Part II. Cissexual Necropolitics: The Political Project to Unmake Trans Life

II. The Transgender Adolescent and Cissexual Necropower

While specific diagnostic terminology have shifted across history, it has long been the case that to access transition-related healthcare, a person (regardless of age) generally requires a diagnostic grounding for their needs(Gill-Peterson, 2018). This is borne out of both the needs associated with securing insurance coverage to mitigate the costs of these medications for patients, as well as the reality that gender affirming care has historically been gatekept by the healthcare system. Therefore, transgender people seeking out the means to embody their gender are forced to do so via the diagnosis driven healthcare system. Despite the conservative myth of “hormones on demand”, access to TRH is conditioned upon satisfying a specific diagnostic criteria, which can be quite rigid and restrictive, particularly for adolescents(Ashley, 2019; Coleman et al., 2022; Hembree et al., 2017; Rafferty et al., 2018; T’Sjoen et al., 2019).

The diagnostic model used in the U.S. for the provision of many forms of TRH is the presence of “gender dysphoria” (GD), which describes the distress or impairment of function resulting from the “marked incongruence” of a person’s “experienced/expressed gender and their assigned gender”(American Psychiatric Association, 2022). GD can have a significant negative impact on transgender people of all ages such as increasing the risk of negative psychiatric health outcomes including depression, eating disorders, anxiety, and suicidality (Brecht et al., 2024; D. S. Day et al., n.d.; García-Vega et al., 2018; B. A. Jones et al., 2016; Li et al., 2024; Marconi et al., 2023; J. Olson et al., 2015; van de Grift et al., 2017). These negative psychiatric health outcomes may be further exacerbated by other baseline negative mental health disparities experienced by transgender people due to lack of familial or societal acceptance, harassment, and minority stress (Bailey et al., n.d.; K. A. Clark et al., 2024; Eccles et al., 2024; Esposito et al., 2024; Gonzales & McKay, 2024; Lee et al., 2024a; Newcomb et al., 2020; J. Olson et al., 2015; Pattison et al., 2021; Price-Feeney et al., 2020; A. Restar et al., 2024; Suarez, 2024).

It is important to provide a caveat that at this point should be understood as a given in literature discussing TRH – one need not experience GD in order to be transgender. Similarly, not every transgender person’s gender modality, expression, and embodiment goals will be the same, nor will their experiences with GD. This diagnostic approach and the historical pathologization of transgender people has created an implicit cultural frame around access to TRH that creates the narrative that TRH is accessed in order to undo, mediate, mitigate, or remedy negative, ego-dystonic conditions such as GD(American Psychiatric Association, n.d.; Cooper et al., 2020; Davy & Toze, 2018; Li et al., 2024; Mumford et al., 2023; Russo, 2017). This inherently pathology-driven approach to TRH undoubtedly contributes to cultural associations with being transgender as somehow being “unwell”. Furthermore, such a framework is an overly narrow view of why a person may seek forms of TRH such as pubertal pause, exogenous hormone therapy, or surgical interventions. Far less has been done, even among the allies of transgender people and the providers who serve this population to describe the role of gender-euphoria in one’s consideration and initiation of TRH.

Gender euphoria describes positive and empowering experiences of comfort, connection, and authentic embodiment relative to an individual’s internal sense of their identity (Beischel et al., n.d.; Blacklock et al., 2024; Grant et al., 2024). This is a state of being that most cisgender people experience implicitly. Unfortunately, our cultural image of transgender people and our broader cultural approach to access to biomedical technologies in the U.S. do not typically allow for one to access what is titled “health care” without being burdened by some affliction or pathology. As such there is functionally no clinical framework for understanding gender euphoria as a means to access TRH, although contemporary advocates and ethicists continue to advocate for such an expansive view of TRH(Blacklock et al., 2024). All of these factors will heavily influence what types of TRH are desired or required, or if TRH is even the appropriate framework to describe their access to this type of healthcare. Some may not describe this framework as a “transition”, others may.

