Ivan Hsiao: Good afternoon, everybody. On behalf of the Harvard LGBTQ Health Center of Excellence, welcome to our inaugural speaker series. My name is Ivan Hsiao, and I use he and they pronouns, and I'm an alumni advisory council member here at the center, as well as the founder of Trans Health HQ.
I'm delighted to be back at Harvard Chan, which is my alma mater as of May this year, with none other than journalist and activist Erin Reed, who I admire very, very much. Erin is an award-winning journalist and activist who recently won Best Blog at GLAAD Awards and was named a Human Rights Defender by the European Union.
This event is really special to me because Erin's newsletter on trans and queer news, called Erin in the Morning, has been an integral part of my Saturday morning routine for the past couple of years, and it's really enabled me to stay informed on the landscape of gender-affirming care, which is crucial to the work that we're doing here at Trans Health HQ.
Additionally, as part of Erin's activism, she also created an informed consent clinic map, which has been used millions of times to help patients find medical facilities for transition-related care and was one of the first resources that I used to access the healthcare that I needed. So thank you so much, Erin, for being here, and welcome back to Harvard.
Erin Reed: Thank you so much for having me.
Ivan Hsiao: Yeah, so to get us started, could you please tell us about your path to becoming a journalist and a content creator on LGBT health issues, and just give us an overview of the key challenges that we're facing in this field today?
Erin Reed: Yeah, absolutely. So as you had mentioned, I first got started in this realm of work by finding all of the hormone therapy clinics that exist. I actually wasn't getting into journalism, that wasn't what I saw myself doing. It was very hard when I first transitioned six years ago to find those clinics. The clinics were sort of hidden around the internet and spoken by word of mouth. And so what I did was I mapped them. I went out to all of the Planned Parenthood websites and put in a zip code in the middle of each state, and I put these resources on a map so that people can access them. And it blew up. I mean, people suddenly were able to transition because this dream that they had had gone from being a dream to being something that you can do that's 10 minutes from your front door or 20 minutes from your front door.
And after doing that, I got all of these connections in each of these states. The clinicians got to know me, the people who transitioned got to know me. And then 2021 happens. We start to get the first anti-trans healthcare bans. First in Arkansas, a gender-affirming care ban for trans youth in Arkansas, which was vetoed in the state, the very first one. I reported on that one. And as I started reporting on these laws, I started getting information from, again, the clinicians, from the people who had transitioned, and I very quickly found myself becoming just sort of like a central repository for this info. After that, everything just sort of took off. I started speaking to attorneys. I started speaking to leading healthcare researchers. And that's sort of what brought me to today, and now I report on my newsletter.
Ivan Hsiao: Thank you so much for that overview. Just as we're sort of going forward in this conversation, I'd love it if you could set it up for our audience, some of the key challenges in particular in gender-affirming care that we're seeing in the U.S. and beyond.
Erin Reed: Yeah. So over the last three years, I have tracked over a thousand anti-trans and anti-queer bills. And these bills affect us in every aspect of our lives. We see bills banning our books, our history, our forms of art and drag. We see bills that ban medical accepted best practices for transgender youth. And in many cases for transgender adults, you know, we think about the gender-affirming care bans that do affect trans youth, but it's also important to note that the ban in Florida affected 80% of all adult trans healthcare. It's important to note that Missouri and West Virginia are banning incarcerated trans people from accessing gender-affirming care. And we see now nationally in the NDAA bill, the military bill, how they're attempting to put another trans military healthcare ban.
And so all of these bills we continue to see pushed forward. We also continue to see harmful narratives about trans people pushed forward that, you know, that we're deluded or that we're going to de-transition at any moment or that we live unsatisfying lives. And these narratives are used to then push these bills further.
Ivan Hsiao: And I think to that point around pathologization and medicalization of the trans identity as a public health practitioner and also as a trans person, I've both observed and experienced that harm that's been done on our community because of that. And I would love to hear from you about just like the history of anti-LGBT pseudoscience and some of the harmful conjectures today that we see targeting trans people's healthcare.
Erin Reed: Yeah. So, you know, it's important to note that anti-queer and anti-LGBTQ pseudoscience has a history. This isn't something that just popped up in the last five years with respect to transgender people. You can go back to the 1970s and you can look at the narratives that, you know, homosexual men, for instance, where they didn't use groomers at the time. That's a word that's being used now, but it's an analogous word to what they used at the time was recruiting, that gay people couldn't reproduce. And so in order for there to be more gay people, really, it's just homosexual men who are grooming or recruiting young children. We see these narratives pulled back into what we're seeing today.
