When Wendy Davis wanted to get birth control as a teenager in the 1980s, she went to her local Planned Parenthood in Fort Worth, Texas, with a friend. “There is absolutely no way I would have asked my mother for her permission to do that,” says Davis, the former Texas state senator who famously filibustered an anti-abortion bill for 11 hours in a pair of pink sneakers. “That’s just not something that’s possible for many, many, many teenage girls.” 

Forty years later, with abortion banned in wide swaths of the country, access to reliable contraception is more important than ever. Yet for Texas teens, getting prescription birth control is arguably harder now than it was when Davis was an adolescent. Over the past two years, federal courts—including the notoriously conservative 5th Circuit—have ruled that minors must have parental consent to obtain prescription birth control from Texas clinics subsidized by a federal family planning program known as Title X. Flush with victory, Texas Republicans have made it clear: They have no intention of stopping there. In late July, Attorney General Ken Paxton filed suit to overturn a new federal rule that reaffirmed teens’ ability in other states to get contraception without their parents’ consent. “The Biden Administration continues to prove they will do anything to implement their extremist agenda,” Paxton said in a press release.

To anyone paying even a modicum of attention, the far right’s plans to limit access to birth control have long been hiding in plain sight. When the Supreme Court overturned the federal right to abortion in the Dobbs decision in 2022, Justice Clarence Thomas wrote that the court “should reconsider” other rulings with similar legal principles, including Griswold v. Connecticut, the 1965 decision establishing a right to contraception (and, more fundamentally, a constitutional right to privacy). The ultra-conservative strategists behind Project 2025— including Roger Severino, longtime anti-abortion movement lawyer, and Russell Voght, an avowed Christian nationalist—have spelled out a plan for how a Republican-led White House could gut or rewrite key federal birth-control regulations, building on efforts that began during the first Trump administration. (While Trump has tried to distance himself from Project 2025, even claiming he doesn’t know who wrote it, at least 140 members of Trump’s team, including Severino and Voght, had a hand in drafting it.)

But what has escaped many Americans is that these threats aren’t just terrifying what-if-this-happens scenarios. As the Texas lawsuits show, in some parts of the United States, that scary future has already arrived. States have been passing laws allowing pharmacies to refuse to fill birth control prescriptions based on moral objections, or proposing legislation that unscientifically classifies emergency contraception and IUDs as “abortifacients.” Reproductive Health and Freedom Watch has found that since 2021, at least 21 states have directed a total of $513 million to religiously affiliated crisis pregnancy centers and “alternatives to abortion” programs that actively spread misinformation about birth control and discourage its use.

And though contraception is supported by around 90 percent of voters, when Congress had the chance earlier this year to pass a law protecting access to birth control, Republican senators blocked it, claiming it was unnecessary.

The Biden administration has repeatedly pushed back—most recently, with a new proposed rule under the Affordable Care Act to require private insurance to cover 100 percent of the cost of over-the-counter birth control and offer patients more choices for prescription contraception. In a statement, Vice President Kamala Harris described the move as “the largest expansion of contraception coverage in more than a decade.” But the regulations won’t be finalized until after the presidential election, and the new rules are virtually certain to be challenged in GOP-packed federal courts even if Harris wins. 

And what if she doesn’t?

A new Trump administration and its right-wing allies are expected to escalate attacks on contraception on a multitude of fronts, including appointing extremists to key government positions. Rather than outright bans, we should expect more subtle incursions—regulatory changes, limits on insurance coverage, and funding reductions for family planning, as well as rules like the parental consent requirement for teens, according to reproductive health policy experts interviewed by Mother Jones. “It would be cleaner if there was some direct attack on the right to contraception that opponents of reproductive healthcare were pursuing,” says Kelly Baden, vice president for public policy at the Guttmacher Institute. “They’re not. It is much more behind-the-scenes, around the margins. And yet, the impact is still potentially devastating.”

“It would be cleaner if there was some direct attack on the right to contraception that opponents of reproductive healthcare were pursuing. They’re not.”

“That’s what happened to abortion,” adds Amanda Stevenson, an assistant professor at the University of Colorado-Boulder who studies the impact of family planning policy. “Death by a thousand cuts.”

Here are four key strategies we can expect under a new Trump administration intent on undermining access to contraception:

Doubling Down on False Claims that Birth Control Causes Abortion

One of the most common attack lines against contraception is the claim that certain methods—notably IUDs and morning-after pills—are abortifacients, which is to say they cause abortion, purportedly by preventing fertilized eggs from implanting in the uterus. In fact, decades of research show that these methods block fertilization from ever happening—by preventing the release of eggs, for instance, or stopping sperm from reaching them. Yet the belief that IUDs and emergency contraception, like Plan B and Ella, end pregnancies rather than preventing them has become distressingly common, thanks in part to rampant misinformation spread by the anti-abortion movement—including appointees in the first Trump administration.

The falsehoods have made their way into Food and Drug Administration policy, with decades-long repercussions for reproductive health. Back in the early 2000s, when the FDA was trying to decide whether Plan B should be sold over the counter, it relied on an advisory committee that included several abortion opponents. Over the objections of their colleagues, those committee members persuaded the agency to include language in Plan B’s packaging that stated the drug “may also work” by preventing implantation. Not until 2022 did the FDA finally update the Plan B label to clarify the drug “does not terminate a pregnancy.” But anti-abortion groups could challenge that update in a second Trump administration.

Meanwhile, since 2015, the “abortifacient claim” has inspired lawmakers in at least seven states to vote to cut off funding for contraception or block bills to protect access to it, USA Today found in a recent investigation. Project 2025 also continues this line of attack, describing Ella as a “potential abortifacient” and proposing to wipe out mandatory insurance coverage for it. Some anti-abortion organizations, including the influential Students for Life, even falsely claim that the daily birth control pill is an abortifacient. As my colleague Kiera Butler has written, it’s all part of a growing right-wing movement to persuade women that hormonal contraception is just plain bad for them. If Trump wins, his appointees are likely to bring those arguments with them to the agencies they oversee, further threatening birth control access.

Rewriting Title X

Attacking government subsidies for contraception has been part of the GOP playbook for decades. A favorite target is Title X, a federal safety-net program that underwrites free reproductive health services—birth control, cervical cancer screenings, and STI screening and treatment, but not abortion—for low-income and uninsured people. Planned Parenthood clinics, a common provider of these services, receive about 20 percent of Title X funds.

No surprise: Texas has led the way in attacking the federal program since 2011, when the legislature slashed state funding for reproductive health care and redirected Title X money to primary care providers. The changes that year—designed to kneecap Planned Parenthood—forced scores of reproductive health clinics to close, and others to reduce hours, charge patients new fees, or ration the most effective (but expensive) forms of contraception, such as IUDs. As a result of the changes, the number of clients served by Texas family planning organizations fell by more than half, and the teen birth rate rose an estimated 3.4 percent. “It shredded the safety net for women’s health care in our state,” says Davis, now a senior adviser to Planned Parenthood Texas Votes. “Tens of thousands of women literally lost the only health care they had ever known, overnight. It was devastating, and slowly, we’ve been building our way back.”

“Tens of thousands of women literally lost the only health care they had ever known, overnight.”

Trump’s first-term appointees, following Texas’ lead, set about dramatically reshaping the entire Title X program. The administration’s “gag rule,” first proposed under Ronald Reagan but never fully implemented, which forbids any clinics that took Title X money from referring patients to abortion providers. It also required them to keep separate books and separate facilities from their abortion services, if they offered them—a logistical nightmare. Some 1,300 reproductive health facilities, including 400 Planned Parenthood clinics, withdrew from the program rather than withhold abortion referrals from patients who wanted them, and roughly 1.6 million patients lost access to federally subsidized birth control. “It was a very difficult time in the program,” says Clare Coleman, president of the National Family Planning & Reproductive Health Association. “Of course, the numbers plummeted.” What happened to the freed-up Title X money? The Trump administration sent some of it to a chain of Christian “crisis pregnancy centers” that refused to provide contraception or even referrals for birth control, as my colleague Stephanie Mencimer found in a 2019 investigation.

When Joe Biden took office, his administration promptly revoked the Trump rule, and the Title X network started rebuilding. But Vice presidential candidate Ohio Sen. JD Vance has already signaled that a second Trump administration would try again to defund Planned Parenthood—code for attacking Title X. Project 2025 urges the next president to “quickly” reissue the gag rule. It also advocates that Title X be “reframed with a focus on better education around fertility awareness”—a less-reliable method of cycle tracking favored by anti-abortion activists and wellness influencers—with grants opened up once again to anti-abortion religious organizations.

In anticipation of a Trump win, Coleman’s organization has been working with reproductive health clinics to prepare for the old gag rule to be reissued and even expanded soon after Inauguration Day. Not only could the next version of the rule pick up on Texas’ efforts to require parental consent for teenagers, Coleman warns Trump appointees are also likely to attack gender-affirming care. (Title X does not explicitly fund such care but some providers offer those services separately, just as they do abortion.) “They may say, if you take Title X, you can’t provide any of that care,” Coleman speculates. “We are quite concerned about them trying to enforce not only a gender binary—because we also do see men in the Title X program—but to recast it as: ‘This is a program about biological sex.’”

That’s if Title X survives at all: House Speaker Mike Johnson’s budget bill in September 2023 would have defunded the program entirely.

Gutting the Affordable Care Act

Before the Obama administration passed the Affordable Care Act, birth control accounted for around a third of women’s out-of-pocket healthcare expenses, according to the National Women’s Law Center. Monthly copays deterred women from getting the Pill, while an IUD could have an up-front cost of $1,000.

The ACA changed all that for over 62 million women. Starting in 2012, the law classified contraception as a form of preventive care and made it mandatory for private insurance to cover a wide range of prescription birth control at no cost to consumers. Last year, responding to the fallout from Dobbs, the Biden administration directed agencies to find ways to strengthen the contraception mandate and make sure insurers follow it; last month’s announcement on coverage of over-the-counter contraception follows that effort.

Fighting the contraception mandate has been one of the key ways conservatives and religious groups have sought to erode access to birth control. In 2014, the Supreme Court’s infamous Hobby Lobby ruling blew a crater in the ACA’s contraception mandate in the name of protecting religious freedom. There had always been a religious exemption for churches and houses of worship. But Hobby Lobby expanded that exemption to include 90 percent of US businesses—letting them deny coverage for birth control in employee insurance plans if the owners had a religious objection.

Trump broadened the exemption even further in his first term, allowing employers to decline to provide birth control based on moral, not just religious, objections. “It opens the door wide for any employer that provides health insurance to pick and choose what kind of contraception they would like to cover,” says Dana Singiser, cofounder of the Contraceptive Access Initiative.

Of course, there’s always the chance that a Republican White House and Congress would wipe out the ACA altogether, as Trump tried to do in 2017. Trump has since made conflicting statements about whether he would try again for a repeal or impose “concepts of a plan” to replace it. In late October, Speaker Johnson promised a “massive reform” of the ACA if Trump is elected.

Even with the ACA still on the books, experts say Trump could do significant damage, bypassing Congress by issuing new regulations or guidance from executive-branch agencies. Project 2025 leans in on this idea, urging the next president to make regulatory moves that would hobble the contraceptive mandate. “It’s not flashy,” says Lauren Wallace, senior counsel for reproductive rights and health at the National Women’s Law Center. “Every administration is allowed to put out proposed rules, put out guidance. So those are the ways this coverage can be stripped.”

“Every administration is allowed to put out proposed rules, put out guidance. So those are the ways this coverage can be stripped.”

The Biden administration is currently finalizing a replacement to Trump’s rule allowing moral objections to the contraceptive mandate; it’s safe to say that Trump would block or revoke it. He could also issue other regulations to make the contraceptive mandate “unworkable,” Wallace says. He could give insurers more agency to make rules around which types of birth control they choose to insure or require patients to try certain methods, before covering more expensive ones.

Project 2025’s authors, of course, have their own ideas about which forms of birth control are preferable. Their blueprint urges the next president to require the Department of Health and Human Services to issue new regulations about what is covered by the ACA contraceptive mandate. In: “fertility awareness” methods. Out: male condoms and Ella.

Shrinking Medicaid While Increasing Surveillance

Back to Texas.

Over the past decade or so, at the same time the state was attacking family planning clinics, it found a way to mess with the most common way people pay for birth control: Medicaid. And Davis sees what it did as a potential model for other states should Trump win.

First, the state passed a law banning abortion providers and their affiliates from participating in the state’s Medicaid-funded family planning program. The law conflicted with a federal rule allowing Medicaid patients to choose any “willing” provider. That meant Texas had to apply to the Obama administration for a waiver of the rule. “They got into a standoff,” Davis recalls. “The Obama administration said, ‘We’re going to remove all of your funding if you do this.’ And Texas said, ‘Fine, do it.’”

For the next few years, Texas ran a shrunken version of the program using state funding. Then Trump appeared, installing a National Right to Life Committee lobbyist to oversee national family planning policy. Texas applied for the Medicaid waiver again—and this time, received it. The Trump administration also gave the state permission not to cover emergency contraception in its Medicaid-funded program.

Davis predicts that other states will use the same maneuver to sever Planned Parenthood from Medicaid, should Trump return to office. Tennessee, which bans virtually all abortions, and South Carolina, which bans them at six weeks, have already applied for similar waivers. And Missouri recently enacted a law to ban all Medicaid reimbursements for abortion providers and their affiliates—even though the state’s abortion ban means they now only provide services like contraception and cancer screening.

Project 2025 proposes making federal Medicaid family planning funding conditional on states participating in a frighteningly detailed abortion surveillance system. “Because liberal states have now become sanctuaries for abortion tourism,” the blueprint says, “HHS should use every available tool, including the cutting of funds, to ensure that every state reports exactly how many abortions take place within its borders.” The database would include the gestational age at which the abortion was performed, the method, and the reason for it.

The proposal would force states to make an “impossible choice,” says Madeline Morcelle, senior attorney at the National Health Law Program. Participating in that “weaponized program,” she says, “would likely be used to criminalize pregnant people,” particularly immigrants, Black, Indigenous, and other people of color, young people, and people with disabilities. But dropping out would likely mean losing federal funding for vital Medicaid services affecting millions of those same low-income people.

Davis, in Texas, says she knows that predictions about losing access to birth control can sound exaggerated. She’s heard such criticisms before—from people who believed that Roe would never fall. “There are those out there who believe that this is hyperbole,” she says. But as a Texan who has witnessed how what appears radical becomes normalized, she has no illusions about the potential dangers. “I don’t think it’s unlikely at all that as Republicans become more and more extreme, and governed in a more and more extreme way by their rightward flank, that we are going to see these things become a reality.”

Correction, October 31: An earlier version of this story misstated which funds Project 2025 suggests withholding from states that don’t participate in an expanded abortion surveillance program.

When Wendy Davis wanted to get birth control as a teenager in the 1980s, she went to her local Planned Parenthood in Fort Worth, Texas, with a friend. “There is absolutely no way I would have asked my mother for her permission to do that,” says Davis, the former Texas state senator who famously filibustered an anti-abortion bill for 11 hours in a pair of pink sneakers. “That’s just not something that’s possible for many, many, many teenage girls.” 

Forty years later, with abortion banned in wide swaths of the country, access to reliable contraception is more important than ever. Yet for Texas teens, getting prescription birth control is arguably harder now than it was when Davis was an adolescent. Over the past two years, federal courts—including the notoriously conservative Fifth Circuit—have ruled that minors must have parental consent to obtain prescription birth control from Texas clinics subsidized by a federal family planning program known as Title X. Flush with victory, Texas Republicans have made it clear: They have no intention of stopping there. In late July, Attorney General Ken Paxton filed suit to overturn a new federal rule that reaffirmed teens’ ability in other states to get contraception without their parents’ consent. “The Biden Administration continues to prove they will do anything to implement their extremist agenda,” Paxton said in a press release.

To anyone paying even a modicum of attention, the far-right’s plans to limit access to birth control have long been hiding in plain sight. When the Supreme Court overturned the federal right to abortion in the Dobbs decision in 2022, Justice Clarence Thomas wrote that the court “should reconsider” other rulings with similar legal principles, including Griswold v. Connecticut, the 1965 decision establishing a right to contraception (and, more fundamentally, a constitutional right to privacy). The ultra-conservative strategists behind Project 2025— including Roger Severino, longtime anti-abortion movement lawyer, and Russell Voght, an avowed Christian nationalist—have spelled out a plan for how a Republican-led White House could gut or rewrite key federal birth-control regulations, building on efforts that began during the first Trump administration. (While Trump has tried to distance himself from Project 2025, even claiming he doesn’t know who wrote it, at least 140 members of Trump’s team, including Severino and Voght, had a hand in drafting it.)

But what has escaped many Americans is that these threats aren’t just terrifying what-if-this-happens scenarios. As the Texas lawsuits show, in some parts of the US, that scary future has already arrived. States have been passing laws allowing pharmacies to refuse to fill birth control prescriptions based on moral objections, or proposing legislation that unscientifically classifies emergency contraception and IUDs as “abortifacients.” Reproductive Health and Freedom Watch has found that since 2021, at least 21 states have directed a total of $513 million to religiously affiliated crisis pregnancy centers and “alternatives to abortion” programs that actively spread misinformation about birth control and discourage its use.

And though contraception is supported by around 90 percent of voters, when Congress had the chance earlier this year to pass a law protecting access to birth control, Republican senators blocked it, claiming it was unnecessary.

The Biden administration has repeatedly pushed back—most recently, with a new proposed rule under the Affordable Care Act to require private insurance to cover 100 percent of the cost of over-the-counter birth control and offer patients more choices for prescription contraception. In a statement, Vice President Kamala Harris described the move as “the largest expansion of contraception coverage in more than a decade.” But the regulations won’t be finalized until after the presidential election, and the new rules are virtually certain to be challenged in GOP-packed federal courts even if Harris wins. 

And what if she doesn’t?

A new Trump administration and its right-wing allies are expected to escalate attacks on contraception on a multitude of fronts, including appointing extremists to key government positions. Rather than outright bans, we should expect more subtle incursions—regulatory changes, limits on insurance coverage, and funding reductions for family planning, as well as rules like the parental consent requirement for teens, according to reproductive health policy experts interviewed by Mother Jones. “It would be cleaner if there was some direct attack on the right to contraception that opponents of reproductive healthcare were pursuing,” says Kelly Baden, vice president for public policy at the Guttmacher Institute. “They’re not. It is much more behind-the-scenes, around the margins. And yet, the impact is still potentially devastating.”

“It would be cleaner if there was some direct attack on the right to contraception that opponents of reproductive healthcare were pursuing. They’re not.”

“That’s what happened to abortion,” adds Amanda Stevenson, an assistant professor at the University of Colorado-Boulder who studies the impact of family planning policy. “Death by a thousand cuts.”

Here are four key strategies we can expect under a new Trump administration intent on undermining access to contraception:

Doubling Down on False Claims that Birth Control Causes Abortion

One of the most common attack lines against contraception is the claim that certain methods—notably IUDs and morning-after pills—are abortifacients, which is to say they cause abortion, purportedly by preventing fertilized eggs from implanting in the uterus. In fact, decades of research show that these methods block fertilization from ever happening—by preventing the release of eggs, for instance, or stopping sperm from reaching them. Yet the belief that IUDs and emergency contraception, like Plan B and Ella, end pregnancies rather than preventing them has become distressingly common, thanks in part to rampant misinformation spread by the anti-abortion movement—including appointees in the first Trump administration.

The falsehoods have made their way into Food and Drug Administration policy, with decades-long repercussions for reproductive health. Back in the early 2000s, when the FDA was trying to decide whether Plan B should be sold over the counter, it relied on an advisory committee that included several abortion opponents. Over the objections of their colleagues, those committee members persuaded the agency to include language in Plan B’s packaging that stated the drug “may also work” by preventing implantation. Not until 2022 did the FDA finally update the Plan B label to clarify the drug “does not terminate a pregnancy.” But anti-abortion groups could challenge that update in a second Trump administration.

Meanwhile, since 2015, the “abortifacient claim” has inspired lawmakers in at least seven states to vote to cut off funding for contraception or block bills to protect access to it, USA Today found in a recent investigation. Project 2025 also continues this line of attack, describing Ella as a “potential abortifacient” and proposing to wipe out mandatory insurance coverage for it. Some anti-abortion organizations, including the influential Students for Life, even falsely claim that the daily birth control pill is an abortifacient. As my colleague Kiera Butler has written, it’s all part of a growing right-wing movement to persuade women that hormonal contraception is just plain bad for them. If Trump wins, his appointees are likely to bring those arguments with them to the agencies they oversee, further threatening birth control access.

Rewriting Title X

Attacking government subsidies for contraception has been part of the GOP playbook for decades. A favorite target is Title X, a federal safety-net program that underwrites free reproductive health services—birth control, cervical cancer screenings, and STI screening and treatment, but not abortion—for low-income and uninsured people. Planned Parenthood clinics, a common provider of these services, receive about 20 percent of Title X funds.

