Opinions
Science must not be a weapon against trans people
HHS directive would fund studies on ‘detransition’ among children
A concerning research directive is quietly circulating through the U.S. Department of Health and Human Services. The directive, issued in response to presidential Executive Order 14187, calls for the National Institutes of Health to fund studies focused on “regret” and “detransition” among children who have accessed gender-affirming care. It explicitly demands that researchers avoid “subsidizing or incentivizing” such care – language that is both vague and deeply ideological.
President Trump’s executive order, titled “Protecting Children from Chemical and Surgical Mutilation,” was signed in January 2025 and frames all gender-affirming care for minors as inherently dangerous. It calls for an investigation into the “long-term side effects” of such care and restricts federal funding to any institution providing it. In effect, it lays the groundwork for a federally sanctioned research agenda that aims not to understand transgender health but to discredit it.
Behind the recent HHS memo lies a dangerous truth: The federal government is attempting to repurpose science as a tool for political ideology. If this directive proceeds, it will not only erode the credibility of public health research, but it will also put transgender lives at risk.
This warning is not hyperbole. The memo uses inflammatory language like “chemical and surgical mutilation” to describe standard gender-affirming treatments such as hormone therapy and surgery. These terms are not neutral. They are the rhetorical weapons of anti-trans movements, now embedded in federal policy language. Their use signals a chilling shift: science is no longer being asked to explore, understand, or improve lives. It is being asked to justify harm.
Let’s be clear: Regret following gender-affirming care is exceedingly rare. Evidence suggests that the regret rate among individuals who have had gender-affirming surgery is less than 1%, compared to a surgical regret prevalence of about 14% among the general population. Moreover, studies have found that when transgender people report regret following gender-affirming surgery, it is often related to external factors like lack of support from family and peers.
The evidence is consistent and overwhelming: gender-affirming care, including gender-affirming surgery, improves mental health, reduces suicidality, decreases substance use, and affirms a person’s identity and autonomy. That’s why the American Medical Association, the American Academy of Pediatrics, the American Psychiatric Association, and every major medical organization in the United States recognize the safety, efficacy, and medical necessity of gender-affirming care when provided in accordance with established guidelines.
And yet, this new directive demands the opposite. It explicitly instructs researchers to avoid using methods that “subsidize” or “incentivize” transition – a vague prohibition that could limit recruitment, constrain study design, and exclude institutions that provide care. It also bars federal funding to any site offering gender-affirming care to minors, ensuring that the very institutions with the clinical expertise and trust of transgender communities are excluded from the research altogether.
This is not how science works. It is how propaganda works.
There is no scientific integrity in a process that defines its conclusions in advance. There is no public benefit in research that singles out one of the most vulnerable populations – transgender youth – as the sole subject of scrutiny while erasing their overwhelmingly positive outcomes. There is no ethical justification for using federal funds to stigmatize identities and restrict medical freedom.
All aspects of transgender health – positive, negative, and complex – deserve rigorous scientific study. That is what good research does. It seeks truth through comprehensive, community-engaged inquiry. But this directive does not aim for understanding; it fixates exclusively on harm. By selectively funding studies on regret and detransition and explicitly discouraging research that might affirm or support transition, it transforms science from a tool of discovery into an instrument of ideological control.
The consequences of this directive are real. It will erode trust in health research, particularly among transgender people who already face systemic discrimination in medicine. It will chill academic inquiry, pushing researchers away from transgender health for fear of political reprisal. And it will feed a wave of state-level legislation banning gender-affirming care – legislation that increasingly cites distorted or misrepresented science as justification.
This directive is not just an attack on trans rights. It is an attack on science itself.
We must respond with urgency.
First, institutions that receive NIH funding must speak out. Silence enables political interference to become normalized. Deans, department chairs, and ethics boards must draw a clear line: public health research cannot be allowed to serve discriminatory ends.
Second, scientific societies and journals must reaffirm their commitment to ethical, community-engaged, and evidence-based research on transgender health. This means actively promoting rigorous work that reflects the full complexity of transgender people’s lives. Not just those experiences that fit a political narrative.
Third, Congress must exercise its oversight powers. Lawmakers should demand transparency around how and why this directive was issued and ensure that federally funded research respects both scientific standards and human rights.
And finally, the research community must organize. Transgender health researchers, bioethicists, and community partners need to work together to defend the autonomy of science and the dignity of research participants. This is not a moment for neutrality. It is a moment for moral clarity.