Prior to pubertal onset, transgender adolescents do not receive any medical interventions and their transition is mostly comprised of socially affirming measures such as the use of a new name, using new pronouns, changing one’s physical appearance, and modifying one’s gendered social interrelationships. Adolescents may be prescribed GnRHAs shortly after pubertal onset to mitigate the distress caused by pubertal development(Coleman et al., 2012; D’hoore & T’Sjoen, 2022; Hembree et al., 2017). Between ages 14-16, transgender adolescents may begin gender-affirming hormone therapy to induce pubertal develop that is consistent with embodiment goals of the adolescent (Coleman et al., 2012; D’hoore & T’Sjoen, 2022; Hembree et al., 2017). Interventions such as pubertal pause may confer further benefits that transgender adults will continue to appreciate later in life, including making subsequent forms of PTRH more effective. Patients seeking GAHT may not require supraphysiological doses, to suppress endogenous hormone production (Hembree et al., 2017; T’Sjoen et al., 2019). While beginning GAHT in adulthood may remedy some aspects of GD, there are changes that GAHT alone cannot resolve. Pubertal pause renders surgical procedures of adult transition less invasive, less costly, or unnecessary altogether, and is associated with greater satisfaction regarding an individual’s transition (Cohen-Kettenis et al., 2011; Delemarre-van de Waal & Cohen-Kettenis, 2006). What is implicitly understood by many, is that by successively pausing endogenous puberty and inducing exogenous puberty, the some transgender adolescents may very well be perceived as a cisgender member of the same gender modality. This presents a challenge to the purported coherency of cissexuality as the dominant modality of gender and sex.

The state and those who support its restrictions on PTRH often frame such policies and actions as being undertaken to “protect adolescents” from these treatments, which are often criticized as being dangerous and experimental(Bojórquez, 2024; Trump, 2025c). Others suggest such restrictions are intended to preserve adolescents’ rights in trust to an open future(Jorgensen et al., 2024). Such noble intentions seem at odds with how policies are actually crafted, particularly when we zoom out from simply analyzing the effects of PTRH restrictions on transgender youth. Below, we will further articulate connections between these policies and others that seek to dehumanize trans adolescents as well as rob them of their ability to participate in public life. There are still otherways to problematize the claim that these restrictions are put in place in order to “protect” children.

As ethicists and scholars Katri and Sudai articulate, these restrictions not only withhold consensual access to PTRH for adolescents who would benefit from it, but is specifically preserves the rights of parents and surgeons to subject intersex and sex-variant infants and children to non-consensual surgical reassignments (Katri & Sudai, 2024). By both banning PTRH and enabling nonconsensual surgeries on intersex infant, lawmakers are attempting to exert a form of biopolitical control over two unique counters to cissexual modes of being. These modes are embodied by transgender or intersex people, whose existence undermines what the cissexual state normatively argues to be “biological truths” of sex and gender.

Significant amounts of literature have been dedicated to addressing these claims and discussing the safety and efficacy of PTRH(Betsi et al., 2024; Brezin et al., 2024; Fisher et al., 2024; Gawlik-Starzyk et al., 2025; German Society for Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, 2025; Giordano & Holm, 2020; McNamara, Baker, et al., 2024; McNamara et al., 2023; McNamara, McLamore, et al., 2024; Schall et al., 2024; Telfer et al., 2018; Tornese et al., 2025; T’Sjoen et al., 2019; Utah Department of Health and Human Services, 2025). This paper will not recount and assess each individual critique or claim and is counter argument. This is primarily for the purposes of scope as such explication would derail the argumentation of this essay. Beyond purely logistical considerations, such explication cedes important conceptual ground. Many of the politicians, pundits, activists, and ethicists who oppose the provision of TRH to patients of any age, do so regardless of the safety and efficacy of these medications. For this group, even if the medications had immaculate safety profiles, it is a more elemental opposition to gender-diversity that compels them. There are many though who genuinely oppose PTRH out of an earnest concern for the safety of adolescent patients. While the author does not wish to discount those concerns, they are not the focus of this essay. Instead, this essay concerns itself with the pretextual opposition to PTRH that is rooted in a more elemental opposition to the phenomena of gender-variance itself. For this group the minutiae of side-effects, trial design, and evidence-base are opportunistically deployed to obfuscate their innate biases against gender diversity.

