injury to all” and “Protect trans youth! Gender-affirming care for all!”

Aware of the recent history of police violence, I came prepared with a respirator, goggles, gloves, and a hard hat I had purchased from a hardware store. As another precaution, I  left my phone, ID, and credit cards behind.

Upon meeting the rest of the crowd, I was approached by one of the organizers who wished to know with whom I was affiliated. When I said I was with the press,he informed me that their press liaison would arrive shortly. I walked around trying to get a feel for how this event would be organized and scouting vantage points for good photos.

This turned out not to matter because the group moved the event to another part of the park at the last minute for better crowd control at the speaker stage.

Local anarchists had also converged on the scene of the park, though not participating in the march, instead organizing their march towards the Federal Office Building located at 909 First Avenue. For the past couple of months, many of the protests taking place in Cal Anderson Park would split off into their march at the Federal Office Building, with the No-Kings protests and the Anti-ICE rallies being notable examples of this. This has culminated in continual pressure being put on the offices of the many federal agencies in Seattle through mass protests, vandalism, and extreme police intervention.

My sense was that Socialist Alternative and the unaffiliated anarchists don’t see eye to eye, mainly with SocAlt viewing their appearance as a sign of trouble.

While the stage for the event speakers was being arranged, I had rendezvoused with Amber, the press liaison for Socialist Alternative. I asked what the organization's goal was with the march, and Amber explained that the march was conducted as a way “to take the anger and desperation around Trump’s attacks on trans people and the working class” and channel it into this march.

My second question was what challenges the group believes they would face at this rally.Amber’s replied, “Honestly not too many — there is always the risk of the right wing.”

Three speakers were featured at the event: Joan Wright, the organizer of the event, Marissa, a nurse from the Service Employees International Union 1199 in the Northwest, and Rose, an educator with the Renton Educators Association.

“Last month we witnessed something that should outrage every queer person in this city; Seattle police brutally attacked protestors who stood up against a far-right anti-queer group” Joan Wright said in her speech, referencing the actions of SPD on the May 24th at the MayDay counter protest.

“Mayor Bruce Harrell and the majority of the city council, all of them Democrats, are responsible for this. Instead of fully condemning this far-right group and standing with trans and queer people, The mayor and the democratic party political establishment decided to blame the protestors” Wright continued.

There was a small disturbance during the speeches when the arrival of a frequent counter-protester, considered a nuisance by protest organizers, resulted in police intervention after the counter-protester was accused of grabbing the backpack of a protester.

As this was happening, the speeches were wrapping up, and the march began. It was largely uneventful, with very little trouble from law enforcement or counter-protesters. The protesters marched down the street with rallying chants and received waves of support from bystanders and people who lived in the neighborhoods we passed.

In the current political landscape of Trump’s America, which makes it seem that trans people have no place in this world, it is very humbling to be reminded that not everyone has lost their humanity.

Arin Waller (She/They) is a transgender journalist based in Seattle and covers LGBTQ+-related topics

This article was downloaded from https://www.assignedmedia.org/breaking-news/seattle-socialist-trans-march-june-27 at Jul 15, 2025, 7:23 PM EDT.

JUL 9, 2025, 7:05 AM EDT | ASSIGNED | SOURCE

Diagnoses like “Gender Dysphoria” May Not Be Medically Real — But They Sure Are Politically So

In Skrmetti, the court’s legal logic hinges upon a medical disorder, which has never been proven to exist— an “open secret” that applies to all psychiatric diagnoses.

Opinion, by Sandy Ernest Allen

A few years ago, I realized my life and work were at odds in a way that increasingly concerned me, like I was a train noticing my two tracks steadily diverging. In order to receive the life-saving healthcare I needed — like a Testosterone prescription, and top surgery, and most recently, a hysterectomy — I had to wilfully obtain a diagnosis I know to be medically … not necessarily real.

As a journalist, I focus on mental health care. My first long feature about “mental health care” was this one in 2015, about a woman with myriad psychiatric challenges, who’d been shot in her bedroom by SFPD deputies who’d been summoned there by a social worker. But for years I’d already been working on what would become my first book, about our mental health care system’s past and present, focused around the diagnosis “schizophrenia.”

I sometimes say my first book was like a baton I had been handed in a relay race; My late Uncle Bob had begun the project, years back, during the decades he lived alone in his California desert home. He sent the original manuscript to me back in 2009, a project I eventually took on. During the early summer of 2015, I got a book deal, one so seemingly life-changing, I put in my notice at my job.

But I gave myself a few months, not two weeks, because, first I had to wrap up editing many other stories and also writing a few, including the aforementioned, about the woman who’d been shot in San Francisco,  the case of which was then heading to the supreme court … I began wondering, more and more, what was the deal with all of psychiatry? Because back then, to my tremendous dread: I was still confused.

