JEFFERSON CITY, Mo. — Russel Neiss glanced down at his Apple Watch. The screen glowed bright red, warning of something he already knew: Though he was sitting stock still, waiting to testify before state senators, his heart was hammering.
Mr. Neiss hates everything about his family’s regular trips to the Missouri statehouse. He hates trying to squeeze a meaningful story into his allotted two minutes at the microphone. He hates stashing his backpack in the office of a sympathetic lawmaker so he can maneuver politely among the bronze busts and oil paintings and bureaucrats, shaking hands and trying to appear calm and relatable, terrified all the while for his family.
Mr. Neiss is the father of an 11-year-old transgender boy, a fact that has tangled into every aspect of his life. He and his wife are trying to figure out how their son can have a bar mitzvah in accordance with their Orthodox Jewish faith. A New York City transplant to St. Louis, Mr. Neiss now stays up late combing through Zillow listings for houses across the Mississippi River in Illinois, worried that this will be the year Missouri legislators outlaw the medical care he and his wife believe is saving their son’s life.
Mr. Neiss had taken yet another day off from his job as a software engineer to drive to the capital. The trips have become routine: Missouri lawmakers have filed a record number of anti-trans bills this session. This time, to save time, they bundled for discussion a group of bills that would, at their most extreme, force even kindergartners to play on sports teams corresponding to their sex at birth.
Mr. Neiss’s son is not a particularly avid athlete; he’d rather ride his unicycle than run after a ball. But the family regards this bill as part of a broader and more ominous program to ostracize transgender kids and complicate their lives as much as possible. Or, Mr. Neiss said darkly, “trying to legislate into law that my kid is not normal and should not exist.”
Missouri is among dozens of states — from New Hampshire to Idaho and Alabama to North Dakota — where legislators have filed or already passed bans on various aspects of transgender life. There are sports bills, birth certificate and pronoun bills, drag bills, bathroom bills, “Don’t Say Gay” bills. It all adds up to a nationwide legislative feeding frenzy to exploit any legal angle that might weaken the rights of transgender Americans, shunning and humiliating them in the process.
Amid all this legislation lurks the sharpest threat to families like the Neisses: aggressive efforts to outlaw what’s known as gender-affirming care for minors — a range of interventions from talk therapy and social transition, such as adopting a name, clothing style or pronoun without any medical treatment, to puberty blockers and, for older kids, hormones. Conservative lawmakers tend to dabble in lurid insinuations about mastectomies and genital surgery, but, according to doctors, surgery administered to minors is rare — even two of the most outspoken politicians who filed the bills reluctantly acknowledged when I interviewed them earlier this month that they couldn’t point to a known case of a Missouri minor undergoing gender transition surgery.
The proposed health care bans would put transgender kids and their families in an impossible position. It’s crucial to understand that, if you are the parent of a child who has received a diagnosis of gender dysphoria — the persistent sense that one’s true gender identity doesn’t match one’s sex at birth — the medical advice you are most likely to hear, from your family doctor all the way to the American Medical Association and the American Academy of Pediatrics, is that your child should have access to gender-affirming care. Withholding that care, doctors warn, leaves transgender kids at risk of despair and suicide.
The bills now floating around America’s statehouses — including Missouri’s — would revoke the licenses of doctors who dare to care for their patients according to best practice, risk child abuse investigations and custody loss for parents who have already agonized over how best to protect their kids and strip ongoing treatment from a particularly vulnerable set of youth.
At the statehouse, Mr. Neiss glanced up into the faces of the senators, arrayed above him behind a high table. His son sat at his side, kicking his sneakers at the legs of the table. When Mr. Neiss told the lawmakers that the bills constitute a government overreach, his voice trembled like he was fighting back tears.
“I oppose these bills on conservative principles,” he said. “But mostly I oppose these bills because they hurt my son.”
Debi Jackson is probably not what most Americans imagine when they picture the mother of a transgender child. She’s a self-described “army brat” who came to Kansas City, Mo., from Alabama — a faithful Southern Baptist, Rush Limbaugh devotee, straight-ticket Republican voter. When her second child, Avery, a preschooler with a buzz cut, began to demand girl’s clothing, Ms. Jackson — like many of the parents I interviewed — balked.
She and her husband, at first, stonewalled the pleadings for a princess dress. When Halloween came, they steered Avery away from the fluffy frocks and bought, instead, an Iron Man costume, congratulating themselves for avoiding playground taunts. It’s probably just a phase, the Jacksons decided.
