After trans bathroom ban, how Utah therapists say you can help transgender Utahns

After the trans bathroom ban and Gov. Cox’s comments attacking gender-affirming care, therapists say transgender Utahns and the wider LGBTQ+ community are feeling unsafe.

(Trent Nelson | The Salt Lake Tribune) Sami Simpson and Lisa Hansen console each other while discussing the effect of anti-LGBTQ legislation on patients, in Orem on Monday, Feb. 12, 2024.

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Therapists who assist Utah transgender clients have advice for people who want to help: Listen and don’t jump straight to a fix, and be willing to be uncomfortable.

The situation for transgender Utahns and the wider LGBTQ+ community is, therapists say, an increasingly hopeless situation — as the Utah Legislature passes laws targeted at transgender people.

“We’re starved for hope right now,” said Sami Simpson, a therapist at Flourish Therapy, a therapy service focused on the LGBTQ+ community and their family, friends and other allies.

That assessment comes just weeks after Utah Gov. Spencer Cox signed legislation targeting transgender people into law for the second year in a row.

The latest law, which Cox signed Jan. 30, targets fewer than 1% of Utahns by excluding transgender people from gender-specific public spaces such as bathrooms and changing rooms.

The new law has led to a diminished sense of safety among transgender Utahns, said Lisa Hansen, who founded Flourish in Provo in 2017 and serves as its clinical director.

One family, Hansen said, was going to go to Goblin Valley State Park — but one parent is transgender and wouldn’t be able to use gender-specific restrooms, so they didn’t go.

The parents of a transgender girl in kindergarten write in a letter shared by student intern and therapist KT Mendes that the “door can’t hit us fast enough when we leave.” The parents speculate that was legislators’ intent all along.

Five of Mendes’ other clients would leave Utah if they could, they said, and several of Flourish’s clients left before this year’s legislative session, as new state laws made them feel unwelcome.

Hansen described a “universal sense of terror and grief” even among those who decide to stay in Utah.

(Trent Nelson | The Salt Lake Tribune) KT Mendes discusses the effect of anti-LGBTQ legislation on patients, at Flourish Therapy's offices in Orem, on Monday, Feb. 12, 2024.

Therapist: Lawmakers’ rhetoric is ‘gaslighting’

According to the Movement Advancement Project, a nonprofit think tank, Utah joined Florida as the only states to enact a so-called “bathroom bill” that explicitly prohibits transgender people from using bathrooms and other gendered facilities in schools, colleges and government-owned buildings that match their identity.

Seven other states have such bans in K-12 schools, and North Dakota’s ban covers K-12 schools and some government-owned buildings.

Utah’s HB257, with the title “Sex-based Designations for Privacy, Anti-bullying and Women’s Opportunities,” changes the state’s legal definitions of “female” and “male” to categorize Utahns by the reproductive organs they were born with.

Under the bill, people can only use a changing room — including locker rooms, showers and dressing rooms — in a government-owned and government-controlled building if they meet the legal definition of sex that corresponds with the space.

Those who don’t meet that definition can use the space if they have legally amended their birth certificate and had bottom surgery. Both requirements can be difficult for people to meet because of cost, laws in some states and other factors.

There are some exceptions, including dependent minors and adults with caretakers, intersex individuals, public safety workers and employees cleaning the space.

Cox said in a statement after signing HB257 into law that Utah’s leaders want “public facilities that are safe and accommodating for everyone and this bill increases privacy protections for all.”

At an event in Washington, D.C., on Thursday, Cox lamented what he called an “explosion” in gender-affirming care — which he compared to “having genital mutilation surgeries before they’re 18.”

The World Health Organization defines genital mutilation as the removal of genital parts — mostly female — for non-medical purposes. According to the WHO, gender-affirming care is research-based intervention designed to help transgender people align various aspects of their lives with their gender identity.

Conflating the two, Hansen said, seems “deliberately ignorant” and is “irresponsible and unnecessarily stigmatizes life-saving medical care.”

Heather Kester, the mother of a transgender teen, said in a comment provided by Hansen that it’s “very harmful verbiage” for transgender kids to hear.

“They are already exceptionally vulnerable, and to hear and see their representatives saying things like this is further ‘othering’ them,” Kester said. “This rhetoric isn’t protecting children, it’s pushing them farther away.”