It can be said, though that significant bodies of evidence accumulated over the last 5+ decades challenges claims of experimentality (Bragge et al., 2024; Brezin et al., 2024; D’hoore & T’Sjoen, 2022; Gawlik-Starzyk et al., 2025; 2025; Gill-Peterson, 2018; Ingelhart, 2024; Ramos et al., 2021; Rew et al., 2021; Swiss National Advisory Commission on Biomedical Ethics, 2025; Telfer et al., 2018; Watson et al., 2020) – as well as undermines the notion that adolescents are incapable of consenting to this healthcare (B. A. Clark & Virani, 2021; Hein et al., 2015; Pullen Sansfaçon et al., 2019; Ravindranath et al., 2024; Vrouenraets et al., 2021). And with regard to “biological truths”, many experts suggest that our contemporary understanding of sex and gender development does support upholding a male/female binary is in fact a biological truth (Ainsworth, 2018; Barnhart, 2024; Clancy et al., 2024; Fuentes, 2023; Montañez, 2017; Rehmann-Sutter et al., n.d.-b). Mbembe’s necropolitics draws our attention to the sovereign’s distortion of or disregard for “evidence” in favor of exacting and totalizing control – “forgoing evidence, one needed [sic] only to invoke secrecy and security” (Mbembe 2019, p 26). This sense of secrecy and security is key to understanding why PTRH and the existence of intersex children may frighten the cissexual state, as the existence of modes of gender and sex that do not conform to the state’s biases are condemned as “immoral” and “unjust” (The White  House, 2025).

In this way, politically disempowered figures like TGD child or the intersex infant paradoxically are granted positions of political specters, whose very existence is grave threat to the status quo. Considerations of safety and efficacy are post-facto justifications for actions taken to prevent these figures from destabilizing our cultural assumptions about cissexuality as being either natural or coherent. Such an abandonment of pretense is evident in an internal memo written by U.S. Attorney General Pam Bondi is late April of 2025. She describes the very phenomena of gender variance itself as “a radical ideological agenda being pushed throughout every aspect of American life” which she suggests we ought to “root out and eliminate” (Geidner, 2025). The evidence supporting TRH is not scrutinized but instead gender variance is positioned as a cultural threat. Indeed the memo’s only citations are often heavily biased media coverage or the administration’s own prior claims, which do little more than establish and unresolved chain of unresolved signification. Gender variance is invoked here as an innate threat to American culture, which particularly endangers adolescents who may be most vulnerable to this supposedly malicious, devouring specter of gender variance which as she describes it is “result of a coordinated, unchecked ideological attack on America's children” (Geidner, 2025). And for Bondi, and many like her gender diversity is not simply an intolerable difference that transgender people embody. Instead, Bondi describes the threat to children and adolescents as an unseen infectious force – a plague that, lacking the sort of social hygiene (or genocide) she advocates for, will invade the child and corrupt them. This is why Bondi described gender variance as a “sociological disease”, which she is compelled to cure (Geidner, 2025). Gender variance is assembled by Bondi as system of violence that targets “confused” adolescents who are left “disfigured, scarred, and sterilized” by the healthcare they seek out (Geidner, 2025).

Bondi describes clinicians who provide the medical care that TGD adolescents beg for, flee home for, research, subject themselves of dehumanizing gatekeeping for, and politicize their lives over, as coercive. To Bondi, gender affirmation is inflicted upon TGD children, who she does not believe exists – arguing that clinicians manipulate and coerce adolescent patients. Bondi’s remarks are intended to reframe evidence-based healthcare as malicious and seditious iatrogenic chemical and surgical violence, which she likens to “female genital mutilation”. Yet, Bondi, much like others who advocate against the provision of PTRH, make no mention of the nonconsensual surgical and chemical procedures enacted on intersex and sex variant infants and children, who cannot understand or participate in the decisions surrounding such procedures. Many, if not all restrictions on PTRH contain explicit exceptions to enable such procedures(Katri & Sudai, 2024). So why ban the care that can be consented to for the parties who seek it out and demand it, under the guise of “protection” when the nonconsensual procedures enacted on parties who cannot consent to it, are unchallenged? The answer is a simple reframe – the necropolitics of the cisgender state. In both cases, the control of bodies and identities that would implicit challenge or undermine the sanctity of cissexuality must be kept in check. Bondi describes the means by which the carceral violence of the U.S. will be brought to bear to do just that – to punish the supposedly terroristic clinicians and parents who enable the adolescents under their care to be infected by this “sociological disease”. For Bondi, the transgender child becomes a specter, looming over our nation’s security.

According to Toby Beauchamp, ban particular focus on prohibiting TGD adolescents from accessing TRH is because this with this access, TGD archetypally threatens the coherence of the cissexual norms the define gender politics in the U.S. Therefore the targeting of PTRH is likely intended to both prohibit transgender people from evading legibility (Beauchamp, 2019). PTRH, when accessed earlier in adolescence, enables TGD individuals to undermine and destabilize the cissexual state’s normative ideals of sex and gender, by successfully contravening the supposedly impossible-to-cross border between “the two sexes”. Put another way, this thinking most easily summarized in a slogan often utilized by pro-transgender advocates; “these lawmakers aren’t worried these medications aren’t effective, they’re worried that they are”.