It wasn’t. Avery grew depressed and withdrawn, refusing to leave the house in boys’ clothes. The child interrogated Ms. Jackson about death, about which methods would be least painful and whether a kid could come back to life in a different body after dying. One day, as the family hurtled along the interstate, Avery threw off the seatbelt and tried to wrench the door open. “A.J.’s trying to die,” Ms. Jackson’s first child cried out.
A therapist explained that the 4-year-old Avery was transgender. Ms. Jackson had never heard this term before and wasn’t sure what it entailed, but the family was rattled enough to pay attention. On the advice of their doctors, they started allowing Avery to live as a girl. The day Avery first headed off to school in girl’s clothing, Ms. Jackson recalled, the child seemed happy for the first time in a very long time.
There was, of course, social fallout. Some of the parents at school were scandalized, and the family ended up cutting ties with many friends and some family members who didn’t approve of Avery’s transition.
Still, for a while, the dread receded, and Ms. Jackson often felt hopeful. Transgender people started appearing more frequently on television shows and in magazines, and tolerance seemed to be growing. A video of Ms. Jackson talking about her child’s transition went viral in 2014 and, the next year, she told a rapt audience at a Human Rights Campaign national conference how she, a conservative Southerner, had become a stalwart defender of transgender rights — spurred on by her unconditional mother’s love.
“We have a thriving and joyful 7-year-old,” Ms. Jackson told the crowd that day. “Today our story is one of success.”
In 2016, the Obama administration instructed publicly funded schools to let transgender kids use the bathroom of their choice and, more generally, accept the gender identity of students. A few months later, Avery appeared on the cover of National Geographic, gazing straight into the camera with a soulful and defiant expression, sunlight falling on the pink streaks dyed into the child’s hair. “Gender Revolution,” the magazine headline read.
But what the Jacksons had mistaken for a happy ending was only the eye of the storm. The Trump administration revoked the federal protections for transgender students. In Jefferson City, a backlash against transgender rights was underway, and growing with every legislative session. Avery, now a teenager who recently started identifying as nonbinary, suffered from anxiety. Money got tighter in part, Ms. Jackson said, because every time the family appears in the news, her husband, a doctor, loses another batch of patients.
“I used to think, My gosh, they’ve just never met a trans person. I just need to tell them and they’ll understand.” Ms. Jackson paused and laughed bitterly. “Now we see where we are.”
Ms. Jackson’s unease contains a streak of cold-eyed pragmatism: She is acutely aware of her family’s notoriety, and of the fact that she herself has put on public record repeated testimonies of her child’s use of puberty blockers and, later, hormones. She worries that, should lawmakers eventually criminalize the treatments, she and her husband could be targeted. She worries they could end up under investigation or lose their children.
Still, she says, she wouldn’t do anything differently.
“I’ve been ready for four years to walk up to those legislators with my hands out and say, ‘Just put the handcuffs on me now and throw me in jail,’” she said. “Because I will do anything I have to do to take care of my child.”
As the number of young people identifying as transgender has grown, so has the complexity — and acrimony — of public discussion. With researchers rushing to gather data about this relatively new cohort of minor patients, heavily politicized debates have erupted over the treatments, intensified by the emergence of some people who say they regret the treatments they received. Scandal broke in Missouri this month after a former case manager at a major transgender children’s clinic in St. Louis came out as a whistle-blower, accusing the clinic of using dubiously loose standards for providing gender-affirming care to minors. Republican lawmakers immediately said they hoped she’d come to testify. The state’s attorney general announced an investigation into the clinic. One of the fathers I’d interviewed, meanwhile, sent me a note: “Things in Missouri are about to go from bad to worse.”
Most of us take mainstream medical advice at face value — not necessarily out of blind faith, but because we lack greater insight. I am not a doctor or a scientist; neither are most of the lawmakers in Missouri. Suppose lawmakers and others not directly involved in raising or treating a transgender child ceded medical questions to the doctors? What if, when making fundamental and complex decisions about children, we fell back on — dare I say it — parental rights?
“They want to believe that society and TV and parents are cramming this into the kids, as if anyone would want to put those kinds of headwinds on a kid,” said Nate Orr, a corporate lawyer in Kansas City whose daughter began identifying as transgender at the age of 6.
