“Up to 10% of youth express some degree of gender expansivity and about 1.8% identify as transgender. All providers working with children and adolescents care for transgender or gender expansive (TGE) youth, but knowledge gaps and low comfort levels with GAC are common. Legally codified misinformation presents an additional challenge to those on the front lines of clinical care. In this commentary, we identify and correct misconceptions that providers may encounter in this new sociopolitical climate.”
“Transgender and nonbinary (TGNB) youth in the US face growing sociopolitical obstacles in pursuit of health care. In 2021 and 2022, Arkansas and Alabama enacted legislative bans on gender-affirming care (GAC), with penalties for physicians ranging from loss of licensure to imprisonment.1 In 2022, the Texas attorney general set a troubling precedent by issuing a legal opinion equating GAC with child abuse, claiming that this treatment constitutes forced sterilization and experimentation.1 Such actions rely on scientific misinformation, retracted research, and politically biased sources.1 As of June 2022, enforcement of the Arkansas and Alabama laws has been temporarily enjoined by the federal courts, but the Texas Department of Family and Protective Services has continued investigations into parents who provide GAC to their children. A summary of legal initiatives is presented in the Table. These bans on GAC place guardians and health care professionals in an ethically precarious position, in which the law and the standard of care conflict….”
I had the privilege of working with six scientists from Yale and the University of Texas Southwestern to refute, point-by-point, the purported scientific justifications for banning gender-affirming care in Texas and Alabama.
Family law in the United States is governed by an assortment of legal doctrines and policies that often undermine, and sometimes sever, the relationships between children and the adults with whom children are most closely bonded. For example, the “best interests of the child” standard, which has long governed a host of legal determinations such as custody, offers only a vague and indeterminate guideline for decision making, an approach that risks undervaluing the importance of children’s relationships to close caregivers. Similarly, courts and commentators commonly assert that the federal Constitution provides special protection to biological parent-child relationships, despite the fact that biology as a category excludes children’s bonds with many LGBTQ parents and other nonbiological parental caregivers. Finally, the United States lacks a national legal commitment to economic support for vulnerable children and families, leaving poor children and parents without resources and at risk of family separation. When the state fails to support and protect relationships between children and the individuals who provide them with parental care, children are likely to experience developmental harms with potentially life-long damage to their physical and mental health.
This Article proposes and elaborates what we term the psychological parent principle, which would replace current inadequate and indeterminate standards with a clear guideline focused on the protection of relationships between children and the individuals who provide them with consistent, predictable, and emotionally-invested parental care. The psychological parent principle is explicitly grounded in both developmental science and democratic values. The psychological parent principle reflects the scientific finding that the parent-child relationship is critical to human development. The principle aims to provide an overarching guideline for law, one that protects the relationship between the child and the psychological parent, with due attention to normative considerations including equality, social inclusion, and democratic self-determination. As this Article shows, reorienting law and policy around the psychological parent principle would be especially valuable for Black, LGBTQ, low-income, and other marginalized parents and children who disproportionately suffer from the failure of the state to recognize and support parental caregiving bonds.
In providing a new, overarching guideline for family law, the psychological parent This Article illustrates how the psychological parent principle would operate by suggesting reforms in three areas of law that are foundational to children’s lives—social welfare, parentage, and custody.
Ganesh Sitaraman and I edited a new collection of essays on public options. The authors include Mallory SoRelle and Suzanne Mettler, Jon Michaels, Jacob Hacker, Alison Hoffman, Shelley Welton, Mehrsa Baradaran, and more. Cambridge University Press has made the book available online here. Have a look!
In this piece in the Boston Review, I point out the ordinary but tragic choices facing parents — mostly mothers — as they care for children during the pandemic. Mothering work has been mostly invisible during the COVID crisis, as it usually is. But the pandemic has made the job both harder to do (with schools and day care closed) and more socially important. Children are suffering tremendous (and often unacknowledged) stress right now, and consistent, hands-on parental care is the best buffer.