The bill’s sponsor, Rep. Kera Birkeland, R-Morgan, like Cox, cited safety — more specifically “reports of perpetrators going into women’s facilities in our state for improper purposes and they do it under the pretext of being something they are not.”

Jocelyn Akwenye, a student intern with Flourish, said the comments from lawmakers in support of HB257 were just gaslighting.

(Trent Nelson | The Salt Lake Tribune) Jocelyn Akwenye, KT Mendes and Veronica Argyle, from left, discuss the effect of anti-LGBTQ legislation on patients, at Flourish Therapy's office in Orem on Monday, Feb. 12, 2024.

Hansen compared the rhetoric to growing up in Indianapolis in the 1960s, when people used the same kind of language to justify segregated bathrooms, but it was “all about [white people] just not wanting to share the bathroom” with people of color.

“The irony is the most vulnerable person in that bathroom is the transgender or nonbinary person,” Simpson said.

In Oklahoma earlier this month, Nex Benedict, a 16-year-old who identified as nonbinary according to their family, died one day after a fight in a bathroom. Police have said they didn’t die from injuries sustained in the “physical altercation,” but Benedict’s mother has said Nex were bullied for more than a year.

The bullying got worse at the beginning of the 2023 school year, their mom said. That was a few months after Oklahoma Gov. Kevin Stitt signed a bill requiring public school students to use bathrooms that matched the sex listed on their birth certificates.

Trans people are four times more likely than cisgender people to experience violence, studies show, and half will be sexually abused at some point in their lives. They also are far more likely to struggle with mental health, with higher rates of depression and suicide than the rest of the population.

“There are other things they would hope to work on in therapy,” Kristen Schmitt, another student intern, said of Flourish’s clients. “But now they have to use it to process people telling them where they can and can’t go to the bathroom.”

‘They may have reasons they love the state’

At least one of Flourish’s clients has left Utah every month in the last few years, Hansen said, and more are committed to following them as they keep track of the places where they would feel safe moving.

Some choose to remain in Utah, Hansen said, whether that’s for skiing and access to the outdoors or because of family.

“They may have reasons to stay,” she said. “They may have reasons they love the state.”

Others aren’t able to leave. Securing and maintaining a job is “really difficult,” Simpson said.

She talked about one client who has had 39 job interviews and would be a great employee, but hasn’t found an employer who will give her a chance.

Three of Mendes’ clients are unhoused.

Uprooting also isn’t a decision anyone — including people with financial means to do so — takes lightly, said Veronica Argyle, an associate therapist at Flourish.

Therapists are struggling to give people hope and peace, Akwenye said, even in the safe space of a therapy session.

As Flourish’s therapists gathered in a space in their Orem office to talk about HB257 and its compounding effects, there were tears, hugs, long pauses and a general heaviness.

(Trent Nelson | The Salt Lake Tribune) Therapists discuss the effect of anti-LGBTQ legislation on patients, at Flourish Therapy's offices in Orem, on Monday, Feb. 12, 2024.

There were also glimmers of hope.

CJ Michalec, a student intern, holds some hope in large stakeholders.

They talked about the national uproar over North Carolina’s bathroom ban in 2016. After that bill became law, A-list performers like Bruce Springsteen and Cyndi Lauper canceled shows in the state, global companies tanked plans to expand, the NCAA moved championship games and the NBA relocated its annual All-Star Game to New Orleans.

There hasn’t been a similar reaction in Utah, but Akwenye has heard about some efforts to ramp up opposition.

Rebecca Wilson, an associate therapist, said she hopes the professional community, advocates and others can work collectively to do what they can.

‘Be OK being uncomfortable’

Individually, there’s a lot Utahns can do to help, therapists said: Hanging Pride flags, offering solidarity and listening with the intent to understand.

People can and should empathize, Akwenye said, and there are books they can read to understand the experience.

Argyle said she hears from clients that there’s a trend of cisgender people minimizing the effects of state laws to make them seem less scary. While such comments can be well-meaning, they said, that just makes people feel less secure they can trust their own sense of safety.

Argyle said she wishes people who aren’t directly affected by the bill would listen when people want to tell their story and “be OK being uncomfortable” instead of jumping directly into trying to fix things.

Megan Banta is The Salt Lake Tribune’s data enterprise reporter, a philanthropically supported position. The Tribune retains control over all editorial decisions.

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