In Winning Battles, Are We Losing the War?

My name is Danni Askini. I’m the Executive Director of Gender Justice League, a civil rights organization I founded in Seattle in 2012 with some of my best friends. I’m also the ED of Trans Pride Seattle, our annual pride festival now reaching 30,000 people, the second largest trans event in the country and going 13 years strong. I am currently Co-Chair of the No Hate in Washington State campaign.

As a person who transitioned in late middle school and early high school in the 1990s, I’ve spent nearly thirty years in this work. Across thirty-two state legislatures. In international human rights bodies including the UN Human Rights Council. And in the streets, the clinics, the courthouses, and the living rooms where the actual consequences of these policies land on actual people. I am a trans woman, a policy strategist, and, at the moment, a person trying to build a statewide campaign to defeat two anti-transgender ballot measures in Washington State this November.

This newsletter is where I will write about what I see: not just the headlines but the architecture beneath them. I’ll do my best to identify the patterns, the legal doctrines being constructed, the historical parallels, the institutional mechanisms being assembled against trans people. The things I wish more people understood about how our rights are dismantled. Not in one dramatic act, but through the patient, bureaucratic accumulation of precedent, procedure, and fear of the populations least able to actually cause harm.

What trans people are experiencing in 2026 is sadly nothing new in American and global history, but it does have particular salience to my own life. I will do my best to draw parallels, to look at past examples of similar tactics, while not drawing direct one-for-one comparisons to past horrors. Oppression morphs, evolves, and has become increasingly sophisticated and bureaucratic. We don’t need to invoke killing fields, murderous campaigns of conquest, concentration camps, or mass incarceration to illustrate the extreme harms that are happening. Few genocides were “obvious” at the start. They only became apparent once the bureaucratic machinery was in place to achieve the destruction of a population.

I’ll do my best to publish monthly updates like this one. I will also write longer analytical pieces when something demands it or when I see a topic that isn’t being engaged with broadly. I’ll be honest about what I don’t know, and I’ll provide the inside scoop when it won’t hurt our efforts.

If you work in this movement as an organizer, a funder, a litigator, a legislator, or a journalist, I want this to be the most strategically useful thing in your inbox. If you’re a parent, a family member, a friend, or someone who simply believes that civil rights should not be subject to popular referendum, I want you to finish each edition understanding something about our politics, culture, and history that you didn’t before.

That’s the deal. So here is March’s overview.

On Wednesday, March 18th, a federal judge in Eugene, Oregon announced from the bench that he was vacating Robert F. Kennedy Jr.’s declaration from December 2025 on gender-affirming care, specifically the one that threatened to strip Medicare and Medicaid participation from any provider who offered puberty blockers, hormones, or surgery to transgender youth. The ruling was unequivocal. Judge Mustafa Kasubhai called the declaration what it was: an end-run around the Administrative Procedure Act, issued without notice, without comment period, without the basic procedural requirements that separate policy from decree. “The notion that ‘I will go forward and issue a declaration and see if we can get away with it,’” the judge said, “is not a principle of governance.”

Good news, right?!

The headlines certainly thought so. “Judge blocks Kennedy’s anti-trans healthcare declaration.“ Attorneys general celebrated. At that very moment I was in a meeting with Attorney General Nick Brown of Washington State in Seattle when we received the news, and we were elated. Advocacy organizations sent fundraising emails and I’m grateful for the shot in the arm for our community - we can use all the good news we can get these days.

The bigger story about the ruling is that while these District Court wins help, they only go so far. Federal district and appeals courts have largely sided with us over the last 15 months, but the US Supreme Court is another story altogether. Behind every victory in a lower court (Shilling v. Trump, Talbot v. Trump, Orr v. Trump) where we have secured an injunction, the conservative majority on the US Supreme Court has used the so-called “shadow docket” of emergency appeals to allow the Trump regime’s policies to go into effect with devastating consequences for trans service members and accurate passports.