No surprise: Texas has led the way in attacking the federal program since 2011, when the legislature slashed state funding for reproductive health care and redirected Title X money to primary care providers. The changes that year—designed to kneecap Planned Parenthood—forced scores of reproductive health clinics to close, and others to reduce hours, charge patients new fees, or ration the most effective (but expensive) forms of contraception, such as IUDs. As a result of the changes, the number of clients served by Texas family planning organizations fell by more than half, and the teen birth rate rose an estimated 3.4 percent. “It shredded the safety net for women’s health care in our state,” says Davis, now a senior adviser to Planned Parenthood Texas Votes. “Tens of thousands of women literally lost the only health care they had ever known, overnight. It was devastating, and slowly, we’ve been building our way back.”

“Tens of thousands of women literally lost the only health care they had ever known, overnight.”

Trump’s first-term appointees, following Texas’ lead, set about dramatically reshaping the entire Title X program. The administration’s “gag rule,” first proposed under Ronald Reagan but never fully implemented, which forbids any clinics that took Title X money from referring patients to abortion providers. It also required them to keep separate books and separate facilities from their abortion services, if they offered them—a logistical nightmare. Some 1,300 reproductive health facilities, including 400 Planned Parenthood clinics, withdrew from the program rather than withhold abortion referrals from patients who wanted them, and roughly 1.6 million patients lost access to federally subsidized birth control. “It was a very difficult time in the program,” says Clare Coleman, president of the National Family Planning & Reproductive Health Association. “Of course, the numbers plummeted.” What happened to the freed-up Title X money? The Trump administration sent some of it to a chain of Christian “crisis pregnancy centers” that refused to provide contraception or even referrals for birth control, as my colleague Stephanie Mencimer found in a 2019 investigation.

When Joe Biden took office, his administration promptly revoked the Trump rule, and the Title X network started rebuilding. But Vice presidential candidate Ohio Sen. JD Vance has already signaled that a second Trump administration would try again to defund Planned Parenthood—code for attacking Title X. Project 2025 urges the next president to “quickly” reissue the gag rule. It also advocates that Title X be “reframed with a focus on better education around fertility awareness”—a less-reliable method of cycle tracking favored by anti-abortion activists and wellness influencers—with grants opened up once again to anti-abortion religious organizations.

In anticipation of a Trump win, Coleman’s organization has been working with reproductive health clinics to prepare for the old gag rule to be reissued and even expanded soon after Inauguration Day. Not only could the next version of the rule pick up on Texas’ efforts to require parental consent for teenagers, Coleman warns Trump appointees are also likely to attack gender-affirming care. (Title X does not explicitly fund such care but some providers offer those services separately, just as they do abortion.) “They may say, if you take Title X, you can’t provide any of that care,” Coleman speculates. “We are quite concerned about them trying to enforce not only a gender binary—because we also do see men in the Title X program—but to recast it as: ‘This is a program about biological sex.’”

That’s if Title X survives at all: House Speaker Mike Johnson’s budget bill in September 2023 would have defunded the program entirely.

Gutting the Affordable Care Act

Before the Obama administration passed the Affordable Care Act, birth control accounted for around a third of women’s out-of-pocket healthcare expenses, according to the National Women’s Law Center. Monthly copays deterred women from getting the Pill, while an IUD could have an up-front cost of $1,000.

The ACA changed all that for over 62 million women. Starting in 2012, the law classified contraception as a form of preventive care and made it mandatory for private insurance to cover a wide range of prescription birth control at no cost to consumers. Last year, responding to the fallout from Dobbs, the Biden administration directed agencies to find ways to strengthen the contraception mandate and make sure insurers follow it; last month’s announcement on coverage of over-the-counter contraception follows that effort.

Fighting the contraception mandate has been one of the key ways conservatives and religious groups have sought to erode access to birth control. In 2014, the Supreme Court’s infamous Hobby Lobby ruling blew a crater in the ACA’s contraception mandate in the name of protecting religious freedom. There had always been a religious exemption for churches and houses of worship. But Hobby Lobby expanded that exemption to include 90 percent of US businesses—letting them deny coverage for birth control in employee insurance plans if the owners had a religious objection.

Trump broadened the exemption even further in his first term, allowing employers to decline to provide birth control based on moral, not just religious, objections. “It opens the door wide for any employer that provides health insurance to pick and choose what kind of contraception they would like to cover,” says Dana Singiser, cofounder of the Contraceptive Access Initiative.

Of course, there’s always the chance that a Republican White House and Congress would wipe out the ACA altogether, as Trump tried to do in 2017. Trump has since made conflicting statements about whether he would try again for a repeal or impose “concepts of a plan” to replace it. In late October, Speaker Johnson promised a “massive reform” of the ACA if Trump is elected.

Even with the ACA still on the books, experts say Trump could do significant damage, bypassing Congress by issuing new regulations or guidance from executive-branch agencies. Project 2025 leans in on this idea, urging the next president to make regulatory moves that would hobble the contraceptive mandate. “It’s not flashy,” says Lauren Wallace, senior counsel for reproductive rights and health at the National Women’s Law Center. “Every administration is allowed to put out proposed rules, put out guidance. So those are the ways this coverage can be stripped.”

“Every administration is allowed to put out proposed rules, put out guidance. So those are the ways this coverage can be stripped.”

The Biden administration is currently finalizing a replacement to Trump’s rule allowing moral objections to the contraceptive mandate; it’s safe to say that Trump would block or revoke it. He could also issue other regulations to make the contraceptive mandate “unworkable,” Wallace says. He could give insurers more agency to make rules around which types of birth control they choose to insure or require patients to try certain methods, before covering more expensive ones.

Project 2025’s authors, of course, have their own ideas about which forms of birth control are preferable. Their blueprint urges the next president to require the Department of Health and Human Services to issue new regulations about what is covered by the ACA contraceptive mandate. In: “fertility awareness” methods. Out: male condoms and Ella.

Shrinking Medicaid While Increasing Surveillance

Back to Texas.

Over the past decade or so, at the same time the state was attacking family planning clinics, it found a way to mess with the most common way people pay for birth control: Medicaid. And Davis sees what it did as a potential model for other states should Trump win.

First, the state passed a law banning abortion providers and their affiliates from participating in the state’s Medicaid-funded family planning program. The law conflicted with a federal rule allowing Medicaid patients to choose any “willing” provider. That meant Texas had to apply to the Obama administration for a waiver of the rule. “They got into a standoff,” Davis recalls. “The Obama administration said, ‘We’re going to remove all of your funding if you do this.’ And Texas said, ‘Fine, do it.’”

For the next few years, Texas ran a shrunken version of the program using state funding. Then Trump appeared, installing a National Right to Life Committee lobbyist to oversee national family planning policy. Texas applied for the Medicaid waiver again—and this time, received it. The Trump administration also gave the state permission not to cover emergency contraception in its Medicaid-funded program.

Davis predicts that other states will use the same maneuver to sever Planned Parenthood from Medicaid, should Trump return to office. Tennessee, which bans virtually all abortions, and South Carolina, which bans them at six weeks, have already applied for similar waivers. And Missouri recently enacted a law to ban all Medicaid reimbursements for abortion providers and their affiliates—even though the state’s abortion ban means they now only provide services like contraception and cancer screening.

Project 2025 proposes making Medicaid and other federal health funding conditional on states participating in a frighteningly detailed abortion surveillance system. “Because liberal states have now become sanctuaries for abortion tourism,” the blueprint says, “HHS should use every available tool, including the cutting of funds, to ensure that every state reports exactly how many abortions take place within its borders.” The database would include the gestational age at which the abortion was performed, the method, and the reason for it.

The proposal would force states to make an “impossible choice,” says Madeline Morcelle, senior attorney at the National Health Law Center. Participating in that “weaponized program,” she says, “would likely be used to criminalize pregnant people,” particularly immigrants, Black, Indigenous, and other people of color, young people, and people with disabilities. But dropping out would likely mean losing federal funding for vital Medicaid services affecting millions of those same low-income people.

Davis, in Texas, says she knows that predictions about losing access to birth control can sound exaggerated. She’s heard such criticisms before—from people who believed that Roe would never fall. “There are those out there who believe that this is hyperbole,” she says. But as a Texan who has witnessed how what appears radical becomes normalized, she has no illusions about the potential dangers. “I don’t think it’s unlikely at all that as Republicans become more and more extreme, and governed in a more and more extreme way by their rightward flank, that we are going to see these things become a reality.”

Content warning: The story discusses childhood sexual abuse.

In Polk County, Florida, where its sheriff has said his department will “go to the ends of the earth” to arrest child predators, one child victim was left wondering how she ended up on the other side of the law. 

Taylor Cadle was 12 years old when she disclosed to a trusted adult that her adoptive father had been sexually abusing her since she was 9. Law enforcement was quick to respond, and almost just as quick to suspect that Taylor had made up the allegations. The lead detective, Melissa Turnage, began to question Taylor aggressively, even threatening her with returning to foster care if she continued with her allegations.

“I told her time and time and time and time again that I am not the liar here,” Taylor said of the detective. 

Despite Taylor’s pleas, Turnage eventually sought criminal charges against her for lying to police. 

For the Emmy-winning Center for Investigative Reporting and Netflix documentary Victim/Suspect, I found hundreds of others nationwide who, like Taylor, began as alleged victims reporting sexual assaults to police, and ended up criminal suspects. My reporting uncovered shocking police missteps in several of those investigations. All of those alleged victims remain adamant that their reports were truthful. 

In a surprising development in her case, Taylor vindicated herself. With our partner PBS News Hour, I went to Polk County to meet her—and hear how she finally put her abuser in prison.

Immaculate may appear to be all about evil nuns. In the movie’s grisly opening, four nuns break a runaway sister’s leg. Another holy mob tries to skewer the protagonist, Sister Cecilia, like a shish kebab just after she takes her final vows—and before she unexpectedly becomes pregnant. Halfway through the film, Cecilia catches two sisters slicing off a mouthy novitiate’s tongue. Candles burn, incense wafts, and their habits conceal evil intentions.

But the real villain is the parish priest. A former geneticist who’s found his calling trying to engineer the next messiah, he inseminates Cecilia with DNA pulled from—wait for it—one of the nails used to crucify Jesus Christ. Producer and lead actor Sydney Sweeney said she and the rest of the crew behind Immaculate “never really looked at a lot of nun films.”

It appears that they never really looked at a lot of actual nuns, either. Immaculate is hardly the first horror film to commit this sin. Nuns, with their unmistakable silhouettes, have long been made caricatures by the horror genre, revealing that, long before JD Vance became a VP candidate, society was never comfortable with unmarried, childless women, much less those living communally. The fact that nun horror is most often set in earlier eras—­usually back when nuns were sporting habits and chanting in Latin—feels like a middle finger to these women, who had some measure of self-determination in a world long before the Western women’s rights movement.

Tales of satanic nuns are older than film itself. For centuries, the expectations imposed on cloistered women were as constricting as the social roles available to them and the walls surrounding them—and speculation ran wild. Some of these accounts went on to inspire late-20th-century nunsploitation films, like Convent of Sinners in 1986, which laid the foundation for modern movies like Immaculate.

These days, nuns are an endangered species. The numbers peaked at about 180,000 American sisters in 1965, but declined to fewer than 36,000 by 2023. In 2009, more than 90 percent of American sisters were age 60 or older. While nun characters have appeared in films of all stripes, from a soul-searching novice in Ida to Whoopi Goldberg’s comedic turn in Sister Act, the horror genre seems especially, and lucratively, fixated on them. The Conjuring series, which includes The Nun and The Nun II, is one of the highest-grossing horror franchises of all time. Nuns also star in—or haunt—such recent releases as The First Omen (2024), Sister Death (2023), Deliver Us (2023), and Consecration (2023).

“[Nuns] are figures that, for Americans, are very other,” said Ryan Duns, a Jesuit priest and author of the new book Theology of Horror. “And there’s a fascination with that.” Yet nun horror films reflect society’s larger discomfort with these independent women and conveniently ignore that for many real-life nuns, forgoing secular marriage and childbearing has freed them to perform invaluable academic, artistic, and social justice work.

Today’s nun horror can best be understood through its progenitor: nunsploitation. This genre, often as blood-soaked as it is pornographic, was popularized in ’70s Europe, largely as a critique of the Catholic religion. Whereas the church believed that vows of poverty, chastity, and obedience could bring women closer to God, these films seemed to posit that such strictures were more likely to turn women into wanton, slutty psychopaths.

Italian director Joe D’Amato clearly had a score to settle in his 1986 flesh flick Convent of Sinners, which he made under the name Dario Donati. The film liberally draws from Denis Diderot’s 18th-century novel La Religieuse, a seminal work of anti-­Catholic criticism. Convent of Sinners is one of three major film adaptations, with Jacques Rivette’s The Nun (1966) and Guillaume Nicloux’s The Nun (2013). Rivette’s take is considered an arthouse classic, and Nicloux’s premiered in competition at the Berlin International Film Festival, but Convent of Sinners aimed lower. A foremother of today’s nun horror, the film features exorcism, sexual hysteria, and lots of ominous harpsichord, plus a ­demon-purging douche.

For many women in the past, “marriage, prostitution, and the convent were about the only choices.”

Unlike today, when evil nuns tend to appear in the background, they’re often front and center in early nunsploitation films. In Convent of Sinners, heroine Susanna faces off against a predatory lesbian abbess and her scorned second-in-command. The former wants to show Susanna the ways of the flesh; the latter is so jealous that she poisons Susanna and stages her alleged possession. An opening intertitle quotes La Religieuse: “What need has Christ of so many foolish vergins [sic] and the human race of so [many] victims?”

La Religieuse excoriated cloistered life as repressive and intolerable. According to Craig A. Monson, author of the 2010 book Nuns Behaving Badly, there was some truth to that assessment. For many women in the past, “marriage, prostitution, and the convent were about the only choices,” Monson explains, and each came with (usually male) supervision. A woman’s purpose was dictated either by her husband, her male relatives, a brothel owner, or the church. The Council of Trent in the mid-1500s, which called for “the enclosure and safety of nuns,” stipulated that unless approved by a bishop, a nun could not “go out of her convent, even for a brief period, under any pretext.” There was no such thing as a mental breakdown for being shut away against your will, but there was such a thing as demonic possession.

Still, while filmmakers like D’Amato may have had some valid points about Catholic repression, they loved to show as much female nudity and sexual violence as possible while making them. Convent of Sinners opens as Susanna is graphically raped by her father and ends with a still of her lifeless, topless form. All the frames in between feature more naked breasts than a French beach in June. As a novice, Susanna sheds her secular clothes and puts on special underwear in front of the entire convent. Later, in a bathing area, the sisters frolic naked, splashing each other with water and giggling. While two nuns are doing laundry, one laughs to her companion, “Whenever I have to wash these, I think of dirty habits.”

Many nunsploitation films masqueraded as sex-positive propaganda, but leave it to men to fetishize a ­population of women who have opted out of sexual life altogether. (A nunsploitation sex scene is comparable to two “sexy nun” costumes from your local Spirit Halloween come to life and robotically feeling each other up.) These films also serve as anti-Catholic vehicles, casting nuns as repressed to the point of psychosis (or, gasp, lesbianism). The church might not look great, but neither do these filmmakers’ opinions of women. The best sisters in these films end up dead like Susanna, doe-eyed martyrs to a supposedly progressive cause.

Sigmund Freud famously posited that certain men are unable to be aroused by the women they love and unable to love the women who arouse them. This “psychical impotence,” more commonly known as the Madonna-whore complex, sums up the cinematic nun nicely. She is either too pure, forced by some evil external force to the brink of ruin, or, as with the oft-used Mother Superior trope, she is the one doing the ruining. The moral of the Conjuring franchise—which wildly fictionalizes the lives of Ed and Lorraine Warren, two real-life Catholics and paranormal investigators—is that no evil can truly harm those with enough faith in the Christian God. The franchise’s The Nun and The Nun II have become easily the most successful nun horror films, grossing more than $630 million to date. While it’s refreshing to see our pious protagonists not being brutalized, sexualized, or exorcised, these women are barely human in an entirely different, even nostalgic way: They’re practically divine.

This franchise seems to be an effort to memorialize the days when nuns were shut away and, quite literally, holier than thou. “Catholicism has not historically modernized the way that other religious traditions have. There’s something atavistic about it,” Duns, the Jesuit priest and academic, told me when I asked why horror movies are still so obsessed with habit-sporting nuns and collared fathers. “These are people who dwell in our midst, but they’re tied to a past we don’t quite understand.” He pointed out that this must have felt especially true after the reforms of the Second Vatican Council in 1965, which, in an attempt to collapse the distance between clergy and laypeople, dictated, among other things, that Mass could be conducted in vernacular languages and nuns’ traditional floor-length habits could be jettisoned. “All of a sudden,” Duns noted, “you show up to Mass the next week and the priest is facing you, he’s now speaking your language, and the liturgy that had composed your sense of space, time, and the sacred has evanesced.” So why does the big screen always show habited nuns chanting in Latin?

The Nun films, set in the decade before Vatican II, seem to long for these bygone rituals while exploiting them. In the first film, one nun tormented by Valak—a demon who manifests as a nun—is so pious that she would rather kill herself than be a vessel for evil. Another nun, Sister Irene, takes her vows to become “a true bride of Christ,” and is able to weaponize an actual vial of Jesus’ blood. The Nun II takes this even further. Turns out Sister Irene is a direct descendant of St. Lucy, the patron saint of the blind, and the visions she’s been having are holy rather than delusional. (Convenient!) This time, the power of her prayer turns barrels of wine into demon kryptonite, Christ’s blood.

Because convent life “is this weird, sealed, matriarchal thing,” Elle Carroll, the author of Vulture’s “18 Essential Nunsploitation Films,” tells me, “there’s this automatic assumption that insane things must be going on. They must be up to something, be it truly everything from demonic possession to silly, softcore-porn lesbianism.”

In reality, the something many nuns have gotten up to over the centuries is innovation, unencumbered by wifely duties or childbirth. Intentionally or otherwise, Catholic nuns were the original female separatists, and convents were often the best option for self-sufficient women. Lucrezia Orsina Vizzana flourished as a singer, organist, and composer from within her convent in 17th-century Italy. Hildegard of Bingen, who made groundbreaking contributions to music and medicine in the 12th century, was a Benedictine nun. The 20th-century artist Corita Kent, who joined the Sisters of the Immaculate Heart of Mary in 1936 at age 18, made indelible contributions to pop art with her political serigraphs and advocated for Catholic progressive reform during Vatican II.

“They must be up to something…from demonic possession to silly, softcore-porn lesbianism.”

Their self-government opened opportunities to develop scholarly, artistic, or technical pursuits that Monson, the author of Nuns Behaving Badly, says “would not have been readily available in the world.” He acknowledges that some nuns “got their jollies out of being super-pious,” but others were “more intellectual, whether it was in music or in writing or in becoming accountants—even running the finances” for their convents.

The Roman Catholic Church is still one of the biggest charitable organizations in the country, and without its legions of female volunteers, these efforts would grind to a halt. Many nuns see such good works as a specific part of their calling—take the Dominican Sisters of Hope, based just north of New York City, who name “poverty, eco-justice, civil rights, access to health care, and access to education” among their key issues. The St. Louis–based Daughters of Charity work in health care, prisons, and social services. Pope Francis is reportedly friendly to nuns, but in 2012, the Vatican under arch-conservative Pope Benedict XVI accused the largest umbrella organization for nuns of promoting “certain radical feminist themes incompatible with the Catholic faith.” Their crimes? Voicing support for the Affordable Care Act and, allegedly, mentioning “patriarchy.”

Perhaps nuns terrorize the big screen because their social role is so complex. In a society where the value of exclusively female spaces remains confusing, nuns are reduced to objects of fear (or derision). In nun horror, elderly nuns are always the most monstrous. The nubile protagonists in Immaculate and Convent of Sinners are preyed upon for their fertile wombs and pert physiques, and that the predators are their mothers superior speaks volumes.

In a society where churchgoing is on the decline, horror movies may serve a unique purpose. Duns, the Jesuit priest and academic, said he’s witnessed rampant religious alienation among his undergraduate students, but the horror genre offers a novel outlet for existential angst. “Interpersonal communication and shared ritual has been displaced, and I think relocated into horror,” he told me, where “you confront mortality, evil, the meaning of life.” Monsters—psychopathic serial killers, vampires, malicious ghosts—serve this purpose, but assigning that baggage to an actual class of women suggests a deeper problem. Few other professions feature so heavily in horror films, but why? Because these women used to dress strangely? Because they have faith? Because they’ve opted out of the usual marriage-and-children script?

With habit reform nearly 60 years in the rearview mirror and many nun horror films painting Catholics as godless hypocrites, it’s hard not to feel as though that last reason is the one with the most sticking power. After all, if Cecilia had just stayed in the Midwest and done the “normal” thing, there wouldn’t be a movie, would there?

When Monica Duran, the Democratic majority leader in Colorado’s House of Representatives, was 19 years old, she escaped domestic abuse with her young son and did what many survivors try to do: She fled to a shelter and sought counseling.

“For so long, you hear that you are worthless,” Duran told me. The support she received after leaving, she said, helped her realize that “I was worthy, I did have something to offer.”