Uncle Bob had first been psychiatrically hospitalized in his hometown of Berkeley, CA when he was a teenger (this during the late sixties and early seventies). His psychiatric ‘label’ was “paranoid schizophrenic,” as he’d spelled out across his own autobiography’s cover. He’d typed his life story in all caps, no paragraphs, quite misspelled, hardly punctuated except with colons. He’d mailed me the sixty cigarette-stinking pages just as I’d started grad school.

My own attitudes about Bob and “crazy” people like him prior were, in hindsight, stuff I’d picked up from my family and culture; it’s clear now that, previously, I just wasn’t very informed. (I’d comment, it’s pretty normal for the public without direct connections to these topics to hold such prejudiced, misinformed views as I did before.)

Back when I was first writing about Uncle Bob, I was fully closeted, even to myself, and didn’t think of myself as being like him; however in hindsight it’s clear how much as a trans person, an outsider, I was like him. I probably resisted seeing our affinity however, resistant as I was through my teens and twenties of being seen as “weird” or as “crazy.”

*

An error I often observe — amongst my fellow media professionals and in discussions of mental health: No person is actually objective (as regards “mental health” or “gender,” for example). Put simply: Cis people often think they are objective or unbiased when it comes to trans people — but they aren’t. Cis people are simply, according to this repressive binary’s rules, more powerful than us.

Debates within mainstream psychiatry frequently focus on who gets to assign pathology-laden labels to whom. These are the same conversations that we have about trans identity, about who can correctly be called trans, and what it means to shift from centering the opinions of a therapist or doctor to affirming the ability of a trans person to know themselves.

There’s history to this. Before we were trans in today’s parlance, trans people were trapped in psychiatry’s big purple book of diagnoses, the DSM—and to the extent we must obtain gender dysphoria diagnoses to obtain care, we still are. This is because we don’t conform to society’s norms, and mainstream psychiatry’s all-powerful book defines which nonconformity is "pathological" at a given time.

It’s long been an ‘open secret’ that what goes in the DSM is decided not in medical laboratories but via a political consensus of American Psychiatry Association members, the professional organization that publishes the book. This became very clear to those of us observing it when, for example, Dr. Thomas Insel, then head of the NIMH, basically conceded the APA diagnoses aren’t medically validated enough to base research on — a full 12 years ago.  However “objective” such doctors might believe themselves to be, no human is objective — as that famous instance from half a century ago of (white, male) homosexual psychiatrists removing themselves from their own big book of supposed pathologies really gave away.

*

I am no stranger to being on the receiving end of mental health care, to an extent that I, for practical reasons at the time, totally ellided when writing my book about Uncle Bob. My first book was about Bob, not about me, my two editors and I reasoned.

My initial interest in writing Bob’s story hadn’t even been “mental health” — it had been “truth,” because I was a nerdy nonfiction MFA student. My peers and I often sat around classrooms and afterwards bars, debating the limits of our own genre. I knew that in Uncle Bob’s rather fantastic manuscript, I had a perplexing entry as pertained to these truth debates. I had therefore begun trying to develop Bob’s materials into some form more readers might be willing to listen to. The project eventually grew a second font (what I think of as “my font”; the book’s literally written in two fonts). In a typewriter-y one, I “cover” my uncle’s origins story, sometimes interrupting from him in all caps. In my own font, I added a layer of context and commentary about our family but also about psychiatry and our society itself.

In America in particular, we have a bit of an upside-down situation wherein many degree-having supposed experts are largely unaware as to the broader reality. Our mental health care premise is one in which diagnostic categories are topics of great debate, and the treatments that come along with them can be even more hotly debated. According to our paternalist paradigm various professionals have often been trained to ignore their patients’ reports, to whatever degree, while being faced with often fast-moving, even dangerous or potentially deadly situations in which they often must make tough calls. The overall situation, in my long observation, produces lots of hurt feelings on all sides, patients and professionals and their families; while the public otherwise remains largely oblivious about all of this.

Conversely, in my long years now of studying this space, it’s some activist former psychiatric patients (read: “crazy” people) who tend to understand the full picture, as exemplified by the very existence of the publication Mad in America (which was started by a pharmaceutical journalist, who wrote this now-classic muckraking work amongst others, and is spearheaded nowadays mostly by individuals “with lived experience” as one might hear it phrased, in this scene). To give another example, Uncle Bob it turned out really knew his stuff, which I learned after I fact checked all his claims to death, as I discussed at length in my book.

