Safe, Legal and Rare:
​Why Prohibition Fails Abortion Care and Trans Healthcare Alike

The comparison between abortion bans and restrictions on trans-affirming care is not rhetorical flourish; it is structural. In both cases, prohibition does not eliminate the underlying reality—it ensures that when people act to meet their needs, they do so under worse, more dangerous conditions. Abortion bans do not stop abortions. They stop safe abortions. History is unequivocal on this point. When abortion is illegal, people do not stop seeking it; they seek it unsafely, or they are forced into pregnancies that damage or destroy their lives. The people with money, mobility, and connections still find care. Everyone else pays the price.

The same dynamic is now playing out with trans healthcare. Trans people do not stop being trans because a legislature decides they shouldn’t exist. Gender dysphoria does not resolve itself because access to care is blocked. What changes is whether people can receive medically supervised treatment or are pushed into untreated suffering, desperation, DIY regimens, and suicide. This is not hypothetical. It is already visible in online spaces, especially Reddit, where trans people openly discuss underground hormone access, improvised dosing, and medical guesswork because the healthcare system has abandoned them.

This harm is not evenly distributed. Testosterone is significantly harder to obtain on the black market than estrogen, which means trans men are disproportionately trapped. Restrictive policies do not “pause” transition; they create tiers of survivability. Some people find workarounds. Others are left to endure bodies that feel intolerable, with no viable path forward.

I know this not as an abstraction but as lived experience. In 2014, when I told my doctor I was trans, I was told I would need to live socially as male for two years and then spend at least a year in therapy before I could even be considered for a referral to a gender clinic. I did exactly what was asked. In 2016, after complying with every requirement, I was denied a referral anyway—this time because of my trauma history and because I am a trans man attracted to men. In other words, because my existence was too complicated, too queer, and too inconvenient to fit the approved narrative.

In 2018, I attempted to access care through informed consent and was denied again, this time due to naturally elevated testosterone levels—levels that would not be properly explained until I was diagnosed in November 2025 with non-classic congenital adrenal hyperplasia. At no point was the question “how can we help this person live a functional, stable life?” The question was whether I met an ideological threshold of acceptability. Gatekeeping did not protect me. It selected against trauma, queerness, and biological variation.

Being forced to live in a body that feels wrong is not a neutral waiting period. It is a daily erosion of quality of life. I live in a heavily MAGA area and am out only on a case-by-case basis for safety. My friends know. My rabbi and shul knows. My partner knows. The general public sees someone gender-confusing and reacts accordingly, with harassment, including and especially in whatever public bathroom I use that isn't a single occupancy. This is not theoretical harm. It is ongoing, embodied, and preventable. And it has significantly damaged my mental health, exacerbating long-standing depression and PTSD. The inability to access medical transition did not freeze my life in place; it pushed it downhill. Severe, untreated dysphoria narrowed my capacity to function, eroded my sense of safety in my own body, and contributed directly to years of substance abuse as a means of survival and self-medication. I have been sober since 2024, but sobriety does not erase the structural harm that led me there. Had I been allowed timely access to medically appropriate transition, I might have had a chance at a more stable, functional life—one not spent managing constant psychological injury layered on top of trauma.

This pattern mirrors abortion policy in another crucial way: abstinence-only logic. Abstinence-only sex education does not reduce unwanted pregnancies; it increases them. When people are denied accurate information and access to contraception, harm predictably rises. The same denial-based logic underpins trans healthcare bans. Suppressing information, forbidding social transition, and enforcing conformity do not resolve dysphoria; they intensify it.

So-called “pro-life” ideology relies on a fundamentally religious misunderstanding of abortion. Claims that life begins at conception are not scientific facts; they are Christian theological assertions. Judaism explicitly rejects this framework and, under certain circumstances, mandates abortion to protect the life and well-being of the pregnant person. Yet the same people who claim to care so deeply about the “unborn” reliably abandon all concern once the child is actually here, opposing social welfare, healthcare, disability support, and food assistance with equal zeal. What they defend is not life, but forced birth followed by indifference.