A Wednesday workday was winding to a close, and Mr. Orr sipped whiskey behind his desk as dusk charred the windows of his home office. He kept steering the conversation away from private stories, preferring to defend his daughter’s rights by using the tactics of a hard-charging lawyer. He likes to tell the legislators that the bills are an embarrassment to the state, and remind them that even the debates could cost Missouri both clout and economic opportunity. He was involved in Kansas City’s efforts to be designated a World Cup host city in 2026, and those discussions drove home to him the leeriness with which corporations and sporting events regard controversial politics.
An expansive and rapid-fire conversationalist, Mr. Orr tended to pause, then change the subject when I asked about his concerns for the slight, bespectacled daughter I met only briefly. Mr. Orr didn’t want to subject the child to an interview, but he did make a point of introducing us. He wanted to demonstrate to her, he explained, that some people care what happens to her.
Mr. Orr had little doubt about what he needed to do once he understood the sincerity of his daughter’s revelation.
“It doesn’t take very long, if you’re an educated, process-driven person, to get your arms around the path you have to take,” he said. “Because the other path leads to horrible stories.”
In Jefferson City I dropped in on Mike Moon, a state senator, cattle rancher and Sunday school teacher who strolls the halls of the Missouri capitol building in cowboy boots. Mr. Moon is sponsoring a bill called Save Adolescents From Experimentation (the SAFE Act), which would ban doctors from providing minors with any sort of gender-affirming care or referring them to other doctors for those services. He sat behind his desk — a broad, tall man with an easy grin and a thick mustache.
His bill, he explained, was meant to take a stand against the kind of social decay that has already normalized homosexuality — which Mr. Moon considers a mental disorder — and has gotten so far out of hand that parents now give kids dollar bills to tip drag queens.
Then he began to question me: If he, Mr. Moon, wanted to arrange a penis operation for his son or have the breasts cut off his daughter, should he be allowed?
“Where is that happening?” I asked. “Where are these cases?”
Mr. Moon hedged. “Well, it’s coming to Missouri,” he said, and then named a Kansas City hospital that was, he claimed, “doing transgender therapies down to 2- and 3-year-olds.”
“What therapies?” I asked.
“Hormone therapy.”
“Are you sure?”
“I mean, don’t quote me on that,” he said.
Parents, Mr. Moon pointed out, can’t simply do whatever they want to their kids. For example, they can’t beat up their children. (Another lawmaker pointed out to me that parents can’t give their young children cigarettes and alcohol.)
But doctors recommend the treatments, I said.
“Maybe the doctors are wrong,” Mr. Moon replied.
Even if they are, I said, do you address that by legally persecuting families? Why not take this up in the academies, with the doctors themselves?
“That could take 20 years,” he said indignantly.
I asked Mr. Moon whether all of this attention to a small number of transgender kids made sense given the severe problems faced by so many of the state’s children.
Missouri’s foster and child welfare systems are notoriously shambolic — in late January, the head of the child welfare agency warned lawmakers that the state had, in effect, “legally orphaned” about 1,500 children by severing ties to their biological parents when there were no new families to adopt them. An estimated 18 percent of Missouri kids are living in poverty, and a dearth of teachers has forced many schools to shrink down to only four days of instruction per week.
That was all bad, Mr. Moon agreed. Still, he insisted, transgender care for minors must be banned. Arkansas, Alabama, Utah and South Dakota have all recently passed laws banning or severely restricting such treatments for minors. Gov. Greg Abbott of Texas bypassed lawmakers, issuing direct instructions to state agencies that gender-affirming care was “child abuse” and parents who allow it should be investigated. At the urging of Gov. Ron DeSantis, Florida’s state medical board banned gender-affirming treatments for minors.
The paradox is not lost on the affected families that the politicians who invoke “parental rights” when moving to ban books, buck vaccine mandates or challenge local school boards are the very same people trying so hard to curtail autonomy for families of transgender kids.
“It’s parents’ rights as long as you live the kind of life we want you to live, and that’s what’s scary,” Ms. Jackson said. “What will they do next, when they don’t have us as the scapegoat anymore?”
Ms. Jackson believes the legislative push is motivated by white Christian nationalism, and sees it as having the potential to spread to other communities. Maybe, she suggested, they’ll turn their attention to preventing Muslim kids from praying in public buildings, or choose yet another group to single out.
“The parental rights they’re taking away from me today,” she added, “they’re going to take away from you tomorrow.”