Another thing, if you ever watch the old ex-gay movement videos, you'll see they'll gather around in these little community groups and they'll explain how, you know, sexual trauma made them gay. And these things are still used today. You know, right now we're seeing, for instance, explanations about transgender people saying that sexual trauma is why people are turning trans.
Another thing that was commonly used back then, another pseudoscientific view back then was that being gay was actually being spread, it was contagious, it was a social contagion. That you learn to be gay from your gay-straight alliances, that you learn to be gay from your gay teachers. And we see that again today too, that being trans is some sort of a social contagion. That by your mere presence with another transgender person, you are at risk of being pulled into a trans identity. People say that TikTok makes you trans, that Instagram makes you trans. I promise you that none of you listening today are going to leave this audience transgender if you were not already just by virtue of being around somebody like me. That's just not how it works.
You know, I think that trans people will tell you that, you know, our gender identities often develop over a long period of time and we get to know them over a long period of time. In fact, there was even a research study that came out that showed, and it was one of the biggest papers that's been used to debunk the idea of like rapid onset gender dysphoria and social contagion around being trans, that the average transgender youth spends around four years on average before they tell their parents. And whenever they tell their parents, whenever we come out as trans, either to our parents or our friends, it can look rapid sometimes. It can look contagious sometimes, because we found somebody who's trans that we can connect with, or because we suddenly feel empowered to be who we are, to come out and declare our identities to the world. But that's only because so many of us have held it in for so long. And that first ability for you to make yourself known to the world, it's so important for so many people.
And so, yes, we do have this history of anti-trans and anti-queer pseudoscience, but I want to actually point something else out. In the past, in the 1970s, 1980s, this pseudoscience was defeated because it was very clearly attached to Christian nationalist and Christian fundamentalist viewpoints. And it became very hard to disentangle anti-gay and anti-queer activism and pseudoscience from the very religious dogma that it was based off of. And so in the modern time, we have very good evidence, including some emails that got leaked on Vice News, but also just looking at the social network analysis of the current groups. They were very cognizant not to appear connected with the Christian far-right fundamentalist viewpoints, even though they are, even though they very much share the same revenue streams. For instance, the Society for Evidence in Gender Medicine receives money from the same funding source that also funds the Heritage Foundation, which is in charge of Project 2025, for instance, which seeks to paint transgender people as obscene or pornographic.
And so they're very cognizant of not wanting to appear like they are Christian fundamentalist. And so they use techniques for this. They use techniques to disguise their viewpoints through pseudoscience. For instance, I'll give you a really good example. The American College of Pediatricians recommends that trans youth should not access care. It was a Fox News headline, big Fox News headline. And you see that and you're like, oh my God, the American College of Pediatricians is recommending against trans youth care. For a regular reader, and many of you probably know this, but for people who don't, who aren't aware of these organizations, they might think that that is the organization of 67,000 pediatricians across the United States. It's not. It's a group of a few hundred people that splintered off whenever the American Academy of Pediatrics, which is the actual organization, supported gay parents. And so they splintered off at that moment.
And so the reason why it's important to note this is that this is how pseudoscience works. This is how laundering pseudoscience works. They knew that they can't be, you know, the association of Christian doctors that hate gay people. No, no. Like they had to name themselves something different so that whenever a legislator hears you, whenever, you know, Fox News hears you, they see that they're coming from this, this official scientific sounding group, but it's not, you know, it's, it's again, the same, the same groups of people. And so I think that that's something we have to be cognizant of when we look at how anti-trans pseudoscience is laundered.
Ivan Hsiao: Yeah. Thank you for that overview and for tracing it back for us in history. For sure. When I open up the news, I am very devastated just seeing the myths and disinformation that's out there sort of being spread by influential people and making its way to the policymakers because this information really allows these folks in power to debate my humanity on a national stage. It impacts the type of healthcare that I might be able to access and decisions that I can make about my own body. And seeing what's put out there right now is really important to know. This is why places like the center exist and TransHealth HQ is because we need an effective way to combat this myths and disinformation campaign with evidence-based information that both trans individuals and the public can trust. So I'd really love to hear your thoughts on how we as public health practitioners can effectively engage the public in helping address some of these issues that you've just highlighted.
