The Health Impacts of Anti-Trans Legislation: Looking Back on NC House Bill 2 to Understand the Current Political Climate by Jen Gathings

Hi everyone! My name is Jen Gathings (she/her) and I’m a Senior Research Associate with ETR Services, LLC in Durham, North Carolina. In 2018, I had the honor of conducting a health impact assessment of NC’s HB2 and HB142 legislative actions, what came to known as NC’s “Bathroom Bills.” These bills attempted to regulate the use of public facilities by transgender and gender nonconforming people in the state and were widely condemned by a number of groups, from the American Civil Liberties Union and Human Rights Campaign to the National Collegiate Athletic Association and the Atlantic Coast Conference. In December 2020, a key provision in HB142 expired, once again giving local governments the power to strengthen local protections to protect LGBTQ people from harm.

Our exploration of the health impacts of HB2 and HB142 taught us many lessons, some of which are unfortunately still applicable to NC’s current policy environment. You see, our legislature is at it again – but this time, they’re pushing three pieces of trans-discriminatory legislation:

  • SB514 seeks to deny gender affirming healthcare to individuals under the age of 21 and provide legal protections for “conversion therapy,” a scientifically-discredited and harmful practice that attempts to “cure” LGBTQ people;
  • HB358 aims to restrict transgender students from participating in school sports, essentially making assigned female at birth a requirement for competing in any girls’ or women’s sports; and
  • SB515 would allow healthcare workers the ability to deny any form of care or service “on the basis of conscience, whether such conscience is informed by religious, moral, ethical, or philosophical beliefs or principles.” 

So what did we learn from our work on HB2 and HB142 that’s relevant today? Regardless of whether these bills pass, they are doing harm. The media attention these bills receive is a double-edged sword: while important for raising awareness about how legislators are choosing to spend their time as we navigate a pandemic, the media attention these bills receive is harmful for transgender and gender nonconforming people.

During the height of HB2’s media coverage in North Carolina, transgender and gender nonconforming residents reported increased anxiety, depression, and sadness, being uncomfortable in public, feeling unable to use public restrooms, and changing or restricting their activities. News stories about bills such as these are often the catalyst for hurtful comments from unsupportive family members, acquaintances, and strangers online, opening up deep wounds and painful traumas for transgender and gender nonconforming people.

And here is the thing: North Carolina is not an anomaly. Similar measures are under consideration (or have passed) in states across the U.S., including Arkansas, Idaho, Michigan, South Carolina, and Texas, among others.

The evaluation community has an important role to play in pushing back against these legislative actions. Through policy work, health impact assessments, and other types of data-driven strategies, we can build a culture of decision-making rooted in evidence rather than fear. Our qualitative methods can work to humanize groups that are far too often dehumanized in our culture by sharing stories of harm, but also power, agency, and resilience. And through our connections with organizations and others, we can quietly (or loudly, your call) sow the seeds of justice everywhere we go.

Rad Resources:

Learn more about current anti-trans legislation under consideration:

Galupo, M. Paz. (2017). Researching While Cisgender: Identity Considerations for Transgender Research. International Journal of Transgenderism. 18(3): 241-242.

Darwin H. (2020). Challenging the Cisgender/Transgender Binary: Nonbinary People and the Transgender Label. Gender & Society, 34(3): 357-380.

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1 thought on “The Health Impacts of Anti-Trans Legislation: Looking Back on NC House Bill 2 to Understand the Current Political Climate by Jen Gathings”

  1. Hi Jen,

    I’m a graduate student, completing my Masters in Education at Queens University and am a middle school (grade 6-8 educator) in British Columbia, Canada. This is my first course in Evaluation and in searching out a blog post that interests me I found yours and was instantly intrigued by the use of evaluation, or health impact assessments as you note, in determining the detrimental impact of these bills on trans-youth. I am completely new to evaluation and am picking my way through concepts and learning, attempting to find the intersection between my role and passion as an educator and the use of evaluation in my day-to-day practice. What grabbed me about your post is that, while I live in Canada and am not dealing with the same trans-phobic legislation and bills, I do reside in an area with a very split school board, with some members being vocally anti-trans. The result has been divisive and detrimental to our students. I spent this past school year with a student in the midst of transitioning and could not imagine not supporting and loving this student regardless of gender or presentation. I think you summed it up beautifully: Through policy work, health impact assessments, and other types of data-driven strategies, we can build a culture of decision-making rooted in evidence rather than fear. I thank you for showing me the very human side of evaluation and how this new-to-me topic has such vast and impactful uses. I love the idea of using data to humanize, a pairing that doesn’t seem intuitive, but which may help build a more just society.

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