Hazel Smack (she/her) is the author of Rigged, Tipping Points Press/ASDE’s first novel for young people.

February 12th, 2025

I’m offering these words with enthusiastic consent and collaboration with the self-directed trans young person in my family, and in consideration of The Alliance for Self-Directed Education’s commitment to collective liberation and the human rights of young people. Queer young people are often drawn to the Self-Directed Education community to escape oppression (among many other reasons), and we want to be part of demystifying affirming medical care for trans young people — a scary elephant in the room of many intersecting lives and convictions right now. We want to be part of directly acknowledging the elephant in an effort to set it free.

We’re especially thinking of those who feel super okay with gender affirming care “except for the kids.” These are folks who we suspect genuinely want to feel supportive, but the scare campaign against the protection of trans young people is distracting and resonating with them, filling knowledge gaps with fear, exactly as intended.

Did you know that fewer than 1% of patients who receive affirming care note regret with those medical care decisions, which is much lower than in other areas of medicine? Fears about future regret are unfounded, unless you’re also using the rate-of-regret rationale for the withholding of lots of other medical care options that you and people you love (of all ages) have undergone or may want or need access to in the future.

Did you know that even the WPATH (World Professional Association for Transgender Health) and USPATH, who are concerned with human health rather than political ideology, already DO NOT recommend affirming surgical or medical intervention in young children? And that transition-related care is not recommended for every transgender person in every situation? That for young people in puberty and beyond, but not yet age 18, there is ALREADY IN PLACE a lengthy, thorough process to weigh the benefits vs. the risk in accessing affirming medical care for each individual?

In our first-hand experience, it took two years of working with pediatricians, pediatric endocrinologists, psychologists, and other professionals just to be cleared for the most basic care. In fact, by the time we gained access, more intervention was warranted than we originally sought. It is ALREADY, NOW, TODAY a cumbersome process that requires privilege and gatekeeper access that it shouldn’t. It was ALREADY RESTRICTIVE before erasure of trans and nonbinary young people became a favorite national political pastime in the U.S.

Human history has given us a pretty good idea about how fascist tyranny rolls out and over the easiest targets in order to get to the bigger ones who, by then, are too mortified to acknowledge that they were complicit in their own destruction. So here’s a thought experiment that’s easier to conceptualize, particularly for Americans:

How might it feel if your access to the best, most current science-backed cancer care for your child becomes limited or revoked because, in an effort to Make America Healthy Again, politicians codify into policy the idea that you’re not a healthy-enough American family? Maybe you brought on your child’s cancer with their diet, or you lack documented participation in school or extracurricular sports activities, for example. Or first, you must spend precious time and energy trying electromagnetic therapy, or urine therapy, or mushroom juice enemas, even if that’s not what you or your child wants to do and not what your doctors recommend as the best, or only, course of action in your child’s specific situation. And there are risks and side effects with medical cancer interventions in young people, so let’s keep it really simple and say that, in this thought experiment, politicians use this, alone, to severely limit or deny access.

Further, imagine that, if you try to find ways to get your child the help that you, their doctors, and they themselves know they need, you’ll now be arrested, prosecuted, and imprisoned on the public’s dime — so, with your own money–which is far more expensive than, in the case of basic affirming medical care, simply getting the small number of young people who are actually seeking this care the help they need (for those who insist on measuring everything in dollars).

We’re also hearing a lot about mental health-only approaches lately, including from our friends and family on the left, some whose families practice SDE. If you’re prepared to tell young folks to simply psychology their way out of needing gender-affirming care, you and the young people you’re raising need to immediately stop getting your nails done, stop wearing bras, stop wearing make-up, stop skipping leg day to focus on pumping your pecs, stop putting babies in dresses based on their genitalia, stop breast augmentation, butt lifts, Botox, Ozempic, facelifts, extensions, nose jobs, hair plugs, dyeing, curling, straightening, sculpting, waxing, tweezing, plumping, sucking, filling, and everything else you do to affirm who you’re trusted to know you are, but don’t match on the outside without PAH-LENTY of affirming intervention.

Instead of having the choice to access these and other forms of gender-affirming care, have you considered simply going to counseling to learn how to exist without them, as you were born? Because the ways that YOU deserve to exist in the world based on gender role expectations has a profound effect on my child, see? Still, I think you have the right to do these things and to facilitate them for the young people in your care. I want you to have the freedom to make those decisions, particularly if you’re doing it with consideration of input from medical and mental health experts, and particularly if there’s more risk of harm by taking away your access.

Another elephant-sized layer underneath concern for trans young people getting care, is a fear that other young people will catch communicable Queer. The percentage of young people who are trans and who also seek medical affirming care is very small, and the number of trans people is not growing. Trans, nonbinary, and otherwise Queer people have ALWAYS been here, in every culture in every corner of the globe. The increase we’re seeing is people of all ages in some spaces — including SDE spaces like free schools, Agile Learning Centers, democratic schools, and Flying Squads–feeling braver to exist freely instead of hiding themselves in order not to lose their friends, families, or livelihoods, or instead of harming themselves, all while not infringing on the rights of anybody else to do the same thing. What a concept.

Please remain open (or reopen) enough to consider that your own rights and those of people you love are very much at risk along with the rights of those who some are very actively trying to erase. Erasing health care for trans young people is an easy inroad to allowing one fearful and overrepresented brand of American to retain and grow their power over others.

Deschooling includes continuously working to unburden ourselves from the absolute lie that life is a competition and that there are a finite number of free people allowed to exist on Earth at the same time. Learn something new to you, even if you’re 80 and already know everything. At a minimum, be big enough to reconsider any support you feel for targeting and removing health care access for this small, already vulnerable population of young people.

Hazel Smack (she/her) is the author of Rigged, Tipping Points Press/ASDE’s first novel for young people.