Social justice is a philosophical and political perspective that emphasizes the importance of fair interactions between individuals in society with regard to the distribution of wealth, social privileges, and other opportunities. America’s history is punctuated by a variety of social justice movements, all of which have prioritized the preservation of individual rights and liberties. The Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) movement has significantly improved the lives of individuals who have, for a long time, been subjected to discrimination. Today, the LGBTQ community is under threat due to the banning of gender-affirming care services in some states across the United States. As a result, many transgender youths run the risk of experiencing depression and suicidal ideation, which is detrimental to their overall health. The denial of essential health services to LGBTQ individuals is a gross violation of their fundamental human right to healthcare.
Analysis of a Social Justice Trend Using a Social Justice Theory
The libertarian perspective on social justice recognizes the need to govern society. However, the protection of individual rights is a necessary requirement. Kant postulated that liberty is the coexistence of an individual’s freedom with other people’s freedom in line with universal law. He further stated that liberty is the sole right that belongs to every individual as a result of their humanity. Therefore, every individual, transgender or otherwise, is entitled to a specific degree of freedom, which is governed by every other individual’s right to the same. It is also worth noting that the universal principle of right emphasizes the fact that every individual must exercise their choice in a manner that is consistent with the freedom of the rest of society to exert their choice. The aforementioned conception of liberty prohibits the subjection of individuals to the choices of others. In essence, the states’ decision to ban gender-affirming care is a direct infringement of the liberty of those who need the services.
Each individual has a right to their own master. This means that no other individual is entitled to make decisions that are supposedly beneficial to another by forcing them to abide by a specific set of rules (Mazor & Vallentyne, 2018). Transgender individuals bear the sole right to decide whether the benefits associated with gender-affirming interventions are worth the burdens associated with the procedures. In addition, the libertarian perspective disqualifies the justification that the banning of gender-affirming interventions is of benefit to the rest of society. Transgender individuals must be accorded the opportunity to choose their desired path in the context of available resources.
The libertarian perspective views freedom as an inherent human right that must not be constrained by the choices of others. It is worth noting that public institutions play a critical role in safeguarding people’s rights. This is because a system of private rights without oversight from a public entity is morally incoherent, given the need for a public authority that is entitled to design, enforce and apply laws (Mazor & Vallentyne, 2018). Public institutions ensure the maintenance of freedom in three key ways. The first is by implementing a universal will that makes a specific act binding to all others. Secondly, it provides a system of public enforcement that every individual in society must observe in order to maintain the security of specific rights. Finally, public institutions serve to address disputes that may arise due to the enforcement of specific rights. The state is, therefore, a collective body that acts on behalf of its residents to facilitate reasonable interactions in the context of equal freedom.
The view that gender-affirming care is morally reprehensible despite having numerous benefits for transgender individuals is not sufficient to compel the public to support the abolishment of the services transgender individuals are reliant upon (Mazor & Vallentyne, 2018). It is only activities or services that are considered necessary for equal freedom that may be altered for legitimate public services. Gender-affirming care is most certainly not one of the services that must be altered for equal freedom.
The state is obligated to protect the rights of all its citizens, including transgender individuals. The innate freedom of individuals is inextricably linked to the premise that no single individual has a legitimate claim over others for the accommodation of their needs. However, the fact that the state has the capacity to act on behalf of all its people mandates the state to offer certain protections to marginalized groups (Mazor & Vallentyne, 2018). Consider s scenario in which an individual in a state does not own land. This individual is dependent on other people’s choices for the basic need of shelter. Therefore, the aforementioned individual has made a significant contribution to the unilateral will that has made land rights feasible, thus eliminating their capacity to obtain specific objectives given that he needs permission from others just to have shelter. This make’s the state’s role in people’s lives and more specifically, transgender lives important.
While the state is required to enforce laws governing access to essential health services, it must preserve individual freedoms. An individual who is entirely dependent on other people’s private charity is not free. Therefore, the innate right of individuals by virtue of their humanity makes systems of enforceable rights illegitimate, unless specific measures are implemented to prevent individuals from becoming entirely dependent on the choices of others (Mazor & Vallentyne, 2018). For instance, a rich individual’s right to exclude others from their property observes the laws of equal freedom only when there are specific tax laws that protect others from the rich individual’s choices by catering to their basic needs (Mazor & Vallentyne, 2018). The transgender community’s dependence on systems informed by religious and cultural beliefs rather than sound evidence-based practices strips them of their freedom. With regard to health, if specific health conditions that plague the transgender community result in increased instances of depression, suicide, and low self-esteem, the state must act proactively and provide services such as gender-affirming care. The justifications for such action are that by providing gender-affirming care the state guarantees equal freedom and prevents the dependence of individuals on others for the achievement of specific health objectives.