It is thus that I have watched with painful reluctance as our cases move forward. I am increasingly fearful that we could just be putting another brick in the wall of our own destruction. I say that not without hope, but with a clear-eyed analysis that this Supreme Court has very clearly spelled out that they have little to no interest in placing restrictions on Executive Branch overreach when it comes to harming trans people. In their Skrmetti decisions, in issuing a stay of our injunctions, the Court has clearly signaled that they do not believe trans people should be given “suspect class” standing under the Fifth or Fourteenth Amendment and that only “rational basis” review should be applied. That is, any reason, no matter how flimsy, that the government puts forward should be sufficient to allow executive actions and state laws to go into effect.

I read the ruling from Oregon, and then I opened the Fourth Circuit’s decision from ten days earlier and I have not been able to stop thinking about what these two rulings look like when you hold them side by side.

The Oregon ruling matters in that it stops immediate harm that trans youth are facing nationwide. Providers in plaintiff states can continue offering gender-affirming care to young people without the threat of federal program exclusion hanging over their heads, at least for now. As someone who fought tirelessly from 2000 until 2024 to expand Medicaid and Medicare coverage to include gender-affirming care, both at the state level in Oregon and Washington and federally, mobilizing literally thousands of people, attending hundreds of hearings and meetings, filing nearly a dozen lawsuits, to see it revoked by a single man’s “opinion” is deeply insulting to my sense of justice and indeed to the very core ideas of democracy.

The Kasubhai ruling is a procedural victory, and that’s important. Kennedy’s declaration was struck down because he didn’t follow the federal Administrative Procedure Act’s (APA) notice-and-comment requirements.

For folks who are unaware, the APA is the federal law that governs how “rules” issued by executive agencies must be made. The APA is very well known in legal and policy circles, but is rarely taught in school or discussed in the media. It is a congressionally passed law that outlines the “rules of the road” when a federal agency or administration wants to change a policy that is not explicitly spelled out in federal law. In many cases Congress doesn’t get into the weeds of how a law should work in practice. They leave it up to each agency to write the rules through “rulemaking.” The APA outlines how this rulemaking happens and is one of the most important mechanisms for ensuring a transparent, fair, and public process that allows all stakeholders to give input before a final rule that will impact our real lives goes into effect. I will spend a lot of time talking about state and federal Administrative Procedure Acts. It has been one of the key aspects of my advocacy and litigation work over the last 25 years.

In the end, even with this big ruling, the administration can simply do the rulemaking correctly next time.

In December, HHS already proposed two additional rules through proper channels that would accomplish the same objective: withholding federal funds from providers who offer gender-affirming care to youth. Those rules are moving through the pipeline while we celebrate the Oregon decision. Gender Justice League and many of our national partners worked together to submit public comments opposing these rules, but we know the outcome. No matter what evidence, public comment, or stories we bring forward, the steamroller of this administration’s bureaucracy will continue to pave over our rights.

Unlike our win in Oregon, constitutional losses at the appellate level build walls that lower court procedural wins cannot knock down.

On March 10, a three-judge panel in Anderson v. Crouch ruled that West Virginia can exclude gender-affirming surgeries from Medicaid coverage. It was the first federal appeals court to apply United States v. Skrmetti, the Supreme Court’s June 2025 decision upholding Tennessee’s youth care ban, but this time to adult healthcare. The panel cited Skrmetti over seventy times. Consider this a “one ruling to rule them all” approach. Judge Julius Richardson wrote that “it is not irrational for a legislature to encourage citizens to appreciate their sex and not become disdainful of their sex.“

Read that sentence again. That is a federal judge, writing in a published opinion, articulating a state interest in compelling gender conformity.

Then the critical line: “If a State can reasonably ban it, of course a State can reasonably refuse to pay for it.“

Legal commentators immediately recognized that language as a roadmap for future litigation. If Medicaid exclusion is constitutional, the logical next step, adult care bans, is already pre-authorized by the court. At least seven other states face active lawsuits over similar Medicaid exclusions. The Ninth Circuit is currently reconsidering M.H. v. Hamso, a parallel case also remanded post-Skrmetti. If the Ninth Circuit follows the Fourth, the appellate consensus solidifies. If it splits, we get another Supreme Court case, this time on adult care. I feel horrified to face the simple fact that the Supreme Court is not on our side, around youth gender-affirming care or adult. It feels almost a requirement for the majority who struck down Roe v. Wade in the Dobbs decision to remain intellectually consistent and allow states to ban gender-affirming care across the board. Conservatives know this, and that’s why they are going after it.