*

Some years ago, I might have been too timid to so clearly state the big issue regarding our psychiatric paradigm. I’d have worried about offending or alienating those who take psych meds for example or who for their jobs depend upon the continuation of our current mental health norms. But Uncle Bob took psych meds until his dying day, for many nuanced reasons my book unpacks. He also spoke highly of at least one of his psychiatrists, for example. All such is not uncommon amongst even those “Mad Pride” types I’ve known and interviewed.

Many Americans take psych meds — many trans and queer folk included; some of you reading might even adore your meds and/or your psychiatrists or therapists and such. Conversely, others amongst you might find yourselves much more wary of seeking traditional such interventions — perhaps because of previous bad experiences in such treatment settings, maybe even as kids. In general: trans people must “prove” our “sanity” — to obtain the surgery and hormones we find life-saving (or insurance coverage for such). Those cis readers unfamiliar for example maybe don’t realize we must get two letters of support from “mental health” professionals oftentimes — even trans adults like myself who’ve lived openly for years in our gender. I went through just recently trying to get a hysterectomy (and my coverage was initially rejected, by United Health, in December).

Meaning trans people, regardless of our other psychiatric experiences, however positive or negative or mixed bag, we must interface with “mental health” professionals in order to obtain the life-saving trans healthcare we need — gatekeeping that harms many wary of psychiatry itself. I also work with two talented “mental health” type professionals myself these days. In general: I respect all individuals’ choices. These days, I also understand, and fully respect — as someone who’s now reliant on Testosterone nowadays— the feeling of fearing some bullshit eugenicists in power taking away my life-saving pharmaceutical.

Underscoring: I am not arguing we should take away anyone’s life-saving medications or other treatments — ever. No radical mental health activist I’ve known is arguing to take away anyone’s meds, nor even ECT/shock — arguably the most controversial psychiatric treatment still in use. Radical psychiatric patient  activists (and their professional allies like me) are typically just concerned with whose decision it is when it comes to which chemicals and such go into our bodies and minds. Nonetheless, American psychiatry’s book remains very powerful, authoritative in our country especially, in our schools, in our doctors’ offices and our therapists’ ones — and in our courtrooms.

*

I have long been diagnosed with anxiety and CPTSD, amongst other mental health-influenced conditions. Which is unsurprising given my being a survivor of childhood domestic abuse, for example. Also worth disclosing to you all here: In 2021, some three years after AKOMP first published, I had my own severe, life-altering psychiatric emergency — one I will be discussing in my in-progress sequel to the first book.

In brief, this crisis and its aftermath cemented my already strongly held beliefs that these are universal considerations. By which I mean, in practical terms: The form our mental health care takes matters — especially for those experiencing severe totally disabling emergencies.

What sorts of options does the supposedly “sane” tax-paying public fund for such emergencies? Bullets and jails? ERs? Or something better, something more humane? Something more science-backed and also commonsense? To echo a rhetorical question a Voice Hearer activist I greatly admire often asks: ”What would you want, if you were having the worst day of your life?”

I’m a proud trans, queer, Mad reporter who covers “mental health care.” I try to do so in a way that’s science-backed and also humane. I try to admit my own biases — including to myself. I hope my (in some cases literal former) colleagues in the mainstream press, those cis folks stubbornly focused on writing on trans children in particular, can learn to do the same. Because their delusion, however self-protective, is killing my community — especially vulnerable kids.

Trans rights are human rights. Mad Pride is another way of saying the same thing. These are conversions about the unchecked rot that is eugenics. These are conversations about bodily autonomy. These are conversations about the great diversity of humanity itself, including within. And yes, we’re talking about “truth” itself. These conversations do matter given for example the Supreme Court hinging their entire ruinous decision in Skrmetti to the psychiatric diagnosis of “gender dysphoria — again prerequisite for us trans folks to access care. Hence me, those years ago, I went and I willingly got one, in order to get top surgery and then T and then, most recently, a long-delayed hysterectomy.

But really we’re talking about power: Who gets to define you? Doctors? Governments? Industry-funded lobbying groups? Or do you as an individual get listened to, regarding your own truths? Do you get to follow that inner light, the one only you have experienced and feel inside? As for that truth, I often don’t know what to call that, other than “divine.”

Sandy Ernest Allen is an author, essayist and journalist whose work focuses on mental health and gender from a human rights perspective.

This article was downloaded from https://www.assignedmedia.org/breaking-news/gender-dysphoria-diagnosis-psychiatry-mad-rights-movement at Jul 15, 2025, 7:23 PM EDT.

Table of Contents

Assigned Media: 2025 Jul 15

All articles

Skrmetti and the Future

Justice Department Uses Anti-Trans FTC Workshop to Announce Investigations

TWIBS: PA Punishes Angry Gay Grandpa

In Washington, Seattle Socialists Marched for Trans Solidarity

Diagnoses like “Gender Dysphoria” May Not Be Medically Real — But They Sure Are Politically So