Parents, most reasonable people would agree, get the deciding vote on serious decisions made by their minor children. Some parents, at least. The ones who think like us. Not the other ones, obviously.
The American Civil Liberties Union, for example, is waging a parental-rights-based court battle against states that ban gender-affirming care for children. At the same time, though, the organization is advocating children’s rights in cases where education officials have decided against informing parents that their children have come out as trans at school.
There is some logic to this apparent contradiction. Children enjoy limited rights independent of their parents, although defining their scope is an ongoing judicial process. With medical associations warning that gender-affirming care can prevent suicide, it may be possible to argue that refusing it could constitute abuse.
That could be a tough case to win, though. Ours is a nation that prizes parents’ rights, in both culture and legal precedent. The United States takes such a dim view of children’s rights that we’re the only member state in the United Nations that has steadfastly refused to ratify the Convention on the Rights of the Child.
“We have a longstanding tradition of parental autonomy,” said Stacey Steinberg, a law professor and director of the University of Florida’s Center on Children and Families. “Parents have a right to raise children as they see fit.”
These rights can stretch surprisingly far: Parents can make children work in dangerous conditions on family farms — operating heavy machinery, for example. Some Amish children have been removed from school after the eighth grade as a result of a U.S. Supreme Court ruling that prioritized the parents’ religious rights over the state’s interest in educating children. Parents can, under some circumstances, withhold medical treatments.
The recognition of transgender kids is relatively new, and legal precedent is scant, but related questions have been confronted by courts. During the decades when women were entitled to terminate pregnancies as a matter of constitutional right (before Roe v. Wade was overturned last summer), the court grappled with whether a minor needed parental approval for an abortion.
Parents, the court decided, should not get absolute control over a child’s desire to terminate a pregnancy. That meant, in practice, that many states created judicial workarounds allowing kids to ask permission directly from a local court in lieu of their parents.
“The unique nature and consequences” of abortion, the court found, meant it was inappropriate for parents to have “an absolute, and possibly arbitrary, veto over the decision.”
Snow had fallen overnight, icing the roads and closing the schools, and the Neiss family was scattered through their rambling house. Rori Picker Neiss, the mom, tucked away at her desk to finish Zoom calls; she is the executive director of the Jewish Community Relations Council of St. Louis. The younger kids sprawled around, gaping into various screens. Their son played Mario Kart in the living room, pausing occasionally to yell out that he was hearing his name from the conversation in the next room.
Mr. Neiss was talking about pikuach nefesh, a principle of Jewish law by which life is so sacred that other laws may be broken in order to preserve it. That, he explained, is how he answers any religious questions about his son’s transition — as something that was justified and necessary because it had saved a life.
In the next room, his son was yelling into the Mario Kart screen: “I won and I got so scared! Suddenly Mario was on top of me and turned out to be invisible! I won! I don’t care!”
“Congratulations,” his father said, then muttered, with the wry wince of a parent on a snow day, “I kinda wish you were in school.”
When the boy wanders in to talk, he has more to say about his upcoming school band concert than about the particulars of life as a transgender kid. He plays the trombone. The theme of the concert is stars, so his grade will play “Starsplitter Fanfare.” When he goes to Jefferson City to meet lawmakers, he sometimes misses school.
Mrs. Neiss joined us at the table. She was worried. Mrs. Neiss has made the journey to Jefferson City more frequently than anyone else in the family. The mood, she insisted, has shifted.
“It has felt unpleasant before, but it never felt underhanded,” she said.
“You’ve never been optimistic,” her husband interrupted. “Every time I express optimism you tell me, ‘Don’t do that.’”
“Yeah, because then you’re just asking for trouble,” she agreed. “Now it’s not a question of, ‘Will we lose?’ but ‘How much can we minimize the loss?’”
In private meetings, the Neisses say, some lawmakers would express empathy for the transgender kids and distaste for bills they’d nevertheless support publicly. Or they’d assure Mrs. Neiss that the Democrats would filibuster them.
But this year, even some formerly ambivalent lawmakers are sponsoring bills that target transgender rights. It’s infuriating for Mrs. Neiss to watch the spectacle of her family’s future get bargained and postured over — especially when it’s done in the name of protecting children.
“I’m not advocating that every child should get every procedure they want,” she said. “I can’t speak for every single family. All I’m saying is that the government shouldn’t be deciding.”
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