So here is the question I want to sit with and ask myself every day:

We are getting procedural injunctions, temporary relief contingent on administrative error, while the constitutional architecture for eliminating transgender healthcare is being built at the appellate level, one published opinion at a time. The Fourth Circuit ruling isn’t the final word. But when combined with similarly appalling rulings coming out of the Fifth Circuit (Louisiana and Texas) it is a deeply disturbing development.

On March 2, the Supreme Court blocked California from enforcing rules that restricted when schools could notify parents about students who come out as transgender. Mirabelli v. Bonta. Six to three, along ideological lines.

I want you to hold Mirabelli next to Skrmetti and next to last summer’s Mahmoud v. Taylor. Because together, these three cases reveal something the Court has not yet been forced to say aloud.

In Skrmetti, parents who supported their transgender children’s access to gender-affirming care brought claims under the Due Process Clause of the Fourteenth Amendment arguing that Tennessee was interfering with their fundamental right to direct their children’s medical treatment. The Court refused to hear those claims. Justice Kagan, dissenting, noted that the majority “would not even hear the parents out.”

In Mahmoud, decided in June 2025, Muslim, Catholic, and Ukrainian Orthodox parents in Montgomery County, Maryland sued after the school board introduced LGBTQ-inclusive storybooks into elementary classrooms and then eliminated the opt-out policy it had originally offered. The books, including stories about same-sex weddings and transgender children, came with teacher guidance designed, in the Court’s language, to “disrupt” children’s thinking about sexuality and gender. Justice Alito, writing for a 6-3 majority, ruled that the school board’s refusal to allow opt-outs burdened the parents’ right to free exercise of religion under the First Amendment. Montgomery County settled in February 2026 for $1.5 million and a permanent injunction requiring advance notice and opt-out rights. The Becket Fund attorney who argued the case warned that “public schools nationwide are on notice.”

Then in March, Mirabelli extended the logic. Parents who opposed their children’s gender identity brought First Amendment Free Exercise claims against California’s nondisclosure policies. The Court, citing Mahmoud, not only heard those claims; it blocked the state policy while litigation continues.

Now line up all three cases. In Skrmetti, parents who affirm their transgender children invoke the Fourteenth Amendment and are turned away. In Mahmoud and Mirabelli, parents who object to LGBTQ-inclusive education or their own children’s gender identity invoke the First Amendment and win 6-3. The same constitutional principle, parental rights, now operates in only one direction. Parents who reject their children’s gender identity receive heightened constitutional protection. Parents who affirm their children’s gender identity do not.

This is not a neutral principle being applied evenhandedly. This is a doctrinal weapon being aimed. And with Mahmoud now on the books, every school district in the country is calculating the cost of including LGBTQ people in the curriculum at all. Educators are already pulling back not because they’ve been ordered to, but because the legal risk and administrative burden of offering opt-outs for every lesson that mentions a gay or transgender person makes the simpler choice obvious: don’t mention us at all.

The last few years of anti-trans rulings have been a “mask slipping” moment for the Roberts Court, destroying any pretense that the current Supreme Court is an ideologically neutral body merely carrying out impartial judicial procedures. The Roberts Court’s doctrinal thesis when it comes to trans rights can be summed up as: “The powerful shall rule, and the powerless will suffer what they must.”

It has become alarmingly clear to me, and I’m certain to many other scholars, that the Roberts Court is now a purely political body carrying out a political program. For trans people, this means a program designed to attack and rip away any rights or progress we have made as a disfavored minority. This is a classic fascist political approach: crush and destroy the powerless “enemies within” to create fear among your political opponents and ensure compliance with authority. That is what makes an authoritarian regime, and certainly the current Roberts Court is an extension of that intellectual philosophy.

