Families with transgender children seek refuge in Minnesota

The ‘Trans Refuge Bill’ would protect families who travel to access gender-affirming care in Minnesota

By: - March 9, 2023 6:00 am
A young girl with brown hair carrying colorful teddy bear in blue pajamas sits in between the legs of adults in dark and neutral clothes. The girl looks up at her brother and the adults. The teddy bear is almost as big as the girl.

Asher Nguyen, a 6-year-old trans girl, looks up at her brother right before Gov. Tim Walz signed an executive order to protect access to gender-affirming care in Minnesota. Her father, Hao Nguyen, testified for the Trans Refuge Bill and spoke at the executive order signing. Photo by Grace Deng/Minnesota Reformer.

Louie Bullock was 17 years old when Texas Gov. Greg Abbott ordered the state to investigate families with children receiving gender-affirming care for child abuse. Bullock, who is non-binary, said that’s when they knew their home in a small town outside of Austin was no longer safe. 

“There had been moments where I would just cry,” Bullock said. “I’d be so scared about what was going on. My safety was on the line. My family’s safety was on the line. It was a surreal experience. It really felt like we weren’t being looked at as people who have feelings.” 

Last year, Bullock, their mother and their three siblings moved to Rochester. 

Bullock, now 19, said the situation in Texas stirred up anti-trans sentiment — so they got out while they could. Bullock’s mother, Catherine Mattijetz, said she was hearing from trans friends who were being verbally and physically assaulted. One friend, she said, was hit by a car. 

Nationally, right-wing attacks on transgender people have skyrocketed: At a recent conservative political conference, Daily Wire host Michael Knowles said “transgenderism must be eradicated from public life entirely.” 

In the United States, transgender people are four times more likely to be the victim of a violent crime. Bullock’s family moved to Minnesota in part because of its status as relatively trans-friendly — but trans people face violence everywhere, including Minnesota: On Feb. 27, a transgender woman was brutally attacked at a Minneapolis light rail station. Investigators are considering the possibility it was a bias-motivated attack. 

Although Texas is the first state to investigate families of trans kids, at least 29 states have proposed bans on gender-affirming care for minors. Florida recently introduced a bill that would allow courts to “vacate, stay, or modify” child custody determinations if a child seeks gender-affirming care, allowing a disapproving parent to take custody away from a child’s custodial parent. At least seven states ban gender-affirming care for youth, according to the Movement Advancement Project, which tracks LGBTQ-related legislation. One state, Alabama, makes it a felony to provide gender-affirming care to trans youth. 

There is not yet data on the number of families with trans youth who have left their homes to seek refuge in Minnesota, but the medical director of the gender health program at Children’s Minnesota, Dr. Angela Kade Goepferd, said they have seen more out-of-state patients and families. 

Rep. Leigh Finke, DFL-St. Paul, the state’s first out trans legislator, said she gets messages roughly daily from families with trans kids planning to come to Minnesota or thinking about coming. 

“Families who have fled are already here, and many more are planning to come. We’re going to be ready to take care of them, and to provide them with the health care they need,” Finke said.

In January, Finke introduced the “Trans Refuge Bill,” which would protect trans people, their families and medical practitioners from legal repercussions if they travel to Minnesota to seek gender-affirming care. A similar bill was introduced last year, but the DFL trifecta means Finke’s bill (HF146) has a shot at passing. 

“As soon as we realized we would be in the trifecta, this was the bill I wanted to pass,” Finke said. “To me, it’s the most straightforward thing we can do right now to help my community.” 

A woman with dark roots and pastel pink hair in a pastel pink suit stands behind a podium and looks down, with a slight smile on her face.
Rep. Leigh Finke speaks before Gov. Tim Walz signs an executive order to reaffirm the right to access gender-affirming care in Minnesota. Photo by Grace Deng/Minnesota Reformer.

Gov. Tim Walz signed an executive order Wednesday barring Minnesota’s agencies from cooperating with other states seeking to prosecute people for traveling for gender-affirming care in Minnesota. At the signing, he called on the Legislature to add additional protections by passing the Trans Refuge Bill. He said he would even travel to other states and use his platform to advertise Minnesota as a welcoming place. 

“It’s one thing to not be a bully. It’s another to be anti-bullying,” Walz said. 

What is ‘gender-affirming care’ and why is it important? 

Goepferd, who is also a practicing pediatrician, said gender-affirming care for prepubescent children just looks like a supportive environment for trans and gender non-conforming children, such as using inclusive language and the correct pronouns. 

“It’s developmentally appropriate care to help understand and support a child’s gender experience,” Goepferd said. 

Trans people have crossed state and national borders seeking gender-affirming care since at least the 1930s. In the 1950s, American World War II veteran Christine Jorgenson traveled to Denmark to receive care and became the face of gender-affirming surgery. 

