SAFE or Not Safe? Perspectives of MO Gender-Affirming Care Providers in Response to Anti-Trans Care Legislation

Receiving gender-affirming care is a life-saving intervention for many, yet the current wave of transphobic rhetoric and anti-trans legislation, such as the Missouri (MO) Senate Bill 49 “Save Adolescents From Experimentation” (SAFE) Act, continue to restrict trans individuals from accessing gender-affirming care. Previous literature depicts medical providers as enactors of medical power and authority, producing knowledges of trans subjectivities, constructing and controlling trans bodies, and gatekeeping medical care from trans individuals; however, the changing roles, labor, and acts of resistance trans care providers perform under the recent context of heightened social surveillance and legal restrictions have yet to be documented. This study analyzes the nuanced positionality of MO gender-affirming care providers through semi-structured interviews, demonstrating how the current medical institution reproduces imbalanced patient-provider power dynamics on the basis of empirical objectivity and places a double bind on providers between quietly maintaining trans care and vocally advocating for trans rights. Many providers of trans care also exist at the intersection of multiple disciplines, roles, and identities, demonstrating the necessity for reproductive justice frameworks in future research to critically evaluate the systems that produce intersectional harm for non-White, non-cis, non-heterosexual, physically and/or mentally disabled people.