WASHINGTON — In a far-ranging, free-wheeling 90-minute acceptance speech for the Republican nomination to the presidency, former President Trump hit the populist highlights: Americans will have faster access to new medicines, real answers for cancer and Alzhiemer’s disease, and better Medicare in his second term, he claimed.
But aside from a passing comment about womens’ sports, Trump stayed away from a growing effort by GOP lawmakers to limit transgender peoples’ rights and bar gender-affirming care. He also did not mention abortion, reflecting his campaign’s effort to distance Trump from increasingly unpopular bans that have alienated voters in key states.
Limiting abortion access and transgender health care are two key policy priorities that made it into a relatively sparse 16-page platform from the Republican National Committee this month. While the party is effectively shifting away from a hard-line push for a federal abortion ban it has leaned into making transgender people, roughly one percent of the U.S. population, central to GOP voters’ ire.
The shift happened as Trump and other Republicans saw broad voter opposition to interference in reproductive care, LGBTQ advocates say. As Trump, his VP pick JD Vance, and other party members softened their stance on abortion policy, they ratcheted up attacks on another avenue of health care, promising federal prohibitions on gender-affirming surgeries and treatments.
“They started to throw spaghetti at the wall to try to figure out where they could go next. And, unfortunately, what stuck was transgender youth,” said Lanae Erickson, senior VP for social policy, education and politics at Third Way, a center-left think tank.
Gender-affirming care for minors has ignited the conservative base and unleashed hundreds of bills in primarily red states seeking to bar it entirely, limit youth sports participation, and prohibit taxpayer funding for any procedure or care.
Yet nationally, polls suggest that moderate and independent support for gender-affirming care has actually grown in the past years. Fifty-six percent of independent voters opposed criminalizing gender-affirming care for minors in a March 2023 NPR/PBS/Marist poll, compared to 45% who opposed bans in an NPR/Ipsos poll the previous June. Republican opposition to minors’ gender-affirming care grew during that time, while Democrats’ support remained steady at just under 70%.
The polling runs parallel to voters’ answers on abortion policy: Sixty-three percent of Americans believe abortion should be legal in “all or most cases,” according to May 2024 polling from Pew Research Center.
Transgender peoples’ rights represent yet another thorny area of health care freedom for Republicans to step into, as voters respond to state bans. Most Ohioans, for instance, dislike candidates who champion gender-affirming-care restrictions. A federal court in the state this week heard challenges to a law that would bar gender-affirming surgery and medication such as hormone therapy.
The Supreme Court recently agreed to hear a case on Tennessee’s ban on gender-affirming care for minors, promising arguments as early as this fall about how far lawmakers can go to restrict health care services.
Trump hits the high points
Trump on Thursday night stuck to the high points of his presidency, touting a law intended to provide patients quick access to experimental therapies and pledging that he would fortify Medicare. While the vast majority of his hour-and-a-half speech rallied convention-goers on the economy, border control, and foreign relations, the former president hit on health care issues, such as Right to Try legislation, that have polled well with voters even if they have seen little impact so far.
“They’ve been trying to get that approved for 52 years. Wasn’t that easy,” Trump said of the Right to Try law, intended to expand terminally ill patients’ access to therapies still in the development pipeline. “What’s happened is we’re saving thousands and thousands of lives. It’s incredible.”
The Food and Drug Administration already has a compassionate use pathway for patients to appeal to take not-yet-approved medicines, and has cleared thousands of uses over the years. But under the Right to Try law, there were just four applications in the last fiscal year.
The former president also lambasted President Biden’s efforts to find cancer cures through the multibillion-dollar Cancer Moonshot project and railed that the Democrat has made no progress on Alzheimer’s disease.
“This man said we’re going to find the cure to cancer. Nothing happened. We’re going to get to the cure for cancer, and Alzheimer’s, and so many other things,” Trump said. “We’re so close to doing something great, but we need a leader that will let it be done.”
The fight over transgender rights
It was directly after Trump’s remarks on cancer and Alzheimer’s disease that he made his one passing mention of the brewing battle over transgender rights, pledging that “we will not have men playing in women’s sports, that will end.”
The comment bypassed what both the party and his vice presidential pick, Vance, have championed to effectively end certain forms of gender-affirming care, regardless of the person’s age.
The RNC platform states that the party will “ban Taxpayer funding for sex change surgeries, and stop Taxpayer-funded Schools from promoting gender transition.”
Besides blocking Medicaid and Medicare funding for such procedures,Republicans could institute laws that handicap any hospital with CMS funding that practices gender-affirming care.
Louisiana last year passed legislation blocking gender-affirming care for minors; the state’s department of health subsequently released a report showing that less than 10 minors in the state had received gender-affirming medicine such as puberty blockers between 2017 and 2021. The state recorded no instances of a minor undergoing gender-affirming surgery during that time.
“It is an exceptionally cruel policy that is looking for a problem,” said Kellan Baker, executive director of the Whitman-Walker Institute, a nonprofit medical organization focused on LGBTQ health care.
Limits to transgender peoples’ rights and health care rapidly became a Republican lightning rod in so-called culture wars with the left. The word ‘gender’ appears nowhere in the Republican National Committee’s 2016 platform, which it re-issued in 2020. By comparison, the Democratic National Committee’s 2020 platform mentions the word 15 times, mostly in the context of equity or anti-discrimination protections, but also twice in the context of protecting trans and nonbinary childrens’ wellbeing.
Republican lawmakers are well-aware that broad limits on transgender rights and health care do not resonate broadly. North Carolina’s so-called bathroom bill in 2016, which would have barred people from using facilities that aligned with their gender identity, was met with corporate boycotts and national criticism. But the pivot in recent years to focusing on minors’ health care choices has rallied not just conservative voters but concerned parents, advocates said.
“Democrats felt that they won the day on that issue,” in North Carolina, said Erickson. “But then, we’ve turned now to young people, and that’s where voters just think things are a lot more complicated.”