We are living through a time when transgender people are being targeted by laws, banned from public life, and erased from textbooks. Now, the very tools of science are being turned against them. If we don’t stop this weaponization now, the damage won’t just fall on transgender communities; it will fall on all of us who believe in evidence, equity, and truth.
Harry Barbee, Ph.D., is an assistant professor at the Johns Hopkins Bloomberg School of Public Health. Their work focuses on LGBTQ+ health equity and public policy.
I was disappointed when the Blade didn’t publish my response to a personal attack on me in a column by Hayden Gise, in last week’s print edition. They did publish it online. To be clear, I have no problem with people disagreeing with my columns and opinions. That is absolutely fair. But when they get into personal attacks, it often means they don’t have enough to say about the ideas they are trying to criticize.
In a recent column ‘Why the Democratic Socialists of America are right for D.C.,’ the author decided to attack me personally. Here is the response I wrote to her column:
“I am responding to a column by Hayden Gise who says in her column she is a transgender, lesbian, Jewish, Democratic Socialist, and supports having the Democratic Socialists of America (DSA) in Washington, DC. She is definitely as entitled to her view on this, as I am to mine. However, I was surprised she clearly felt it important to use the column to attack me personally, without even knowing me. What she didn’t do is respond to the issues in the DSA platform I wrote having a problem with, and which I asked candidates endorsed by the DSA to respond to. 1. Are they for the abolishment of the State of Israel? 2. What is their definition of a Zionist? 3. What is their definition of antisemitism? 4. Will they meet with Zionist organizations? 5. Do they support BDS? One needs to know when a candidate claims they are only a member of the local DSA, according to the DSA bylaws no person can be a member of a local DSA without being a member of the national organization. So Hayden Gise has a little better idea of who I am she should know: I was a teacher and a union member. I worked for the most progressive member of Congress at the time, Bella S. Abzug (D-N.Y.), and supported her when she introduced the Equality Act in 1974, to protect the rights of the LGBTQ community, and have fought for its passage ever since. I have spent a lifetime fighting for civil rights, women’s rights, disability rights, and LGBTQ rights. I have no idea what Hayden Gise’s background is, or what her history of working for the causes she espouses is. But I would be happy to meet with her to find out. But she should know, I take a back seat to no one in the work I have done over my life fighting for equality, including economic equality, for all. So, I will not attack her, as I don’t know her, and contrary to her, don’t personally attack people I don’t know much about.
“I have, and will continue to attack, what the government of Israel is doing to the Palestinian people, and now to those in Lebanon and Iran. I will also attack the government of my own country, and the felon in the White House, and his sycophants in Congress, for what they are doing to our own people, and people around the world, and will continue to work hard to change things. However, I will also continue to stand for a two-state solution with the continued existence of the State of Israel, calling for a different government in Israel. I also strongly support the Palestinian people and believe they must have the right to their own free state.”
I have not heard from Gise, but I hope she knows that since she wrote her column indicating her support for Janeese Lewis George for mayor, her preferred candidate has attended a birthday party to celebrate a person who still refers to gay people as ‘fags.’
We should not personally attack people we don’t know as a way to criticize their views on an issue. Once again, I have no problem with people disagreeing with what I write, and having the Blade publish those contrary columns. But a plea to all who disagree with any columnist, or story: disagree with the issues and refrain from making personal attacks on the writer. That actually takes away from whatever point you are trying to make.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
Imagine if researchers found that coffee drinking increased your risk of death by more than 50%. The public health response would be immediate – regulations, warnings, a swift mobilization of policy to match the evidence. We would act, because protecting people from documented harm is what evidence-based policy exists to do.
The same logic is why Colorado banned conversion therapy. The science was clear: research from The Trevor Project and others shows that exposure to conversion therapy increases suicidal ideation among LGBTQ+ youth, and more than doubles suicide attempts for transgender youth. Every major medical organization in the country – the American Medical Association, the American Psychological Association, and the American Academy of Pediatrics – has condemned the practice.
Colorado looked at the evidence and did what public health is supposed to do. It intervened.
On March 31, 2026, the Supreme Court struck down that intervention 8-1 in the Chiles v. Salazar case, ruling that conversion therapy is protected speech.