I cannot guess where the United States will end up in 100 or even 50 years, whether we will still be a democracy, or even a single country. But I do know that legal and political historians will look back on this period, on the federal courts’ actions, and see quite clearly that the Court abandoned any pretense or sense of duty to protect a powerless minority’s rights in the face of a genocidal majority hell-bent on the destruction of a group. These last few years since the Bostock decision (perhaps itself a case of temporary insanity), not even a fig leaf of consideration has been offered to conceal the Roberts Court’s contempt, disdain, and denial of trans people’s inherent rights. In their view only “past minorities” should retain future protections. There are “no new suspect classes” because of course human beings and society are completely static. But even as we saw with the Dobbs decision, their thesis of past minority protections is itself squarely in doubt.

Kansas SB 244 took effect on February 26, after the legislature overrode Governor Laura Kelly’s veto. The ACLU filed suit the same day.

I need you to understand what this law does, because it is the template of what is to come.

It retroactively invalidates existing, lawfully issued driver’s licenses and birth certificates for transgender Kansans. People received letters from the state, mailed the day before the law took effect, informing them that their IDs and licenses were “no longer valid.” It prohibits future changes to birth certificates or driver’s licenses. It bans transgender people from using government building restrooms consistent with their gender identity, where they would be safe. It also creates a private right of action allowing anyone who suspects someone may be transgender and in the wrong restroom to sue that person for a thousand dollars.

Of course, to put a cherry on top, Kansas requires valid ID to vote. Let that sit.

The state issued identification documents to its transgender citizens under lawful authority. Then it retroactively revoked them. Rep. Abi Boatman, the only transgender member of the Kansas legislature, said it plainly: “The persecution is the point.”

This connects directly to work I’ve been doing on a Washington State framework for judicial gender recognition, the idea that states can use their sovereignty over vital records as an affirmative tool rather than waiting for the federal government to strip recognition from above. Kansas is the other side of that coin: state sovereignty weaponized to erase. For several years I’ve tried my hardest to establish a clear judicial process for people in Washington State to obtain an optional gender marker change court order, perhaps solidifying a more clear authority to change identity documents. Many states require a court order to amend things like birth certificates, yet Washington has no clear-cut process for obtaining one. This is my future work for the 2027 legislative session.

Another ongoing area of my work is trying to address the crisis faced by trans youth in accessing gender-affirming care. If you’re trying to understand why hospitals are closing gender clinics without any law requiring them to do so, you have to look at the full constellation of pressure they have been facing. This can be difficult if you don’t have three decades of advocating and navigating the healthcare and health insurance bureaucracy as I have. So I’ll do my best to lay it out for you.

CMS Administrator Mehmet Oz, aka “Doctor Oz,” met directly with medical society leaders to press them to withdraw their support for gender-affirming care. Most of them held the line at the meeting. But the Society for Plastic Surgeons did not. Somehow the idea that “for cash” surgeons, largely dominated by conservative cis men, were the ones to betray trans people first basically surprises no one. On February 18, NYU Langone permanently shuttered its Transgender Youth Health Program after federal funding threats. On February 25, New York AG Letitia James demanded the program be restarted. On March 10, Oz sent a public letter defending the closure and describing gender-affirming care as “sex-rejecting procedures.”

“Sex-rejecting procedures” is the kind of language designed and intended to be dehumanizing, inflammatory, and flatly genocidal. It is the type of language used to incite violence against medical providers, patients, and parents who are seeking gender-affirming care. This is not merely an ontological “battle” between how we label medical procedures. There is ample scientific literature and medical consensus about what gender-affirming care is. Dr. Oz’s relabeling is a strategic choice to attack trans people. It is exactly the type of rhetoric that precedes the destruction of any population, and Dr. Oz should be ashamed to participate in such hatred. It is completely unsurprising, however. Dr. Oz faced sharp criticism as a Turkish American candidate for office in Pennsylvania when he was unwilling to publicly condemn the actions of the Turkish government in World War I that resulted in the Armenian Genocide.