As intimate partner violence continues to rise, such services are critical for helping survivors of domestic and sexual violence heal. But as I learned during my recent investigation for Mother Jones, they are becoming increasingly difficult to access due to a yearslong decline in federal funding from a pot of money created by the Victims of Crime Act, or VOCA. Colorado is not exempt. The state went from getting $31.3 million in VOCA funds in fiscal year 2017 to about $13.6 million in the most recent fiscal year, when the money was stretched to help support more than 125,000 survivors—mostly women who were victims of domestic violence or sexual assault, Department of Justice data shows.

Like most states, Colorado has tried to stave off the worst effects of the funding cuts, with state lawmakers allocating millions of dollars to affected programs. But those providers are still struggling after years of plummeting federal funding. Roshan Kalantar, executive director of Violence Free Colorado, the statewide domestic violence coalition, said some have had to close office space and eliminate legal advocacy services, which help survivors file for divorce or obtain emergency protective orders against abusers. More could soon follow. “We have at least two programs that might close,” Kalantar told me last week, “but many more will essentially limit what they can do.”

Duran and Kalantar are trying to avoid those outcomes. They are among the forces behind a ballot measure that, if passed by voters next month, would create a new funding stream for victims’ services in the state by imposing a 6.5 percent excise tax on firearms and ammunition as of next April, when it would take effect. The measure, known as Proposition KK, would create an estimated $39 million in annual revenue, the bulk of which—$30 million—would support VOCA-funded services for victims of crime, as well as crime prevention programs in Colorado. The rest of the funds would go toward mental health services for veterans and young people and increasing security in Colorado public schools. The bill that proposed the ballot measure passed in the Colorado General Assembly in May, with most Democrats supporting it and most Republicans in opposition. Should voters support the measure, the tax would not apply to firearms vendors that make less than $20,000 annually, law enforcement agencies, or active-duty military personnel.

Supporters—including Democratic Gov. Jared Polis, the National Network to End Domestic Violence, and Everytown for Gun Safety—say Prop KK would bolster desperately needed services in the state and could serve as a model for other states trying to come up with innovative ways to respond to federal VOCA cuts. Accessing support after intimate partner violence, Duran said, “is a matter of life and death—this is how serious this is.”

The tax on firearms has resulted in strenuous opposition from the gun lobby. The National Rifle Association’s Institute for Legislative Action, the organization’s lobbying arm, said earlier this year that the proposal “should be seen as nothing more than an attack on the Second Amendment and those who exercise their rights under it” and pointed to a similar measure in California, which imposed an 11 percent excise tax on firearms and ammunition earlier this year and has faced a court challenge for being unconstitutional.

Several Colorado pro-gun groups—including the NRA state chapter, the Colorado State Shooting Association; Rocky Mountain Gun Owners; and Rally for Our Rights—have also opposed Prop KK, noting that firearms and ammunition are already taxed at 11 percent on the federal level. Ian Escalante, executive director of Rocky Mountain Gun Owners, said in a video posted to X: “This is the radical anti-gun left trying to punish gun owners for exercising their rights.” Spokespeople for the three state-level groups did not return requests for comment from Mother Jones.

Duran, who said she’s a gun owner, said she’s “disappointed that this has been turned into a Second Amendment issue,” especially because domestic violence and the shortage of resources to support survivors is “a crisis.” Kalantar sees the tax on guns and ammunition in Prop KK as fitting, given the role that firearms often play in intimate partner violence. Research has shown that more than half of domestic violence homicides involve a gun and that access to a firearm makes that outcome more likely. Last year, there were 58 domestic violence fatalities in Colorado, more than three-quarters of which were caused by guns, according to data released this month by the state attorney general’s office. “It feels very appropriate that people making money off the sale of guns in Colorado should participate in the healing” of survivors, Kalantar said.

“It feels very appropriate that people making money off the sale of guns in Colorado should participate in the healing” of survivors.

If the measure passes, the Blue Bench, a sexual assault prevention and support center in Denver that served about 7,000 survivors last year, is one of the organizations that would benefit from this new source of revenue. Executive Director Megan Carvajal says VOCA funds make up half of its budget, paying for counselors who lead therapy sessions for survivors, the 24-hour hotline they can call in a crisis, and case managers who offer support at hospitals and police stations in the aftermath of assaults. In June, Carvajal learned that the Blue Bench’s latest VOCA award would be less than $650,000—a 40 percent cut compared with the previous year’s budget—which will mean laying off three therapists, two case managers, and a community educator who visits schools to talk about informed consent and healthy relationships. The organization will also have to move out of its Denver office space by the end of the year and transition to being mostly remote, Carvajal said.

If Prop KK does not pass and organizations like the Blue Bench face even further funding cuts, Carvajal’s prediction is grim: “People are going to die.” Research suggests that more than 30 percent of women contemplate suicide after being raped and more than 10 percent attempt it. More than half of all suicides involve a firearm, and suicides by firearm are highest in states with the fewest gun laws, according to a KFF analysis of Centers for Disease Control and Prevention data. For Carvajal, the work she and other advocates do is essential to reduce those statistics—but is only possible with adequate funding.

“If you pick up the phone and someone says, ‘I believe you,’” Carvajal said, “it can change your mindset from wanting to die to wanting to live.”

If you or someone you care about is experiencing or at risk of domestic violence, contact the National Domestic Violence Hotline by texting “start” to 88788, calling 800-799-SAFE (7233), or going to thehotline.org. The Department of Health and Human Services has also compiled a list of organizations by state.

If you or someone you care about may be at risk of suicide, contact the 988 Suicide and Crisis Lifeline by calling or texting 988, or go to 988lifeline.org.

Paris Alexander had been in a destructive relationship for over a decade, learning to tolerate the intolerable even as the abuse progressed—first mental and emotional torment, then physical and sexual torture. Like many survivors, Alexander, who is nonbinary, stayed in the relationship hoping that it would improve. “We stick it out,” they said, “because we think that they’re going to change and come to their senses.” 

Then, one day in September 2020, Alexander’s male partner beat them up and dragged them outside their Providence, Rhode Island, home by their hair. Wandering their neighborhood, covered in blood and desperate to flee, Alexander felt haunted by the years of forced isolation: “I had nowhere to go, no one to turn to,” they recall. A Google search on their phone led them to Sojourner House, which runs the state’s only shelter specifically for LGBTQ victims of intimate partner violence. Almost miraculously, there was some space. Finally, Alexander had caught a break. 

At the shelter, known as RISE, Alexander focused on taking “baby steps” toward independence. They got a library card. They started individual therapy. They joined a weekly virtual LGBTQ support group, where they heard terms like “nonbinary,” “gender-queer,” and “gender fluid” for the first time. Back then, Alexander identified as a transgender woman and felt pressured to “look female as much as possible.” The support group taught them, “You don’t have to be [male or female]—you can just simply be who you are, and that’s okay.” 

RISE is one of three shelters operated by Sojourner House, named for the 19th-century slave-turned-abolitionist Sojourner Truth, who was also an ardent advocate for women’s rights. Since its founding in 1976, the organization has served more than 60,000 people—1,800 last year alone. A small but critical part of this past year’s $7.4 million budget comes from the federal Crime Victims Fund, a pot of money created by the 1984 Victims of Crime Act, also known as VOCA. Across the country, VOCA helps pay for the hotlines survivors call in crisis, the shelters they flee to, and the advocates who accompany them to court and help them heal.

VOCA-supported programs helped almost 8 million people in fiscal year 2022–2023, funding nearly 3 million shelter beds and 2.3 million crisis-hotline calls, according to the Department of Justice. Those services have become more critical since the pandemic, as rates of intimate partner violence have soared, a housing crisis has made it even harder for survivors to flee, and the overturning of Roe v. Wade has given abusers another way to threaten pregnant survivors. But even as the need is growing, VOCA funding has been plummeting—and Congress has failed to act on what many advocates say may be the best hope for a legislative fix.

The current funding crisis is rooted in changes in DOJ policy that date back years. The Crime Victims Fund gets most of its money from financial penalties levied in corporate criminal cases, according to the department. Those fees and fines have been falling as federal prosecutors have pursued more deferred and non-prosecution agreements, which allow defendants more time to pay up or avoid charges entirely if they cooperate with the government. As a result, deposits into the pot shrank from a high of $6.6 billion in 2017 to $1.39 billion in fiscal year 2023. (Because of congressional caps, the actual amount of money disbursed is even lower.) These declines have trickled down to state agencies—which receive VOCA funds based on their state’s population size—and then to eligible programs. Rhode Island, which has one of the smallest populations, has seen a 54 percent drop in VOCA funds since 2017, to $2.9 million in the last fiscal year. California, the most populous state, went from receiving $218.9 million in VOCA funds in 2017 to $87 million over the same period.

Most states, including California, have managed to come up with some funding to offset the federal cuts, but the money is mostly temporary—lasting a year or two max. Fourteen states, including Rhode Island, did not appropriate any money in their most recent budgets to offset the VOCA cuts, I found in my reporting. This past spring, Rhode Island lawmakers proposed $2 million in supplemental funding, but the bill died in committee.

I’ve spent four months trying to understand how these extreme VOCA cuts are affecting domestic violence programs across the United States, doing more than two dozen interviews and tracking down budget data from every state. The picture that has emerged is deeply troubling: Lifesaving services for survivors are struggling to stay afloat, and experts fear what might happen if a long-term funding solution isn’t found.

Law enforcement groups are equally worried. “Without Congressional action, victim service providers will be forced to cut critical services, and many will be forced to close,” more than 700 prosecutors wrote in an open letter to lawmakers in February. “Millions of victims, including abused children and battered women, will be left without access to safety, justice and healing.” But with the November elections looming, Congress’ attention has been focused elsewhere.

The VOCA Fix Act, which President Biden signed into law in 2021, diverted revenue from deferred and non-prosecution agreements to the Crime Victims Fund—but this turned out to be inadequate. This term, Sen. Dick Durbin (D-Ill.) and Sen. Lisa Murkowski (R-Alaska) have proposed a bill to supplement VOCA with funds collected through the False Claims Act, which penalizes defrauding of the government. The legislation has attracted 170 bipartisan co-sponsors in the House but languished in the Senate Judiciary Committee, which Durbin chairs. A spokesperson for Sen. Lindsey Graham (R-S.C.), the committee’s highest-ranking Republican, did not respond to questions about whether the bill will get a hearing. Congress has also punted on Biden’s proposal for a $7.3 billion infusion into the Crime Victims Fund for next year. (The White House did not respond to repeated requests for comment.)

“Victims of crime, and specifically, victims of domestic and sexual violence, just are not priorities.”

At a virtual event this week commemorating the 40th anniversary of VOCA, the mood was less than celebratory. “I’m hearing about programs shutting down, positions being cut, victim services being impacted,” Claire Ponder Selib, executive director of the National Organization for Victim Advocacy, told more than 250 attendees. To Vanessa Volz, Sojourner House’s president and CEO, the funding crisis illuminates a harsh reality: “Victims of crime, and specifically, victims of domestic and sexual violence, just are not priorities.” 

Domestic violence hotlines like the one that led Paris Alexander to Sojourner House are among the most critical services that VOCA funds. Because hotlines are the point of entry to a support system that can mean the difference between life and death, slashed budgets can be especially disastrous. Rhode Island’s statewide 24/7 helpline has historically relied almost entirely on VOCA funding—about $118,000 last year, less than half what it received in 2019. More cuts would likely hit the helpline’s overnight shifts hardest. For people who are abused in the dead of night, or who have a small window to seek help while their abusers are sleeping or working, this could be catastrophic.

The Rhode Island helpline routinely gets calls from people in Massachusetts and Connecticut who can’t access services in their own areas—even though both of those states, unlike Rhode Island, have appropriated supplemental funds to offset VOCA cuts. Connecticut’s additional money came from the pandemic-era American Rescue Plan Act, which disappears at the end of this year. Without a new infusion of money, the statewide domestic violence hotline, Safe Connect—which is 100 percent funded by VOCA—will have to drastically cut services, lay off advocates, or even shut down, says Meghan Scanlon, president and CEO of the Connecticut Coalition Against Domestic Violence, which staffs the hotline. “The reality is, as much as we are advocates who don’t want to say ‘no,’ at some point, we’re gonna have to,” she laments. “And that doesn’t feel great.” 

Some of the greatest effects are likely to be felt in programs that serve transgender clients and undocumented immigrants, such as Sojourner House’s RISE shelter and THEIA Project, which supports victims of human trafficking. Hot-button politics around LGBTQ+ and immigrant clienteles make such programs especially difficult to fundraise for, Volz says.

Yet as Alexander’s story shows, immigrant survivors are particularly vulnerable to abuse from partners who exploit their status as another form of control. Despite their strong New England accent that makes them sound as if they had been born and raised in Boston, Alexander originally hails from São Miguel, a lush island in the Azores archipelago of Portugal. When they were 5 years old, they arrived in New Bedford, Massachusetts, with their parents—but without documentation. Their mother secured US citizenship when Alexander was a teenager—a process that automatically made them a citizen, too. But after getting kicked out of the house at 16, and no parental contact over the years, Alexander lacked both identification and proof of their citizenship status. “I became like a ghost,” they recall. In their 20s, they told me, essentially undocumented, they dropped out of cosmetology school and the regular labor force and drifted into sex work.

Sojourner House didn’t just get Alexander out of an abusive relationship. Its VOCA-funded team of immigration advocates helped Alexander secure identification, represented them in immigration proceedings, and prepped them for their citizenship test—a process that took over a year; in March 2022, Alexander was officially sworn in as a US citizen. “We’re really at risk of not being able to continue providing these services at the same level,” Volz notes.

In some places, cuts affecting VOCA-funded legal advocacy services have already been devastating. Judge Shelley Santry, a family court judge in Louisville, Kentucky, used to have advocates in her courtroom every Tuesday, the day she hears domestic violence cases involving people seeking emergency protective orders against their abusers. The advocates—employed by the statewide Center for Women and Families—would bring survivors into a private room after their hearing and explain a new set of risks: “Once the order is entered, it’s really the most dangerous time,” Santry told me. “The perpetrator is losing that control, and that’s when the lethality red flags are elevated.” Recently in Hardin County, 60 miles from Louisville, a man fatally shot his ex-girlfriend and her mother near the courthouse where they had a hearing about an emergency protective order against him. (He also killed himself.)

In Santry’s courtroom, the advocates would help survivors come up with practical strategies to safeguard themselves and their families: keep gas in their cars, charge up their phones, pack emergency bags in case they had to flee. Their in-person presence was essential, says Elizabeth Martin, the center’s president and CEO: “If you aren’t where people are, they’re not necessarily going to reach out to you.”

But over time, the number of advocates in Santry’s courtroom dwindled, and since August 2021, they’ve been completely gone. With VOCA funding for the center plummeting more than 60 percent since 2019, to just over $437,000 last year, Martin was forced to cut her domestic violence staff in half and remove advocates from courtrooms. Now, a court staffer hands out pamphlets and business cards to survivors bearing the center’s name, website, and phone number. Martin only sends an advocate if a survivor asks for one. “They don’t know what they don’t know,” Martin says. “The contact, that personal touch, that involvement has been watered down significantly.”

Lawmakers “need to understand this isn’t a personal problem, this isn’t a family problem—this is all of our problems, and we’ve got to work to eradicate it.” 

Domestic violence groups were grateful when Kentucky legislators allocated $7.1 million in their latest budget to offset VOCA cuts, but say the one-time grant isn’t enough. Without advocates to provide support, “the consequence may be death,” Santry says. In 2020, Kentucky ranked 10th in the nation for domestic violence homicides, according to the Violence Policy Center, with men murdering 46 women across the state. Lawmakers “need to understand this isn’t a personal problem,” Martin says, “this isn’t a family problem—this is all of our problems, and we’ve got to work to eradicate it.” 

California is another state where advocates say lawmakers haven’t done enough to address a steep decline in VOCA funds—down 60 percent since fiscal year 2017. Now domestic violence organizations there are facing a new crisis as they grapple with the repercussions of this summer’s decision in Grants Pass v. Johnson, in which the Supreme Court’s conservative supermajority essentially greenlit the criminalization of homelessness.

After a months-long advocacy campaign that drew the support of actress Angelina Jolie, Gov. Gavin Newsom’s office scrounged up $103 million in June to supplement the $87 million in federal VOCA funds. That one-year reprieve helped to avert what could have been a catastrophe for VOCA-funded organizations. But then in July, Newsom ordered state agencies to clear out homeless encampments following the Grants Pass ruling. Advocates warned that the decision could be devastating for survivors of intimate partner violence, who struggle to access shelter and housing nationwide—and especially in California, which has the largest population of unhoused people in the United States.

“The reality before [Newsom’s] executive order was that there were not enough DV-specific shelter beds, and just in general, there’s not enough emergency shelter beds,” says Jennifer Willover, housing policy analyst at the California Partnership to End Domestic Violence. Since Newsom’s mandate, Willover adds, domestic violence programs across the state have reported increased calls to their hotlines requesting shelter. In some parts of the state, advocates report that they are spending more time visiting encampments and informing unhoused people of domestic violence-specific services they offer, Willover says. (Newsom’s Office of Emergency Services did not respond to requests for comment.)

Experts see the situation there as a harbinger of what’s to come nationwide: As the National Network to End Domestic Violence and other advocacy groups said after the Grants Pass ruling, “Gender-based violence is a cause and consequence of homelessness, and this ruling will further trap people who are homeless, including survivors, in cycles of poverty and housing insecurity.”

In a report about homelessness in the state published in January by researchers at the University of California, San Francisco, nearly one-fifth of cisgender women surveyed said they had experienced intimate partner violence in the six months prior to homelessness, and 40 percent said violence was a reason for leaving their last housing. Many were homeless because of the far-reaching effects of domestic abuse: living in isolation from family and friends and unable to work, their financial resources controlled by their abusers, resulted in intractable poor credit and records of eviction. “There’s a lack of awareness, still, of the fact that there is that intersection of domestic violence and homelessness,” says Leticia Campos, chief programs officer at the Marjaree Mason Center, which serves victims of domestic violence in Fresno County, where the population tops 1 million and the poverty rate is well over the national average. 

Marjaree Mason—established in 1979 and named after a 36-year-old woman murdered by her ex-boyfriend, a sheriff’s deputy with the county—offers a case study of the problems facing VOCA-funded organizations in California post–Grants Pass. Fresno County has the highest number of calls to law enforcement for domestic violence per capita in California, and Marjaree Mason is the county’s only 24/7 domestic violence shelter and service provider. The Fresno City Council allocated $300,000 earlier this year to help the organization fend off the impacts of the years-long decline in VOCA funds, but staff members say they still struggle to meet the needs of survivors.

In June, I visited the VOCA-funded emergency shelter, which can accommodate 140 people. The rooms have bunk beds with colorful, patterned bedspreads, and televisions mounted on the walls, and outside there’s a playground shaded by palm trees. But even before the Supreme Court ruling, getting a bed there wasn’t easy. Empty beds are often filled within hours, Campos says; when I visited, the shelter had been at capacity for three weeks. Survivors who are turned away often have no choice but to return to their abusers. A spokesperson told me that last year, 80 percent of the organization’s clients had no income of their own, and of the ones who did, two-thirds made under $15,000. 

After Newsom issued his executive order, the Fresno County Board of Supervisors unanimously approved an ordinance making “unlawful camping” a misdemeanor punishable by a $500 fine and up to six months in jail. The city of Fresno passed a ban that was even more aggressive: a $1,000 fine and a year behind bars, which took effect in late September. The mayor has said that arrests will be limited to “habitual offenders” and that people will first be offered supportive services, though it’s unclear whether those include referrals for domestic violence treatment.

Staff at Marjaree Mason saw an impact within days of Newsom’s executive order, when the sheriff’s office dropped off an unhoused woman and two children at the drop-in center in the middle of the night after clearing an encampment, according to Joseph Hickman, the center’s interim crisis response manager. “It was very eye-opening to see that it happened that quickly,” Hickman says. “It definitely kind of lit a fire under us.”

The problem, as Campos says, is this: “What should we do when we’re at capacity? Where should we send victims of domestic violence?” Laura Moreno, program manager at the Fresno County Department of Social Services, says those questions point to a broader, county-wide issue. “We don’t have enough shelter beds, period, for the number of people we have on the streets,” she told me. A federally mandated one-day census in Fresno and neighboring Madera counties in January 2023 found nearly 4,500 unhoused people, up 7 percent from the year before. A county spokesperson said outreach teams provide homeless people with relevant resources, including information about Marjaree Mason’s services.

Helping survivors find assistance elsewhere when the shelter is full is a task left to Diana Hernandez, a former 911 dispatcher who joined Marjaree Mason’s staff in September 2021. In her previous job, she told me, she hated having to hang up on callers who were clearly in need but not in the throes of an emergency. Now, as a client navigator, she can talk to survivors who call the hotline for as long as they want, providing them with emotional support and resources. But she can’t always give them what they need most, which is usually a bed.

While we were chatting in her cubicle in June, she received a hotline call from a woman who said she’d been physically assaulted by her boyfriend. She had been living in a car, and needed a safe place to stay. Marjaree Mason’s shelter was full, so Hernandez offered to call homeless shelters in the area to see if they had room. But she also cautioned that those shelters wouldn’t offer advocacy support and legal services specifically for domestic violence victims. Nor would their locations be confidential, like domestic violence shelters’ are. Add to that, most likely they would require residents to leave during the day; Marjaree Mason lets them stay. 