PTRH’s efficacy demonstrates that non-cissexual gender modalities are not incompatible with a degree of life satisfaction that the cissexual state wishes to reserve for cisgender people alone. It reframes purportedly “unlivable” or “impossible” lives as being profoundly meaningful and enriching and in this way poses a threat to the promise of coherence and stability that cissexuality sells to individuals. By averting endogenous puberty, and through timely access to gender-affirming hormone therapy (GAHT), TGD people may not be legible to society – and  most importantly, to the state – as being TGD. Thus PTRH represents a means to contravene the cissexual delimitation of the state. This is very likely to enable gender-variant individuals to better achieve their embodiment goals and enhance their satisfaction with one’s transition. This may include “passing” or being perceived as a cisgender person of the same gender identity, such as a transgender woman innately being perceived as a cisgender woman (Cohen-Kettenis et al., 2011; Cohen-Kettenis & van Goozen, 1998; Delemarre-van de Waal & Cohen-Kettenis, 2006; Vance et al., 2014). This is a boundary of critical importance in the U.S. and to cultural narratives of gender-politics which underpin many of the core beliefs of capitalist U.S. Any erosion or perceived weakness of this boundary risks the unraveling of these narratives, resulting in a loss of forms of control afforded to the state by these narrative’s coherence. The TGD adolescent, by being capable of so successfully transgressing this boundary, so as to be undetectable once they have, therefore becomes a matter of national security to the state.

The state does not want such a potentiality to be known, let alone for that potentiality to be so potent as to be illegible to them when cissexual modes of embodiment have been transgressed. If one’s TRH enables the body to be sexed and resexed, the core principles of the cissexual state become unstable, along with the many cultural norms and biases that innately depend on or refer to normative cissexuality. If a person can avail themselves of biomedical technologies that enable them to be readily perceived as a cisgender member of a gender other than the one assigned to them at birth, it undermines the supposedly natural quality of cissexuality. In this way, the transgender adolescent innately represents the cissexual state’s biggest weakness, challenging the brittle notion that sex is binary and immutable.

What seems to be even more frightening to the state is that TGD adolescents’ embodiment goals may not even conform to the binary conceptualizations of “medical transition”, in favor of more expansive and radically creative modes of gendered or de-gendered embodiment (Department of Health and Human Services, 2025). Perhaps the only thing more frightening to the state than TGD youth being able to contravene the boundaries between “the two sexes” by crossing to “the other side”, is a radical negation of these boundaries outright. Such a rejection of these boundaries and contours, in favor of ever-expansive horizons of nonbinary gender modalities and embodiments does not simply leave these boundaries shot through, but it fundamentally annihilates the weave of this matrix. This transhumanist redrawing of boundaries for the body’s sexed and gendered potentiality radically refuses the foundational principles upon which the cissexual state is constructed. Gender here is not simply capable of being redefined a single time, but can become iterative throughout one’s life – and as the state of biomedical technologies advances through innovation, so too does gender itself become the loci for innovative expression and self-construction.

Such a body politic may seem hard to imagine in the present, where we struggle so greatly simply to achieve simple rights to access TRH, in order to express basic forms of gender self-determination, but this is intentional on the part of the state. By forcing TGD people into a place of defensiveness and desperation – by keeping our attention panickingly focused on the immediate future and our struggle to access TRH it is able to easily limit our thinking about the potentiality of the body and our identities to engage in greater deconstruction of these cissexual boundaries. Cissexual boundaries are kept safe in this way, by preventing us from ideating and envisioning more radical and expansive modes of bodily autonomy and self-determination. By forcing TGD people to simply fight for survival, we are kept from constructing more expansive future, where these boundaries have been utterly eradicated.

Fear of these futures is likely legible between the state’s words, where they attach stigma to modes of TRH driven by a diverse and permissive approach to gender embodiments, that challenge the cissexual binary, such as phallus-preserving vaginoplasty or nullification of genitalia, which the state has invoked in an implicit argument that attempts to use these “extreme” examples to show the dangerous of such a permissive approach to gender embodiments(Department of Health and Human Services, 2025). Such arguments hope to show these forms of embodiments as cautionary tales of a field of medicine that “has gone too far”.

I-A. Suicidality and Risk.

