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Across the U.S., lawmakers are pushing for restrictions on transgender youth’s right to gender-affirming care — despite continuing evidence that such care comes with major benefits, particularly for trans people’s mental health. Just this year, state legislatures in 46 states have introduced almost 500 “anti-trans” bills, according to the Trans Legislation Tracker.

In this climate, Minnesota is looking to establish itself as a “trans refuge state” — an effort led by state Rep. Leigh Finke, the first trans person in Minnesota’s state government. In January, Finke introduced legislation to proactively protect trans youth who live in her state, as well as people who may travel to Minnesota seeking gender-affirming care they can’t get at home. The Minnesota House of Representatives recently passed the bill, which is now with the Senate Judiciary and Public Safety Committee. Governor Tim Walz, who has already signed a symbolic executive order in support of gender-affirming care, has said he will sign the bill.


STAT spoke with Finke, who was recently named one of USA Today’s “Women of the Year,” earlier this month about protecting trans youth and the overlap in the backlashes against gender-affirming care and reproductive rights.

The conversation has been edited for length and clarity.

What is a trans refuge state? And can you tell me about some of the details of the legislation you’re proposing?


We have legal gender-affirming care available for everyone who needs it in the state of Minnesota, but not every [other state] does. So this bill would allow people who live in states where gender-affirming care is banned — mostly for minors and vulnerable adults, currently, but not for long — to travel to Minnesota to receive their care. Minnesota’s legal system will protect them from out-of-state legal consequences. Many states make it not just illegal to receive gender-affirming care, but illegal to travel to receive that care. So we are saying while you’re in the state of Minnesota receiving that care, Minnesota’s jurisdictional system of custody and courts will protect you while you’re here receiving that care from out-of-state legal prosecution.

So how exactly would this legislation protect these families?

It does it in a few ways. One is protection of the data. So it says, what’s happening in Minnesota will stay in Minnesota, essentially. We will not return medical records to a state that intends to use those records to prosecute. And it also allows temporary emergency custody for court proceedings to unfold in the state of Minnesota while [parents and children are] in the state for that care.

Why is it important now to put this legislation forward?

I am the first trans person in the state government. We also have a nonbinary person here. We came in expecting to be in a divided government, but we ended up in the trifecta [of Democratic party control of the state Senate, House, and governor’s office]. In my mind, this is the most important thing that we can do — the most important thing that also seemed possible.

And it’s just gotten clearer and clearer. Our neighbor, South Dakota, has banned gender-affirming care [for people under age 18]. People from Texas have already moved here — I’ve met several people and families from Texas, from Florida. So the urgency couldn’t be more real for my community. Our neighbors are taking away our rights. This has support. We want to be the kind of state that says: If somebody needs help, we want to be a state that will help them. If you are a parent who’s concerned about your child’s future, come to Minnesota, and we will do everything in our power to make sure that you will be safe, and you will access health care that you need, and that your child needs, really, to survive.

That’s interesting phrasing you used — “the most important thing that also seemed possible.” What do you wish could be done? 

There’s a switch that happens when you’re doing politics as a trans person, right? Sometimes we are like a social contagion that’s taking over every child in America, but other times we’re just this teeny little thing that doesn’t really matter, and we shouldn’t bother spending money on it. I hear things like, “Oh, you only care about trans people and trans rights.’’ And it’s like, well, it feels like the only thing the whole entire Republican establishment cares about, too. So having one person who’s trans and worried makes sense.

I think the most important thing we could do after trans refuge would be to protect kids in schools. We need to make sure every child can play in the athletic space that is correct. It’s not just that they want to, but that it’s the right team for them to play on. We want to do that. And that’s harder. That’s going to take a lot more convincing than “we should continue to provide health care that we already provide.” We need to make sure that children who are queer — because there are queer children — have a space at their schools to have their own reality reflected back to them, if they do not live in an environment at home where that’s happening. We can’t have children just being completely denied who they are in every aspect of their life.

Are there other political movements related to health care, perhaps abortion and reproductive rights, that you look to for guidance as you work through this?

The trans refuge bill is a shield law. We have a very similar bill for abortion care that’s moving right now. And I’m part of the Reproductive Freedom Caucus. The Venn diagram of what’s happening for trans people and what’s happening to abortion, it’s the same work. The values of bodily autonomy and the values of the freedom to make your own health care choices, they really overlap so often. And I’ve been really grateful — I don’t think we would have the success we’re seeing with the trans refuge bill without the support of the Reproductive Freedom Caucus. So we definitely look at their work and we work together.

I introduced [another] bill called the Gender-Affirming Rights Act. It’s saying we need to be proactive, we need to put into statute in this state that we will protect gender-affirming care. We don’t have that right. We have that care available, but no one’s ever said we need to protect it in the future. I very strongly believe that right is going to be at the Supreme Court in the next five years. And we can do it now instead of doing it after the fall, like we are doing on abortion.