Hernandez gave the woman phone numbers for other local organizations that could provide services, and suggested that she change her passwords on her email and social media accounts, make sure her phone’s location-sharing feature was turned off, and call back on the hotline at any time if she wanted to talk. In such instances, “I try to exhaust my resources,” Hernandez told me after the call ended, “so I know I did everything I could.”

After seven months at RISE, Sojourner House’s LGBTQ shelter, Paris Alexander might have ended up like so many other survivors of intimate partner violence: homeless and back on the street. But because Alexander had been a victim of sex trafficking, they were eligible for assistance through another Sojourner House program offering transitional housing for survivors of human trafficking. The program paid the rent and utilities on a third-floor apartment where Alexander lived while they were sorting through their citizenship problems and unable to work. Without a Social Security number, they couldn’t apply for food stamps or government assistance. Every few weeks, Alexander recalls, a Sojourner House advocate showed up with some food—bread, peanut butter, canned beans. “And that was pretty much what I had to live off of.” 

Alexander finally secured their citizenship in March 2022 and was able to begin searching for permanent housing. Once more, Sojourner House provided vital support. Robin Greene, an advocate who had once been unhoused, also works with trafficking survivors through the organization’s THEIA Project, which includes a VOCA-funded shelter. Greene helped Alexander find an apartment and even convinced the landlord to renovate the space by replacing the floors and covering up cracks and holes in the walls. 

For Greene, ensuring her clients live in comfort is key to helping them stay on the road to recovery. Greene recalls spending time in homeless shelters that were “gross,” “vermin-ridden,” “humiliating,” and “degrading.” At the shelter for trafficking victims, she painted the walls and floors with pops of green, yellow, and purple and adorned the office space with house plants. She mows the front lawn herself. “I want it to look not like a shelter,” she told me when I visited. “I want it to look like a home.” 

Two years after Alexander moved in, their apartment—the same one that Greene helped secure—has become their “sanctuary,” where they live with their two cats, Bast and Isis. They painted the walls yellow, green, and blue; hung up their own artwork; and put some of the house plants Greene brought to life in front of the bay windows in their living room, a daily reminder of someone who helped transform their life.

According to Greene, Alexander represents “the epitome” of what Sojourner House and domestic violence organizations like it can do, if they have the vision, the people—and the funding to support survivors. “Paris was determined to just sit in their little apartment and never come out with their cats,” Greene told me, “but not now.” 

Today, Alexander volunteers with Sojourner House and spreads word of its services within the community. They also volunteer with a trans youth mentorship program, through which they meet weekly with a younger trans mentee, and they host events—including a recent makeup workshop, drawing on their cosmetology background—for trans and nonbinary young people. In November, they’ll host a virtual Friendsgiving hangout—meant to be “a safe and loving space during Thanksgiving,” they said, adding, “the holidays can be a tough time of the year for queer folks.”

Alexander knows firsthand the negative thoughts that can run rampant through survivors’ minds: “We feel like we’re not worthy. We feel like no one cares. We feel like no one understands. You don’t trust that there’s genuine empathy out there.” Empathy, though, tends to be abundant among people who support survivors of domestic violence; what’s in short supply is cash. This is partly why Alexander was eager to tell their story: They want lawmakers to know that VOCA funds have “the power and the ability” to save lives. “I wouldn’t be here today,” they told me, “if it weren’t for the Sojourner House program.”

If you or someone you care about is experiencing or at risk of domestic violence, contact the National Domestic Violence Hotline by texting “start” to 88788 or calling 800-799-SAFE (7233) or going to thehotline.org. The Department of Health and Human Services has also compiled a list of organizations by state.

This article was produced with the support of the USC Annenberg Center for Health Journalism’s 2024 Domestic Violence Impact Reporting Fund.

If you want a glimpse into what Project 2025’s education agenda might look like if implemented nationwide, look no further than Florida, where Gov. Ron DeSantis has already been leading book-banning, inflaming culture wars over LGBTQ rights, and dismantling comprehensive sex education.

Recent reporting by the Orlando Sentinel revealed that Florida state officials are pressuring some districts to adopt an abstinence-only approach, stripping students of basic knowledge about contraception, anatomy, and human development. Students are being taught abstinence as the sole method of avoiding pregnancy and STDs, and terms like “abuse,” “fluids,” and “LGBTQ” are absent from classrooms. “Under recent changes to state law,” reports the Associated Press, “it’s now up to the Florida Department of Education to sign off on school districts’ curriculum on reproductive health and disease education if they use teaching materials other than the state’s designated textbook.”

This week, Mother Jones Creator Kat Abughazaleh analyzes one of these state-approved plans, “Real Essentials,” which encourages “spiritual intimacy” and traditional marriage. The plan’s author has a history of citing pro-abstinence education research from the Heritage Foundation, the conservative think tank behind Project 2025.

Florida’s approach is a test for a much broader movement, Kat argues. Just pages into Project 2025, you’ll find a promise to register “educators and public librarians” who purvey “pornography”—a term so vaguely defined as to potentially include any term currently being weaponized in the culture war—as registered “sex offenders.” Another section calls for provisions to prevent types of sex education that might “promote prostitution, or provide a funnel effect for abortion facilities and school field trips to clinics.”

For more details, watch Kat’s full breakdown of Florida’s new sex education laws.

When the US Department of Health and Human Services finalized a rule in May asserting that gender dysphoria can be considered a disability under federal anti-discrimination laws, it codified what the overwhelming majority of courts have found for nearly a decade. The new rule put states on notice: Discrimination against transgender people in employment, education, health care, child care, housing, and elsewhere may violate federal disability protections, and the Biden administration was prepared to fight it.

Now, in a lawsuit led by Texas Attorney General Ken Paxton, 17 states are asking a federal court to strike down the rule in its entirety, including numerous provisions that have nothing to do with trans people. This isn’t a random collection of states; 15 of them have passed restrictions on gender-affirming care, and all have embraced myriad anti-trans policies. 

Among the states’ objections to the new federal rule: They would have to “expend time, money, and resources” to accommodate employees with gender dysphoria, including using the pronouns that align with their identities, eliminating sex-specific dress codes, and letting employees use gender-aligned bathrooms or locker rooms. Nebraska’s attorney general is concerned that his state’s restrictions on gender care put it at risk of disability rights complaints and federal investigations. South Dakota objects to the rule “essentially add[ing] a new category of potentially disabled individuals” whose gender care must be covered by Medicaid.

But gender dysphoria is just part of the 130-page federal rule. It also protects disabled parents’ rights in child welfare cases and prevents hospitals from using disability as a factor in determining who gets care in crisis situations, such as equipment shortages during a pandemic. It adds Long Covid to the list of conditions that may constitute a disability and strengthens protections against unnecessary institutionalization, requiring that care be offered in the least restrictive setting and, ideally, in a patient’s community. 

“The attack is really about the regulatory process of the federal government, and this will impact almost every interaction that a disabled person has with the services and supports that they receive.”

Striking down the entire rule would have wide-reaching implications for all disabled Americans and other marginalized groups who rely on federal agencies’ interpretations of decades-old laws to enforce their rights, says Mia Ives-Rublee, senior director of the Center for American Progress’ Disability Justice Initiative. “They’re utilizing LGBTQ issues as a wedge,” Ives-Rublee says. “The attack is really about the regulatory process of the federal government, and this will impact almost every interaction that a disabled person has with the services and supports that they receive.”

The new rule pertains to two federal statutes passed decades ago to protect people with disabilities on multiple fronts. The Rehabilitation Act of 1973 prohibits discrimination on the basis of disability by the federal government, federal contractors, and—in its Section 504—by any organizations or employers that receive federal funds. The Americans with Disabilities Act (ADA), signed into law in 1990, broadened disability protections into most aspects of public life, including education, access to businesses open to the public, and public transportation. Both statutes define a disability as “a physical or mental impairment” that “substantially limits” one or more major life activities. 

When the Rehabilitation Act and ADA were passed, gender dysphoria was not a recognized medical condition, and both statutes expressly excluded “transvestism, transsexualism,” and “gender identity disorders not resulting from physical impairments” from the definition of disability. But over the decades, medical experts and courts have come to understand that for many people who identify with a gender different from the one assigned to them at birth, there can be profound psychological distress and other major negative effects in their work and social lives. In 2013, gender dysphoria was added to the Diagnostic and Statistical Manual of Mental Disorders.

Since then, lawsuits by individuals—the primary way the ADA is enforced—have forged a body of legal decisions that recognize gender dysphoria as a protected health condition and its exclusion from disability protections as discriminatory, says Ben Klein, senior director of litigation and HIV law at GLBTQ Legal Advocates and Defenders. The exclusion of gender dysphoria “was based on obvious animus toward a disfavored group. That is a concept that judges who look at petitions have easily understood—the bias is so clear,” Klein says. 

The 4th Circuit Court of Appeals broke legal ground in 2022 when it became the first federal appeals court to rule on the issue of whether gender dysphoria could be considered a disability under federal disability protection statutes. The court determined that the basis of a gender dysphoria diagnosis—whether it causes a noticeably negative impact on daily life—distinguishes it from the ADA’s definition of gender identity disorder. (The US Supreme Court declined to hear the case in June 2023, letting the decision stand.) Lower federal courts have found, similar to the 4th Circuit, that gender dysphoria is distinct from gender identity disorder. Others have found that even if gender dysphoria is a gender identity disorder, it results from a physical impairment: a mismatch between a person’s physical body and gender identity that can be remedied through gender care. 

In finalizing its new rule—the first administrative update to Section 504 in half a century—the Department of Health and Human Services alluded to this body of case law, which it said has “shifted the legal landscape of disability discrimination protections.” But none of that matters much to the states that joined the Texas lawsuit, which was filed with little national media attention in late September. 

The lawsuit seizes upon the original exclusionary language in the ADA, claiming that what the medical community now considers gender dysphoria falls under the law’s concept of gender identity disorder. “The Biden Administration is once again abusing executive action to sidestep federal law and force unscientific, unfounded gender ideology onto the public,” Paxton said in a press release announcing the suit. “Texas is suing because HHS has no authority to unilaterally rewrite statutory definitions and classify ‘gender dysphoria’ as a disability.”

Beyond the gender dysphoria issue, the lawsuit also makes broad claims about “new regulatory burdens” and “substantial costs” associated with the rule’s impacts to state Medicaid programs. Alaska, Montana, and Nebraska, for instance, argue that the rule’s “least restrictive setting” requirement will be difficult to implement because of health care worker shortages and their states’ unique geographies. 

“One of the goals of the ADA is to address discrimination and stereotypes, particularly about stigmatized health conditions. Gender dysphoria is the quintessential stigmatized health condition.”

Klein and Ives-Rublee emphasized that both the Rehabilitation Act and ADA were written vaguely with the intent that, over the years, experts working for federal agencies would reexamine and refine the regulations implementing the statutes, as scientific and public understanding of disability evolves. When the ADA was passed, trans identity was pathologized, Klein says. “One of the goals of the ADA is to address discrimination and myths and stereotypes, particularly about stigmatized health conditions,” he tells me. “Gender dysphoria is the quintessential stigmatized health condition.”

The new Texas case is just one of many avenues GOP officials are using to enforce their anti-trans beliefs. As I’ve reported, Republican attorneys general—many from the same states as in the Paxton lawsuit—are also threatening major medical associations with criminal investigations for promoting trans youths’ access to gender care.

Ives-Rublee warns that the Texas suit is also part of a multifaceted attack on the power of federal agencies to interpret civil rights laws, including protections for pregnant workers and access to reproductive health care. This broad conservative effort to rip the teeth out of the administrative state was emboldened by a series of Supreme Court decisions last term, including one that ended courts’ expected deference to federal agency interpretations of vague laws. 

Because the gender dysphoria lawsuit was filed in the federal district court in Lubbock, Texas, any appeal will go to the 5th Circuit Court of Appeals, home to some of the most radically conservative decisions in recent legal history. If the 5th Circuit sides with the states in this case, it would create a conflict with the 4th Circuit decision that could force the Supreme Court, with its far-right supermajority, to weigh in. “I am almost 100 percent sure this is their intention,” Ives-Rublee says.

This article was published in partnership with The Marshall Project, a nonprofit news organization covering the U.S. criminal justice system, and Arizona Luminaria. 

The first punch to her head knocked Grace Pinson to the floor. She put up her arms to protect her face as Ricki Mahkimetas struck her again. When his fist hit her nose, she felt it crunch.

The cells in the special housing unit at the federal penitentiary in Tucson, Arizona, have solid steel doors, making it almost impossible to see what is going on inside. Each cell is designed with an alarm button that can alert corrections officers down the hall if there’s an emergency. But Pinson’s cell had no button—just a hole in the wall with exposed wires.

Pinson is transgender, a woman with breasts and long curly hair in a prison full of men. She is also a dogged jailhouse lawyer. Over the 17 years she’s spent in federal prison, she’s brought more than 100 lawsuits against the Bureau of Prisons and its staff. For refusing to provide her with adequate gender-affirming care. For refusing to move her to a women’s prison. For failing, again and again, to keep her safe. In the years leading up to the July 2019 attack in cell B-140, she had been beaten, stabbed, slashed, and struck in the head with a padlock. Government lawyers, prison officers, and psychologists have kept meticulous records of these assaults and described them in court. “I have been attacked many times,” she told me. “My trauma haunts my very dreams.”

“I have been attacked many times. My trauma haunts my very dreams.”

This beating by her cellmate, who is serving more than 16 years for sexual assault, became the basis of another lawsuit. Neither the Bureau of Prisons nor Mahkimetas disputed that he beat her, but they contested her other allegations. Pinson said that during the attack Mahkimetas tried to yank off her pants. Whenever she reached down to hold up her waistband he would punch her in the face. He denied this to prison investigators, saying there was nothing sexual about the assault. She said she had told a guard earlier in the day that Mahkimetas had been threatening to rape her and asked to be moved to another cell. The guard later said he knew nothing in advance. So much of the case came down to who could be believed about what happened to Pinson that day.

Over several years and hundreds of handwritten pages of filings, Pinson jumped over one legal hurdle after another, all the way to trial. Fewer than 1 percent of federal prisoner civil rights claims reach that stage without an attorney, a luxury almost no one in prison can afford.

The federal Bureau of Prisons declined multiple requests to make officials available for an interview and declined to comment on the assault and the ensuing lawsuit, citing privacy, safety, security, and deference to the court. The bureau “takes seriously the duty to protect individuals entrusted in our care,” spokesperson Randilee Giamusso said in an emailed statement. “When we are made aware of security hazards, such as faulty duress alarms, we take steps to immediately address the issue.”

If Pinson’s legal tenacity makes her unusual, the harm she has suffered in federal prison does not. Life in prison is relentlessly dangerous, and for transgender people especially so. More than 1,300 trans women are locked in federal prisons alongside men. Not only are they at risk for extortion and assault, they are particularly vulnerable to sexual abuse. A 21-year-old law meant to prevent prison rape created a world of rules and procedures, yet hundreds of people continue to report being violated in federal prison each year. The prison where Pinson was held has and one of the highest rates of sexual abuse allegations in the entire federal system.

The trial in Pinson’s lawsuit offered a window into how difficult it can be to hold prison officials accountable, and in doing so, raised other questions: Why is it so dangerous to be a trans woman in prison? And when you are harmed in a place whose purpose is to punish wrongdoing, why is it so hard to get justice?

Curled up in the fetal position as Mahkimetas beat her, Pinson yelled for help. It felt like the beating went on for a very long time. The floor began to tremble as people in nearby cells started kicking their doors, trying to get the attention of the guards. Pinson said she felt a pang of gratitude that people didn’t want her to die.

Finally, she heard keys jangling as officers made their way toward her cell. Mahkimetas backed away. When officers rolled the steel door open, they found Pinson bruised and bloodied, her nose broken and her eyes beginning to swell shut.

Pinson v. the United States of America convened in November 2023, on a hot Monday in Tucson. Pinson shuffled into a federal courtroom wearing an oversized white T-shirt and prison-issued, gray-green canvas pants, shackles clanking at her ankles. She sat alone at the plaintiff’s table, her left hand padlocked to a chain around her waist. She couldn’t afford an attorney, or even the $350 filing fee for the lawsuit, and so she represented herself. Three lawyers in dark suits sat at the defendant’s table, representing the Bureau of Prisons for the US Attorney’s office.

The courthouse sits about 20 minutes away from the prison, a complex that includes a high-security penitentiary, where Pinson was housed, a medium-security correctional institution, and a low-security camp.

Pinson hoped her case would lead to a sort of #MeToo moment for the federal prison system. Her court filings framed Mahkimetas’ attack as part of a longstanding, pervasive pattern of sexual violence at her facility. And in the months leading up to the trial, she proposed a list of witnesses that included dozens of people who said they saw, or in some cases experienced, sexual assaults in the penitentiary—and the staff’s indifference when they tried to report it.

Pinson argued that the assault represented a failure of Bureau of Prisons employees to enforce the Prison Rape Elimination Act, almost universally referred to by its acronym, PREA. Passed by Congress in 2003, the law’s stated purpose was to “establish a zero-tolerance standard for the incidence of prison rape” in the United States. Its passage created a universe of new procedures and requirements and—as a result—increased awareness among correctional workers of the problem of sexual assault in prisons and jails.

Pinson, who is serving time for writing threatening letters to public officials, tried to argue that the officers guarding her in the Tucson penitentiary should have known that as a transgender woman, she was at high risk for sexual assault. Prison psychologists knew she’d been raped before. And yet officers assigned her to a cell without a working alarm, locking her in with Mahkimetas, who had been convicted of sexually assaulting a young girl. Pinson said she had warned an officer, Miguel Vasquez, earlier that day that Mahkimetas was threatening to rape her, and she needed to be moved. She said that after Mahkimetas attacked her, officers didn’t take what happened to her seriously and gave her a disciplinary infraction for fighting, leaving her to languish in the special housing unit. Mahkimetas did not respond to letters seeking comment on Pinson’s allegations. Vasquez declined to comment through a representative from his union.

In pretrial filings, government lawyers said Vasquez’s handling of PREA was “irrelevant and immaterial.” The case was not about whether Mahkimetas was punished for attacking her, the lawyers told the judge. It was also not about her cell’s missing duress alarm; alarms are provided at the bureau’s discretion, they said, and are not required.

As far as the government was concerned, the only relevant questions were: Did the officer on duty the day of the attack know Pinson’s cellmate had threatened to rape her? And, if so, did he fail to separate them?

Federal District Judge Rosemary Márquez agreed and denied Pinson’s request to call witnesses about the rape elimination law.

On the stand during the trial, Vasquez testified he was “100 percent positive” that Pinson did not warn him in advance that Mahkimetas had threatened to rape her.

Pinson later tried to get Vasquez to admit that he didn’t always act on requests to change cellmates. “If a cellie is telling staff they’re about to be raped, what’s the response?” she asked.

“We would move them immediately,” Vasquez said.

She talked about her gender identity and the Bureau of Prisons’ failure to “recognize me for the woman that I am.”

In an attempt to keep the focus on her suffering, Pinson put her psychologist on the stand and asked him about her experiences of being assaulted, about her anxiety, her self-harm, her PTSD. She talked about her gender identity and the Bureau of Prisons’ failure to “recognize me for the woman that I am.” She asked the officer who investigated Mahkimetas’ assault if he had treated the cell as a crime scene or reviewed video of that night. (He did neither, he testified.)

In closing arguments, one of the government’s lawyers repeated that these issues “have no bearing.” The judge was clear in her pretrial ruling, he reminded her. “Plaintiff focuses on these extraneous issues because she cannot meet her burden to prove that alleged negligence actually occurred in this case.”

Every year since 2016, the penitentiary in Tucson has been among the top 5 percent of federal facilities with the most allegations of sexual abuse or harassment, according to federal data analyzed by The Marshall Project.

Incarcerated people and prison workers alike attribute the high rate of sexual assault at the prison in part to the mix of people housed there. The penitentiary in Tucson is home to a sex offender treatment program, one of 10 throughout the federal system. People convicted of sex offenses are widely despised and often targeted for physical and sexual abuse in prison.

“Those people are more likely to be victimized. But then they also are predators,” said Jill Roth, a psychologist who retired as the bureau’s PREA coordinator in 2021. “In an institution with a sex offender treatment program, you’ll usually have a lot more allegations” of prisoner-on-prisoner sexual assault and harassment.

The program at Tucson is the only one in a high-security penitentiary that holds people with serious or violent convictions or disciplinary problems. Keith Raniere, convicted of sex trafficking as head of the NXIVM sex cult, is incarcerated in Tucson. Larry Nassar, the disgraced USA Gymnastics doctor who molested hundreds of girls in his care, was there for a time too. Roughly 60 percent of the population at the penitentiary is in the sex offender program, according to numbers provided by the Bureau of Prisons.

In a prison full of predatory men, transgender women are a ready target. Trans people in prison are sexually assaulted at a much higher rate than prisoners in general. A federal survey published in 2014 estimated that nearly 40 percent of transgender people in prison were sexually assaulted, compared with 4 percent of all people in prison. According to the bureau’s data, the penitentiary in Tucson houses 120 transgender women, more than any other federal prison.

