1

The Autonomy of Transgender People in the USA

Adam Cartwright

Bowling Green State University

PHIL 2420

Professor Cheryl McKinley

November 4, 2022
 2

Abstract

Transgender healthcare in the United States has not always been very consistent or

reliable. Currently, Arkansas has a law in place that explicitly prevents transgender people from

being insured if they chose to have gender-affirming surgery (Movement Advancement Project,

2022). Some states like California and New York do cover this, but everything is up to the states.

Along with medical care not always being covered by insurance, there is no federal law

preventing discrimination against LGBTQ+ in public businesses like shops or restaurants

(ACLU, 2020). Persons should not be discriminated against because of what they do to their own

bodies and how they choose to present themselves. Once again, trans people’s fate is left in the

hands of the state or county they reside in. These problems continue to be discussed in our

country, and lawmakers go back and forth on how they would like to resolve them. The purpose

of this paper is to show that due to the lack of protection for trans rights, they still face

discrimination in a healthcare setting.

 3

Introduction

The United States lawmaking system is preventing transgender people from being

autonomous and making decisions about their own bodies. The states currently have control

over what trans people can do with their bodies. This paper will argue that the fight shouldn’t be

on the state level, it should be a federal discussion. What is the real reason for preventing trans

people from being themselves? This question can be answered by looking at the laws being

passed in the United States. This paper will also argue that religion is being involved in law

making which is unfair to trans people. The last problem that will be argued is that transgender

youth’s autonomy isn’t respected because they need parental permission to go through with some

medications or procedures, but a lot of trans youth don’t have very accepting parents willing to

sign off on that. Laws being put in place can help prevent these problems from existing, but steps

must be taken now.

Argument 1

Throughout recent years, the United States has made many improvements in laws

regarding the LGBTQ+ community; for example, the legalization of same-sex marriage in 2015

(Livesay, 2022). This was a big step for the community, and it made history for the LGBTQ+

movement. While this was a big step taken, there were still so many stones left unturned that

needed federal attention. One of the biggest fights of the Trans community has been for using the

bathroom of their choice. One lawmaker argued that she doesn’t feel safe with a trans woman in

the restroom with her (Li, 2022). This is extremely insensitive for someone to say, and she

clearly has not taken time to think about what it might be like to be in a trans person’s shoes.
 4

Transgender people have their autonomous right to do what they want to their own bodies, and

for a lawmaker to judge someone based on those decisions goes against the whole concept of

autonomy. When they were deciding on the law for a trans person’s right to use their bathroom

of choice, it did not seem like they were thinking ethically. A utilitarian lawmaker may vote to

allow trans people to use their restroom of choice because they would not want to make an entire

community suffer any longer. A lawmaker with the Kantian mindset might say no to this law

because they feel like they have a duty to keep the bathrooms set up how they have always been.

Either way, trans people have their autonomous right to do what they want with their bodies.

Currently, a lot of the laws put in place either protecting or going against trans people are on a

state level. Trans autonomous rights shouldn’t be up to the states, it should be a given, and

without federal laws protecting that right, they continue to struggle with their fight for equality.

Argument 2

The United States clearly enforces a separation of church and state, meaning no laws can

be enforced based on religious concepts, but that doesn’t prevent lawmakers from holding this

value when voting. That can especially be a problem when deciding on laws involving the

LGBTQ+ community because a lot of religious people feel that the community is unholy, or bad

for society. Supreme court justice, Amy Coney Barrett once said she would never discriminate

against someone based on sexual orientation; however, in a previous church leadership position

she held, she would be exposed for expelling male members who had any sexual interaction with

another man (Kirchgaessner, 2020). Barrett is not the only lawmaker who is known to take

religious beliefs into consideration when deciphering right versus wrong, there are many more,
 5

such as Jena Powell, Adam Holmes, Gary Click, Bill Dean, and countless others (Freedom For

All Americans, 2022). The idea of using religion, something that has yet to be proven factual, to

judge how transgender persons can live their life is not ethical. They are taking a Kantian

approach by feeling that they have a duty to follow their religion and not seeing the harm that is

second-handedly caused to the trans community. They may think making laws that prevent the

youth from learning about the LGBTQ+ community is protecting them, but in reality, it does no

harm. All the community wants is equality and the ability to be themselves but these laws that

have hidden religious ideologies are making that impossible. Once again, trans persons are being

denied their autonomous rights because of the religious values some lawmakers hold.

Argument 3

In most places in the United States, to get surgical or hormonal treatment for

transitioning as a minor, you need parental consent (The American College of Obstetricians and

Gynecologists, 2022). While this is common to need parental permission to get any medical

treatment as a minor, transitioning is a little bit different. Some trans youth do not have very

supportive parents and they do not support the idea of transitioning, or any treatment whatsoever.