Implications for the Healthcare System
The Office of Population Affairs (2021) defines gender-affirming care as surgical, mental health, medical and non-medical services designed to serve the needs of nonbinary and transgender people. The provision of these services for young transgender individuals is necessary for the maintenance of overall health and wellbeing. The services allow affected individuals to dedicate themselves to social transitions that boost self-confidence as they deal with the challenges that characterize America’s healthcare system. The validity of gender-affirming services is supported by a litany of research studies. For instance, a study by Green et al. (2022) on the link between gender-affirming hormone therapy with depression and suicidal ideation among transgender youth made significant contributions to transgender health. The researchers noted that increased access to gender-affirming hormone therapy was directly linked to low rates of suicide and depression among transgender and non-binary youth (Green et al., 2022). In a study to evaluate the mental health outcomes among nonbinary and transgender youth with access to gender-affirming care, similar results were noted. Tordoff et al. (2022) found that gender-affirming services were associated with low rates of depression and suicide among transgender and nonbinary youth over a twelve-month period. Access to gender-affirming care was associated with a 60% reduction in cases of moderate to severe depression and a 73% reduction in self-harming behavior or suicidal ideation among the study participants (Tordoff et al., 2022). In addition, transgender individuals who did not have access to gender-affirming care experience a two to threefold rise in depressive symptoms compared to the baseline (Tordoff et al., 2022). The study proves that increasing access to gender-affirming care significantly reduces the incidence of depression and suicide.
The restriction of access to essential health services poses a major risk to transgender individuals. The Williams Institute (2022) notes that by March 2022, fifteen American States had restricted access to gender-affirming care or were in the process of passing laws that would achieve the aforementioned objective. As a result, more than 58,000 transgender individuals risk access to essential healthcare services (Williams Institute, 2022). It is vital to note that in addition to fueling stigma, the proposed laws put the lives of transgender individuals in peril. They risk suffering serious mental health challenges such as depression and suicide.
The initiatives that deny transgender individuals access to essential health services have had negative ramifications. For instance, families are fleeing specific states in search of jurisdictions that will provide their children with the care they need. A report by Yurcaba (2021) indicates that families are making plans to leave their home states in search of essential care for their children. The lives of innocent children are being affected on an immense scale as individuals with limited resources are forced to relocate without a means of income to support their households.
Evaluation of Policies Impacting Social Justice Movement
Arkansas has officially banned the provision of gender-affirming services for transgender minors. Many other states in the U.S. are taking similar legislative measures to limit access to gender-affirming services to residents in their jurisdictions. Numerous states have implemented harsh punishments for individuals found receiving or administering gender-affirming procedures. In Texas, healthcare institutions are limiting access to care for fear of legal consequences (Dey, 2022). The Texas governor, Greg Abbot ordered that parents and licensed facilities that offer medical care to transgender teenagers should be investigated (Dey, 2022). The order was the result of the interpretation of the Attorney General’s statement, which deemed hormone therapy, puberty blockers, and surgical interventions as child abuse (Dey, 2022). The net effect has been a reduction in access to essential services for transgender individuals in the state.
The efforts to criminalize gender-affirming care have been condemned by numerous organizations. In a joint statement American Academy of Family Physicians et al. (2022), which represents an estimated 600 physicians strongly opposed efforts in Texas and the other American States that were aimed to criminalize gender-affirming care. The organizations vowed to speak out against actions that threatened the health of transgender and nonbinary individuals in the United States. They further noted that any measures designed to interfere with the confidentiality of the patient-physician relationship and the provision of evidence-based care in the determination of what was best for the patient were a violation of fundamental human rights. According to the American Academy of Family Physicians et al. (2022), each patient has the right to access evidence-based care, regardless of their gender or sexual orientation.
Nurse Practitioner Impact
Nurse practitioners can play a critical role in their communities to ensure transgender individuals have access to essential services. For instance, practitioners can lobby their local leaders to intervene and address the discriminatory laws seeing as they deny a section of the population access to essential care. In addition, practitioners can partner with lobby groups to take legal action against states that refuse to observe transgender rights and freedoms.
Conclusion
Freedom is feasible only when every individual’s freedoms are respected and protected by public institutions that allow individuals to achieve their health objectives without being dependent on the choices of others. The state must act on behalf of all its citizens seeing as it possesses powers that private individuals are denied. The transgender community, by virtue of the abolishment of gender-affirming care, is dependent on the choices of others, which is an indication that their individual freedom has been ignored. Their access to essential healthcare services has been denied, which is a contravention of an essential human right. The policies that ban the provision of gender-affirming care are discriminatory. The destruction of the physician-patient relationship and the objection to the use of evidence-based procedures are reprehensible. The government’s attempts to force the disclosure of privileged patient information regarding gender-affirming care is a violation of fundamental human rights.
References
American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American College of Physicians, American Osteopathic Association, & American Psychiatric Association. (2022). Joint statement opposing Texas efforts to interfere in the patient-physician relationship and criminalize gender-affirming care. Web.
Dey, S. (2022). Texas trans teens shut out from medical care amid GOP efforts. The Texas Tribune. Web.
Green, A. E., DeChants, J. P., Price, M. N., & Davis, C. K. (2022). Association of gender-affirming hormone therapy with depression, thoughts of suicide, and attempted suicide among transgender and nonbinary youth. Journal of Adolescent Health, 70(4), 643–649. Web.
Mazor, J., & Vallentyne, P. (2018). Libertarianism , left and right. In S. Olsaretti (Ed.), The Oxford handbook of distributive justice (pp. 129–151). Oxford University Press. Web.
Office of Population Affairs. (2021). Gender affirming care and young people. Web.
Tordoff, D. M., Wanta, J. W., Collin, A., Stepney, C., Inwards-Breland, D. J., & Ahrens, K. (2022). Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Network Open, 5(2), 1–13. Web.
Williams Institute. (2022). Prohibiting gender-affirming medical care for youth. UCLA School of Law. Web.
Yurcaba, J. (2021). “It’s not safe”: Parents of transgender kids plan to flee their states as GOP bills loom. NBC. Web.