Under PREA’s rules, prison officials should decide where to house transgender people on a case-by-case basis, with the person’s “views with respect to his or her own safety…given serious consideration.” Yet, in practice, transgender people are almost always housed according to their sex assigned at birth. Last year, of the more than 1,000 transgender women in federal prison, only 10 were held in women’s facilities, according to information that bureau Director Colette Peters provided to Congress.

PREA also requires that staff assess each person’s “risk of sexual victimization,” and in a statement, spokesperson Scott Taylor said the Bureau of Prisons “uses that information to inform housing, bed, work, education, and program assignments.” Taylor said the bureau “works to ensure the best fit for everyone in our care and custody.”

Despite all of its infrastructure, PREA often fails to protect vulnerable people like Pinson, prisoners and correctional experts say. Effective implementation relies on the good faith of prison staff, many of whom share the prejudices against LGBTQ people that make them vulnerable in the first place. To Pinson, because the law includes few repercussions for staff who break it, her lawsuit was an opportunity to prove the devastating consequences of their indifference.

But the dynamics of victimization are complicated. At the Tucson penitentiary, 75 percent of the transgender women—who as a population are so vulnerable to sexual assault—have committed sex crimes, according to data provided by the Bureau of Prisons. For them, lonely men can also be targets, Pinson and others say.

“Some people are doing forever in there. They want companionship,” said Eric Ontiveros, who served time with Pinson at Tucson. Some transgender women exploit that loneliness and “use that to manipulate the situation in their favor, to get money, drugs, whatever they need.”

“Some people are doing forever in there. They want companionship.”

Public health research suggests that LGBTQ people are more likely than others to be convicted of sex offenses, though it’s unclear whether this reflects over-policing, unfair treatment within the system, or other dynamics is difficult to say, says Ilan Meyer, a public health researcher at UCLA law school. Transgender people face significant barriers in housing, education, and employment, and those limited opportunities can force people into sex work and other black market jobs that can lead to legal trouble, research shows.

After an incarcerated person reports a sexual assault, PREA requires that the prison conduct an internal investigation. Federal prison investigators almost never prove, or “substantiate,” that an assault happened. From 2016 through last year, officials corroborated fewer than 6 percent of the 4,100 allegations in federal prisons, according to bureau data analyzed by The Marshall Project. Tucson’s rate was similar to the national rate. At dozens of facilities each year, investigators don’t substantiate any allegations at all.

Experts say prison investigators should confirm far more reports of assault because under PREA they do not have to meet the high bar of “beyond a reasonable doubt” required in a criminal courtroom. Instead, investigators must be more certain than not—at least 51 percent sure—that an assault happened.

“PREA fails in a whole shit-ton of ways,” said Julie Abbate, an attorney who helped implement the law while working at the civil rights division of the Department of Justice in the 2010s and now works for an organization dedicated to ending prison rape.

Bureau of Prisons leadership “say the right things at the headquarters level, and, for the most part, I believe them,” she said. “The disconnect happens between headquarters, regional offices, and individual facilities.”

Several correctional experts noted that investigators too often discount testimony if it comes from incarcerated people. “The only people that say it happened were inmates,” was a common refrain at the penitentiary in Tucson, according to a recently retired bureau official who asked not to be named because they still have family working at the agency. A 2022 report by the inspector general who oversees the bureau said investigators’ practice of not relying on this testimony also makes it harder for the agency to punish staff who break rules in other ways.

Giamusso, the bureau spokesperson, said in an emailed statement that the inspector general’s concerns have been addressed, that investigations are thorough and witnesses’ credibility is “evaluated on a case-by-case basis, and is not based on the individual’s status as an incarcerated individual.” Sexual abuse investigations in prison, she added, “are as complicated, if not more so, than those outside of prison.”

For all its shortcomings, PREA does offer victims and those at risk of sexual assault one protection: Each allegation sets in motion a chain of events—reporting, investigation, response. Other kinds of physical assault are often downplayed or ignored by prison officials. No federal law requires officers to investigate when an incarcerated person is beaten or stabbed. In a place where incarcerated people feel helpless and silenced, PREA can become an avenue to make someone take notice.

“You’re looking at people who have very few options,” said Cathy Thompson, who retired last year as a top psychologist at the Bureau of Prisons. “There’s nothing else they can allege that is given that kind of attention.” Staff, correctional experts and incarcerated people alike report that PREA allegations can be misused for a variety of reasons, like retaliating against an ex-lover, or having an enemy removed from a compound.

“Someone legitimately made me feel so unsafe that I did not feel I could spend another 24 hours with them having access to me without hurting me.”

Pinson herself has been accused of using false allegations of sexual harassment “as a weapon against other inmates,” according to incident reports the government filed in response to one of her lawsuits. She denied this but did concede that sometimes PREA is the only way to get officers to take a scary situation seriously. “Every single person I have filed a PREA complaint against them, I can tell you this much is true: I genuinely feared that person was going to hurt me,” she said. “Whether I feared they were going to rape me is a different story. Someone legitimately made me feel so unsafe that I did not feel I could spend another 24 hours with them having access to me without hurting me.”

She insists that in the case of Mahkimetas, the attempted sexual assault was real, and terrifying. But when it came to PREA, it was her word against his: There were no cameras in their cell and no eyewitnesses. Investigators at the Tucson penitentiary labeled Pinson’s allegation that Mahkimetas tried to rape her as unsubstantiated.

She had little redress beyond going to the courts.

In some of Pinson’s earliest memories, she is rummaging through her mother’s jewelry box, trying on the shiny baubles and makeup. “And my mom would just look at me with amusement and befuddlement,” Pinson recalled in an interview. Debra Pinson didn’t know what to make of this child of hers. When, as a teenager, Pinson told her mother she was a girl, Debra replied, “You’re just gay.” Grace didn’t argue.

Extremely precocious, Pinson was also troubled. She began reading the newspaper before she started kindergarten, her mother recalled. Debra’s father was “so abusive and so tortuously cruel” to Grace, according to a psychologist’s court testimony, once locking her out of the house overnight in the winter. A neighbor began sexually abusing her when she was 7, and she was hospitalized for psychotic symptoms and suicide attempts several times throughout her childhood.

In school, Pinson was bullied by other kids who called her “queer” and “fag.” Whenever she had problems at school, her mother would move them—they moved a lot. Children can be vicious, and so could Pinson. Once, she stabbed a classmate with a pen. She threatened to blow up her school with her Toys R Us chemistry set. Debra Pinson recalls one psychiatrist telling her, “Ma’am, your child is just evil.”

Pinson was diagnosed at different times with bipolar disorder, schizophrenia and PTSD. “Pinson had not experienced any significant period of effective psychological functioning since early childhood,” according to a court evaluation.

At some point in her adolescence, her mother gave up and didn’t enroll Pinson in school at all. That meant even fewer checks on her impulsive behavior. While living in North Carolina, she got into trouble with the law, ransacking an office where she worked after she said a coworker made a homophobic comment. She pleaded guilty to several felonies and spent time in a county jail and a psychiatric hospital. They moved again.

In Oklahoma City, she was arrested again. She had gotten a job in a congressman’s district office and was accused of stealing campaign money. In recent interviews, she said she spent money she was told to spend, but in 2003, at age 17, Pinson pleaded guilty to embezzlement and was sentenced to three years in an adult state prison.

While waiting for her case to be resolved, Pinson spent months in the Oklahoma County jail. At that time, the US Department of Justice was investigating conditions at the jail and a report released years later revealed violence, overcrowding, and inadequate access to medical and mental health care, among other problems. It was not a safe place for anyone, let alone a teenage transgender girl. She had been experimenting with female pronouns for years, and it was in jail that she read a book with a chapter called “Grace,” and thought, “That’s me.”

Pinson said her cellmate at the state prison—which Pinson said was even more violent than the jail—told her about the cushy setup in “Club Fed,” a slang term for federal prison. All she needed to escape the oppressive conditions in the Oklahoma system, she was told, was to commit a federal crime. So she dashed off a seven-word letter and mailed it to the White House. “YOU WILL DIE SOON!” she scrawled. “DIE BUSH DIE.”

“I thought I was playing a big prank on the federal government,” she said in a recent interview. “As it turns out, I was playing a prank on myself.”

“I thought I was playing a big prank on the federal government. As it turns out, I was playing a prank on myself.”

The Secret Service descended on the Oklahoma County jail. Sitting in endless interrogation sessions and facing a slew of new charges, it dawned on her that she had traded a three-year state sentence for much more serious trouble. Still, she scrawled more threatening letters, “in impotent anger at a situation that I had created myself,” she told me: one to a Secret Service agent, one to a US Marshal, one to a judge.

Pinson emerged from the letter-writing spree with a new sentence: 21 years. She arrived in a maximum-security federal prison in 2007 and discovered that for a transgender woman, it was hardly “Club Fed” at all.

By the time she was processed into federal prison, Pinson had already suffered stabbings, beatings, and sexual assault in Oklahoma, she said in court papers. She filed more than half a dozen lawsuits, accusing sheriffs and corrections officials there of failing to keep her safe. In each of those instances, the cases were dismissed, or Pinson lost, or gave up and voluntarily dismissed the case when it was clear she was not going to win.

These were her first lessons in the Prison Litigation Reform Act. The 1996 federal law, passed during an era of tough-on-crime legislation, “made cases harder to bring and harder to win,” said Margo Schlanger, a law professor at the University of Michigan who studies civil rights litigation. It was meant, she said, to stem what legislators described as a wave of frivolous prisoner lawsuits by throwing up legal hurdles that no one else faces in the courts.

Pinson’s early years in federal prison did not go well, either. She tried to repress her gender identity, wearing a beard and short hair and joining a gang for protection. She fought with other incarcerated people and guards; she set fires and flooded cells.

A psychologist had testified at her sentencing that she would need intensive mental health treatment, so the judge recommended she be sent to a federal medical center for care. Instead, she was sent to some of the system’s most notorious penitentiaries, including one known as “Bloody Beaumont” and the supermax in Florence, Colorado, where she was held in solitary confinement alongside the Unabomber, Ted Kaczynski. The placements meant “extreme violence and trauma,” Pinson wrote in a 2008 legal filing, which “exacerbated and worsened Plaintiff’s mental state.” According to lawsuits she filed later, she was sexually harassed and assaulted.

When PREA went into effect in 2012, it created new procedures to keep people safe from sexual assault, but it did not create a way to sue officials when they failed to follow those rules.

“All transgender inmates interviewed reported that they were asked about their safety but felt staff did not take their concerns seriously.”

The law does require prisons to hire outside auditors to assess their compliance. But audits are often rushed and cursory, according to Abbate. Tucson’s most recent audit, in 2023, said, “All transgender inmates interviewed reported that they were asked about their safety but felt staff did not take their concerns seriously.” Still, the auditor gave the prison high marks and did not require any corrective action.

“Every supposed mandate that is included within the guidelines has weasel language that the government can use to say, ‘Well, we can’t really be held to it, we’re only required to make reasonable efforts,’” said Gregory Sisk, a professor at the University of St. Thomas School of Law in Minnesota who represented a transgender woman who said she was sexually assaulted at the penitentiary in Tucson. She sued the Bureau of Prisons and lost.

Pinson learned all this the hard way. “I learned to litigate through books and I learned to litigate through filing lawsuits, and ultimately losing a lot of them,” she said. “But the thing is, I’m an incredibly stubborn individual.”

In 2012, while at the supermax unit in Colorado, Pinson was a plaintiff in a landmark class action lawsuit that challenged the use of solitary confinement for people with mental illnesses. The case ultimately led to an overhaul of the bureau’s treatment of mentally ill people, updating policies and creating new housing units and treatment programs.

She “has a brain for law,” said Deborah Golden, one of the lead attorneys on that case. Pinson was smart and organized and “by self-training and instinct she was really good at figuring out relevant facts,” she said. “Maybe in a different world, she would have been a law professor.”

In 2014, prison psychologists diagnosed Pinson with gender dysphoria—the distress resulting from her body not matching her gender identity—and she began to receive hormone therapy. Still, housed among men and being harassed and assaulted, hormone therapy alone has not adequately treated her gender dysphoria, she said. Her records include a long list of suicide attempts and self-harm, including trying to castrate herself in her cell.

Pinson has asked the Bureau of Prisons many times to move her to a women’s facility. Each time, the bureau’s Transgender Executive Council—a team of psychologists and administrators who make decisions about trans people in federal prison—have said no, arguing that Pinson needs to stay in maximum security and isn’t on the proper dosage of hormones. A lawsuit Pinson filed requesting a transfer to a women’s prison and gender-affirming medical treatments is ongoing. The judge in that case has issued several rulings in her favor, ordering the government to provide her with female undergarments and toiletries and to make housing decisions about her as they would about any other woman.

In a case brought by another trans woman, Cristina Iglesias, a judge found in 2022 that the Transgender Executive Council offered shifting and contradictory reasons to deny Iglesias’ transfer to a women’s facility and her access to surgery. The judge ultimately ordered the bureau to provide Iglesias with gender-affirming surgery, which it did last year—only the second time the bureau has ever done so.

In 2018, Pinson arrived in Tucson, where she kept landing in the special housing unit after a series of assaults. Special housing in Tucson is structured like solitary confinement with a cellmate: two people locked in a claustrophobic concrete box together around the clock, with little access to programs, work, or recreation.

Still, people build relationships in the most austere circumstances, passing notes under cell doors and talking through cages in the rec yard, and Pinson has made a lot of friends in prison. One of them, Bruce Altenburger, wrote in a recent letter to me that Pinson often spotted errors in people’s convictions or sentences and helped correct them. “There really ain’t too many remarkable individuals with such a big heart like her.”

In 2020, Pinson had been in special housing for most of the year following Mahkimetas’s assault. Officials would not allow her to transfer back into a less restrictive part of the prison, even after she filed numerous complaints. In an act of protest, she said, she used a razor to cut herself 243 times—one for each day she had been held in the special housing unit, by her count. Then, she sued, arguing officers at Tucson should not have provided her a razor blade, given her long history of suicide attempts and a rule that prohibited razors in special housing. After a two-day trial, the judge found her more credible than the officer who denied having given her the razor. That officer was Vasquez, the same man who insisted that Pinson had not warned him about Mahkimetas before she was attacked. The judge awarded her $243 in damages: one dollar for each cut.

In Pinson’s lawsuit about Mahkimetas’ assault, she argued that officials had failed to protect her by not providing a functional duress alarm. In pretrial briefs, she asked the government about procedures for responding to emergencies in a cell, but the bureau’s lawyers told her there were no such documents. In the absence of any rule requiring duress alarms, the government argued, the bureau could decide whether or not to provide one.

Because the judge agreed with the bureau, the only issue at trial was whether Pinson had warned Vasquez that Mahkimetas had threatened her, and, if she did, whether she was seriously harmed by his failure to move her.

In its closing argument, the government’s lawyers laid out other times that Pinson was injured while in the custody of the Bureau of Prisons. “She’s been stricken by a sock with a lock in it. She was attacked in the general population on the prison yard,” Assistant U.S. Attorney Michael Linton told the judge. Then there was “a more recent incident involving an inmate swinging a rope with a sharp object at her.” She couldn’t prove that she had developed PTSD due to Mahkimetas’ assault specifically, the attorney argued—so the judge should not find in her favor.

As the trial was winding down, government attorneys handed Pinson a document. They had told the court months before that there were no documents regarding duress alarms, but after “re-reviewing” their paperwork, they said, they were turning over instructions for officers working in the special housing unit in Tucson. Amid pages of blacked-out language, one paragraph said that each cell in the special housing unit contains a duress button on the wall. The instructions continued, “In the event that the duress alarm is pushed…Staff must immediately respond to the cell.”

Pinson was floored.

She asked the judge for a mistrial. The trial had been shaped by the government’s claim that there were no rules about duress alarms, Pinson said. The judge said she would consider the request, but that closing arguments would continue in the meantime. A few hours later, the trial was over, and Pinson went back to her cell to wait for the judge’s verdict.

Two months later, the Bureau of Prisons transferred Pinson from Tucson to a more restrictive unit in rural Pennsylvania. She was locked in an 8-by-10-foot cell by herself around the clock. The bureau said the unit “is designed to support individuals vulnerable to mental health crises.” Pinson believes that the warden in Tucson was retaliating against her because of her outspokenness. Others she served time with in Tucson thought so too. In requesting the move, the warden had said Pinson was fabricating PREA allegations and recruiting other transgender people to invent complaints about their treatment by the prison’s staff. He said she was a disciplinary problem and needed more intensive supervision. The near-total isolation in her new prison cell led her to constant thoughts of suicide, she said. She also said she was sexually assaulted again, this time by a correctional officer, and filed a complaint with the Bureau of Prisons.

Bureau spokespeople declined to explain why Pinson was transferred, and wouldn’t comment on her allegation of sexual abuse. “Allegations of misconduct are thoroughly investigated, and appropriate action is taken if such allegations are proven true,” said spokesperson Emery Nelson.

Pinson is scheduled to be released from federal prison in 2026 after serving more than two decades. When she gets out, she will be 40 years old, free for the first time in her adult life.

In June, a prison staffer arrived at Pinson’s cell with a slim manila envelope from the court: The judge had ruled in her case.

Márquez did not grant Pinson’s request for a mistrial. She did not find that the government was negligent by placing Pinson in the cell with Mahkimetas. She did not believe that Pinson had asked Vasquez to be moved. But the judge did find the government had violated its own guidelines by not having a functional duress alarm in the cell and that if Pinson had had access to the alarm, she would have had officers there to help her within one minute.

Because it took about five minutes for staff to respond, Pinson was beaten unnecessarily for approximately four minutes, the judge wrote in her decision. With an alarm, Pinson would have still been beaten, but her injuries would have been less severe. The judge ordered the government to pay her $10,000. The bureau declined to comment on the ruling.

Pinson is gratified that the judge found in her favor, but frustrated she was prevented from making a broader point—one that was, in her mind, more important—because of how the judge limited the issues at trial. She has filed paperwork to begin an appeal.

Because she wasn’t allowed to introduce evidence of all the other sexual assaults in Tucson, she said, the judge could only weigh this one incident and Pinson was prevented from showing that her suffering was part of a larger pattern of staff disregarding PREA and not taking sexual assault seriously. In a recent call, Pinson reflected on how the experience continues to weigh on her. “The thing that has driven me crazy in this case, start to finish,” she said, “is that the bureau was never willing to acknowledge, not even at the trial, that it could have done things differently to keep me safe.”

Additional reporting by John Washington. Data analysis by Geoff Hing.

“Today’s newsletter will probably overwhelm you,” Jessica Valenti wrote in a note preceding the Wednesday, September 25, edition of Abortion, Every Day, the Substack where she breaks down the news on reproductive rights. The first order of business: an explanation of how a powerful anti-abortion group is directing an ad campaign that blames pro-choice advocates for the deaths of Candi Miller and Amber Nicole Thurman. Miller and Thurman were two Georgia women who, according to a ProPublica investigation, died because of the state abortion ban. “Honestly, how dare they,” Valenti wrote. “How dare they use these women’s names; how dare they use their pictures. It’s just beyond the pale.”

The same newsletter also covered Florida Gov. Ron DeSantis’ efforts to oppose adding the right to abortion to the state constitution, a report on the increasing criminalization of pregnancy since the end of Roe v. Wade, and a summary of a New York Times/Reveal investigation into Florida maternity homes. That wasn’t even all of it—and that was just Wednesday.

Valenti, known for her previous columns at the Nation and the Guardian, has written about feminism and politics for nearly two decades. She started Abortion, Every Day almost immediately after the Dobbs v. Jackson Women’s Health Organization ruling leaked, when she found herself unable to turn away from the news. “It was not a deliberate pivot,” she tells me in a phone interview as she prepares dinner for her family in Brooklyn. “I was just so mad and upset. Like so many people, I think I just wanted to know everything, so I just started writing about it.”

She never stopped. “Hilariously,” Valenti says, “I really did ask myself in the beginning, ‘If I do this, am I going to have enough stuff to write about every day for more than a few months?’” Now, Valenti writes a newsletter every day of the workweek—mostly on her own, though she recently hired an assistant and a part-time researcher. She’s also gathered enough material to fill a new book, Abortion: Our Bodies, Their Lies, and the Truths We Use to Win, out this month. From the very beginning of Abortion, Valenti makes the case that the deluge of news is itself a part of the anti-abortion movement’s strategy. “The anti-abortion movement is hitting Americans with everything all at once in the hopes that those of us who want our rights back will be too exhausted and crushed to fight back,” she writes in the introduction. “It’s hard for any single person to keep track of all the anti-abortion attacks and tactics happening in different states around the country. But it’s vital that we do.”

It’s only by tracking the day-to-day onslaught that Valenti says she and, by extension, her readers can see the full scope of the attack on abortion rights. “I can see a difference in my own knowledge if I skip a day in the newsletter,” she says. “Things are moving so quickly.” If that seems exhausting, well, it is. “I think everyone who is working on this issue is in a very similar place, and I worry about burnout for myself and everyone who does this work because you can feel the impact physically,” Valenti says. “You start losing sleep. It takes a toll on your health.” Since beginning the newsletter, Valenti says she’s given up on seeing almost anyone besides her husband and 14-year-old daughter, Layla.

