Utah Gov. Cox calls gender-affirming care ‘genital-mutilation surgery’ during ‘Disagree Better’ event

Gov. Spencer Cox’s comments came in response to a student’s question during a George Washington University event promoting his efforts to encourage civil discussion.

Gov. Spencer Cox called gender-affirming health care for transgender people “gender mutilation surgery” during an event promoting his “Disagree Better” initiative in Washington, D.C. He also claimed that “no one” in Utah has taken their own life as a result of the state’s ban on such care for transgender youth.

During a conversation at George Washington University, Cox was asked to detail how he has worked to facilitate discussions between people with opposing viewpoints on contentious issues. He pointed to the ban on gender-affirming health care for minors that lawmakers passed last year.

“I invited transgender youth and their parents over to the governor’s mansion to meet with legislative leadership and the bill’s sponsors. I promise you, this did not happen in any of the 23 states where this, or however many states now, where this issue has come up,” Cox said.

Cox said those discussions prompted some changes to the bill, including softening an outright ban on hormone therapy for youth to an indefinite pause and funding for mental health services.

“That did not make it great for the transgender community. They were not happy about that. They came. It was a very positive discussion. People saw each other as human beings. They met each other in good faith,” Cox said of the meeting.

During the Q&A part of the program, a student challenged Cox’s description of the state’s ban on gender-affirming care.

“Where is the line where conversation becomes pointless,” the student asked. “A trans kid kills themselves because they couldn’t access the gender-affirming care they needed. Do you think the parents of that kid would care that you had a conversation at the governor’s mansion about legislation before he passed?”

Cox bristled at the question, claiming that the state’s ban had not resulted in any youth taking their own lives.

“No one in Utah has taken their life because there wasn’t gender-affirming care. Yes, I think the parents do care that we’re having those types of conversations,” Cox said without citing research on deaths in Utah.

The governor — who is up for reelection this year — then explained he signed the ban into law because there are “very real reasons to be concerned about what’s happening with our young people.”

“The explosion that we’re seeing in that type of care, something is wrong. No one can explain exactly what’s happening out there,” Cox said. “I care deeply about these kids. I love these kids. I want these kids to thrive. I want them to be successful. I think there’s a better way to do that than having genital mutilation surgeries before they’re 18.”

In Utah’s 2023 Student Health and Risk Assessment Survey, 61% of trans students who participated indicated they had seriously considered suicide at some point in the previous 12 months. Approximately 18% of their peers statewide responded they had such thoughts. A quarter of trans students answered that they had gone through with attempting to end their life.

“Gov. Cox misunderstood a question and was not happy with his answer,” a spokesperson for the governor told The Salt Lake Tribune on Thursday. “After the public exchange, the governor invited the student backstage and respectfully listened, and they discussed their differences for about 10 minutes. Both left the conversation with a better understanding of the other’s perspective.”

Equality Utah Executive Director Troy Williams, whom Cox name-checked during the discussion, said he was disappointed by the governor’s remarks.

“Even before Utah’s moratorium on transgender medical care, genital surgeries for youth simply did not happen. In order to disagree better, it’s important that the language our leaders use be factual and not inflammatory. In his recent comments, Governor Cox missed the mark on both counts,” Williams said in a text message to The Tribune. “So, we are going to challenge him to be true to his Disagree Better initiative. We are not going to blast or shun him. We are going to invite him into deeper dialogue and face-to-face connection with LGBTQ Utahns. Because that’s the only way Americans are going to successfully navigate this polarized era.”

‘An ally to the LGBTQ community’

Last year, the Republican governor signed a bill that bans gender-affirming surgeries for trans youth and indefinitely bars them from accessing hormone therapy and puberty blockers. Defending his decision in a conversation with The Washington Post soon after, Cox described himself as “an ally to the LGBTQ community.”

“We will continue to push the Legislature for additional resources to organizations that work to help this important Utah community,” Cox wrote in a statement at the time announcing his signature. “While we understand our words will be of little comfort to those who disagree with us, we sincerely hope that we can treat our transgender families with more love and respect as we work to better understand the science and consequences behind these procedures.”

His characterization of gender-affirming surgeries comes two weeks after he called on the Utah State Board of Education to take action against school board member Natalie Cline to resign following a social media post she made falsely insinuating that a Utah high school basketball player is transgender. In a statement, he and Lt. Gov. Deidre Henderson said Cline “embarrassed the state.”

The World Health Organization differentiates between female genital mutilation and gender-affirming care, defining the prior as “procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.” It is currently developing guidelines addressing the health of trans and gender-diverse people, although the organization opted to focus on care for adults.

Cox’s comments exemplify the hard right turn the governor — previously described by Time Magazine as “woke” — has taken.

Republican governors Greg Abbott of Texas and Ron DeSantis of Florida have also echoed misinformation around transgender health care, calling gender confirmation surgeries “genital mutilation.” During court proceedings on a gender-affirming care ban for trans youth, a federal judge reportedly noted DeSantis’ characterization of the care was false information.

Under his role as commander in chief of the Utah National Guard, Cox recently sent troops to aid Abbott’s controversial “Operation Lone Star” at the southern border with Mexico.

The governor is up for reelection in 2024, and as the election draws closer, he has faced increasing pressure from the political right. Cox faces four other Republican primary challengers, including Blanding state Rep. Phil Lyman and former Utah Republican Party chair Carson Jorgensen.

When 49 people were killed at a gay nightclub in Orlando nearly a decade ago, then-Lt. Gov. Cox made national headlines for an emotional speech he gave in support of Utah’s LGBTQ+ community.

As governor, he attracted national attention in 2022 again for vetoing a bill that would have banned trans girls from playing school sports. The Legislature came together in a special session to override his veto, and the law is currently tied up in court. Student-athletes currently must provide their birth certificate documenting their gender, and transgender girls have to prove they have undergone at least a year of hormone therapy.

After signing the gender-affirming care ban for trans youth in 2023, he went on to sign another bill targeting the transgender community for the second year in a row. Last month, Cox signed into law a bill that bans trans people from bathrooms and locker rooms that conform with their gender identities in government-owned buildings, including schools.

While Cox remains one of the few Republican governors to recognize Pride Month, he took a less enthusiastic approach in his 2023 declaration of the celebration.

In his first two years in office, Cox marked Pride Month with declarations encouraging Utahns to “be more inclusive and accepting of the LGBTQ+ members of our community.” But last year’s declaration didn’t mention the community at all.

Instead, it said, “the state of Utah values the uniqueness of all individuals within our communities and recognizes that everyone has a place in our state,” while a governor appointee overseeing multiple state agencies ordered Pride Month posts taken down from social media pages.

Editor’s note • This article discusses suicide. If you or people you know are at risk of self-harm, call or text 988 to reach the Suicide & Crisis Lifeline for 24-hour support.