Transgender patient’s lawsuit a front for conservative war on LGBTQ rights

by Michael Hiltzik

California teenager Chloe Cole has become something of a star of the movement to deny treatments to transgender youth.

She has given testimony or made public statements in support of anti-treatment bills in Florida, Ohio, Kansas, Missouri, Louisiana, Idaho and North Dakota; appeared on Fox News; and shared a Washington platform with right-wing Rep. Marjorie Taylor Greene, R-Ga.

That’s useful for you to know in assessing Cole’s latest moment in the spotlight: her filing of a lawsuit against the giant Kaiser Permanente health care system.

Cole’s legal complaint, filed Feb. 22 in San Joaquin County state court, accuses Kaiser doctors and other professionals of having railroaded her into gender reassignment treatment and surgery before she turned 18, leaving her with “deep physical and emotional wounds, severe regrets, and distrust of the medical system.”

In her public appearances, Cole describes herself as a detransitioner — that is, a person who had second thoughts about transitioning from their gender assigned at birth and has chosen to go back.

For the moment, all Kaiser is willing to offer is a generic statement that it “provides patient centered gender-affirming care that is consistent with the standards of medical care and excellence (and) … founded on sound research and best medical practices” for all transgender patients including adolescents.

The context of Cole’s lawsuit bears close scrutiny. It’s part of a concerted right-wing attack on LGBTQ rights, in which the health of transgender youth is exploited as a pretext for bans on gender-affirming care. It resembles the right-wing attack on abortion rights, another movement that cynically masquerades as an effort to improve health care but actually exposes millions of Americans to injury and death for strictly partisan purposes.

Cole is one of a handful of self-described detransitioners who have been flown around the country by anti-transgender activists to speak in favor of treatment bans. Their presentations aim to persuade legislators that second thoughts are common among transgender patients, as though to suggest that gender-affirming treatment is a sham.

In fact, studies indicate that only 1% to 2% of transgender individual “detransition,” and that often happens because of discrimination and other social pressures, not because the patients genuinely feel they have made a mistake about their gender identity.

Proponents of these bans assert that puberty blockers and hormones used in such care endanger the lives of adolescents. They say the youths may be going through a phase that they’ll soon outgrow and the treatments are based on overly indulgent diagnoses of “gender dysphoria” — that is, the psychological distress caused by “an incongruence between one’s sex assigned at birth and one’s gender identity,” in the words of the American Psychiatric Association.

The truth is just the opposite. Gender dysphoria diagnosis is neither novel nor a fad, as some partisan critics assert. Instead, it’s recognized by professionals as a serious medical condition.

For many patients, outlawing the use of therapeutic hormones until adulthood or the use of puberty blockers on children, as is mandated by laws and regulations passed in some states, condemns them to living with a serious medical condition that could have been alleviated through medical treatment.

Cole has addressed public events with right-wingers who have broader agendas, such as opposition to abortion and support of the Jan. 6 insurrection, including Greene and the Proud Boys.

Cole’s legal complaint bears all the shortcomings common to initial filings in cases dealing with controversial topics, plus a few all its own. It incorporates what seem to be misleading or inaccurate descriptions of developments in the gender dysphoria treatment field. Cole’s complaint also describes the conclusion of a 2011 Swedish study it cites as having found that “transition treatment does not improve long-term mental health for transgender individuals.”

That’s not what the study concluded, however. The study compared the mental and physical health of 324 patients who underwent gender reassignment surgery between 1973 and 2003 to the health of a control group of non-transgender individuals — not to transgender persons who had not undergone surgery.

“No inferences can be drawn as to the effectiveness of sex reassignment as a treatment,” the study’s authors cautioned. “Things might have been even worse without sex reassignment.”

That doesn’t surprise transgender advocates, including Kellan E. Baker, executive director of the Whitman-Walker Institute, a Washington research center and provider of health services to the LGBTQ community. “Experiences of discrimination, harassment, violence, rejection get under the skin,” Baker says.

“It is very hard to be transgender in a transphobic society. When you see high rates of depression and anxiety among transgender adults, that’s the reason.”

Michael Hiltzik is a columnist for the Los Angeles Times.