The first gender-affirming clinic in the United States opened at Johns Hopkins University in 1966. The University of Minnesota can trace the roots of its current gender care program back to the 1970s, when it established one of the longest-running gender care services in the country. 

Data from over a dozen studies shows access to gender-affirming care is associated with better mental health outcomes for trans and nonbinary people. Trans people have much higher suicide rates than the general population: One study found 82% of trans people have thought about killing themselves and 40% have attempted suicide. 

Today, medical treatments for transgender and nonbinary youth can start with prescribing puberty blockers at the start of puberty — usually between 8 and 12 years old — according to current medical standards. Hormone replacement therapy can start as early as age 14, according to recently updated guidelines from the World Professional Association for Transgender Health. The same guidelines suggest that some surgeries can be done at age 15 or 17, a year earlier than previous guidance. Goepferd said it’s rare for minors to receive surgical care. 

WPATH guidelines recommend a mental health screening before any medical transition. Many clinics require a referral from a licensed mental health professional before allowing patients to access hormones or surgery. 

Bullock, for example, did not receive any medical gender-affirming treatments as a minor, despite realizing they were non-binary around 10 years old — although looking back, their mother says she picked up signs as early as Bullock’s toddler years. Now, Bullock is looking into starting testosterone soon and eventually receiving top surgery, a procedure to remove breast or chest tissue.

Hao Nguyen, who testified in support of the Trans Refuge Bill at a committee hearing, said his 6-year-old daughter, Asher, goes to Goepferd because he wants her to receive health care from doctors who understand. (Goepferd provides no medical treatment to patients that young other than talk therapy.) 

“It’s no different from saying, ‘Well I’ve got this semi-unique condition and it’s something to do with my spine,’ — you go find someone who knows about that,” Nguyen said. 

Why the “Trans Refuge Bill” matters to families with trans youth 

Nguyen, whose testimony went viral on TikTok, said he read every single comment on the video, and he found them heartbreaking. Nguyen said the commenters were “grown-up Ashers” — his daughter, but grown up — who wrote about wishing they had support when they were younger or that their families could be supported by legislation like the Trans Refuge Bill. 

“For me, it was just like, wow, there are so many people hurting. There are so many people who need acceptance. There’s so many people who want to know that this part of their life is gonna be OK. I mean, life’s hard enough,” Nguyen said. “People shouldn’t have to — grown-up Ashers, little Ashers shouldn’t have to think, ‘Can I get health care?’”

Opponents of the bill claim it infringes on parental rights. 

“HF146 takes away custody from parents or guardians who deny their children access to gender-affirming health care,” said Rebecca Delahunt, assistant director of public policy for the Minnesota Family Council.

The claim refers to a section of the bill that gives courts “temporary emergency jurisdiction” over cases in which a child has not been able to obtain gender-affirming care. Christy Hall, an attorney with the progressive nonprofit group Gender Justice, said the bill has no impact on child custody law. 

The section on temporary emergency jurisdiction gives families and youth seeking gender-affirming care the right to have their case heard in Minnesota without the six-month residency period usually required in state court cases, but it does not change the way child custody cases are decided by courts. 

“This just makes it possible so a parent can say: ‘Wait, I want a Minnesota court to decide this.’ I don’t want, let’s say, Texas, to have jurisdiction. I want Minnesota to have jurisdiction,” Hall said. 

A person wearing a colorful graffiti shirt with green hair hugs a black and brown medium-sized dog in a bowtie. Both are wearing little party hats.
Louie Bullock with their dog, Corn, celebrating their birthdays together. Photo courtesy of Catherine Mattijetz.

Bullock’s family said Minnesota’s environment overall has been much more accepting than Texas. Doctors are more likely to ask for Bullock’s pronouns, and when people say Rochester is “conservative,” Mattijetz said it’s like when Minnesotans tell you it’s “hot” outside: It’s just a completely different frame of reference. 

It was hard for Bullock to leave behind people who meant the world to them — their father, who they’re close with, is still in Texas — but moving to Minnesota was like moving toward hope. For Bullock’s family, the Trans Refuge Bill represents a sorely needed piece of legislation. Mattijetz said the bill makes her feel like her family chose the right place. 

“I hadn’t realized just how much pressure and how much weight I was carrying on my shoulders out of worry for them,” said Mattijetz, referring to Bullock. “Once I got up here and saw things were good for them, I realized that weight was just gone.” 

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Grace Deng
Grace Deng

Grace Deng was a reporting intern with the Minnesota Reformer. They studied legal studies and Asian American Studies at Northwestern University. The Seattle native has previously been a statehouse intern with USA TODAY Network Ohio and an editorial fellow with Washingtonian Magazine.