Layla is the reason Valenti does this work. “It was her I cried for the night the Dobbs decision was leaked,” Valenti writes in Abortion. “I remember crawling into bed with my husband and sobbing. Wailing, really. I kept saying, ‘My daughter, my daughter.’ A mother’s job is to protect her children. How could I possibly do that now?” The newsletter, and now the book, were the answer. The twist is that the work dedicated to Layla pulls Valenti away from her. “She went from having a mom who is writing a weekly column and who is super-present to someone who’s just not,” Valenti says. “It’s a mind fuck, that’s for sure.”

Although Abortion, Every Day began almost by accident, Valenti has in some sense been preparing her whole career for this. After earning a master’s at Rutgers University in women’s and gender studies, she worked as a communications assistant for a feminist organization. A friend encouraged her to start blogging, and in 2004, she and sister Vanessa founded Feministing, which would become one of the most widely read feminist publications in the country during its 15-year existence, with more than 1.2 million unique monthly readers at its peak.

The goal behind her writing was to give young feminists the tools they needed to speak more confidently about their beliefs. “One of the things that I heard, and continue to hear most often, especially from younger women, is this feeling like someone is going to think that they’re stupid or that they don’t know what they’re talking about,” Valenti says. “So the hope was to provide the language, the context, the information that folks needed to say the stuff that they already believed but didn’t necessarily have the language for.”

That idea continues to be a driving force behind Valenti’s work on Abortion, Every Day and her new book. At the back of Abortion, there is a section of quick facts (“Decades of research have shown that both procedural and medication abortions are safe”) and statistics (“States with abortion restrictions have maternal death rates that are 62 percent higher than states with abortion access”) designed so readers can quickly find what they want to reference when talking about the issue, whether that’s on social media or face to face with family and friends. “Sometimes people ask me if I feel like I’m ‘preaching to the choir.’ What I tell them, and what is true about this book, is that I’m arming the choir,” Valenti writes in Abortion.

Valenti wasn’t always the type of person who could pull these kinds of facts from memory herself. “I was not a wonk by any means,” she says. “I could not tell you about ballot measure shit two years ago. It was not something that was on my mind at all.” But her blogging days gave her a bit of a head start on keeping up with the strategy. In 2009, she published The Purity Myth, an investigation into America’s obsession with virginity. Now, she says, the people she wrote about then, who were focused on anti-sex education campaigns, have come back to haunt her. “It really is all the same people,” she says. “They’re still doing the same thing, and honestly, it is a little weird because they’re using the same tactics, they’re using the same language. They haven’t changed much, which shouldn’t surprise me, but it does.” The difference now is that she knows that the fight is not just about purity, or even just about abortion. It’s about birth control, freedom of movement, and defending democracy. It’s more existential.

Although the subject she covers is obviously heavy, there’s a certain catharsis for Valenti in connecting all the dots in her newsletter and book, in unmasking a movement that’s been encroaching on abortion rights for decades. Valenti says that before Roe was overturned, abortion advocates often felt “gaslit, not just by anti-abortion people, but by leftist dudes and pundits who were like, ‘You’re being hysterical,’ and, ‘Don’t scaremonger.’”

The fight is not just about purity, or even just about abortion. It’s about birth control, freedom of movement, and defending democracy. It’s more existential.

Now, all the threats she and others warned about have become reality. It’s, as Valenti puts it, “horrible and also so incredibly fucked,” but after the years of being called hysterical, it feels good to read someone who is honest about the situation and still as angry as she was two years ago. “It’s a terrible thing to write about every day, to read about every day, to think about. Unfortunately, it’s also something we can’t escape, because it is happening,” she says. “My fear is people reading these stories and sort of being like, ‘Oh man, that’s horrible,’ and turning the page. There’s a reason they’re trying to overwhelm us, right? They know that they can make us numb to it.”

Part of what keeps Valenti from becoming numb is the occasional joy she takes in the ability to “fuck some of them over.” Take, for example, Alabama Attorney General Steve Marshall, who said in a 2022 interview that his state’s abortion ban does not criminalize mothers. While searching through news for Abortion, Every Day, Valenti found a comment from Marshall’s office to a local conservative blog, assuring concerned readers that even though the abortion ban wouldn’t allow women to be prosecuted, it wouldn’t stop the office from charging women who had medication abortions under a chemical endangerment law meant to protect children exposed to drugs. “In other words, Alabama’s Attorney General plans to arrest and charge women who take abortion medication…using a law meant to stop adults from bringing kids to drug dealers’ houses,” Valenti wrote in her newsletter. “So much for not jailing women!”

Marshall’s office’s comment to the blog hadn’t otherwise been reported, but after Valenti wrote about it in Abortion, Every Day, it was picked up in local and national outlets. Two days after her newsletter, Marshall backtracked, telling the press that women would not be prosecuted for taking abortion pills.

“What makes me happy about the project are the people who are reading it,” Valenti says. Her readers include people who work directly in abortion access, but also Senate staff and reporters. A few times a month, Valenti says she’ll read a piece she feels like she could’ve written herself and, when she types the reporter’s name into her subscriber list, is delighted to find them there. “It’s been really amazing to see the growth of reporters,” she says. “As horrible as it is, since we’re gonna have to be doing this for a long time, I hope that we’ll see a new generation of reporters who started writing about this issue when they were young and then are just gonna be so outrageously knowledgeable 10 years from now.”

Ten years from now is hard to imagine. Ten years ago, we still had Roe, but the anti-abortion movement was taking hold in the states. The Guttmacher Institute issued a worrying report in 2014 on “an unprecedented wave of state-level abortion restrictions.” A February article in Time that year described how anti-abortion advocates were “looking to turn abortion into an animating issue for the Republican Party.” Valenti was just beginning her stint at the Guardian. She sometimes wrote about abortion in her column. When someone emailed her, she’d get back when she could. It wasn’t urgent.

Now, the emails in Valenti’s inbox come from 17-year-olds who are wondering where they can get abortion medication, from people seeking legal advice, from people whose stories need to be told now. Maybe, Valenti says, she could see herself slowing down the pace of her work in a world with reasonable federal abortion protections. But for now, 13 states have a total abortion ban. Hospitals in those states are unable to recruit OB-GYNs, and maternal health wards are closing. Anti-abortion groups are sowing distrust about birth control. Some pregnant women are being prosecuted; others are bleeding out in parking lots. “No matter what happens in November, we’re still going to be fighting this fight for years, if not decades,” Valenti says. So she will continue tracking the daily churn of legislation moving through statehouses, politicians making crude remarks, and reports on the impact Dobbs has had across the nation. She has to.

In late August, on the fringes of a press conference outside New York City Hall, a man wearing a “Kill your local pedophile” T-shirt and a “Babies Lives Matter” pin screamed at a transgender woman who had shown up to protest the speeches. “Is it a boy or a girl?” the man yelled at the protester, gripping a rainbow Trump flag in his fists. “She shaves her armpits, so it must be a man,” he spat, cursing and hurling epithets. 

On the podium, the transphobic messaging was less vile but no less overt. Speakers were urging the small crowd to vote against Proposal 1, a measure on the November ballot that would strengthen protections for abortion in New York state—and much more. Prop 1 is a statewide version of the Equal Rights Amendment (ERA), the 101-year-old feminist effort to guarantee equal rights for women in the US Constitution. While the federal ERA has been largely stalled since the 1970s, many states have adopted their own versions. New York’s constitution, however, currently bans discrimination based only on race and religion, not sex. That could change if voters accept Prop 1’s expansive vision of equality, which includes protections for segments of the population that historically have been marginalized and demonized, including LGBTQ people.

In a year in which support for abortion rights could determine control of statehouses, Congress, and the presidency, Prop 1 seemed like a shoo-in, especially in the blue state of New York. Yet with a little over a month before the election, the effort to pass the New York ERA has been stumbling. An opposition campaign, calling itself the Coalition to Protect Kids, has fixated on the amendment’s protections for trans people, exaggerating its impact on women’s sports and pushing misleading claims about its effects on parental rights. “By solidifying new constitutional rights based on gender identity, Prop 1 is sacrificing the rights of girls,” Amaya Perez, the New York chapter leader of Gays Against Groomers, a right-wing group known for pushing extremist anti-LBGTQ narratives, said at the press conference. 

Those tactics appear to be working. Leaked polling from the pro-Prop 1 campaign shows that voters find the opposition’s messages extremely persuasive. Months ago, Democrats saw the amendment as a means of motivating liberal turnout in November. Now, state Democratic politics are in a precarious state following the indictment of New York Mayor Eric Adams, and Republican candidates are turning the tables, using opposition to Prop 1 as a rallying cry for their own voters.

“They’re trying to use [trans rights] as a wedge issue,” says Faris Ilyas, policy counsel at the New Pride Agenda, an LGBTQ rights group supporting Prop 1. “Even in New York, it’s a working strategy. We’re a little bit scared of what might happen in November.”

It’s an old trick in conservative politics to argue that equal rights are bad for women. The federal ERA, which says equal rights cannot be denied “on account of sex,” was first drafted by leaders of the women’s suffrage movement in 1923 and introduced in every session of Congress for the next five decades. After it finally passed both the House and Senate in 1972, the next step was to go to the states: An amendment must be ratified by three-quarters of state legislatures before it can be added to the US Constitution. But conservative lawyer Phyllis Schlafly mounted a successful guerrilla campaign claiming the amendment would erase all differences between men and women in the law, thus forcing women into military combat, permitting same-sex marriage, and allowing men to use women’s restrooms. The ERA failed to reach the ratification threshold within the seven-year deadline, though efforts to revive and certify it continue.

Even without the ERA, Schlafly’s predictions have more or less come true: The culture already was shifting toward the kinds of gender equality the amendment attempted to codify. Yet her arguments still hold power. Warnings about mixed-gender bathrooms were used to defeat Houston’s Equal Rights Ordinance in 2015—around the same time conservative legal and political organizations, including the Schlafly-founded Eagle Forum, began whipping up the contemporary anti-trans panic, starting with bills restricting trans students’ bathroom access.

The version of the ERA that will appear on New York ballots doesn’t include the word “abortion,” but it was designed first and foremost to protect the right to choose. The effort started in 2019, when Democrats took control of the state Senate for the first time in a decade. They swiftly passed the Reproductive Health Act, removing abortion from New York’s criminal code—where it had been largely forgotten during the Roe v. Wade era—and protecting access to the procedure through 24 weeks’ gestation. (The new law also allowed abortion later in pregnancy if the fetus was not viable or if the pregnant person’s life or health was in danger.) But soon after, state Sen. Liz Krueger of Manhattan, who had spent a decade shepherding the new law, decided the work wasn’t done. “I realized, nope, not good enough,” Krueger says. “We’ve got to actually start to open up our constitution and modernize it.”

With the confirmation of Justice Brett Kavanaugh to the US Supreme Court in 2018, anti-abortion strategists finally had the far-right majority they needed to overturn Roe. “We were basically a pro-choice blue state with people not really understanding how at risk we were from bad law,” Krueger says. If New York enshrined abortion rights in the state constitution, she figured, those protections would be harder to repeal if the political winds eventually shifted.

So Krueger and Assembly Member Rebecca Seawright, also from Manhattan, convened scholars and reproductive law experts to craft an amendment. Rather than simply writing protections for abortion seekers into the constitution, they decided to swing for the fences: a measure modeled on the federal ERA but even broader. In addition to existing protections for race, color, and religion, Prop 1 would ban government discrimination based on disability, age, ethnicity, national origin, and sex—including sexual orientation, gender identity, and gender expression. The resulting amendment, now known as Prop 1, would make New York’s anti-discrimination protections the “most extensive” in the nation, says Ting Ting Cheng, director of the ERA Project at Columbia Law School, who consulted with the drafters. 

“We were basically a pro-choice blue state with people not really understanding how at risk we were from bad law.”

There are nine other abortion rights ballot initiatives across the country this year, but when it comes to reproductive rights, New York’s ERA is unique. While most of the other measures essentially restore Roe, New York’s approaches abortion “as a matter of gender equality,” says Katharine Bodde, policy co-director of the New York Civil Liberties Union, one of the amendment’s chief backers. To accomplish this, it explicitly says discrimination based on pregnancy status, pregnancy outcomes, and reproductive health care and autonomy count as “sex discrimination” and are forbidden. The idea is to leave little room for judges to interpret the ERA in ways that wouldn’t protect abortion rights or pregnant people in the future. After all, courts have wide latitude to interpret ambiguous language, and they sometimes reconsider their old interpretations—as the US Supreme Court did when it reversed Roe. This past spring, Florida’s Supreme Court overturned a prior decision that said the state constitution protected abortion—after being stacked with judges appointed by Republican Gov. Ron DeSantis. And the Iowa Supreme Court has upheld a six-week abortion ban despite the state’s ERA, which broadly enshrines gender equality but doesn’t get into specifics. “We’re taking no chances in New York with courts interpreting ‘sex discrimination’ narrowly,” Bodde says. 

That scares abortion opponents. New York’s Catholic bishops told their 35,000 mailing list subscribers in September that Prop 1 would “permanently legalize abortion without restriction” and “render impossible any change to the law if the hearts and minds of New Yorkers were ever to shift toward protecting the child in the womb.”

Prop 1 follows an ERA in Nevada two years ago, which passed with 58 percent of the vote after being pitched to the state’s fiercely independent residents as a means of protecting individual liberty. The Nevada ERA overcame opposition from anti-abortion forces—including the religious-right legal firm Alliance Defending Freedom—which predicted that the measure would void Nevada’s ban on Medicaid coverage for abortion. (It was right.) Next up: An expansive ERA is slated for the 2026 ballot in Minnesota, and another is on the table in Oregon. “It’s incremental,” Cheng says. “Every state that does something new, it creates a new bar or a new precedent for other states to go beyond that.”

These amendments work in two ways. First, they harden the state’s existing constellation of anti-discrimination laws by adding them to the state constitution. And second, they give individuals strong constitutional grounds to challenge discrimination by the government. In New York, Prop 1’s  protections for different “pregnancy outcomes” might be used to defend women from criminal prosecution after self-managed abortions or losing a pregnancy in a car accident—both of which have happened in New York, says Dana Sussman, senior vice president of Pregnancy Justice, a nonprofit legal advocacy group. And it might be used to challenge state hospitals that drug test pregnant women, sometimes without their knowledge or consent—policies that can lead to child protection cases and family separation.

Other activists hope the ERA could be used to overturn the state’s 24-week gestational limit, which forces some New Yorkers to travel out of state if—for one of the many reasons women can face delays in accessing care—they need a later abortion. Randi Gregory, vice president of political and legislative affairs at the National Institute for Reproductive Health Action Fund, believes Prop 1 would protect abortion rights “at all trimesters.” “We hope that it will be a framework for other states,” Gregory adds. “We’re really excited to be running an expansive and proactive amendment.”

But that’s only if they can get it passed—a task that looks increasingly daunting.

The coalition behind Prop 1 made big promises in June 2023, after New York Democrats’ embarrassing showing in the 2022 election. Their losses had helped flip control of the US House of Representatives back to the GOP, while former US Rep. Lee Zeldin, an anti-abortion Republican, came within 6 points of winning the governorship.

State Democrats evidently had an excitement problem—one they hoped the ERA could solve. Gov. Kathy Hochul and Sen. Kirsten Gillibrand told the New York Times that they wanted to use the amendment to motivate 2024 turnout. Progressive groups formed New Yorkers for Equal Rights, a committee that pledged to spend $20 million ginning up enthusiasm.

Yet in early September, Politico reported that the committee had raised less than $3 million to counter an opposition that had proven surprisingly well-organized and effective. Suddenly, Democrats were afraid of how Prop 1 might affect their candidates in tight races. In the ensuing scramble, Hochul announced $1 million for TV ads and direct mail and issued a statement: “It’s critical voters know that an abortion amendment is on the ballot in New York this year,” she said. “New Yorkers deserve the freedom to control their own lives and health care decisions, including the right to abortion regardless of who’s in office.”

The opposition campaign, the Coalition to Protect Kids, is largely funded by an upstate anti-abortion activist, Carol Crossed, who is vice president of Feminists Choosing Life of New York. Yet it has leaned heavily on anti-trans rhetoric, arguing the amendment would increase trans people’s access to girls’ sports, women’s bathrooms, and gender-affirming medical care—and that these things would be dangerous. “Anti-abortion extremists are pushing a harmful and cruel agenda,” says Sasha Ahuja, campaign director for New Yorkers for Equal Rights. “They’re lying about a small handful of innocent kids to divide New Yorkers and distract us from what this amendment is actually about: protecting the right to abortion, guaranteeing our personal freedoms, and protecting all of us against government discrimination.”

“They’re lying . . . [to] distract us from what this amendment is actually about: protecting the right to abortion, guaranteeing our personal freedoms, and protecting all of us against government discrimination.”

According to New York politics magazine City & State, internal polling shared with ERA proponents in late August found that 64 percent of voters would definitely, likely, or lean toward voting yes on the amendment when presented with its ballot language. But support plummeted by 24 percentage points after voters heard an attack message focused on girls’ sports, transgender protections, and immigration. (Another blatant lie spread by opponents is that Prop 1 would allow undocumented immigrants to vote.)

Ilyas believes the anti-trans messaging gains credence because many voters don’t have personal experience or relationships with trans people. “When you don’t know a trans person, you have this well-funded messaging at you, and people that you trust are saying the same exact thing and reiterating it, it makes sense for even the average New Yorker who’s middle of the road to believe it,” Ilyas says.

Anti-trans attacks have become a go-to strategy for conservative groups fighting abortion rights ballot initiatives. Opponents to Ohio’s abortion rights measure last year claimed it would permit minors to undergo gender-affirming surgery “without parents’ knowledge or consent” and dubbed it an “anti-parent amendment.” (Such surgeries for minors are very rare, and consent from parents or guardians is required.) In Missouri, a last-ditch lawsuit in September tried to block an abortion rights measure from this fall’s ballot by arguing that it might affect laws around single-sex bathrooms and that the voter petition should have disclosed that. (The state Supreme Court didn’t buy it.)

In New York, Prop 1 supporters have repeatedly pointed out that the amendment says nothing directly about trans participation in sports. In fact, trans inclusion in sports is already New York’s status quo, thanks to existing anti-discrimination laws and a state policy allowing trans students to participate on sports teams matching their gender identity. But like Phyllis Schlafly, Prop 1’s opponents love a dire warning: Lawn signs saying, “Save Girls Sports, Vote No Prop 1,” have become a regular sight in some areas. Republican politicians have been picking up on the theme, including Zeldin, the former congressman, and Gina Arena, a GOP candidate for the state Senate from the lower Hudson Valley.

On Long Island, Nassau County Executive Bruce Blakeman and the Republican-dominated county legislature passed a law this past summer blocking permits for women’s sports teams that include trans women, preventing them from using more than 100 county-run parks and athletics facilities. In response, the New York Civil Liberties Union sued the county on behalf of a women’s roller derby league, citing existing New York civil and human rights laws that forbid discrimination based on gender identity, sex, and disability. If the ERA was in the state constitution, lawyers for the league would doubtless argue that Nassau County had violated it as well. “Transgender athletes have been competing and allowed to compete in the state for a really long time now,” Cheng says. “That’s not going to change because of the ERA.”

“Transgender athletes have been competing and allowed to compete in the state for a really long time now. That’s not going to change because of the ERA.”

Still, uncertainty around which laws the ERA might challenge has been a boon to opponents. On its website, the Coalition to Protect Kids claims that banning age discrimination, for instance, would gut laws governing the drinking age, statutory rape, and parental consent for minors to receive medical treatments—especially gender-affirming care. Bodde dismisses these arguments as “misinformation” meant to “stir fear.” Courts have been clear that constitutional rights apply differently to minors and adults, she says, even despite laws forbidding age discrimination. “The state has long been able to create different rules when it comes to young people, whether that’s ensuring a certain age before people can learn how to drive or vote or purchase alcohol.”

But fear and confusion are powerful tools. Prop 1’s opponents have dubbed the ERA the “Parent Replacement Act.” On social media, the Coalition to Protect Kids has repeatedly cited the American College of Pediatricians, a misleadingly named fringe group of anti-LGBTQ doctors whose frequent declarations against gender-affirming care run counter to the conclusions of dozens of major medical associations. Sometimes the claims slip into self-parody: “If Prop One passes…children will mutilate themselves without the benefit of parental guidance,” reads a mailer sent to voters by the New York Republican State Committee. 

For Ilyas, who is transmasculine, the extremist rhetoric feels very personal—and deeply worrisome. “People don’t think that it could happen in New York, just because it’s New York,” Ilyas says. “These people do exist in New York, and they just maybe haven’t had an outlet.”

In late August, on the fringes of a press conference outside New York City Hall, a man wearing a “Kill your local pedophile” T-shirt and a “Babies Lives Matter” pin screamed at a transgender woman who had shown up to protest the speeches. “Is it a boy or a girl?” the man yelled at the protester, gripping a rainbow Trump flag in his fists. “She shaves her armpits, so it must be a man,” he spat, cursing and hurling epithets. 

