BY ROSA AURELIA
On Thursday, July 24, Yale Medicine and Yale New Haven Health announced that they would be ending their surgical (and medication based) gender-affirming health care for patients under the age of 19. This decision came immediately after Connecticut Children’s Medical said it would do the same. These developments have grave implications for trans people and their allies in the state of Connecticut. As clinics close their doors, the clients of the ones that remain will experience longer and longer wait lists, and this fact will inevitably lead to the (preventable) death of the state’s most marginalized youth.
This calculated move on behalf of the liberal establishment, however, does represent an opportunity for us to assess the strategies that the ruling class is employing in their continued gutting of essential social and medical services—which impacts all working-class Americans. Furthermore, these attacks give the class an opportunity to identify its antagonists, and to fight back against them with the power of a mass movement to protect trans youth that unites with medical workers struggling against neoliberal austerity measures.
In order to understand these attacks and how to fight back, we must look to the national and international context in which Connecticut hospitals have caved to anti-trans right-wing pressures, then speculate as to the possible responses of the trans liberation movement, as well as plan how revolutionists should meet this incredibly determinant moment in this arena of the class struggle.
The motives and strategies of the anti-trans reaction
From Brazil to Britain and from Hungary to China, we’re seeing the agents of capital adhere to anti-trans sentiment because it aids in their goals of dividing the working class along gender lines and because it diverts responses to crises of capitalism onto the already marginalized Queer community.
Strategically, the ruling class can repurpose sentiments of discontent toward the liberal education and health care systems to scapegoat trans people for the failures incurred by decades of neo-liberal policies. This strategy is especially effective on people who know intimately the state of the gutted social services, but who see no class independent alternatives in their elections.
The right’s playbook is rather easy to grasp. In the U.S. we have seen Attorney General Pam Bondi announce that she will be going after these industries for “defrauding” the American people. This framing allows the administration to appear as if it is fighting against the interests of the “elite.”
The Justice Department has also sent subpoenas to about 20 medical providers demanding that they turn over to the government sensitive records about their young transgender patients—including dates of birth, Social Security numbers, and addresses—as well as billing documents, communications with drug manufacturers, etc., going back to January 2020. Bondi said last month that the Justice Department is attempting to hold accountable for their actions “medical professionals and organizations that mutilated children in the service of a warped ideology.”
In addition, Robert Kennedy Jr.’s Department of Health & Human Services sent a letter in April to state Medicaid directors, urging them to “strictly limit” their services for gender-affirming care. Three days later, the department issued a form for whistleblowers to report to the government their “complaints” against providers of such services as long as they have a “good-faith belief” that the medical practitioners “violate professional or clinical standards.” In describing these standards, the document references Trump’s anti-trans Executive Order 14187, titled, “Protecting Children from Chemical and Surgical Mutilation.”
Meanwhile, the Federal Trade Commission (FTC), which is the big bourgeoisie in their governmental guise, is going after “gender ideology” by attacking the rights of clinics and doctors, as well as by holding what amounts to an anti-trans rally (Baum, 2025). What we are witnessing is a paradigm shift in corporate oversight of medical practices, and it shows how the right aims to prosecute their offensive against trans people. There is no doubt that the same strategies employed now against trans people will be used to enforce abortion bans in the future.
Though this strategy plays into the working class’s distrust of the health insurance industry and the medical industrial complex, it cannot actually solve the problem that workers are saddled with enormous medical debt, paying an arm and a leg for insurance, and unable to access the services they need.
Indeed, the right’s characterizations of trans health care prey upon very real and valid distrust of the establishment’s failing health-care system. However, these narratives effectively conceal the fact that Queer people are far more likely than their cis-hetero counterparts, to experience the marginalization that leads to difficulties in accessing health care. And further, these challenges are exponentially intensified for those already facing poverty, racism, ableism, and sexism.
There is a crisis in the U.S. health-care system, and the resulting lack of health care is disproportionately felt by the most oppressed. Yet the right wing claims that it is the “transgender industrial complex,” and not their $880 million in cuts to Medicare, that further debilitate our health-care system. These right-wing narratives are codified by the FTC, the office of the AG, and especially by the Supreme Court’s recent decision in United States v. Skrmetti to uphold Tennessee’s ban on gender-affirming care. And now we see that through these actions they are successfully pressuring supposedly “blue state” liberals in the upper echelons of the medical industry to make the very destructive decision to abandon trans youth entirely.
