Sheridan is a member of the board of Lawyers Defending American Democracy. He previously served as president of the Rhode Island Bar Association.
In the past three years, 23 states have passed legislation that prohibits physicians and other health care providers from providing gender affirming health care to transgender minors. These laws constitute an extreme, unprecedented attack on transgender adolescents, their families and the medical providers who care for them.
Criminalizing accepted medical treatments irresponsibly interferes with the patient-physician relationship and will eliminate the rights of parents to support their transgender children. Worse, prohibiting necessary health care for transgender teens will result in needless suffering and, possibly, suicide. Finally, the National Institutes of Health has noted that these laws are premised on false, unfounded medical claims and assumptions that have been vigorously opposed by virtually every major medical organization in the country, including the American Medical Association, the American Academy of Pediatrics and the American Psychiatric Association.
These cruel laws are grounded in disinformation and bias. They are built on falsehoods that ignore research and facts, and only bring harm to an already vulnerable community.
Gender dysphoria is not, as some legislators contend, a contemporary fad and should not be casually dismissed. Rather, it is a clinical condition marked by distress caused by a discrepancy between a person’s gender identity and that person’s gender assigned at birth, or the gender society perceives them to be. This incongruence can lead to clinically significant distress and impair functioning in many aspects of a person’s life. If not properly treated, gender dysphoria can result in debilitating depression, anxiety, eating disorders, substance use, self-harm and suicide.
The widely accepted view of the medical community is that gender-affirming care is the appropriate treatment for adolescents experiencing gender dysphoria. Gender-affirming care is care that supports a child or adolescent as they explore their gender identity — in contrast with efforts to change the individual’s gender identity to match their sex assigned at birth. There are multiple, well-established, evidence based clinical protocols for the treatment of gender dysphoria.
Gender-affirming medical interventions for adolescents, including, for example, puberty blockers, are only recommended if numerous, specific clinical conditions are documented. Puberty blockers delay irreversible pubertal development until adolescents are old enough and have had sufficient time to make more informed decisions about whether to pursue further treatments. Contrary to the “legislative findings” in many of these state laws, puberty blockers are not “unproven,” “harmful” or “experimental.” Puberty blockers have been prescribed by pediatricians and endocrinologists for over 30 years to treat precocious or early onset of puberty. The efficacy, safety and side-effect profile of puberty blockers are well established. They are also, despite claims to the contrary, “fully reversible.”
Gender affirming surgical interventions are generally not recommended for transgender adolescents. A comprehensive, multiyear study confirmed that such interventions for transgender adolescents are rare.
Finally, many of the states that have enacted these bans have done so with an express finding that a “substantial” or “large” majority of children who experience distress identifying with their biological sex come to identify with their biological sex in adolescence or adulthood. This is simply not true. An NIH survey found that only 8 percent of transgender respondents reported they had temporarily or permanently detransitioned at some point and the majority did so temporarily.
The adverse consequences of these laws are clear, direct and deeply concerning. Decades of research has confirmed that transgender adolescents are at a heightened risk for anxiety, depression and suicide. A recent study conducted by the NIH found that 56 percent of transgender youth reported a previous suicide attempt and 86 percent reported suicidality. Numerous studies have also consistently demonstrated that gender-affirming interventions significantly reduce the incidence of depression and suicide for transgender and nonbinary youths. Despite this evidence, an estimated 38 percent of all transgender adolescents in America now live in states which restrict their access to medical care critical to their well-being.
A thriving democratic society requires leaders to openly debate and engage the public in discourse based on facts and science. We should seek to eliminate, not create, laws that marginalize or scapegoat selected members of society. And respect for individual autonomy in matters that involve deeply personal choices distinguishes a democracy from societies in which those with power determine how individuals and families should live.
Laws that deprive transgender adolescents, their parents and their medical providers of the freedom to make informed decisions with respect to safe, evidence based clinical care contravene these fundamental principles.
Children watch a July Fourth Parade along the Walkway of Heroes and Independence Avenue on July 04, 2026 in Tappan, New York.
The Great American Grumpfest
Our nation’s 250th birthday party didn’t feel especially patriotic and wasn’t as much fun as the 200th anniversary was.