This decision should alarm anyone who believes that science has a role in protecting human lives. The court did not dispute evidence. It did not produce contradicting research or question the methodology of the studies Colorado relied on. Instead, it decided that the ideological underpinnings of conversion therapy deserve more constitutional protection than the children being harmed by it. In doing so, it severed the fundamental link between what science tells us is dangerous and what the law is willing to prohibit.
That severance has consequences far beyond Colorado, as Supreme Court Justice Ketanji Brown Jackson noted in her dissent. More than 20 states and Washington, D.C. have enacted conversion therapy bans. The court majority’s reasoning – that regulating talk-based practices constitutes censorship – hands challengers a blueprint. The scientific consensus that built those protections did not change on March 31, but its power to hold them in place did.
For LGBTQ+ public health researchers like us, this ruling is a reckoning. And a personal one. Both of us came to public health because it offered a way to ask questions that matter: How can we help people live safe, healthy, and happy lives?
As a Ph.D. student and an assistant professor focused on LGBTQ+ health, we have been energized by the possibility that rigorous research could inform policies that protect LGBTQ+ people. The Chiles v. Salazar ruling forces us to recognize something uncomfortable: the possibility of research driving policy is real, but it is not automatic. Evidence reaches policy only when researchers advocate to put it there. As it turns out, scientific evidence itself is not enough.
This means the work of LGBTQ+ health researchers cannot stop at the journal article. It has to extend into the spaces where policy is actually made and public opinion is actually influenced. Researchers must work alongside educators, communicators, and community organizers to make evidence impossible to ignore or misrepresent.
As Sylvia Rivera observed in 1971, “our family and friends have also condemned us because of their lack of true knowledge.” More than 50 years later, misinformation about conversion therapy, gender-affirming care, and LGBTQ+ health still fills the gap that researchers leave when they stay silent.
We also want to say this directly to LGBTQ+ young people: Science has not abandoned you. The evidence of your worth, your health, and your right to be protected is overwhelming and it is not going anywhere. The researchers, clinicians, and advocates who built that evidence are still here and still working to ensure it translates into the protection you deserve.
The Chiles v. Salazar ruling is a serious setback. But it is not the end of the argument.
Science has shown us how conversion therapy causes harm. It has shown us clearly, repeatedly, and with the backing of every credible medical institution in the country. The Supreme Court chose to look away. The only response to that is to make looking away harder. To build a public, cross-sector, science-informed movement that refuses to let evidence be sidelined when lives are on the line.
The evidence is on our side. Now, we have to make sure it counts.
Vincenzo Malo is a Health Services Ph.D. student at the University of Washington’s School of Public Health who studies affirming health systems. Dr. Harry Barbee is an assistant professor in the Johns Hopkins Bloomberg School of Public Health whose research focuses on LGBTQ+ health, aging, and public policy.
Eswatini
The emperor has no clothes: how rhetoric fuels repression in Eswatini
King Mswati III’s anti-LGBTQ comments can have deadly consequences
In an absolute monarchy, the words spoken by the sovereign can swiftly become a baton striking a citizen. When King Mswati III speaks, his words do not simply drift into the air as political “opinion”; they often quickly turn into, sometimes violently, state policy. This reflects the reality of Eswatini, where the right to freedom of expression, including the right to hold dissenting political views, is increasingly being systematically eroded by the very voice that claims to uphold “traditional values.”
To understand the current crisis facing the LGBTIQ+ community in Eswatini, one must view it through the lens of a broader strategy: the weaponization of culture to justify the erosion of democratic institutions, the rule of law, and human rights protections. As observed across Africa, from the streets of Harare and Dar es Salaam to the parliamentary courtrooms of Dakar and Kampala, African leaders are increasingly using the marginalised as an entry point to dismantle civil society. In Eswatini, this strategy has manifest its most brutal expression in the king’s recent harmful rhetoric concerning sexual orientation and gender identity.
The danger of the king’s words lies in how the state apparatus interprets them as a divine mandate for persecution. Recently, we have seen this “Rhetoric-to-Policy Pipeline” operate with chilling efficiency. Shortly after the Minister of Education made public vitriol against the existence of LGBTIQ+ students, reports emerged of children being expelled from schools. In a country where the king is culturally and traditionally called the “ingwenyama” (the lion), the bureaucracy acts as his pride; when leadership suggests that a particular group is “un-African” or “deviant,” the machinery of the state, along with the emboldened segments of the public, moves to purge that group from society.