Erin Reed: Of course, there's lots of ways that public health practitioners can address all of these issues. Literacy, I think, is one of the most important. We have so much disinformation being put out there about transgender healthcare and our public health officials in the United States have been key towards combating it. The guides that you put out, the answers that you put out, the ways in which you critique the poor media disinformation sort of cycles that we see in some of our leading newspapers where again, they will cite a single person from a major medical organization and then on the other side, they'll put somebody from like one of these pseudoscientific groups that doesn't represent very much of the science around gender-affirming care or transgender people, period. So public health campaigns are really important and information campaigns are really important.
The other thing that I'll very much mention, and this is a drum that I'm beating really hard right now, is that the fight for trans healthcare, for trans rights, for access to the facilities that we need to live or to access to the general public, to being able to use the bathroom freely, for instance, it's not just something that's happening isolated in the United States. This is a global issue and it's so important that we tackle this with global solutions. Right now, for instance, many of these organizations that I mentioned, the pseudoscientific organizations that are receiving millions in funding from very harsh anti-trans sources, they know that it's hard to move policy in the United States. We have huge institutions here that are hard to gun up against with this sort of pseudoscientific stuff. And so instead, they know that they can force-magnify their money by going to other countries that are much smaller. We see this happening in Bhutan, for instance, where there was recently a conference in Bhutan that said that transgender youth were disordered and that we should prevent transgender youth, period. What does that even mean? In many cases, it means conversion therapy.
And many of the people that spoke at that conference were associated with some of these anti-LGBTQ pseudoscientific hate groups that we see here in the United States receiving so much funding. Now, the reason why they go to countries like Bhutan, or they even go to some of the European countries that are much smaller, much smaller populations, Sweden, Finland, Norway. The reason why they go there is because if they can start flipping countries that have centralized health care systems, then maybe they can then use that. And they do use that in places like the United States to say, well, hey, look, Sweden is backing away from gender-affirming care. Finland, Norway is backing away from gender-affirming care. Maybe we should too. And we see this cited in the Alliance Defending Freedom briefs immediately after it happens two days later in places like Idaho. We see all of this happening right now in this sort of broader context, in the global context. And it's important to recognize that international cooperation is going to be so important in countering these narratives.
Ivan Hsiao: Thank you for highlighting that. For sure, public health research can definitely contribute to a much fuller picture of what trans care looks like. And I like that you highlighted how important it was for researchers to communicate the implications of their research as well, which could help limit the harm of some of the reports that come out, which disregard evidence for trans care, and also helps build empathy for our community and its specific unique medical needs. And yeah, I think the other thing is it's so important to catch clinicians up on just what trans care looks like now, like across state, but also country lines.
Erin Reed: I'd like to actually weigh in on that. Catching clinicians up is really important too. So one of the actual ways that these organizations have been successful in some of the countries in Europe, for instance, is that many of the doctors in some of these centralized health care systems in Europe, they first learned about trans care and first started sort of practicing trans care a couple revisions ago of the standards of care for WPATH. And a lot of times these doctors, they have not caught up to what we see and how we understand trans people today. And if your medical information and your philosophy on treating trans people is even 20 years out of date, if you started practicing 20 years ago, that's huge. Let me remind you that, for instance, some of the leading theories about trans identity in the early 2000s were that we all had a fetish and that we were sexually disordered. The diagnosis back then was gender identity disorder, and it not only covered trans people, it covered what they called sissy boys, sissy gay boys, for instance, and they lumped everybody in together. This was a very harmful time for what research and what philosophy looked like on what being trans was and like how we treat being trans and how we aid gender dysphoria. And a lot of the doctors that are currently right now, the leaders in the anti-trans movement, they draw their philosophy from those old standards and they've resisted opening their worldviews towards a much broader view of what being trans means and how we exist in the world and individualized care that has been so important for each individual person.
I think that what we have seen is, and this is important to sort of talk about and promote in many ways, is a movement away from very rigid definitions of what being trans is and rigid sort of medicalization or even not even medicalization, but pathologization of trans identities and more towards individualized care. And this is something where I think the United States has actually been a leader in. Something that we have done very well is, even in many of the states that have sort of flirted with these gender-affirming care bans, they have been defeated in several states. And one of the reasons why they have been defeated is because here in the United States, there is a philosophy of like individualized care and the doctor-patient relationship being really important. And for many trans people, I think they really draw on that. They need that individualized care because what a successful transition looks like for each person is going to be different. And what their gender dysphoria stems from is going to be different if they have heavy gender dysphoria. And so, yeah, I think that catching up clinicians is a major public health importance for anybody that works in this field.
