Opponents of gender-affirming health care for children will bring up an alleged medical risk—sterilization—as a talking point. Yet, it is based on myths, pseudoscience, and flawed historical comparisons to eugenics. The threat to trans lives and bodily autonomy does not come from their medical teams but from anti-trans extremists in positions of power and authority.
Eugenics and Forced Sterilization: A Flawed Comparison
The comparison between widely accepted, safe, and rigorously tested medical care and the history of eugenics and forced sterilization is faulty. By using the historically loaded term “sterilization,” and even making explicit comparisons to eugenics, the Right is stoking paranoia around trans healthcare. These are fear tactics: anti-trans crusaders want you to associate trans healthcare with the very worst atrocities done in the name of eugenics, from the genocidal “euthanasia” campaigns in Nazi Germany, to the mass sterilization of the disabled and of racial minorities in the United States. However, the issues of power and of consent involved are simply not comparable: there is no epidemic of children receiving medical care without informed consent of the child and their guardian(s).
Other fear-mongering terms: castration, self-castration, child genital mutilation, the “removal” of a child’s “healthy body parts.”
Question: When people argue that children are at risk of “sterilization,” what do they really mean?
Answer: Opponents of gender-affirming care for children will often use this extreme or even violent language to create fear and disgust. Not only is this medically inaccurate terminology, but the procedures they’re suggesting (“bottom surgery” or gender-affirming surgeries done on a patient’s genitals) are only done on consenting adults, in consultation with an expert medical team: not young children.
Q: So, if children aren’t getting these procedures, then how could they possibly be ‘sterilized’ or become ‘infertile’?
A: Gender-affirming care for children always consists of consultation with doctors and licensed mental health professionals. After deliberation among doctors, parents or guardian(s), and the child themselves, the most frequent route taken is the prescription of puberty blockers; these medications are associated with common myths about infertility, but such claims lack scientific evidence.
The Anti-Trans Playbook
The Legislative Angle
Example: Idaho’s 2022 ‘Child Genital Mutilation’ Bill
Attempting to ban all gender-affirming care for children in the state, Republicans in the Idaho House of Representatives used myths about sterilization—from the conflation of all gender-affirming care with surgery to the misrepresentation of puberty blockers—to push their anti-trans legislative agenda:
The ability to procreate is a fundamental right…I see this conversation as an extension of the pro-life argument…We are not talking about the life of the child, but we are talking about the potential to give life to another generation.
—Rep. Bruce Skaug, who proposed the BillPerforming surgeries that sterilize or mutilate, including castration, vasectomy, hysterectomy, oophorectomy…[or] administering or supplying…medications that induce…transient or permanent infertility…[would be a felony].
—Text of HB 675
Rep. Skaug argued that his proposal was not a “religious crusade,” but that he was “following the science.” Yet, the bill was co-authored with the Idaho Family Policy Center, a local partner of the anti-LGBTQ Family Research Council and the Alliance Defending Freedom.
We know that this concern for the next “generation” is disingenuous, because enforcing this bill (and those like it across the country) would put trans and gender non-confirming kids at high risk of suicide. For these kids to grow up and have families—if they so choose—requires that they be alive.
Rep. Skaug also likened gender-affirming care to eugenics and “other things that were very popular in medical circles … that we now know were evil, outright evil.” This comparison skirts issues of informed consent and repackages real historical injustices to serve anti-trans political ends.
The Legal Angle
Example: Texas Attorney General Ken Paxton’s 2022 legal opinion on “whether certain medical procedures performed on children constitute child abuse.”
Like we saw with the Idaho bill, Paxton weaponizes misinformation and myths about gender-affirming care to advocate for curtailing the rights of trans and gender non-conforming children in his state.
Sterilization of minors and other vulnerable populations without clear consent is not a new phenomenon and has an unsettling history…Given the uniquely vulnerable nature of children…it is important to emphasize…medical procedures and treatments…could permanently deprive minor children of their constitutional right…before those children have the legal capacity to consent…[and] constitutes child abuse.
The surgical and chemical procedures…can and do cause sterilization…These chemical procedures prevent a person’s body from developing the capacity to procreate.
—Ken Paxton, Opinion No. KP-0401, Feb. 18, 2022
Referring to puberty blockers as “chemical procedures,” he implies that taking them is somehow surgical in nature or irreversible. Paxton then states his opinion that all gender-affirming care is “non-medically necessary”—this is not a medical opinion, and he is not a medical doctor. In fact, he sources his “science” from the Society for Evidence-Based Gender Medicine (SEGM) an organization that has helped manufacture debate over the efficacy of gender-affirming care around the world.
The doctors who have deemed treatment medically necessary only do so using their own medical expertise, the expertise of mental health professionals, and the informed consent of a child’s guardians. Put simply, children are never the sole decision makers regarding their medical care. To say this rigorous and highly regulated process somehow constitutes child abuse, and to liken it to the history of forced sterilization, is misleading.
The ‘Scientific’ Angle
Example: Dr. Paul Hruz, anti-trans activist and pediatric endocrinologist at Washington University, gives his “medical” opinions about trans children.
Here, we can see the cracks in the “scientific” façade behind the anti-trans crusade. Hruz frequently testifies as an “expert” witness in defense of anti-trans legislation. A North Carolina District Judge excluded Hruz’s testimony because he “never treated a transgender patient, conducted any original research … or published any scientific, peer-reviewed literature on gender dysphoria.”
Some children are born into this world to suffer and die…[Being transgender] probably goes back to some of the earliest heresies in the church…
—Paul Hruz, responding to the mother of a trans child, when asked about suicide rates among trans youthGender transitioning of any kind is intrinsically disordered…it cannot conform to the true good of the human person, who is a body-soul union unalterably created male or female.
—The National Catholic Bioethics Center, where Hruz is a fellow, official statement on “Transgender Issues in Catholic Health Care”
Hruz’s anti-trans “medical opinions” are, instead, personal religious opinions—violently anti-trans ones. Courts have questioned his expertise, his comments, and his affiliation with the anti-LGBTQ American College of Pediatricians (ACPeds).
Hruz is representative of a common strategy on the Religious Right: co-opting the language of science to advance policy based in conservative theology. For the Christian Right, any science might undermine their beliefs—here, the belief that there exist God-given differences between men and women—becomes evidence of a conspiracy in the “scientific establishment” to threaten conservative, Christian values.
The Real Threat
Violent, anti-trans rhetoric so often signals that trans lives are disposable, unimportant, and unfit for our society: ideas that sound a lot like eugenics
Eugenic ideas steeped in racism, misogyny, and transphobia are being repackaged to look like contemporary science by ‘experts’ and organizations whose primary objective is to push trans and gender non-conforming people out of public life. If anti-trans ‘experts’ believe that trans children are “born into this world to suffer and die,” then we have good reason to be concerned with their safety.
There are also concerning parallels between the Right’s obsession with regulating trans bodies, especially the bodies of AFAB (assigned female at birth) children and adults, and the rhetoric of white nationalism. White nationalists imagine a struggle for the survival of the white race—sometimes called “white genocide” — in which white women play a vital role. Keeping these “desirable” women reproducing is a central tenet of their ideology. The white nationalist slogan, David Lane’s “14 Words” reads: “We must secure the existence of our people and a future for white children.” To the extreme Right, white AFAB trans people pose an existential threat to the white race by living their lives authentically.
The far right, for many overlapping reasons—from religious beliefs to white nationalist ideology — seeks state control over reproduction and bodily autonomy. The current anti-trans crusade is an important part of this campaign.
Read more: Combating Anti-LGBTQ+ Pseudoscience Through Accessible Informative Narratives