President Trump, who did his best to co-opt our holiday for his personal aggrandizement, was a major reason. The party he threw in Washington, D.C., was crankier than uplifting, and less about celebrating our shared past and a promising future than about reminding us how far we have strayed from our founders’ plan to create a republic that future Americans would keep in good working order.
Credit Trump this much. He has a singular gift for picking at scabs that other politicians would rather ignore and pushing us into reckonings we don’t need.
The thing is, Americans have seen all this before. Sometimes the makeover we were encouraged to undertake was more conservative, sometimes more liberal. Whatever direction we were pushing, however, the reckoning we had in mind this time had to be more forthright and the conclusion more definitive than it was the last time.
Our current discontents, the ones behind the reckoning President Trump has been trying to inspire, are not trivial. Included among them are immigration, birthright citizenship, exploding healthcare costs, election rigging, a gag-inducing national debt, how we educate our children, too many genders, racial differences we can’t move past, a lopsided economy that favors more well-off Americans, and historic levels of political corruption and graft. Add to these the several foreign adventures he has pushed us into or is anxious to undertake, and you have the makings of a national headache the likes of which we haven’t had in half a century.
All the elbow-throwing and overheated rhetoric we’re using today have begun to look almost normal in all the ways that bickering neighbors and feuding family members appear normal. But they have also made us look mean-spirited and have portrayed our differences as irreconcilable. To ourselves, of course, but also to many people outside the United States who might be forgiven for turning their heads and not looking at the national car wreck we Americans show no interest in avoiding.
The good news, as I suggested above, is that Americans have had a great deal of practice dealing with challenges and national car wrecks like these.
This essay begins to lay out the reasons why.
By way of illustration, we have our seemingly insatiable demand for more bad news about race in America.
Sixty years after being released from the legal constrictions that bedeviled both white and black Americans, many white people have come to believe the color that used to make them unassailable is now a sign of a moral inferiority born of a racial animus they can never wash off. Many black people, on the other hand, are insisting that America is as hopelessly stacked against them as the formerly unassailable white people’s ancestors used to tell their black ones.
The result is that many people today are buying into racist nightmares and mumbo jumbo that their black and white ancestors worked hard and effectively to put in each other’s heads.
This might be dismissed as crazy behavior if it weren’t so important to rituals Americans have long used to express their deepest fears about each other while figuring out what move they can make that won’t end with their world crashing down on everybody’s head.
Unfortunately, the kind of cultural sleight of hand we have used to ramp up our racial differences has been appropriated by people who have many other cultural fears and unresolved differences with each other. Their clumsy but culturally prescribed missteps are making all these other issues look as irremediable as our racial problems.
A good place to start an answer to how we back away from ledges is Alexis de Tocqueville’s writing on early-19th-century American democracy. He had an optimistic take on Americans’ unscripted displays of public bravado, recrimination, and payback.
For him, these were occasions when people tried to mitigate the effects of the unfair hand they were dealing someone else or had themselves been dealt by behaving in ways quite at odds with how they would otherwise be expected to act. These inversions of what Tocqueville called “the natural order of conscience” presented themselves as a loud but culturally muted challenge to the hypocrisies that people had built into the world they’d made together.
One of his favorite illustrations of early-American hypocrisy involved slave masters sleeping with their less-than-worthy slaves. To the best of my knowledge, he didn’t pick up on all the ways that slaves messed with their owners. Their well-chronicled and quiet resistance showed that even severely ill-treated people can exercise more control over their lives than outsiders appreciate.
Be that as it may, such inversions of a people’s “natural order of conscience” make a good public show of them wrestling with demons they can’t or may not want to shake off, but in any case, are nowhere close to figuring out how to cast out.
Implicit in these disruptions was the discomforting idea that people might flip the entire script and turn the world on its head in more permanent ways. That kind of flipping worked out better for us in our revolution against England than in our Civil War. These events taught us the value of stepping back from historically unprecedented ledges.
Americans of late have been giving loud expression to a long list of things they don’t like about each other and the last makeover they started but didn’t finish a half-century ago. The outcome of our fights today will be as revealing as they are embarrassing to everyone who imagined they could recast our country in a way that privileged their favorite kind of Americans.
