Trump’s recent comments equating trans healthcare with “child sexual mutilation” reaffirms years of campaigning by the far right to falsely conflate gender-affirming care and FGM/C.
By the end of this calendar year, 3 million girls around the world will be at risk of undergoing female genital mutilation/cutting (FGM/C). Currently, in the United States, over half a million women and girls have undergone or are at risk of undergoing FGM/C.
FGM/C is a human rights violation that involves removing part or all of a child’s healthy female sex organs and surrounding tissue for non-medical reasons and can result in negative health consequences, difficulties during childbirth, lifelong psychological and emotional trauma and in some cases, even death. Efforts are underway around the world to ban this harmful practice, and 41 U.S. states have laws on the books to address it.
But the efforts of survivors and activists—and I’m both—have been hamstrung by the current wave of conservative opposition to medical care for trans youth, yet another ugly consequence of the crackdown on rights for transgender Americans. As we try to make sure that girls who are at risk of FGM/C, or who are dealing with the consequences of it, have the protections they need, those who oppose rights for trans people are weaponizing the laws we advocated for to deny trans youth the gender-affirming care they need.
A recent statement from President-elect Donald Trump confirms this harmful conflation of the two very different issues.
“On day one, I will revoke Joe Biden’s cruel policies on gender-affirming care—ridiculous. I will sign a new executive order instructing every federal agency to cease all programs that promote the concept of sex and gender transition at any age,” Trump said in a video posted to social media. “I will then ask Congress to permanently stop federal taxpayer dollars from being used to promote or pay for these procedures and pass a law prohibiting child sexual mutilation in all 50 states.”
That Trump used these words—“child sexual mutilation”—reaffirms years’ worth of campaigning by the far right to disenfranchise the trans community by falsely conflating gender-affirming care and FGM/C.
This dangerous framing has already had consequences at the state level. Connecticut, for example, has yet to introduce a bill on FGM/C, and this weaponization is partly to blame. Last January, The Commission on the Status of Women, Children, Seniors, and Equitable Access for All, alongside the Connecticut Coalition to End FGM/C, hosted a briefing at the Legislative Office building on FGM/C. The Family Institute of Connecticut Action, a conservative advocacy group, used this briefing as an opportunity to conflate FGM/C and gender-affirming care, stating the two were the same.
We have the tools to protect girls from those who would abuse them, and to play politics with the health and safety of those girls is, quite simply, immoral.
In Idaho in 2022 and 2023, an existing bill on FGM/C was co-opted by Republican lawmakers in attempts to equate gender-affirming care for youth as “mutilation.” For example, Idaho’s House Bill 71 sought to amend the anti-FGM/C legislation by removing almost all mentions of FGM/C and removing the word “female” before any remaining uses of “genital mutilation” that were kept in the proposed rewritten bill. Rather than protecting those at risk of FGM/C, the bill’s focus would have targeted transgender youth. Additionally, this political maneuver would have diluted legislative progress towards ending FGM/C that had been achieved by effectively nullifying pre-existing legislation put in place to end FGM/C.
Ultimately, the FGM/C law in Idaho was not altered in part due to the efforts of advocates working to end the practice to keep the anti-FGM/C law as is. Yet, the seed was planted that gender-affirming care was “mutilation,” leading Idaho legislators to propose a new bill that did indeed pass and now denies trans youth the vital care they need.
Framing gender-affirming care as mutilation has become a refrain. Republican legislators in Texas did the same in 2022. Utah’s Governor Spencer Cox made similar remarks that got him in hot water at an event at George Washington University earlier this year, outright equating gender-affirming care to FGM/C. Governor Ron DeSantis of Florida followed suit.
To understand the harm of conflating gender-affirming care with FGM/C, it is important to understand context. First and foremost: Any attempt to co-opt anti-FGM/C legislation for banning gender-affirming care is built upon key misunderstandings of significant differences between the two, which makes this conflation irresponsible and inaccurate. Gender-affirming care requires patient consent and, in the case of a minor, consent and assent from the parent or legal guardian and the patient after a long period of reflection and consultation with health providers. Conversely, FGM/C violates bodily autonomy and a vast majority of those who experience FGM/C have no say in the timing or nature of the cut. It is a social norm that often occurs as a result of societal pressure placed on girls who are told FGM/C is necessary for them to be a woman, to be a member of their own culture and society, and to be married.
In addition, research has shown that gender-affirming treatments lead to decreased rates of depression, improvement in psychosocial functioning and minimal long-term side effects. FGM/C leads to negative psychological outcomes, including PTSD, anxiety and depression. In fact, a study published in October 2024, in JAMA Pediatrics reiterates that transgender teenagers who pursue medical interventions are highly satisfied with their care. These outcomes clearly distinguish gender-affirming care from FGM/C as a medical necessity.
FGM/C harms girls physically and mentally throughout their entire reproductive lives while gender-affirming care for youth has been proven over and over to be life-saving. The National Center for Transgender Equality reports that 40 percent of transgender people in the U.S. have attempted suicide at some point in their lives, which is nearly nine times the nationwide suicide rate. Gender-affirming care can significantly improve this mental health crisis.
Attempts by conservative politicians to co-opt the human rights abuse of FGM/C is nothing more than a discriminatory, political tactic to further transphobic rhetoric around medically necessary care for a marginalized community. At Sahiyo, the organization I cofounded, we work with FGM/C survivors who identify as LGBTQIA+, and this culture of anti-trans hate only isolates those survivors further.
The costs of such political tactics are clear to those of us who care deeply both about survivors of FGM/C and about trans youth. Pitting them against each other leaves millions of children without the resources they desperately need, whether it’s protection from FGM/C and care in its aftermath, or access to medical care and support to live as their authentic selves.
Equating FGM/C and gender-affirming care is not only inaccurate, it’s irresponsible. We have the tools to protect girls from those who would abuse them, and to play politics with the health and safety of those girls is, quite simply, immoral. Our children—all of our children—deserve better.