Ivan Hsiao: Thank you for that. I just wanted to underscore that point that, yeah, transition can look very different for every single trans person, whether that's receiving legal, social, medical affirmation. Personalized health care to enable that to happen is really important and definitely an area of research that we should aim to explore a little bit more. I think some of the examples that you gave around some of these challenges really underscore why social justice is so important in public health and why research interventions for gender health minorities must involve and center those who are affected by such issues.
I wanted now to explore the implications of anti-trans conjectures and such on health care access for people outside of our transgender community. So can you walk us through how some of these conjectures might impact reproductive health access?
Erin Reed: Absolutely. You know, I think a lot of times if we're in public health and talking about public health, people often think that, you know, trans issues and trans health care issues are trans and that's it, that those are the only people that are going to be affected by them. Obviously, you can see how these issues can also affect LGBTQ people at large, but it goes way beyond that, you know. The very next day after the Dobbs decision overturning Roe v. Wade two years ago, the Alabama Attorney General filed a notice with the court in Alabama. This was over the gender-affirming care ban in Alabama which was blocked at the time. In the Dobbs decision there was this very famous line that, you know, a right isn't really a right or you don't have that equal protection unless it is deeply rooted in American history and traditions. And this is a big one we actually just saw today, they're pushing on overturning Obergefell with that same line right there.
But on the very next day in Alabama, the Attorney General had filed a notice saying that, well, gender-affirming care is not deeply rooted in American history and traditions. And you know, imagine the kind of atrocities you can sort of justify by only allowing protection and rights to things that are deeply rooted in American history and traditions. There are plenty of horrible things that are deeply rooted in American history and traditions and there are many rights that we see, especially whenever it comes to medicine, many breakthroughs in science that maybe don't have that deep root but are really important for people today. And so, you know, we see the same harmful narratives that target trans people being used to target reproductive healthcare, birth control, and abortion. We see people like, for instance, like Elon Musk, who's intensely active in the anti-trans space right now, who just yesterday pushed a video that said that the whole reason why he is spending so much money and targeting, you know, targeting the woke mind virus as he said it is because he's got a daughter that's trans that doesn't talk to him anymore.
Like, we see this pop up time and time again. While Elon Musk had actually posted, you know, just a few months ago that birth control makes you fat and is bad for you and there's not enough science behind it and, you know, we see things like that and we... It's so easy to draw the through line to the same narratives they put for hormone therapy and trans care and same thing whenever it comes to abortion. Remember one of the big attacks right now on the Mifepristone pill is that the FDA didn't do its due diligence and it's actually dangerous for people and that youth shouldn't have access to Mifepristone and that it needs to be highly, highly regulated. They're targeting antidepressants the same way.
In Idaho, we saw in Idaho two years ago, it was one of the bills that I tracked. It passed the House and it was a bill that banned taking trans youth across state lines to obtain gender-affirming care. It would have given the parent life in prison. And one of the representatives who sponsored that bill said that, well, I see this as the same fight. It's not about the life of a child, but it's about the potential to give life to a new generation. And so we then saw, you know, a year and a half later we get the abortion travel bill. These fights are so intricately linked. They use very similar methods to fight both trans healthcare, abortion, and many other forms of healthcare.
Ivan Hsiao: Yeah, we certainly have plenty of work ahead of us to advance health equity for not only the LGBT population but anybody who needs access to reproductive healthcare services. So you mentioned the importance of public narrative and public opinion on policy and such. I wanted to talk about how your work has hundreds of millions of views across all these different platforms as well as coverage at major outlets such as Associated Press and the New York Times. So with such a broad audience, there must be a range in their understanding of these concepts of gender, sexuality, and such. I would love to hear how you effectively communicate with your readers from all walks of life about LGBTQ health to build empathy and allyship for our community.
Erin Reed: Of course. So I don't have my degree in public health. I'm not trained in public health, but I think that one of the things that I do is something that I have a hunch that many people in public health also kind of do. You meet people where they are. You meet people where they are. Not everybody has the same knowledge. Not everybody has the lived experience of being trans. A lot of parents, you know, they were brought up in an era where being trans was something that was portrayed as disgusting. Many of us watched Saturday Night Live back in the '90s and early 2000s where you had the "It's Pat" sketch where the entire punchline was gender non-conforming person, haha gross.