Their disappointment with the accommodations they strike will be palpable, but the middling results they achieve with all their pushing and shoving won’t be anything they can’t live with.
Anthropologists who have written about such moments in other cultures less “advanced” than our own show that people find ways to work around their seemingly irreconcilable differences without ever fully resolving them. Indeed, the patches and repairs people make have the unheralded effect of reinforcing rather than undermining the legitimacy of the practices and values they thought were fundamentally flawed.
For example…
White guilt and black pessimism do more good than putting cash into the pockets of professional shamers and handwringers. They give the rest of us who don’t feel guilty or powerless more time to make the world less racially unequal. Good news.
Regarding illegal immigration, the entrance requirements for future immigrants will remain stringent. Americans will applaud the continued detention and deportation of the few illegal immigrants who commit serious crimes. Good news.
All the people who came to the United States without being legally vetted and were locked up for a time will be released in numbers small enough to avoid serious media attention. Along with the several million other good people who snuck in but avoided capture, the former detainees will go to school, find gainful employment, pay their taxes, and stay out of trouble. Many will eventually become citizens. Good news.
Investigations into election tampering and Donald Trump’s 2020 presidential loss will come to an unceremonious conclusion the day after his second term ends. Many Americans will grumble about this, but there will also be some quiet partying, too. Good and bad news.
Congressional hearings into all the grifting accomplished by people tied to the Trump administration will end without anyone having to pay a dime back to the American taxpayers. Bad news, we’ll learn to live with.
New laws and regulations will be created in the hope that the kind of corruption practiced by President Trump will not be repeated for another 250 years. Good news, I hope we’ll live long enough to enjoy.
Show trials for people who allegedly vandalized the Lincoln Memorial Reflecting Pool, if they happen, will get big television viewer ratings. Good news.
Trials for pardoned Capitol insurrectionists who committed serious crimes after their release should get more attention, but won’t. Bad news.
We will continue to hear nothing from most of the people who were pardoned for crimes they committed in the insurrection at the Capitol on January 6, 2021. They will keep their mouths shut and their heads down for the rest of their life. Good news.
The gold-gilded ornaments that Donald Trump had plastered all over the White House will be shipped to Mar-a-Lago, where the former president will sell them on eBay. Fun news.
American taxpayers end up paying for most of the new East Wing, the removal of the miniature gladiatorial arena that was built behind the White House, and the restoration of the White House rose garden. Bad news.
The Triumphal Arch was never built. Good news.
Trad wives and gay couples raise perfectly lovely children. Good but unsurprising news.
Trans men and women learn that most Americans can’t figure out who they used to be. No one gives a second thought to their use of “family bathrooms” or “unisex bathrooms” in public settings, businesses, and schools. Communities will sponsor athletic teams that have trans boys and girls just to show they can. Good news.
Budget deficits will be kicked down the road for someone else’s children to pay down. Bad news.
Federal agencies that had their budgets and employee ranks slashed during President Trump’s second term are getting some of the money and lost positions back. Good news.
Elite universities will buy their way out of DEI purgatory by competing for conservative scholars whose inflated salaries dwarf those of their liberal colleagues, who will think about suing their institutions for reverse discrimination but won’t be able to figure out who would pay for it or care. More fun news.
Okay. I’ve probably missed some ways that Americans will step back from the ledges they have been making noises about leaping off. But to the extent that my predictions pan out, the best and most important moral of the stories about us stepping away is this: everything we lost and took back, or had returned to us, will have happened without our government collapsing, civic traditions crumbling, or our people beating each other up.
The reason why is that the differences Americans have with each other really weren’t as irreconcilable as we made them out to be. The empty-sounding bromide that Americans have more that unites us than divides us turns out to be true, not just metaphorically but in fact.
Now that is really something to celebrate.
Daniel J. Monti (danieljmonti.com) is Professor of Sociology at Saint Louis University and the author of American Democracy and Disconsent: Liberalism and Illiberalism in Ferguson, Charlottesville, Black Lives Matter, and the Capitol Insurrection.