Nationally, we are only going to see this crisis for trans people worsen as surveillance of health-care providers increases, and as the FBI goes after providers who stand up to these pressures. Though they may start with providers and clinicians, this will no doubt expand to trans people themselves; as we saw earlier this year, they have already removed the language barring the FBI from surveilling people purely based on their gender identity.
This form of domestic spying is merely the first step along a path toward the expansion of the medical surveillance apparatus. This surveillance will allow the ruling class to police all bodies, and especially those of pregnant people by monitoring things like their health app data and period tracking apps.
Our strategy for the fightback
Obviously, such grave circumstances can be very scary, and demoralizing, for the trans community. Trans people might be tempted to respond to the increased surveillance and unavailability of gender-affirming care by moving into underground networks. But these strategies, especially if they manifest in underground Hormone Replacement Therapy (HRT) distribution networks, will have an enormous potential to be infiltrated by police or the FBI. In that way, they could kettle trans people and put them in a position to be further repressed.
To defend ourselves, we need public solidarity that prevents the government from isolating and attacking us as criminalized individuals. Out of these decisive moments, workers and oppressed people could build a broad and strong mass movement that can defend trans lives by taking up the struggle to advance the rights of women, Queer people and the particularly vulnerable trans community.
Building robust and effective defense campaigns can be aided when the trans community participates in other movement spaces, such as within the immigrant rights movement, the climate movement, the Palestinian solidarity movement—and in the unions. Campaigns organized by unionized workers might eventually be able to put credible strike action on the table, which could shift the balance of power in our fight.
Additionally, we advise allies of the trans liberation movement against actions that aim to “raise awareness” of our plight through escalatory, performative, and adventurist confrontations with police and the National Guard. These actions risk alienating the movement from its potential allies. Those who put forward such plans lack a complete understanding of the only force that has the potential to make meaningful advances toward liberation, that is the force of the united working class.
The mass action of the working class is enormously powerful. For example, it was only when Black Lives Matter protesters started raising the slogan “Black Trans Lives Matter” that we saw the conservatively led Supreme Court issue an opinion that protected LGBTQ workers from being fired based on their sexual or gender orientation. In 2020 the ruling class felt threatened by workers uniting to defend Black trans bodies, so they conceded Bostock v. Clayton County. But today they feel less of an immediate threat—so we get Skrmetti. The difference between the Court that made that ruling and the one we see today is the strength of our solidarity.
To build such solidarity we must follow the example set by protesters outside of NYU Langone Health in New York and in Michigan earlier this year, where trans activists united with hospital workers to oppose concessions on trans health care that had been made by liberal health-care industry executives. When these forces united, we saw that they won their respective battles, effectively setting back the right-wing anti-trans movement. And when California’s Kaiser Permanente said it would stop providing surgical care to treat gender dysphoria in people under 19, the largest nurses’ union in the nation stood up to condemn those actions. These examples of solidarity need to be repeated at every hospital and clinic across the country. We know such solidarity is possible because as trans people we don’t just want to fight for trans health care; we want to fight for all health care, and the rights of all health-care workers.
It is necessary for all social activists to help build a mass movement of workers and the oppressed that could bring together health-care workers’ unions and their allies within the trans community. When such a movement takes to the streets with slogans as strong as “Black Trans Lives Matter,” we will be able to go beyond defending the most basic gender-affirming health-care for minors and fight for full liberation.
Sources
Baum, S. (July 10, 2025). “Trump’s FTC lays the groundwork to charge GAC providers with ‘fraud.’” https://www.erininthemorning.com/p/trumps-ftc-lays-the-groundwork-to
Maroney, E. (2025a). “The Anti-Trans Witch Hunt.” Spectre, (11). The Anti-trans Witch Hunt Spectre: A Marxist Journal. https://spectrejournal.com › the-anti-trans-witch-hunt
Maroney, E. (2025b, Jan. 30). “Trump, the right, and the broader anti-trans reaction.” Tempest. https://tempestmag.org/2025/01/trump-the-right-and-the-broader-anti-trans-reaction/
