a man waves an intersex-inclusive progress pride flag in the wind on the sky.

Certainty and Uncertainty in Trans-Intersex Science Politics

By Maayan Sudai

Joanna Wuest’s Born This Way: Science, Citizenship, and Inequality in the American LGBTQ+ Movement describes the evolution of the “born this way” framework through pivotal moments in the history of the LGBTQI+ movement.

A central theme of the book’s analysis is the role that “certainty” and “uncertainty” play in the legitimation of science-based policy regarding sexuality and gender issues. Uncertainty of what might happen has been pitted against LGBTQI+ reforms, from when conservative researchers and practitioners argued the exposure of young children to an openly gay guardian or schoolteacher could be harmful (p.92), to present-day attempts to leverage uncertainty to block trans access to sex-segregated bathrooms, prisons, and shelters (p.181).

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Medical Caduceus Symbol as Scales with backlight over Wall in dark room.

Gender-Affirming Care, Abortion, and the Politics of Science: A Response to Wuest’s ‘Born this Way’

By Aziza Ahmed

On August 21, 2023, the 11th Circuit issued a decision that allowed a ban on transgender care to go into effect in Alabama. The Alabama ban, formally called the Alabama Vulnerable Child Compassion and Protection Act, is one of the most extreme of the many bans on gender affirming care. The law defines sex as the “biological state of being female or male, based on sex organs, chromosomes and endogenous hormone profiles…genetically encoded into a person at the moment of conception…” and targets physicians who might undermine this notion of sex with criminal prosecution. Their punishment could be up to ten years in prison.

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SACRAMENTO, CA, U.S.A. - OCTOBER 9, 2021: A mother and child march with Proud Mom and Trans Rights are Human Rights signs during the National Trans Visibility March.

Protecting Trans Children: Scientific Uncertainty and Legal Debates Over Child Custody and Access to Care

By Marie-Amélie George

A tweet turned Luna Younger’s personal struggle into a national controversy. Using 148 characters, Texas Governor Greg Abbott announced that the Texas Attorney General’s Office and the Texas Department of Family and Protective Services would be investigating the seven-year-old’s family. Prompting his declaration was a jury’s award of custody to Luna’s mother, Anne Georgulas, a pediatrician who supported Luna’s gender transition. A year before the case made its way into court, Luna had asked her parents to call her Luna, rather than her (traditionally male) legal name, to reflect her gender identity. That same year, a therapist diagnosed Luna with gender dysphoria, which is distress from the mismatch between a person’s assigned sex at birth and their gender identity. As a result, medical professionals recommended that Luna be referred to as “she” and be allowed to wear the feminine clothing and keep the long hair that she preferred. Luna’s father, Jeffrey Younger, registered his objection to Luna’s gender identity by shaving her head, even as he allowed Luna’s twin brother to maintain his locks. Georgulas petitioned for an order prohibiting her ex-husband from “engaging in non-affirming behavior and/or taking Luna outside the home as [her birth name], or allowing others to do so.” Jeffrey Younger counterclaimed for sole legal custody.

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Washington, DC, USA - December 1, 2021: Abortion rights rally at the Supreme Court, Jackson Women's Health v. Dobbs.

Biological Determinism, Scientific Uncertainty, and Reproductive Rights

By Mary Ziegler

As Joanna Wuest writes, the role played by science in the LGBTQ+ movement “is at once a celebratory and cautionary story.” Something similar could be said of struggles over reproductive rights in the half century since the Supreme Court decided Roe v. Wade.

Today, after decades of staying on the sidelines, physicians have once again been at the forefront of struggles over abortion, launching a ballot initiative in Ohio, bringing lawsuits, and speaking against state criminal bans. Physicians’ investment in the struggle — and the scientific arguments they bring to bear — seem like a possible turning point in future struggles over reproductive rights and justice. After all, medical professionals have both special expertise and political capital that could make a difference at a time when disapproval of abortion bans is already high.

But history suggests that arguments based on science have played a far messier role in struggles over reproductive rights. As often as scientific evidence has advanced reproductive rights, abortion foes have used claims about scientific uncertainty to justify new restrictions — and have harnessed claims of biological difference to assert that there is no connection between sex equality and abortion.

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MONTREAL, CANADA -16 AUG 2015- The annual Fierte Montreal parade took place on August 16, 2015 on Boulevard Rene Levesque in Central Montreal. It is the largest Gay Pride in the Francophone world.

“Born This Way,” LGBTQ+ Rights, and the Politics of Uncertainty

By Joanna Wuest

“Medical uncertainty” is no straightforward matter when it comes to LGBTQ+ health and civil rights. Take for instance the 11th Circuit Court of Appeals 2020 decision striking down a pair of municipal ordinances in Florida that had banned so-called “conversion therapy” for minors (contemporary psychology’s preferred nomenclature is “sexual orientation and gender identity change efforts”). In an enormous blow to the evidence-based notion that such change efforts are harmful — they are indeed responsible for much trauma and death — two Trump-appointed judges declared that the science of sexual orientation and gender identity was much too uncertain to justify the bans. Gesturing to the American Psychiatric Association’s (APA) renowned 1973 removal of homosexuality from its list of disorders, the judges explained that “it is not uncommon for professional organizations to do an about-face in response to new evidence or new attitudes.” Ergo, because the APA had changed its mind once fifty years ago, it may just as easily reverse itself again. According to this view, we may one day wake up to find that mental health professionals have reclassified queerness as a malady to be cured rather than a sense of self to be embraced and protected by law.