A law that restricts a class of people’s bodily autonomy, through the rationing and restriction of access to certain biomedical technologies is the exact form of delimitation that Foucault’s broad concept of biopolitics predicts. This theoretical frame creates a significant potential to analyze the politically deployed restrictions on bodily autonomy as being a critical component in the sustained coherency of the state’s hegemony. But it is through the lens of necropolitics that we can understand the stakes of these political attacks on PTRH for the “exposure to death” they may invite, as a means of enforcement to maintain this coherency. Exposure to death need not be a strictly through modes of direct physical violence. As Mbembe articulates the conformational shift of violence, “the brutality of democracies has simply been swept under the carpet.”(Mbembe, 2019, p. 16) In this way, an exposure to death manifest as creation of conditions that drive or encourage one’s death, by ones own hands or by the hands of others. The administration need not kill a single trans person, they need only create a series of conditions that increase the likelihood they’ll kill themselves. As we have discussed, and will continue to discuss, such is the project of cissexual necropolitics – to hide this exposure to death under the carpet of rule and regulation.

The healthcare being restricted is associated with reduced rates of suicidality, depression, and anxiety amongst transgender people, particularly adolescents (Bränström & Pachankis, 2020; D. Chen et al., 2023; Costa et al., 2015, 2015; de Vries et al., 2014; Green et al., 2022, 2022; Hughto et al., 2020; Marconi et al., 2023; J. Olson et al., 2015; Ramos et al., 2021; Rew et al., 2021; Rowniak et al., 2019; Tordoff et al., 2022; Turban et al., 2020, 2022; van der Miesen et al., 2020). As Baker et al. describe, concrete conclusions regarding death from suicide and lack of GAC could not be concluded(Baker et al., 2021). This does not mean that such deaths do not occur, but simply that they cannot be grasped within the confines of the systemic reviews such as conducted by Baker et al. There is an epistemological limitation on our ability to prove that access to PTRH has prevented a death by suicide, because phenomenologically this cannot be easily studied. To meet the standard required by those skeptical of associations between PTRH and prevention of trans death by suicide,  ine would either need a post-facto confirmation that a lack of TRH was a factor in the death, which has in fact been documented previously(Klee, 2023; Villarreal, 2024; Waldon, 2017; WTHR, 2014); or we would require an individual who contemplated suicide, but access to TRH discouraged them from this course of action. One could argue that the latter is satisfied by associative relationships between PTRH and reduced suicidality, as suicidal ideation and attempts are, from an existential perspective, indicative of a resignation to the end at least from a philosophical perspective.

Exposure to the risk of suicide by successfully restricting access to PTRH is not the only way in U.S. politics obliquely exposes trans people to death. Emergent research has observed increases suicidality among transgender adolescents as a result of mere exposure to and knowledge of this these policies (K. A. Clark et al., 2024; Gonzales & McKay, 2024; Lee et al., 2024b; A. Restar et al., 2024; Villareal, 2024). These increased are compounded by transgender adolescents already increased risk of depression, anxiety, and suicidality, resulting from factors such as harassment, awareness of anti-trans attitudes, familial rejection, lack of peer support, and gender-dysphoria(Biggs, 2022; Bränström & Pachankis, 2020; Campbell et al., 2024; Chodzen et al., 2019; K. A. Clark et al., 2024; J. K. Day et al., 2017; Dhanani & Totton, 2023; Esposito et al., 2024; García-Vega et al., 2018; Haas & Herman, n.d.; Johns et al., 2019; Kidd et al., 2023; Marconi et al., 2023; Newcomb et al., 2020; Norris & Orchowski, 2020; Pattison et al., 2021; Price-Feeney et al., 2020; Sorbara et al., 2020; Witcomb et al., 2018). Because of the positive associations between PTRH and improved mental health outcomes and psychological functioning, some argue that PTRH is lifesaving, preventive care(A. J. Restar, 2023).

This positions archetypal figures like the transgender adolescent or “transgenderism” itself as an inflictive and predatory presence. This construction of a threat to the status quo is then offered as justification for gradual or emergent delimitations on the rights of those who are alleged pose this threat and a broader cultural dehumanization of this group in public discourse (Protect Children’s Innocence Act, 2022; Shrier, 2020). Such rhetoric as Mbembe writes “[appeals] continuously to emergency and to a fictionalized or phantasmal vision of the enemy. All of this as a way of ending with the idea of prohibiting widespread killing, that because we are under the threat, we can kill without distinction whoever we consider to be our enemy”(Mbembe, 2019). Thus cissexual necropower establishes the U.S. as a state cissexual ideology to which all adolescents bodies must conform and adhere “for their own protection”. Those who abide by these norms may freely participate in civil society. Those who transgress these norms gender become the cultural “other” (Mbembe 2003, p.3). Bodies of this type may not be directly destroyed by the state, but as we have discussed, will be exposed to death.