This puts lots of mental stress and anxiety on trans youth. They struggle to not be able to make

these decisions for themselves even when it is what they truly want. When put in the doctor’s

position, one must think, “am I really doing what is best for the patient”? These legal boundaries

hold the doctor back from making a proper ethical decision because they are obligated to follow

the rules set in place. Ideally, these kids would get the treatment they need and be supported by

their doctor, but that simply cannot be the case. Since surgical treatment is more permanent, that
 6

would probably have to stay a decision made by the parents until the patient is no longer a minor.

On the other hand, hormone therapy is reversible, and that could be a solution as to what the

doctor could provide for a transgender person whose parents might not be as accepting, or whose

parents aren’t involved in their life. With laws modified like this, trans people’s lives can be

improved dramatically, but with how the system is set up right now, they probably will not

improve.

Objection 1 and Reply

Some people may think that transgender people already have this right to autonomy and

that nobody is infringing upon that. They see this whole argument of equality as a grab for

attention, and unnecessary. While this belief is not factual, there is still some truth to it.

Transgender people do have rights in the United States, and there aren’t many laws that go

against these rights; however, some do still exist.

A great example of how transgender persons are having their rights limited is by looking

at the ability for trans females to participate in competitive sports. In 18 states, trans persons are

banned entirely from competing, but their cis-gender teammates face no such discrimination

(Movement Advancement Project, 2022). This is one of the many issues that still exist and

prevent trans people from being fully autonomous. Another example is that trans females (born

male) are required to register for the draft (Selective Service System, 2022). If females don’t

have to partake in the draft, why should trans females? This only further enforces the separation

of who is considered female by societal standards and the law.

 7

Objection 2 and Reply

Some opposers may argue that trans youth should not be able to make medical decisions

for themselves with or without parental consent because they are not at a mature enough age to

properly choose how they wish to live. This means that trans youth would not be able to get

transitional surgery or hormonal therapy, or any other gender euphoric treatments.

This is extremely harmful to transgender youth’s mental health and emotional stability.

These kids feel trapped in their own body, and they cannot wait for the day that they can feel like

themselves. Most of the time, some form of treatment, either in the form of surgery or hormone

therapy, is needed to make them feel most comfortable. While they are young and do still have a

lot of maturing to do, most of the procedures that are able to be done to kids can be reversed. If a

child chose to go on puberty blockers, they could be taken off and go through puberty at a later

stage if they wish. The mental health of these kids is what is most important. They may not be

able to make a big life-affecting decision at their young age, but they should still have the option

for more mild opportunities of gender euphoria so they can be themselves and discover their true

inner character.

Conclusion

As a country, it is important to stand together and protect the rights of all citizens.

Transgender people are facing the troubles of fighting for their autonomous right to be

themselves and make their own decisions. They should not have to worry about whether or not

their doctor is going to treat them or deny them service because of who they are. They should not

have to wait till adulthood to make decisions on one of the biggest parts of their persona. With
 8

the refinement of some laws and the reworking of the system, improvements can be made. Trans

people deserve to live their lives the way they want to without unnecessary blocks on that road.
 9

References

ACLU. (2020). LGBTQ Rights. Know Your Rights | American Civil Liberties Union.

https://www.aclu.org/know-your-rights/lgbtq-rights

Federica Vergani, Why Transgender Children Should Have the Right to Block their Own

Puberty with Court Authorization, 13 FIU L. Rev. 903 (2019).

Freedom For All Americans. (2022). Legislative Tracker: Anti-Transgender Legislation Filed

for the 2020 Legislative Session. Freedom for All Americans.

https://freedomforallamericans .org/legislative-tracker/anti-transgender-legislation/

Kirchgaessner, S. (2020, October 14). Amy Coney Barrett faith group would expel members over

gay sex, leader said. The Guardian. https://www.theguardian.com/us-news/2020/oct/14

/amy-coney-barrett-people-of-praise-expel-members-gay-sex

Livesay, J. (2022, June 21). When Was same-sex Marriage legalized? a Quick History of an

LGBTQ Rights Battle in the U.S. USA Today.

https://www.usatoday.com/story/news/politics/2022/06/21/when-same-sex-marriage-

legalized/7628967001/

Movement Advancement Project. (2022, October 25). Healthcare Laws and Policies.

Selective Service System. (2022). Who Needs to Register. Selective Service System.

https://www.sss.gov/register/who-needs-to-register/

The American College of Obstetricians and Gynecologists. (2022, September). Health Care for

Transgender and Nonbinary Teens. Www.acog.org. https://www.acog.org/womens-

health/faqs/health-care-for-transgender-and-nonbinary-teens#:~:text=In%20most%20

places%20in%20the

Www.lgbtmap.org. https://www.lgbtmap.org/equality-maps/healthcare_laws_and_ policies