For an openly gay man who has dedicated most of his adulthood to advancing equality and dignity for all, especially marginalized communities, these are not merely policy changes; they pose existential threats. When a powerful leader speaks, they offer a moral shield for the dogmatist and a legal roadmap for the policeman. In Eswatini, where political parties are banned, and the “tinkhundla” system (constituency-based system) — a system that systematically silences dissent and favors those aligned with the sovereign — is celebrated as the sole “authentic” form of governance, any identity that falls outside the narrow, state-defined “tradition” is seen as treason. By branding LGBTIQ+ rights as “ungodly” and essentially unwelcome in Eswatini, the monarchy effectively views the mere existence of queer Swazis as a subversive act against the crown.
The most harrowing example of this pattern is the assassination of human rights lawyer Thulani Maseko in January 2023. Maseko’s murder did not happen in isolation. It followed a period of heated rhetoric directed at those calling for democratic reforms. The king had publicly warned those demanding change that they would face consequences. On the evening after the king had said, “[t]hese people started the violence first, but when the state institutes a crackdown on them for their actions, they make a lot of noise blaming King Mswati for bringing in mercenaries,” Maseko was shot dead at his home in front of his family.
The parallel here is unmistakable. When the king targets the LGBTIQ+ community with his words, he is aiming at the most vulnerable. If a world-renowned human rights lawyer can be silenced following royal condemnation, what chance does a queer youth in a rural area stand when the king’s words reach the local chief or school head? This is what I call “Chaos as Governance”: a state where the law is replaced by the monarch’s whims, leaving the population in a constant cycle of managed chaos that renders collective opposition nearly impossible. Despite strong condemnation from the organization I founded, Eswatini Sexual and Gender Minorities (ESGM), recent reports already suggest growing support for the rhetoric shared by the king, indicating treacherous weeks and months ahead for ordinary queer people in Eswatini.
The monarchy’s defense of these actions is almost always based on “African tradition.” As Mswati has shown, the ban on political parties and the suppression of minority rights are framed as a return to indigenous governance, the “tinkhundla” system. But we must ask: whose culture is being defended? Is it a culture that historically valued communal care and diverse social roles, or is it a modern, imported authoritarianism cloaked in the robes of the ancestors?
When he uses his platform at the “sibaya” (traditional gathering) to alienate a segment of his own people, he is not engaging in dialogue; he is delivering a monologue of exclusion. This weaponized version of culture serves a dual purpose. First, it offers a “neocolonial” defense against international criticism, portraying human rights as a foreign threat. Second, it creates an internal enemy, the “terrorist” political dissident or the “immoral” LGBTIQ+ person, to distract from the fact that nearly two-thirds of the population live below the poverty line. In contrast, the royal family resides in obscene luxury, acquiring fleets of expensive vehicles.
The silence of Eswatini’s neighbors worsens its situation. The Southern African Development Community (SADC), a regional organization ostensibly committed to democracy and human rights, has repeatedly allowed Mswati to evade accountability. By agreeing to remove Eswatini from the Organ Troika agenda at the king’s request in 2024, SADC sent a message to every authoritarian in the region. If you conceal your repression behind the guise of tradition, we will not intervene.
The call for freedom of expression, including LGBTIQ+ rights, is a fundamental human right vital for safety and dignity. It demands that a child should not be expelled from school because of who they are. It insists that a lawyer should not be murdered for expressing their beliefs. It states that a king’s word should not be a death sentence. We must resist the “politics of distraction” that portrays the fight for minority rights as separate from the fight for democratic reform. The dissolution of political parties in Burkina Faso, the attack on lawyers in Zimbabwe, and the criminalization of advocacy in Senegal, Tanzania, and Uganda are all parts of the same pattern. They reflect a leadership class that fears its own people.
It is time for the African Union and SADC to decide whether to uphold the ideals of their lofty charters or to prioritize political convenience across Africa. For the people of Eswatini, improving livelihoods and human development can only occur when the king’s words are limited by a constitution that protects every citizen, regardless of whom they love or how they pray. Until then, the chaos is not a failure; it is the purpose. The monarch’s word may be law today, but the universal right to dignity is the only law that will endure. We must demand an Eswatini, and by extension, an Africa that seeks to improve the lives of its people, and where the “lion” protects all his people, rather than hunting those he deems “unworthy” of the shade.
Melusi Simelane is the founder and board chair of Eswatini Sexual and Gender Minorities. He is also the Civic Rights Program Manager for the Southern Africa Litigation Center.