Withholding care that prevents greater risk of suicidality necessarily invites a certain degree of risk in exposing adolescents to possible outcomes of suicidality. This exposure seemingly seeks to tacitly or implicitly to “to produce death in a large scale” as Mbembe articulates (Mbembe, 2003). One’s only recourse may be to endure this suffering and/or the sublimation of a core and fundamental aspect of their identity, subjected to conditions that Mbembe calls “living dead” (Mbembe, 2003), or to turn to self-destruction. In fact many transgender people are grappling with these painful existential questions as they consider how they can survive the second Trump Administration(Lang, 2025b). As trans people begin and continue to the make grapple with this existential dilemma, the U.S. becomes transformed into what Mbembe describes as “repressed topographies of cruelty” (p. 40) for their delimitation to forms of life defined by the contours of either misery of self-destruction (Mbembe, 2019, p.40). Insofar as the U.S. continues advance policies that eliminate transgender people from public life – policies that restrict access to accurate identification documents, access to TRH, ability to use gendered-restrooms and public accommodations – transgender people will be subjugated to a state of subhuman existence should they hope to navigate society safely. This subhuman state finds transgender people walking amongst those in the U.S. geographically, but certainly represents an existential removal from society. Mbembe’s articulates such a state as being “divested of political status and reduced to bare life” (Mbembe 2019, p.67).

Arguments have been raised though that suicidality rates of transgender adolescents are overestimated in order to make more compelling arguments regarding the importance of PTRH. While others suggest that such claims are not substantiated by contemporary evidence related to access to TRH, gender-dysphoria’s deleterious effects, and risk of suicidality/successful suicides(Armitage, 2023).

Such argumentation presents a highly subjective consideration of what degree of severity and volume of such risks would be compelling. Is any degree of risk for any group of people too much? Is a moderate risk for a small group of people an acceptable margin? Is suicidality not nearly as compelling as actual confirmed suicide deaths? How do we explain the high degree of scrutiny applied to the argumentation that risk of suicidality compels us to provide PTRH to those who need it? Perhaps more elementally, should individual morality be sufficient to govern and control the bodily autonomy and life chances of others, by restricting trans people from the means of embodiments they seek while forcing nonconsensual surgeries on intersex infants? 

There is a necropolitical quality to the argument that we have not yet met the burden of proof that suicidality is of substantive concern to warrant the provision of PTRH. If we were not dealing with a stigmatized population, would the risk of suicidality regardless of the volume or severity be sufficient to take swift intervening measures. Why is there such skepticism applied to the suicidality risks experienced by transgender adolescents? To disregard the present degree of risk seems like a willful gamble, to wait for a larger, more compelling data point. Of course, to satisfy this need, can we not say they have be determined to be “allowed to die” as Mbembe identifies (Mbembe, 2003). Can we interpret the willful gambling of transgender adolescents’ wellbeing in other ways? Is it not the moral and ethical obligation of providers to adopt a precautionary approach to this risk, and provide patients with the care they need, even if it challenges their personal values? Should our personal values have be privileged over the wellbeing and security of others?

This exposure to death by suicide does not exist in purely extrapolatory forms either. Among the many attacks on trans health and the personhood of the trans community, there are numerous instances in which policies or regulations have been implemented whose downstream effects may be the erasure of knowledge about the health needs and experiences of transgender people. There are also far more direct forms of exposure that can be observed. Such an exposure is evident in policies which would dismantle suicide crisis-support services for LGBTQI+ people(Lurie, 2025). Such policies are in continuity with prohibitions of forms of care that have been found to reduce rates of suicidality. With the known mental health disparities between cisgender and transgender people this cannot be seen as anything but a willful exposure to death. With these disparities in mind, prohibition of the care that obviates these disparities and the dismantling of safety-net infrastructure intended to support transgender people in crisis produces compounding vectors of exposure to suicidality. This country has sent trans people into a freefall and shredded the safety nets. These actions are a deliberate abandonment of transgender people, a severing of lifelines. Perhaps these policies and those in continuity with their principles.