Why Should We Care? (Part 2): On the Growing Interdependence of Science and Our Right to Bodily Autonomy

In the last few decades, the scientific establishment has made lengthy strides to ensure representation of LGBTQ+ individuals in research and academia. Queer people belong in science, and many of us are drawn to it because queerness itself is parallel to the scientific process. Engaging in science and being queer both involve challenging accepted modes of thinking, a willingness to buck normativity, and a desire to reexamine what has been considered already established. The scientific trajectory of knowledge-making itself, the process of generating more questions than answers the deeper one dives into a specialist field, is also like the queer and transgender experience. The more we think about gender and gender roles, the more we realize that we have no idea what gender is (and if you think we do, then I encourage you to talk to more queer and trans people!).

In that vein, this administration’s attacks on science are no different from and are inextricably tied to its attacks on transgender healthcare and bodily autonomy. In May of this year¹, the administration attempted to revoke coverage of gender-affirming care through Medicaid. The bill did not pass, but the Supreme Court decision in June allowing a ban on medical treatments for trans people, US vs Skrmetti, provides more animus for the proposition of similar initiatives. Trans people are not the only ones who receive gender-affirming care and are not even its primary users—trans healthcare was originally developed for and is still primarily used by non-trans people². These treatments include hormone replacement therapy, professional hair removal, and the majority of cosmetic surgeries. Removing access to these therapies for trans people but not for everyone else (who will still retain access) is then tantamount to discrimination.

As scientists, why should we care? Well, one distinction in gender-affirming care is the efficacy of its delivery. For example, fewer than 1% of trans and gender diverse patients receiving double mastectomy surgeries experience regret over their procedure. For comparison to other medical procedures, patients who have undergone knee replacement surgery report regret rates around 30%³. In youth, puberty blockers and gender-affirming hormones reduce rates of suicidality by 73%⁴ while standard and approved treatments in the field of psychosocial counseling average reduction rates around 25%⁵. Even aspirin, one of the most widely prescribed postoperative pain treatments, has a success rate of 40%⁶. In total, gender-affirming hormone therapies have measurably improved quality of life for 94% of patients who receive them⁷. Put simply, gender-affirming care for trans and gender diverse individuals is not simply a social justice issue for a small niche group of people, it is a medical marvel. To then target such a proven set of therapies is an attack on science.

In 2020, this blog published a piece about the legacy of Ben Barres and asked if we as scientists could afford not to care about the rights of people with whom we do not share an identity. It seems apparent—now more than ever—that the targeting of one minoritized group only grants access to target yet another one. It is also increasingly clear that progress is actualized not by frontline activists and not once or twice a year at the voting booth, but by all of us in far more mundane ways: in our hiring decisions, in our lab meetings, in the small stands we choose to take against the consolidation of power. We make the daily choice to either perpetuate or combat discrimination—often in such small moments that we rarely see the immediate effect of our actions. Since we spend most of our waking hours at work, our workplaces become the stage where we enact most of our power and effect most of our change. The question then becomes, which small actions do we take so in sum they are able to stem the rising tide of authoritarianism?

Philosopher Jason Stanley has written that fascist ideology cannot coexist with science, expertise, and truth, and information systems must be destroyed for authoritarians to take power. We can, as writer/historian Rebecca Solnit so eloquently wrote, “resist and check that power [by] holding onto and speaking up about fact, truth, history, science and law, as well as preserving our independence of mind and pursuing good sources of information and analysis.” As scientists, we are in the unique position to defend the scientific institutions and information systems that we not only rely on to conduct our work, but that are the foundation of democracy and freedom in our society. Let’s make sure that when we do, we also defend our queer and trans colleagues and trainees.

References

1. Desk, R. M. | T. N. N. Senate showdown looms as Trump’s budget bill could end Medicaid trans healthcare coverage. WSTM https://cnycentral.com/news/nation-world/senate-showdown-looms-as-trumps-budget-bill-could-end-medicaid-trans-healthcare-coverage (2025).
2. Dai, D. et al. Prevalence of Gender-Affirming Surgical Procedures Among Minors and Adults in the US. JAMA Netw. Open 7, e2418814 (2024).
3. Mahdi, A., Svantesson, M., Wretenberg, P. & Hälleberg-Nyman, M. Patients’ experiences of discontentment one year after total knee arthroplasty- a qualitative study. BMC Musculoskelet. Disord. 21, 29 (2020).
4. Tordoff, D. M. et al. Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care. JAMA Netw. Open 5, e220978 (2022).
5. Erlangsen, A. et al. Short-term and long-term effects of psychosocial therapy for people after deliberate self-harm: a register-based, nationwide multicentre study using propensity score matching. Lancet Psychiatry 2, 49–58 (2015).
6. Derry, S. & Moore, R. A. Single dose oral aspirin for acute postoperative pain in adults. Cochrane Database Syst. Rev. 2012, CD002067 (2012).
7. US Trans Survey. US Trans Survey https://ustranssurvey.org/.