The rhetoric around “protecting children from trans ideology” functions in exactly the same way. Anti-trans activists routinely misrepresent what being trans is, portraying trans adults as “groomers” attempting to recruit children. This fantasy exists alongside a deeply disturbing fixation on children’s bodies: obsessive concern over “healthy breasts,” fixation on the future fertility of twelve-year-old girls and whether or not they'll have nipple sensation or be able to orgasm, and language that treats minors as reproductive assets rather than people. Many of the loudest anti-trans crusaders are simultaneously notorious consumers of trans pornography. The projection is transparent: it's clear who the real groomers are, and it's not trans people.

Complicating this landscape further is the fact that a growing number of cis gay men and lesbians have aligned themselves with anti-trans movements, framing their opposition as concern for gay and lesbian youth supposedly being “transed.” They claim that trans-affirming care functions as a new form of conversion therapy, erasing same-sex-attracted youth by steering them toward transition. Yet when asked what should happen to minors who experience genuine, persistent gender dysphoria, these same voices offer no alternative beyond enforced conformity, suppression of gender expression, and waiting it out—precisely the tactics historically used against gay and lesbian people. The contradiction is stark: in the name of preventing conversion therapy, they advocate conversion therapy. What is often left unsaid is that much of this panic appears to be driven less by concern for youth than by adult discomfort—particularly around desire, attraction, and the destabilizing experience of encountering someone attractive who does not fit rigid expectations about bodies and genitalia.

Care for trans and gender-questioning minors does require nuance. I do not believe irreversible medical procedures should be performed on anyone under eighteen, and I would argue even under twenty-one requires extreme caution—an argument I would apply retroactively to myself, despite how intense my dysphoria was at that age. At the same time, blanket bans that prohibit even social transition are not safeguards. They are ideological interventions that deny reality and do harm.

I reject the claim that “rapid onset gender dysphoria” is a meaningful phenomenon. It is moral panic, recycled. In the 1980s and 1990s, fundamentalists insisted that secular rock music and Dungeons & Dragons were turning children into Satanists and witches. We now recognize that hysteria for what it was. Increased language and visibility do not create identities; they allow people to articulate experiences that previously went unnamed.

That said, not every contemporary gender claim represents the same phenomenon, and pretending otherwise helps no one. There is a visible rise of AFAB people identifying as non-binary who do not appear to experience gender incongruence so much as a desire to escape misogynistic expectations of womanhood. This does not require medicalization. Blue hair and a septum ring are not a gender. Rejecting femininity as it is currently sold to women is not dysphoria.

Any honest discussion of this trend must address the role of social media and influencer culture. Platforms built on monetized self-surveillance push a narrow, pornified, commodified vision of femininity—one that treats the female body as an object to be optimized, displayed, and consumed. For many young women, rejecting the category “female” is less about identifying with another gender and more about fleeing a role that feels degrading, unsafe, and impossible to perform correctly. Medicalizing that distress while refusing to confront the culture that produces it does nothing to protect women or trans people. It simply obscures the source of harm.

Hillary Clinton once described abortion as needing to be “safe, legal, and rare.” This was never a call for total prohibition. It was an acknowledgment that fewer abortions are necessary when people have access to comprehensive sex education, contraception, and reproductive autonomy—including sterilization without arbitrary age barriers. An AFAB person should not have to wait until thirty-five or forty to obtain a tubal ligation if they know they do not want children.

The same logic applies to trans rights. Reducing harm requires expanding options, not criminalizing outcomes. Protecting trans people does not require pretending that every form of gender nonconformity is trans, nor does it justify denying care to those with lifelong dysphoria. Blanket bans, moral panic, and denial-based policy do not protect children. They manufacture suffering while refusing responsibility for the consequences.

The lesson is the same in both cases. When care is denied, people do not stop needing it. They are simply forced to seek it unsafely—or they do not survive long enough to try.