And so, like, people... We all carry baggage. Even trans people carry baggage, especially people who transitioned a little bit later in life because we were brought up in that same environment. And so you have to meet people where they are. And so in my reporting, in how I speak to people, in how I write, in how I talk on TikTok, on Instagram, I never assume that my audience knows everything. I never assume that they know even the basics. I try so hard to make sure that I'm always highlighting the basics like, "This is what this means." I don't just say a word and expect that this word is going to percolate and everybody's going to know what it means. Not everybody is on the same page. I've got a very diverse audience. I've got audience members who feel good about trans healthcare but might be iffy about sports and don't understand about how sports work. I've got audience members who are just starting to come to terms with the fact that their child is trans. I've got audience members who are trans themselves and want to explain to their parents, "Hey, this is what I'm dealing with right now," or their peers or their co-workers.
And I like to think that I do a good job at that. I've gotten many messages from people that tell me, like, "Hey, look, I tried so hard to explain to my parents what I was going through and what I'm seeing. Thank you because I was able to show my mom your video about this particular topic and now she understands." And I think that the work that I've done being able to explain things in that way, being able to teach people the basics all the time, I try really hard to build audience literacy. One thing that you'll know, and if anybody here reads my newsletter, one thing that you'll see is I probably link words more than just about any other paper out there. And anything that I say, any sentence that I have, you can click on it and see it yourself.
And look, I recognize that the space that I occupy is different from most journalists. I'm not like a traditional journalist because I'm reporting for my community. I'm telling my community’s stories and there's issues around bias there and things like that and those are issues that I can't sidestep, but that's not my role. I'm not out there being, you know, the journalist who is completely disaffected by the fact that I am trans and I'm reporting for my community and telling my community's stories. But what I'm doing is making it so that maybe you are a journalist who isn't or a public health worker or anything who isn't trans yourself and who does want to approach things from your perspective. I provide you with those links. I provide you with those sources. You can check what I say yourself. You can come to your own conclusions. And I think that's the way that I approach the people that maybe do know a lot about trans people but want more solid information.
Ivan Hsiao: Yeah, thank you for being that bridge for the trans community to a lot of the broader outlets. You mentioned a lot of other journalists are not trans and they might not have the deep knowledge that you have so plugged into the community. So thank you again for the work that you do there. So as we've established during this conversation it's an exceptionally challenging time for the LGBTQ community right now and it's been that way for the past couple of years but I would love to end this conversation with a vision of freedom and thriving for our community. So could you share a victory in the healthcare space that gives you hope for such a future?
Erin Reed: You know, the one thing that I want to say is that the youth get it. Gen Z gets it. Young people get it. They understand and this comes out in poll after poll. For instance, you know, many younger people, they have trans friends, they have trans people that they know. Last year, we had the Trans Day of Visibility marches which were the most attended Trans Day of Visibility marches in history. They were led by a group called Queer Youth Assemble, all under 26 years old. They are active. They are out there. They're walking out of their schools whenever book bans come into place or whenever bathroom bans come into place. We see them rally around their teammates. We see trans sports people that their high school teammates will rally around them whenever they're kicked off the team. Bathrooms and healthcare and more.
And the story that I often like to give is about a year and a half ago, I was contacted by a trans youth in Louisiana. I'm from Louisiana. And she messaged me and she said, "Hey, Erin, I love your work. I read it all the time. And I just wanted to let you know that I'm from Louisiana. I go to this school," and it was very close to where I grew up. Twenty years ago, I was bullied relentlessly for being, you know, a young queer kid in south Louisiana and the swamps. And she said, she's like, "And I just want to let you know that I was nominated to the homecoming court." That's how things change. That is how things change because here is this trans 17-year-old girl in this place where I had so much trouble being driven around a football stadium waving to all the people in it, you know, wearing her beautiful dress.
That's how things change. I think that so much of the attacks on trans people, on our healthcare, and our ability to move freely, our ability to use the bathroom, our ability to have books about ourselves, our ability to express ourselves in art, so much of these attacks come from misunderstanding and from not having the people close to you who you appreciate, who you can hold on to. That doesn't exist with youth and I think that we are going to move to a place where we can exist freely, where our healthcare isn't going to be challenged, and where we need to go to the bathroom we can go to the bathroom.
Ivan Hsiao: Thank you, Erin. That brings us to the end of our conversation today. We really appreciate the time that you took out of your very busy schedule to teach us about how to effectively engage the public about LGBTQ health. And I also want to express my gratitude to Dr. Charlton from the center as well as the studio for hosting this event. Please consider subscribing to Erin in the Morning, as well as the center's newsletter and connecting with Trans Health HQ on LinkedIn. This will now conclude our live stream. We'll now have a closed-door Q&A with Dr. Charlton as well as Erin, who will share a little bit about the center and additional thoughts about LGBTQ health. We'll see you at the next speaker event.
[Applause]