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Large and diverse group of people seen from above gathered together in the shape of two intersecting circles.

An Intersectional Analysis of Proposed Fertility Leave in England and Wales

By Elizabeth Chloe Romanis and Sabrina Germain

For people in England and Wales needing access to fertility treatment, economic barriers can be a huge hurdle. There are the direct costs of the treatment (some, but not all, of which are covered by the National Health Service). But there are also the less visible indirect costs associated with accessing these treatments. These include needing time off work to attend appointments, funding travel to and from fertility clinics, and having access to spaces at work to store and administer medication and take private phone calls. Indirect costs limit access to fertility treatment for structurally disadvantaged individuals in England and Wales. It is for this reason that a Private Member’s Bill currently being debated in the House of Commons, the Fertility Treatment (Employment Rights) Bill, which seeks to introduce fertility leave in the UK, should be welcomed (see earlier posts in this symposium by Dafni Lima and Manna Mostaghim).

Introducing a formal entitlement to “allow employees to take time off from work for appointments for fertility treatment; and for connected purposes” is a step in the right direction. We offer an intersectional reading of the Fertility Treatment (Employment Rights) Bill and consider how the benefits offered are likely to be stratified along class, race, sexuality, and gender lines. The Bill is well-meaning and highlights the critical issue of indirect barriers to fertility treatment in the workplace, but it is inattentive to structural issues affecting marginalized people experiencing infertility.

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New York NY USA-July 8, 2023 Advertising for the Warner Bros. Pictures Barbie film in Times Square in New York.

Barbie’s Utopia and (the Absence of) Social Rights

By Alma Beltrán y Puga

Is Barbie feminist? Is Greta Gerwig’s script based on ideas of gender equality? The movie is certainly appreciated for promoting a global discussion on feminist ideas and gender roles. But answering these questions is complicated. Barbie opens in a version of a feminist utopia: a world where women are rulers and men servants. These inverted political gender roles are based on radical feminist theories that consider women’s liberation will only be possible when feminist values, such as care and dialogue, are taken seriously, and women in power embrace them. However, Barbie Land is a portrait of this feminist fantasy with too much pink and a very basic liberal idea of the State: civil and political rights are the fundamental rights of society.

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figurine with a void shape of a child and family of parents with a child. Surrogacy concept.

Forced Gifting: English Surrogacy, Gestational Labor, and the Inequality of Choice

By Lucas Taylor

Surrogacy, the practice in which one party (the surrogate) gestates a fetus on behalf of another pair/person (the intended parent/s or IPs), has sparked academic debates regarding gender equality and bodily integrity in the face of both commercial and altruistic agreements. I re-engage with this topic by challenging how the capacity of the surrogate to choose may be restricted under English and Welsh law. This post does not seek to argue against the practice of altruistic surrogacy. Instead, it seeks to highlight, through the lens of Social Reproduction Theory, that central to the legal framework is a highly gendered devaluation of labor which undermines the potential for surrogates to fully exercise choice in relation to their gestational labor.

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WASHINGTON, DC - OCT. 8, 2019: Rally for LGBTQ rights outside Supreme Court as Justices hear oral arguments in three cases dealing with discrimination in the workplace because of sexual orientation.

303 Creative, Transgender Rights, and the Ongoing Culture Wars

By Michael R. Ulrich

The Supreme Court’s ruling in 303 Creative LLC v. Elenis suggests a willingness to ignore the rights and health implications for minority populations under the guise of protecting against theoretical harms. The decision is a crucial blow to strides made in achieving gay rights, and may bolster other attacks on LGBTQ+ rights. As laws that restrict the rights of transgender people in the U.S. face challenges in court, the legal, public health, medical, and bioethics communities have an essential role to play both in properly framing the legal issue, as well as explaining what is truly at stake in these cases to minimize the chances of similarly harmful rulings for the transgender community moving forward.

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young african american woman suffering from abdominal pain while sitting on bed

‘Below the Belt’ Exposes the Silent Crisis of Endometriosis Care

By Timothy Bonis

Premiering tonight on PBS, the film Below the Belt sheds light on endometriosis by documenting four women’s experiences with the disease.

Endometriosis is a silent crisis. One in ten women have it, yet, on average, people with the condition see seven doctors before they get diagnosed. Many experience severe pain, and the disease costs the American economy $80 billion annually in lost productivity, but the standard treatments are outdated and ineffectual.

Below the Belt exposes the failures in practice and policy that have led to the poor state of endometriosis care. Medical students usually don’t learn about endometriosis in medical school, and as a result, most general practitioners can’t recognize it. The majority of gynecologists treat endometriosis with hormones — which have serious side effects and bring little relief — and an ineffective surgery called ablation. Others continue to recommend the 20th-century approach, a hysterectomy. This dismal selection of treatments reflects the state of endometriosis research; historically, the disease has received less than $10 million in research funding per year (compared to $1 billion for diabetes, an equally common condition among women).

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