On the podium, the transphobic messaging was less vile but no less overt. Speakers were urging the small crowd to vote against Proposal 1, a measure on the November ballot that would strengthen protections for abortion in New York state—and much more. Prop 1 is a statewide version of the Equal Rights Amendment (ERA), the 101-year-old feminist effort to guarantee equal rights for women in the US Constitution. While the federal ERA has been largely stalled since the 1970s, many states have adopted their own versions. New York’s constitution, however, currently bans discrimination based only on race and religion, not sex. That could change if voters accept Prop 1’s expansive vision of equality, which includes protections for segments of the population that historically have been marginalized and demonized, including LGBTQ people.

In a year in which support for abortion rights could determine control of statehouses, Congress, and the presidency, Prop 1 seemed like a shoo-in, especially in the blue state of New York. Yet with a little over a month before the election, the effort to pass the New York ERA has been stumbling. An opposition campaign, calling itself the Coalition to Protect Kids, has fixated on the amendment’s protections for trans people, exaggerating its impact on women’s sports and pushing misleading claims about its effects on parental rights. “By solidifying new constitutional rights based on gender identity, Prop 1 is sacrificing the rights of girls,” Amaya Perez, the New York chapter leader of Gays Against Groomers, a right-wing group known for pushing extremist anti-LBGTQ narratives, said at the press conference. 

Those tactics appear to be working. Leaked polling from the pro-Prop 1 campaign shows that voters find the opposition’s messages extremely persuasive. Months ago, Democrats saw the amendment as a means of motivating liberal turnout in November. Now, state Democratic politics are in a precarious state following the indictment of New York Mayor Eric Adams, and Republican candidates are turning the tables, using opposition to Prop 1 as a rallying cry for their own voters.

“They’re trying to use [trans rights] as a wedge issue,” says Faris Ilyas, policy counsel at the New Pride Agenda, an LGBTQ rights group supporting Prop 1. “Even in New York, it’s a working strategy. We’re a little bit scared of what might happen in November.”

It’s an old trick in conservative politics to argue that equal rights are bad for women. The federal ERA, which says equal rights cannot be denied “on account of sex,” was first drafted by leaders of the women’s suffrage movement in 1923 and introduced in every session of Congress for the next five decades. After it finally passed both the House and Senate in 1972, the next step was to go to the states: An amendment must be ratified by three-quarters of state legislatures before it can be added to the US Constitution. But conservative lawyer Phyllis Schlafly mounted a successful guerrilla campaign claiming the amendment would erase all differences between men and women in the law, thus forcing women into military combat, permitting same-sex marriage, and allowing men to use women’s restrooms. The ERA failed to reach the ratification threshold within the seven-year deadline, though efforts to revive and certify it continue.

Even without the ERA, Schlafly’s predictions have more or less come true: The culture already was shifting toward the kinds of gender equality the amendment attempted to codify. Yet her arguments still hold power. Warnings about mixed-gender bathrooms were used to defeat Houston’s Equal Rights Ordinance in 2015—around the same time conservative legal and political organizations, including the Schlafly-founded Eagle Forum, began whipping up the contemporary anti-trans panic, starting with bills restricting trans students’ bathroom access.

The version of the ERA that will appear on New York ballots doesn’t include the word “abortion,” but it was designed first and foremost to protect the right to choose. The effort started in 2019, when Democrats took control of the state Senate for the first time in a decade. They swiftly passed the Reproductive Health Act, removing abortion from New York’s criminal code—where it had been largely forgotten during the Roe v. Wade era—and protecting access to the procedure through 24 weeks’ gestation. (The new law also allowed abortion later in pregnancy if the fetus was not viable or if the pregnant person’s life or health was in danger.) But soon after, state Sen. Liz Krueger of Manhattan, who had spent a decade shepherding the new law, decided the work wasn’t done. “I realized, nope, not good enough,” Krueger says. “We’ve got to actually start to open up our constitution and modernize it.”

With the confirmation of Justice Brett Kavanaugh to the US Supreme Court in 2018, anti-abortion strategists finally had the far-right majority they needed to overturn Roe. “We were basically a pro-choice blue state with people not really understanding how at risk we were from bad law,” Krueger says. If New York enshrined abortion rights in the state constitution, she figured, those protections would be harder to repeal if the political winds eventually shifted.

So Krueger and Assembly Member Rebecca Seawright, also from Manhattan, convened scholars and reproductive law experts to craft an amendment. Rather than simply writing protections for abortion seekers into the constitution, they decided to swing for the fences: a measure modeled on the federal ERA but even broader. In addition to existing protections for race, color, and religion, Prop 1 would ban government discrimination based on disability, age, ethnicity, national origin, and sex—including sexual orientation, gender identity, and gender expression. The resulting amendment, now known as Prop 1, would make New York’s anti-discrimination protections the “most extensive” in the nation, says Ting Ting Cheng, director of the ERA Project at Columbia Law School, who consulted with the drafters. 

“We were basically a pro-choice blue state with people not really understanding how at risk we were from bad law.”

There are nine other abortion rights ballot initiatives across the country this year, but when it comes to reproductive rights, New York’s ERA is unique. While most of the other measures essentially restore Roe, New York’s approaches abortion “as a matter of gender equality,” says Katharine Bodde, policy co-director of the New York Civil Liberties Union, one of the amendment’s chief backers. To accomplish this, it explicitly says discrimination based on pregnancy status, pregnancy outcomes, and reproductive health care and autonomy count as “sex discrimination” and are forbidden. The idea is to leave little room for judges to interpret the ERA in ways that wouldn’t protect abortion rights or pregnant people in the future. After all, courts have wide latitude to interpret ambiguous language, and they sometimes reconsider their old interpretations—as the US Supreme Court did when it reversed Roe. This past spring, Florida’s Supreme Court overturned a prior decision that said the state constitution protected abortion—after being stacked with judges appointed by Republican Gov. Ron DeSantis. And the Iowa Supreme Court has upheld a six-week abortion ban despite the state’s ERA, which broadly enshrines gender equality but doesn’t get into specifics. “We’re taking no chances in New York with courts interpreting ‘sex discrimination’ narrowly,” Bodde says. 

That scares abortion opponents. New York’s Catholic bishops told their 35,000 mailing list subscribers in September that Prop 1 would “permanently legalize abortion without restriction” and “render impossible any change to the law if the hearts and minds of New Yorkers were ever to shift toward protecting the child in the womb.”

Prop 1 follows an ERA in Nevada two years ago, which passed with 58 percent of the vote after being pitched to the state’s fiercely independent residents as a means of protecting individual liberty. The Nevada ERA overcame opposition from anti-abortion forces—including the religious-right legal firm Alliance Defending Freedom—which predicted that the measure would void Nevada’s ban on Medicaid coverage for abortion. (It was right.) Next up: An expansive ERA is slated for the 2026 ballot in Minnesota, and another is on the table in Oregon. “It’s incremental,” Cheng says. “Every state that does something new, it creates a new bar or a new precedent for other states to go beyond that.”

These amendments work in two ways. First, they harden the state’s existing constellation of anti-discrimination laws by adding them to the state constitution. And second, they give individuals strong constitutional grounds to challenge discrimination by the government. In New York, Prop 1’s  protections for different “pregnancy outcomes” might be used to defend women from criminal prosecution after self-managed abortions or losing a pregnancy in a car accident—both of which have happened in New York, says Dana Sussman, senior vice president of Pregnancy Justice, a nonprofit legal advocacy group. And it might be used to challenge state hospitals that drug test pregnant women, sometimes without their knowledge or consent—policies that can lead to child protection cases and family separation.

Other activists hope the ERA could be used to overturn the state’s 24-week gestational limit, which forces some New Yorkers to travel out of state if—for one of the many reasons women can face delays in accessing care—they need a later abortion. Randi Gregory, vice president of political and legislative affairs at the National Institute for Reproductive Health Action Fund, believes Prop 1 would protect abortion rights “at all trimesters.” “We hope that it will be a framework for other states,” Gregory adds. “We’re really excited to be running an expansive and proactive amendment.”

But that’s only if they can get it passed—a task that looks increasingly daunting.

The coalition behind Prop 1 made big promises in June 2023, after New York Democrats’ embarrassing showing in the 2022 election. Their losses had helped flip control of the US House of Representatives back to the GOP, while former US Rep. Lee Zeldin, an anti-abortion Republican, came within 6 points of winning the governorship.

State Democrats evidently had an excitement problem—one they hoped the ERA could solve. Gov. Kathy Hochul and Sen. Kirsten Gillibrand told the New York Times that they wanted to use the amendment to motivate 2024 turnout. Progressive groups formed New Yorkers for Equal Rights, a committee that pledged to spend $20 million ginning up enthusiasm.

Yet in early September, Politico reported that the committee had raised less than $3 million to counter an opposition that had proven surprisingly well-organized and effective. Suddenly, Democrats were afraid of how Prop 1 might affect their candidates in tight races. In the ensuing scramble, Hochul announced $1 million for TV ads and direct mail and issued a statement: “It’s critical voters know that an abortion amendment is on the ballot in New York this year,” she said. “New Yorkers deserve the freedom to control their own lives and health care decisions, including the right to abortion regardless of who’s in office.”

The opposition campaign, the Coalition to Protect Kids, is largely funded by an upstate anti-abortion activist, Carol Crossed, who is vice president of Feminists Choosing Life of New York. Yet it has leaned heavily on anti-trans rhetoric, arguing the amendment would increase trans people’s access to girls’ sports, women’s bathrooms, and gender-affirming medical care—and that these things would be dangerous. “Anti-abortion extremists are pushing a harmful and cruel agenda,” says Sasha Ahuja, campaign director for New Yorkers for Equal Rights. “They’re lying about a small handful of innocent kids to divide New Yorkers and distract us from what this amendment is actually about: protecting the right to abortion, guaranteeing our personal freedoms, and protecting all of us against government discrimination.”

“They’re lying . . . [to] distract us from what this amendment is actually about: protecting the right to abortion, guaranteeing our personal freedoms, and protecting all of us against government discrimination.”

According to New York politics magazine City & State, internal polling shared with ERA proponents in late August found that 64 percent of voters would definitely, likely, or lean toward voting yes on the amendment when presented with its ballot language. But support plummeted by 24 percentage points after voters heard an attack message focused on girls’ sports, transgender protections, and immigration. (Another blatant lie spread by opponents is that Prop 1 would allow undocumented immigrants to vote.)

Ilyas believes the anti-trans messaging gains credence because many voters don’t have personal experience or relationships with trans people. “When you don’t know a trans person, you have this well-funded messaging at you, and people that you trust are saying the same exact thing and reiterating it, it makes sense for even the average New Yorker who’s middle of the road to believe it,” Ilyas says.

Anti-trans attacks have become a go-to strategy for conservative groups fighting abortion rights ballot initiatives. Opponents to Ohio’s abortion rights measure last year claimed it would permit minors to undergo gender-affirming surgery “without parents’ knowledge or consent” and dubbed it an “anti-parent amendment.” (Such surgeries for minors are very rare, and consent from parents or guardians is required.) In Missouri, a last-ditch lawsuit in September tried to block an abortion rights measure from this fall’s ballot by arguing that it might affect laws around single-sex bathrooms and that the voter petition should have disclosed that. (The state Supreme Court didn’t buy it.)

In New York, Prop 1 supporters have repeatedly pointed out that the amendment says nothing directly about trans participation in sports. In fact, trans inclusion in sports is already New York’s status quo, thanks to existing anti-discrimination laws and a state policy allowing trans students to participate on sports teams matching their gender identity. But like Phyllis Schlafly, Prop 1’s opponents love a dire warning: Lawn signs saying, “Save Girls Sports, Vote No Prop 1,” have become a regular sight in some areas. Republican politicians have been picking up on the theme, including Zeldin, the former congressman, and Gina Arena, a GOP candidate for the state Senate from the lower Hudson Valley.

On Long Island, Nassau County Executive Bruce Blakeman and the Republican-dominated county legislature passed a law this past summer blocking permits for women’s sports teams that include trans women, preventing them from using more than 100 county-run parks and athletics facilities. In response, the New York Civil Liberties Union sued the county on behalf of a women’s roller derby league, citing existing New York civil and human rights laws that forbid discrimination based on gender identity, sex, and disability. If the ERA was in the state constitution, lawyers for the league would doubtless argue that Nassau County had violated it as well. “Transgender athletes have been competing and allowed to compete in the state for a really long time now,” Cheng says. “That’s not going to change because of the ERA.”

“Transgender athletes have been competing and allowed to compete in the state for a really long time now. That’s not going to change because of the ERA.”

Still, uncertainty around which laws the ERA might challenge has been a boon to opponents. On its website, the Coalition to Protect Kids claims that banning age discrimination, for instance, would gut laws governing the drinking age, statutory rape, and parental consent for minors to receive medical treatments—especially gender-affirming care. Bodde dismisses these arguments as “misinformation” meant to “stir fear.” Courts have been clear that constitutional rights apply differently to minors and adults, she says, even despite laws forbidding age discrimination. “The state has long been able to create different rules when it comes to young people, whether that’s ensuring a certain age before people can learn how to drive or vote or purchase alcohol.”

But fear and confusion are powerful tools. Prop 1’s opponents have dubbed the ERA the “Parent Replacement Act.” On social media, the Coalition to Protect Kids has repeatedly cited the American College of Pediatricians, a misleadingly named fringe group of anti-LGBTQ doctors whose frequent declarations against gender-affirming care run counter to the conclusions of dozens of major medical associations. Sometimes the claims slip into self-parody: “If Prop One passes…children will mutilate themselves without the benefit of parental guidance,” reads a mailer sent to voters by the New York Republican State Committee. 

For Ilyas, who is transmasculine, the extremist rhetoric feels very personal—and deeply worrisome. “People don’t think that it could happen in New York, just because it’s New York,” Ilyas says. “These people do exist in New York, and they just maybe haven’t had an outlet.”

Last August, the American Academy of Pediatrics renewed its guidance supporting the use of puberty blockers, hormone therapy, and other medical care for transgender children and teens. At a time when trans issues have moved to the center of the culture wars, the AAP—the main medical association representing US pediatricians, with 67,000 members—said its action was aimed at supporting trans minors amid new waves of anti-trans laws.

Now, Republican officials from 21 states have accused the medical group of violating state consumer protection laws by supporting gender-affirming care for trans youth. More ominously, they’re demanding that the AAP turn over extensive records about how it developed its policy. 

In a letter signed by Idaho Attorney General Raúl Labrador and sent to the medical group this week, the GOP officials claim that the AAP is misleading parents and the public about the reversibility of puberty blockers and hormone therapy. The letter calls gender-affirming care “medical experimentation” and demands the AAP produce years’ worth of communications and documents related to its guidance for treating trans youth.

“It is without question that anti-transgender policies, and the dangerous rhetoric surrounding them, take a measurable toll on the health and safety of transgender and nonbinary young people all across the country.”

The letter was signed by the usual array of Republican suspects, including the top lawyers of Texas, Ohio, Florida, and nearly every state with laws restricting gender-affirming care. As state bans face legal challenges and injunctions, these attorneys general appear to be laying the groundwork for a new strategy to further their ideological agendas over the objections of medical experts.

The AAP is the leading US authority on pediatric health care, regularly releasing policy statements on a slew of topics, including medical treatment of LGBTQ youth. Last year, in addition to reaffirming its 2018 guidance on gender-affirming care, the AAP board of directors also authorized a systematic review of existing research to develop an “expanded set of guidance” for pediatricians. The 2018 policy statement supports a “collaborative, multidisciplinary approach” to treating gender dysphoria in trans youth that includes the ongoing, informed consent of the child and parents. 

The GOP officials’ latest salvo disregards the AAP’s expertise and presents a bad-faith interpretation of the association’s gender-care policy. “Children with gender dysphoria need and deserve love, support, and medical care rooted in biological reality,” Labrador asserted in a statement announcing the letter. “Parents should be able to trust that a doctor’s medical guidance isn’t just the latest talking point from a dangerous and discredited activist agenda.”

Labrador’s letter leans heavily on a dispute over whether puberty blockers are reversible, citing the UK-commissioned Cass Review, issued this past April, which experts have criticized for its methodology and biased assertions about gender identity. “Telling parents and children that puberty blockers are ‘reversible’ at the very least conveys assurance that no permanent harm or change will occur,” the letter reads. “But that claim cannot be made in the face of the unstudied and ‘novel’ use of puberty blockers to treat gender dysphoria.” 

In fact, AAP itself emphasizes that there are risks associated with the use of puberty blockers to treat gender dysphoria—mostly the potential for distress caused by social stigma. Research on long-term effects is limited and varied, with some studies suggesting impacts on bone density and fertility. As the Mayo Clinic points out, bone density concerns are typically addressed with calcium and vitamin D supplements. Meanwhile, organizations including AAP and the World Professional Association for Transgender Health (WPATH) recommend that before initiating treatments, providers and patients extensively discuss the fertility implications and options. Indeed, the gap in long-term research on gender-affirming care is precisely why AAP and other experts advocate for the continued study of evidence-based practices.

The Republican officials gave the AAP until October 8 to hand over all its communications with WPATH related to standards of care, dating back to 2020; all communications with the White House regarding gender-affirming care, and “substantiation” for many aspects of the AAP’s 2018 guidance. That policy statement already includes nearly 100 citations, including systematic reviews, AAP committee findings, and other organizations’ standards of care.

The AAP did not respond to Mother Jones’ request for comment.

Twenty-six states have passed laws restricting gender-affirming care for trans youth, according to the health policy think tank KFF. In Idaho—where Labrador is the top law enforcement official—medical providers face felony charges and up to 10 years in prison for prescribing puberty blockers and hormone therapy to trans minors. Most state bans, including Idaho’s, are facing legal challenges, but so far, only Arkansas’ law has been permanently blocked. (Florida’s ban, which also restricts care for trans adults, is in effect while the state appeals.) The US Supreme Court will hear a case this term regarding the constitutionality of Tennessee’s ban on the use of puberty blockers and hormones in trans youth. 

Meanwhile, the effect of laws targeting transgender youth and adults is becoming increasingly evident. A new study by researchers from The Trevor Project, published in the journal Nature Human Behavior, suggests a causal link between anti-trans laws and suicide attempts in trans people. The study of 61,000 transgender and nonbinary kids and young adults, conducted from 2018 to 2022, found that attempted suicide among trans children increased by as much as 72 percent in states that passed restrictions on gender-affirming care.

“It is without question that anti-transgender policies, and the dangerous rhetoric surrounding them, take a measurable toll on the health and safety of transgender and nonbinary young people all across the country,” says Jaymes Black, CEO of The Trevor Project. “It’s not necessary to fully understand their experience to acknowledge that they—like all young people—deserve dignity, respect, and the ability to lead healthy and full lives.”

Last August, the American Academy of Pediatrics renewed its guidance supporting the use of puberty blockers, hormone therapy, and other medical care for transgender children and teens. At a time when trans issues have moved to the center of the culture wars, the AAP—the main medical association representing US pediatricians, with 67,000 members—said its action was aimed at supporting trans minors amid new waves of anti-trans laws.

Now, Republican officials from 21 states have accused the medical group of violating state consumer protection laws by supporting gender-affirming care for trans youth. More ominously, they’re demanding that the AAP turn over extensive records about how it developed its policy. 

In a letter signed by Idaho Attorney General Raúl Labrador and sent to the medical group this week, the GOP officials claim that the AAP is misleading parents and the public about the reversibility of puberty blockers and hormone therapy. The letter calls gender-affirming care “medical experimentation” and demands the AAP produce years’ worth of communications and documents related to its guidance for treating trans youth.

“It is without question that anti-transgender policies, and the dangerous rhetoric surrounding them, take a measurable toll on the health and safety of transgender and nonbinary young people all across the country.”

The letter was signed by the usual array of Republican suspects, including the top lawyers of Texas, Ohio, Florida, and nearly every state with laws restricting gender-affirming care. As state bans face legal challenges and injunctions, these attorneys general appear to be laying the groundwork for a new strategy to further their ideological agendas over the objections of medical experts.

The AAP is the leading US authority on pediatric health care, regularly releasing policy statements on a slew of topics, including medical treatment of LGBTQ youth. Last year, in addition to reaffirming its 2018 guidance on gender-affirming care, the AAP board of directors also authorized a systematic review of existing research to develop an “expanded set of guidance” for pediatricians. The 2018 policy statement supports a “collaborative, multidisciplinary approach” to treating gender dysphoria in trans youth that includes the ongoing, informed consent of the child and parents. 

The GOP officials’ latest salvo disregards the AAP’s expertise and presents a bad-faith interpretation of the association’s gender-care policy. “Children with gender dysphoria need and deserve love, support, and medical care rooted in biological reality,” Labrador asserted in a statement announcing the letter. “Parents should be able to trust that a doctor’s medical guidance isn’t just the latest talking point from a dangerous and discredited activist agenda.”

Labrador’s letter leans heavily on a dispute over whether puberty blockers are reversible, citing the UK-commissioned Cass Review, issued this past April, which experts have criticized for its methodology and biased assertions about gender identity. “Telling parents and children that puberty blockers are ‘reversible’ at the very least conveys assurance that no permanent harm or change will occur,” the letter reads. “But that claim cannot be made in the face of the unstudied and ‘novel’ use of puberty blockers to treat gender dysphoria.” 