Simultaneously, the FTC issued civil investigative demands to the American Academy of Pediatrics and the Endocrine Society, functionally treating their clinical practice guidelines as “deceptive marketing.” Both organizations sued, as did WPATH. The AAP’s filing argued: “Unable to prevail in the marketplace of ideas, the FTC has resorted to burdening AAP with an intrusive and expensive investigation.” The DOJ separately issued over twenty subpoenas to hospitals and clinics providing gender-affirming care. These actions are intended to drive up the cost of providing care, put a “bad taste in the mouth” of providers, stoke fear, and use the power of the federal government to harass a minority ill-equipped to fight back. This is Putinesque in its tactics: use the power of the federal government to burden neutral third parties who do not directly benefit from providing care until they relent. It is abuser tactics. I have seen many domestic violence perpetrators use the same approach: increase the cost of noncompliance through harassment, crazy-making, and conflict, and hope to exhaust any opposition. I am heartened that these professional organizations have continued to fight back. Democracy doesn’t rely on “compliance” with clearly unscientific and ignorant political assertions.

CMS threatens funding. FTC investigates professional guidelines. DOJ subpoenas clinical records. FDA sends warning letters to chest binder manufacturers. The HHS Secretary issues declarations from press conference podiums. And hospital systems, institutions whose risk calculus is dominated by revenue, do the math and close their programs.

No law was passed. No ban was signed. The care simply becomes unavailable. This is the reality of 2026, and it will take us a decade or more of fighting to restore the progress that took us four decades to make. The science didn’t change overnight. Gender-affirming care is still the only proven approach to supporting trans and nonbinary youth. The politics changed.

It is important to name this what it is: fascism in action. Fascists believe in centralized “Daddy knows best” power structures. Trump hates trans people because we are politically and socially vulnerable, so everyone follows the leader. I don’t know about you, but I don’t want to live in a dictatorship ruled by a corrupt and demented con man. Hospital systems should be clear about what is at stake with their capitulations. They should draw wisdom from the domestic violence movement. Acquiescence only invites more attacks from abusers. They learn that their tactics work, and they will only increasingly use them to get their way.

Trump and his ilk don’t want federal dollars flowing into healthcare for the masses. They want it to line the pockets of their cabal. Mark my words: what started with attacks on trans health will be honed and refined to attack every other condition and patient.

Finally, and this is where my day job becomes most visible, anti-transgender ballot measures are advancing in at least four states: Washington, Colorado, Maine, and Missouri.

In Washington, our campaign is No Hate in WA State, which is building the infrastructure to defeat IL 26-001 and IL 26-638. That work includes deep canvassing, voter modeling, multilingual community organizing, and the kind of relationship-by-relationship persuasion that cannot be replaced by advertising budgets. I’ll write more about this in future editions, but it has been an all-consuming project since April of last year and was the primary reason I moved back to Washington State from Virginia.

I’ve been fighting ballot measures since 1998 in Maine, and I don’t plan to stop fighting anytime soon. I hope you will join me this year by donating, volunteering, or phone banking with one of these campaigns.

In Maine: Equality Maine.
In Colorado: One Colorado.
In Missouri: PROMO Missouri.
In Washington State: No Hate in WA State.

The Ninth Circuit’s reconsideration of M.H. v. Hamso. If that panel follows the Fourth Circuit, the appellate architecture for adult care bans locks into place. If it diverges, we may see the Supreme Court take up adult care directly.

The NHS England hormone consultation. The transatlantic feedback loop, where the Trump administration cites UK restrictions to legitimize U.S. policy and UK policymakers cite U.S. precedent in return, is accelerating. The academic critique of the Cass Review is substantial and growing, but it hasn’t yet broken through the political narrative. Many mainstream publications like the New York Times continue to cite Cass lazily to justify their own ignorance, bigotry, and shoddy reporting.

I’ll publish the next public edition in late April. If you know someone who needs to understand the architecture beneath the headlines, a funder, a journalist, a state legislator, a friend, please send this to them!

I’m also going to start posting shorter observations weekly on Substack Notes between editions for subscribers. Follow along if you want the real-time version of how I’m reading this moment. I will also host an end-of-the-month chat and Q&A for founding members and paid subscribers a bit later in March.

We are in a period that will be studied. I’d rather we shape how it ends than simply document how it happened. So let’s get active in ending this nightmare by being informed, engaged, and most of all involved - please volunteer with one of the above campaigns!

-Danni