In fact, AAP itself emphasizes that there are risks associated with the use of puberty blockers to treat gender dysphoria—mostly the potential for distress caused by social stigma. Research on long-term effects is limited and varied, with some studies suggesting impacts on bone density and fertility. As the Mayo Clinic points out, bone density concerns are typically addressed with calcium and vitamin D supplements. Meanwhile, organizations including AAP and the World Professional Association for Transgender Health (WPATH) recommend that before initiating treatments, providers and patients extensively discuss the fertility implications and options. Indeed, the gap in long-term research on gender-affirming care is precisely why AAP and other experts advocate for the continued study of evidence-based practices.

The Republican officials gave the AAP until October 8 to hand over all its communications with WPATH related to standards of care, dating back to 2020; all communications with the White House regarding gender-affirming care, and “substantiation” for many aspects of the AAP’s 2018 guidance. That policy statement already includes nearly 100 citations, including systematic reviews, AAP committee findings, and other organizations’ standards of care.

The AAP did not respond to Mother Jones’ request for comment.

Twenty-six states have passed laws restricting gender-affirming care for trans youth, according to the health policy think tank KFF. In Idaho—where Labrador is the top law enforcement official—medical providers face felony charges and up to 10 years in prison for prescribing puberty blockers and hormone therapy to trans minors. Most state bans, including Idaho’s, are facing legal challenges, but so far, only Arkansas’ law has been permanently blocked. (Florida’s ban, which also restricts care for trans adults, is in effect while the state appeals.) The US Supreme Court will hear a case this term regarding the constitutionality of Tennessee’s ban on the use of puberty blockers and hormones in trans youth. 

Meanwhile, the effect of laws targeting transgender youth and adults is becoming increasingly evident. A new study by researchers from The Trevor Project, published in the journal Nature Human Behavior, suggests a causal link between anti-trans laws and suicide attempts in trans people. The study of 61,000 transgender and nonbinary kids and young adults, conducted from 2018 to 2022, found that attempted suicide among trans children increased by as much as 72 percent in states that passed restrictions on gender-affirming care.

“It is without question that anti-transgender policies, and the dangerous rhetoric surrounding them, take a measurable toll on the health and safety of transgender and nonbinary young people all across the country,” says Jaymes Black, CEO of The Trevor Project. “It’s not necessary to fully understand their experience to acknowledge that they—like all young people—deserve dignity, respect, and the ability to lead healthy and full lives.”

In her latest video, Mother Jones video creator Kat Abughazaleh traces the history of former President Donald Trump’s dangerous lie that some states allow parents to “execute” babies in so-called “post-birth abortions.”

“You can look at the governor of West Virginia,” Trump said during last week’s debate, prompting an incredulous head shake from Vice President Kamala Harris. “He said the baby will be born and we will decide what to do with the baby. In other words, we’ll execute it.”

Northam, of course, did not say that. Trump wasn’t even correct about his own right-wing smear. His reference was to a wildly out-of-context quote from former Virginia governor Ralph Northam (not West Virginia). Northam’s 2019 radio appearance, in which he explained the tragic medical emergencies that can result in late-term abortions, has since been selectively edited by Republicans and used to claim their opponents are permitting infanticide—a lie that has been repeated with relish across Fox News, again and again.

As Kat explains, “There’s no such thing as a ‘post-birth’ abortion. These procedures are extremely rare and reserved for cases where the mother’s life is in danger or when a fatally ill or deformed baby needs palliative care.” In this video, Kat shows how this wasn’t Trump’s first time exploiting these tragedies, which are “designed to demonize grieving mothers and doctors,” while clarifying the facts about late-term abortion care that are too often lost to political noise. She notes that less than one percent of abortions occur after 21 weeks of pregnancy.

“By limiting abortion access in the first place, whether it’s totally or at the six-week mark, or by making parents jump through hoops just to get the medical care they need,” Kat explains, “Republicans are ensuring that there will be more cases that require traumatic medical intervention than if people were allowed to have control over their bodies in the first place.”

A number of prominent figures on the right and far right are once again engaged in energetic antisemitism; this time, Instagram personality Dan Bilzerian, a poker player and lifestyle influencer previously famous for posing with women on large boats, has climbed aboard. Bilzerian and two other masculinity influencers—accused human traffickers Andrew and Tristan Tate—have increasingly pivoted to criticisms of Israel that promptly segue into antisemitic claims clearly rooted in the blood libel, a medieval conspiracy theory about Jews murdering Christians.

Bilzerian is grandiosely known as the “King of Instagram,” where he displays scenes of a lifestyle involving yachts, crowds of bikini-clad hangers-on, and exotic locales to 32 million followers. In the past few weeks, however, Bilzerian has been spouting wild conspiracies about the Israeli government, telling a podcaster that he believes it “knew about 9/11” (presumably in advance) and “had JFK assassinated.”

Last week Bilzerian was among those who shared a viral meme on Twitter/X claiming to show English translations of the Talmud, a foundational Jewish religious text, “proving” that it exists to justify the mistreatment and murder of non-Jews. These claims, which have been debunked many times over the last several centuries, seem to be largely sourced from antiquated antisemitic texts, like 1892’s The Talmud Unmasked. Besides being composed of outrageous lies—claiming, for instance, that Judaism permits the rape and murder of non-Jews—the meme cites a purported book of the Talmud that the American Jewish Committee identified as “altogether fictitious” in 1939.

“Antisemites trying to focus on the Talmud is almost as old as antisemitism gets,” explains Rabbi Mordechai Lightstone, the social media editor of Chabad.org, the Judaism website run by the Chabad-Lubavitch movement, a branch of Orthodox Judaism. “You have places on the dark corners of the internet where people have compiled bits and pieces that are totally made up, or taken out of context. They have the same spelling mistakes and use made-up terms in Hebrew.”

The meme vastly oversimplifies what the Talmud is: an intricate text, composed of thousands of pages of summation of oral tradition, opinions from rabbis and sages, teachings, conversations and debates. While some observant Jews devote years to understanding its mysteries, antisemitic memes presume it is a literal rulebook by which modern-day Jews live, instead of a compilation of religious and ethical arguments written between the third and sixth centuries.  

The Talmud is, Lightstone adds, written “in a language that isn’t accessible to the common person today.” Even at the time it was written, in a blend of Aramaic and Hebrew, it was “incomprehensible to the non-Jewish world,” making it even more attractive for antisemites looking to imbue it with meanings that would demonize Jews, and frame it, as Lightstone puts it, as “the things Jews don’t want you to see.”

Bilzerian isn’t alone among far-right influencers, where antisemitic rhetoric is on the rise as prominent conservatives like Candace Owens and Stew Peters make increasingly overt claims about Jewish people. While they are often cloaked in supposed critiques of the Israeli government’s invasion of Gaza, that isn’t always the case. Last week, for instance, Owens shared posts about Leo Frank, a Jewish man who was murdered in Georgia in 1915 by a lynch mob that claimed he was guilty of rape, a claim most historians dispute. She stated without evidence that Frank was related to the founder of a cult “which practiced ritualistic incest and pedophilia.” (Owens has previously displayed an obsession with Frankism, a long-dead Jewish heretical sect from the 1700s that practiced sexual rituals, but had nothing whatsoever to do with Leo Frank.)

Owens has been joined by the Tate brothers, who she interviewed in Romania last year about the trafficking allegations against them, and who recently sat down with her for interviews again. This week, the Tates were raided at their Romanian compound for the second time, this time reportedly over allegations of sex with a minor. Upon his release, Tate retweeted a post from white nationalist Nick Fuentes, which read, “Just 2 days after Andrew Tate said that ‘the Matrix’ is really just the Jewish mafia—his house was raided and he was arrested again.”

Other masculinity influencers, like Rumble personality Sneako, celebrated their release. “Welcome home,” he tweeted, tagging the Tates. “Tell the truth, whatever the cost.” Later the same day he added in another tweet that “The Matrix is Israel.” 

Posting any one thing for too long—whether it’s misogynist screeds, pictures of women in swimwear, or Andrew Tate’s omnipresent photos of himself smoking cigars—can leave an audience feeling bored and prone to drifting away. For Andrew Tate and Bilzerian, focusing on Israel’s assaults on Gaza brings not only novelty, but an appearance of moral high ground that such influencers don’t typically get to assume; their antisemitism also provides a new enemy that could be, for instance, useful as the human trafficking case against the Tates moves forward. 

Chabad, the movement that Lightstone is part of, encourages less-observant Jews to learn more about their religious traditions. And while he’s disgusted by the meme, he hopes it, and the people like Bilzerian spreading it, might push someone to take time to look into the actual text.

“The Torah and the Talmud is here to bring truth and light to the world,” he says. “All of this hate is darkness and distraction from that purpose.”

The internet has been burning up this past week with the many, many faux pas—faux paws?—of Donald Trump’s running mate, JD Vance, what with his “childless cat ladies” thing, his endorsement of a reprehensible book by a reprehensible guy, and the foreword Vance wrote for yet another book, by Project 2025 architect Kevin Roberts, even as Trump was trying to distance himself from that political dumpster fire.

It is fun, however, to take some of Vance’s more ridiculous assertions at face value, such as his claim that “the entire Democrat Party is like this childless cabal of people who don’t really care about the future.” (You didn’t think the Harris campaign was going to let that one go by, did you?)

Unearthed video: JD Vance calls Democrats a “childless cabal of people who don't really care about the future” pic.twitter.com/dfWKajTc7y

— Kamala HQ (@KamalaHQ) July 30, 2024

Transportation Secretary Pete Buttigieg—whom Vance namechecked as “childless” even as Buttigieg and his husband were in the midst of adopting a child—made the case quite eloquently to Jon Stewart that being childless and caring about your country’s future are not mutually exclusive. Exhibit A: The young people who volunteer for military service. Watch:

.@PeteButtigieg speaks with Jon Stewart about JD Vance’s harmful comments on which Americans have a stake in the future. pic.twitter.com/a2OY36FxkC

— The Daily Show (@TheDailyShow) July 30, 2024

And then it’s worth asking: Is there even truth to this notion of Democrats being childless? I wasn’t about to waste my time looking up every member of Congress, but I did want to run a little truthiness test. So I looked up the parental status of every member of the House of Representatives from my liberal state of California—also the nation’s most populous state.

California has 52 House members: 40 Democrats, 12 Republicans.

Forty percent of those Democrats are women and only 16 percent of the Republicans are. Given the rigors of public office and the fact that moms are often saddled with the lion’s share of child care duties, you might then expect an overall higher rate of childlessness among the Democratic politicians. But you would be wrong.

With the caveat that one of the Democratic women has stepchildren, not biological ones, 85 percent of the Dems have kids, as opposed to 83 percent of the Republicans. If you exclude Rep. Sydney Kai Kamlager-Dove’s stepkids, which isn’t very nice, it becomes even: 83 percent for both.

For a reality check, I also looked at Georgia’s House delegation—9 Republicans, 5 Democrats. All of them have had kids except one: a Republican.

Let’s break down those numbers. On the Democratic side, 88 percent of the male reps have kids and 81 percent of the women do—three-quarters if you exclude the poor stepkids. The Cali Republicans have only two women in their caucus—both with kids—while 8 of the 10 men have them. (And, to be fair, one of the childless ones was just recently married.)

The remaining childless Republican dude, a MAGA type known for his adamant opposition to abortion rights and LGBTQ rights, tried to tell local police back in 1993 that he and the prostitute he was doing stuff with in his car were “just talking.” (He later admitted they were having sex.) But debauchery has no party affiliation: In 1986, one of the childless male Dems had been cited by police for soliciting prostitution.

The other two childless Democratic men are openly gay, and of the four Democratic women with no biological children, one is 35 and unmarried—though in a relationship, so who knows? We don’t know the story with the others, and even Vance concedes that plenty of people who want kids can’t have them for all sorts of reasons.

So what is this guy even talking about? Based on my California House sample, Dems are no more likely to be childless than Republicans are. I would predict the national numbers aren’t much different—there’s a fun weekend project if any of my media colleagues want to take it on.

For a reality check, though, I looked at Georgia’s House delegation—nine Republicans, five Democrats. Republican Andrew Clyde, a firearms dealer, is the only one of them who hasn’t had kids, although he does have a doberman named Kit. Georgia Democratic Rep. Lucy McBath, who is Black, used to have a child. She ran for Congress only after her son, Jordan, was murdered at a gas station by a 46-year-old white man complaining about Jordan and his friends’ “loud music.”

The upshot of this little experiment, I suppose, is that if America’s childless are indeed some sort of cabal, it would appear to be pretty minor—and bipartisan. But a hearty thank you to JD for making it all possible.

The fate of gender-affirming care for transgender youth in Ohio will soon rest in one person’s hands. For the past week, Franklin County Judge Michael Holbrook has heard a case challenging a recent state law that includes a ban on the use of puberty blockers and hormones for trans youth. Now, it’s up to him to decide whether to turn a temporary block on the law into a permanent one—which would make Ohio just the third state to do so as a growing body of anti-trans laws moves through the courts.

From his chambers on the fifth floor of a downtown Columbus courthouse, the judge has heard pleas from the parents of trans children whose lives have been saved by gender-affirming care, physicians from the state’s children’s hospitals, and national experts in trans care. He’s also heard the state’s sharp defense of its law, featuring what is being framed as the “expert” testimony of nationally prominent anti-trans activists who made dubious claims about the efficacy and risks of puberty blockers, hormones, and other gender-affirming medical treatment.

Ohio’s sweeping law, dubbed the “Saving Adolescents from Experimentation” or “SAFE” Act, doesn’t just block the use of puberty blockers and hormones in trans youth (while allowing such medical interventions for cisgender children who may need them for precocious puberty or polycystic ovary syndrome). Passed by a GOP supermajority in January over Republican Gov. Mike DeWine’s veto, it also prohibits trans girls and women from playing women’s sports, including college athletics. The ACLU of Ohio is challenging the entire law as a violation of the state’s single-subject rule for legislation, which requires that bills must pertain to one topic. The state says that topic is “addressing gender transition in children,” but the trial mainly focused on what the families of two trans girls have argued is the discriminatory, life-threatening impact of the ban on gender-affirming care.

“She laid down and wept in my bed. She is carrying looming anxiety and deep sadness surrounding this law.”

Ohio is among the 25 states with laws on the books restricting gender-affirming care, according to the Kaiser Family Foundation, and 39 percent of trans youth live in states with such policies. While most bans have been challenged—and several temporarily blocked, like Ohio’s—the vast majority remain in effect. Only policies in Florida and Arkansas have been permanently enjoined, while the US Supreme Court has agreed to hear a case this coming term about the constitutionality of trans care bans.

On Monday, the mother of a 12-year-old trans girl testified that when her daughter began publicly identifying as a girl, her anxiety “melted away.” The daughter, going by the alias “Grace Goe,” has received gender-affirming mental health care for seven years and hopes to medically suppress puberty at its onset. The prospect of not being able to access that medical care has caused immense distress for Goe and her family. “She laid down and wept in my bed,” her mother said of Goe learning of the ban. “She is carrying looming anxiety and deep sadness surrounding this law.”

The state of Ohio showcased its line of experts, including Jamie Reed, a self-identified “whistleblower,” whose claims about a Missouri gender clinic have been widely disputed by families of the clinic’s current and former patients. Another Ohio witness was James Cantor, a Canadian sex researcher who has testified in support of gender-affirming care bans in trials across the country.

Cantor, a PhD who has never diagnosed a child with gender dysphoria or served on a child’s gender-affirming care team, claimed US studies on gender-affirming care are “sloppy” and that such care causes “sterility in children.” While hormones are known to cause temporary infertility, the long-term effects are unknown—which is why the World Professional Association for Transgender Health (WPATH), the leading professional organization for gender-affirming care providers, recommends providers and patients extensively discuss fertility impacts and options before initiating such treatments. (Some forms of gender-affirming surgery do cause permanent infertility, but for years the Ohio Children’s Hospital Association has assured lawmakers it is not being offered to trans youth in Ohio.)

And as my colleague Madison Pauly revealed last year, it’s not medical professionals or swaths of people who have stopped gender-affirming care proposing these bans to state legislators; many are conservative Christian organizations that believe transness is something to be “cured.”

As the trial wraps up on Friday, it bears repeating what actual experts testified: Dr. Sarah Corathers, an endocrinologist at Cincinnati Children’s Hospital who has served on care teams for about 300 trans youth over the past decade, said she’s seen patients’ quality of life improve under her care. “When medically indicated, gender-affirming medical treatment is safe, effective, and well-established,” she said. Dr. Jack Turban, the director of the University of California, San Francisco’s Gender Psychiatry program, explained the widely accepted protocols clinicians in Ohio and elsewhere use for offering such care to trans youth, including using a multidisciplinary team of providers, offering comprehensive mental health support, and making every decision in concert with the trans child and their parents. He noted that every major medical organization opposes bans on gender-affirming care.

The fate of gender-affirming care for transgender youth in Ohio will soon rest in one person’s hands. For the past week, Franklin County Judge Michael Holbrook has heard a case challenging a recent state law that includes a ban on the use of puberty blockers and hormones for trans youth. Now, it’s up to him to decide whether to turn a temporary block on the law into a permanent one—which would make Ohio just the third state to do so as a growing body of anti-trans laws moves through the courts.

From his chambers on the fifth floor of a downtown Columbus courthouse, the judge has heard pleas from the parents of trans children whose lives have been saved by gender-affirming care, physicians from the state’s children’s hospitals, and national experts in trans care. He’s also heard the state’s sharp defense of its law, featuring what is being framed as the “expert” testimony of nationally prominent anti-trans activists who made dubious claims about the efficacy and risks of puberty blockers, hormones, and other gender-affirming medical treatment.

Ohio’s sweeping law, dubbed the “Saving Adolescents from Experimentation” or “SAFE” Act, doesn’t just block the use of puberty blockers and hormones in trans youth (while allowing such medical interventions for cisgender children who may need them for precocious puberty or polycystic ovary syndrome). Passed by a GOP supermajority in January over Republican Gov. Mike DeWine’s veto, it also prohibits trans girls and women from playing women’s sports, including college athletics. The ACLU of Ohio is challenging the entire law as a violation of the state’s single-subject rule for legislation, which requires that bills must pertain to one topic. The state says that topic is “addressing gender transition in children,” but the trial mainly focused on what the families of two trans girls have argued is the discriminatory, life-threatening impact of the ban on gender-affirming care.

“She laid down and wept in my bed. She is carrying looming anxiety and deep sadness surrounding this law.”

Ohio is among the 25 states with laws on the books restricting gender-affirming care, according to the Kaiser Family Foundation, and 39 percent of trans youth live in states with such policies. While most bans have been challenged—and several temporarily blocked, like Ohio’s—the vast majority remain in effect. Only policies in Florida and Arkansas have been permanently enjoined, while the US Supreme Court has agreed to hear a case this coming term about the constitutionality of trans care bans.

On Monday, the mother of a 12-year-old trans girl testified that when her daughter began publicly identifying as a girl, her anxiety “melted away.” The daughter, going by the alias “Grace Goe,” has received gender-affirming mental health care for seven years and hopes to medically suppress puberty at its onset. The prospect of not being able to access that medical care has caused immense distress for Goe and her family. “She laid down and wept in my bed,” her mother said of Goe learning of the ban. “She is carrying looming anxiety and deep sadness surrounding this law.”

The state of Ohio showcased its line of experts, including Jamie Reed, a self-identified “whistleblower,” whose claims about a Missouri gender clinic have been widely disputed by families of the clinic’s current and former patients. Another Ohio witness was James Cantor, a Canadian sex researcher who has testified in support of gender-affirming care bans in trials across the country.

Cantor, a PhD who has never diagnosed a child with gender dysphoria or served on a child’s gender-affirming care team, claimed US studies on gender-affirming care are “sloppy” and that such care causes “sterility in children.” While hormones are known to cause temporary infertility, the long-term effects are unknown—which is why the World Professional Association for Transgender Health (WPATH), the leading professional organization for gender-affirming care providers, recommends providers and patients extensively discuss fertility impacts and options before initiating such treatments. (Some forms of gender-affirming surgery do cause permanent infertility, but for years the Ohio Children’s Hospital Association has assured lawmakers it is not being offered to trans youth in Ohio.)

And as my colleague Madison Pauly revealed last year, it’s not medical professionals or swaths of people who have stopped gender-affirming care proposing these bans to state legislators; many are conservative Christian organizations that believe transness is something to be “cured.”

As the trial wraps up on Friday, it bears repeating what actual experts testified: Dr. Sarah Corathers, an endocrinologist at Cincinnati Children’s Hospital who has served on care teams for about 300 trans youth over the past decade, said she’s seen patients’ quality of life improve under her care. “When medically indicated, gender-affirming medical treatment is safe, effective, and well-established,” she said. Dr. Jack Turban, the director of the University of California, San Francisco’s Gender Psychiatry program, explained the widely accepted protocols clinicians in Ohio and elsewhere use for offering such care to trans youth, including using a multidisciplinary team of providers, offering comprehensive mental health support, and making every decision in concert with the trans child and their parents. He noted that every major medical organization opposes bans on gender-affirming care.