Anytime Donald Trump is accused of being a pedophile, his base runs to the rescue as if they were personally slapped in the face. Currently, there are over 80 comments on this cartoon on my Facebook page, with the bulk of them being MAGAts demanding “verifiable” evidence that Trump is a pedophile. Of course, the same people who are demanding “verifiable” evidence are posting memes with fake quotes about Joe Biden and his daughter.
But how is this for verifiable evidence? Donald Trump went on the Howard Stern show in 2005 and bragged about walking into dressing rooms for teenage contestants in his beauty pageants. He bragged about it as if he had just won Michigan.
Donald Trump is attempting to select his own citizenry and control who can vote by gathering the personal details of all Americans, Arizona’s top election official has warned.
Adrian Fontes, Arizona’s Democratic secretary of state, fears that the Trump administration’s active efforts to forcibly extract voter files from 30 states including Fontes’s own are part of a bigger plan to gather vital information on all US citizens into a centralised database. “Trump is trying to amass a master list that will allow him to declare someone an enemy of the state,” he said.
In his 19th-floor office in Phoenix, Fontes said that in his view Trump wants to create the equivalent of “apartheid in the United States” and likened his actions to those of his counterpart in North Korea. With personal information on all Americans at his disposal, the president could regulate key aspects of the lives of his opponents, including “shutting off their bank accounts, or keeping them from getting healthcare”.
“This is Donald Trump trying to pick his own voters,” he said.
Fontes won a major victory in his running battle with the Trump administration on Tuesday when a federal judge threw out a lawsuit from the US justice department against Arizona over its refusal to hand over its voter roll. The judge, Susan Brnovich, a Trump appointee, ruled that the Department of Justice was not entitled to the document under federal law.
The suit was part of a push by the DoJ to obtain voter roll information from all 50 states, suing 30 including Arizona that have refused to co-operate. At least 13 states have voluntarily complied with the DoJ’s demands, but many others are resisting.
In those cases where courts have ruled on the dispute – California, Oregon, Michigan, Massachusetts and Rhode Island – all judges have found against the administration. Fontes – who was himself sued after he declined to hand over the data, pointing out that it would be illegal under state law to divulge sensitive personal information about almost 5 million Arizonan voters – has joined that list of vindicated parties.
“This is now the sixth federal court to reach the same conclusion. Arizona acted correctly in refusing this request, and today’s ruling vindicates that decision,” he said.
Fontes was elected secretary of state four years ago as part of a sweep by Democrats of top statewide positions. Katie Hobbs was elected governor and Kris Mayes as attorney general.
All three are now in re-election battles facing Republican challengers who have in varying degrees embraced the lie that the 2020 election was stolen from Trump.
Arizona has for years been pivotal to Trump’s efforts to stoke election denial conspiracy theories. Maricopa county, which covers Phoenix, is one of the largest and most electorally consequential swing counties in the country.
In 2020, it was the focus of a fierce battle in which Trump loyalists attempted to declare victory in the face of his defeat to Democratic rival Joe Biden. The Republican-controlled state senate contracted Cyber Ninjas, a private security firm that had no background in election administration, to conduct an audit into Maricopa county’s results.
The audit, which was widely debunked, concluded that Biden had won the election.
Arizona is now back in the crosshairs as the November midterm elections approach. The state has been the subject of at least three federal investigations into its election procedures, with the Trump administration continuing to press unfounded claims that electoral fraud is rife.
The DoJ claims that its data demands aim to root out rampant fraud and voting by noncitizens. Fontes rejects that argument .
“This doesn’t have anything to do with non-citizens, because non-citizens don’t vote. Every study shows that,” he said. “So what you have here is an unprecedented invasion into the privacy of Americans, sold under a false narrative of illegal voting.”
In March the FBI seized a vast stash of digital data that had been compiled by the Cyber Ninjas’ audit of Maricopa county in 2020. Though it is unclear what exactly was in the trove, it is possible that it included details of votes cast and images of actual ballots.
The material was handed over to FBI agents under a federal grand jury subpoena by the Republican president of the state senate, Warren Petersen. Fontes was scathing about Petersen’s decision to cooperate with the subpoena, suggesting it may have broken state data-protection laws.
“He was so quick to turn over the material as a political favor to Donald Trump,” Fontes said. “Clearly he had no intention of protecting Arizona voters or legal processes.”
Petersen’s compliance with the FBI subpoena is likely to be a factor in the mid-term election for Arizona attorney general. He is currently the frontrunner to become the Republican candidate challenging Mayes, the incumbent Democrat.
The third federal investigation into Arizona elections is being conducted by Homeland Security Investigations (HSI), the investigative arm of US Immigration and Customs Enforcement (ICE). It is also taking a renewed look at the 2020 presidential election result in a further bizarre move to relitigate a contest that was settled more than five years ago.
“It’s like herpes,” Fontes said, referring to the perpetual resurfacing of the election denial conspiracy in Arizona. “It just keeps coming back. And I just don’t think the state, or the nation, deserves that.”
Trump’s latest ploy to wrestle control over elections from the states is his executive order last month that tries to limit mail-in voting by creating a national voter file to which the US postal service would have to defer before delivering mail ballots. The order, which is being challenged as unconstitutional, is especially sensitive in Arizona, where 80% of votes are cast by mail in a system devised decades ago, ironically, by the Republican party.
“This is a bald-faced attempt at completely controlling American democracy according to the whims of one political actor, and that’s not just un-American, it’s absolutely anti-American,” Fontes said.
Fontes is gearing up for his own potentially bruising re-election battle in November, in which he is likely to be competing against an election denialist. The two Republicans vying for their party’s candidacy in the secretary of state’s race both have election-denial track records.
Alexander Kolodin, a lawyer, was placed on probation by the state bar association after he filed lawsuits challenging Biden’s 2020 victory that a judge slammed as being full of “gossip and innuendo”.
The other candidate, the former chair of the Arizona Republican party, Gina Swoboda, was the Trump campaign’s director of operations on election day in 2020. She claimed in a lawsuit that was dismissed for lack of evidence that more than 1 million ineligible voters may have been on the rolls.
Fontes said he was “cautiously optimistic” that he and his Democratic peers would sweep the state again in November. But he conceded that “we have to be extra vigilant”.
“We have to spend every single day from now until November focused on communicating as clearly as we can with every Arizona voter,” he said.
Two factors were in play this midterm cycle that would make re-election more difficult, he said: unlike in 2022, there is no US senate race in Arizona this year, so there is less of a draw to attract Democratic voters to the polls.
The other factor he pointed to was that since 2022, the rightwing activist group Turning Point USA has grown in influence. Turning Point, whose leader Charlie Kirk was killed by a gunman in September, is headquartered in Arizona and in Fontes’s view has largely surplanted the old Republican party in the state.
“We’ve got to be cautious because we’re going to be running against the conspiracy theories, lies and misrepresentations,” he said. “The stakes of this election are enormous, and every voter will be impacted by the outcome.”
🚨 HOT MIC: Sen. Chuck Grassley (R-IA) was caught asking staff during questioning of Trump judicial nominees: “What would be wrong if they said Biden won?” Multiple people in the room heard it. GOP staffers were reportedly panicking, according to sources familiar.
Ali Davis invited us to reprint this post from The Camelopard. As always, we said yes.
Hello, Goopers!
Wow, things are getting wild, huh? Did you ever think, during all those long years when you boosted him and covered for him, that the Trump Train would be plowing through so many guardrails? Rumor has it — or at least a Gateway Pundit writer has it — he tried to use nukes last Saturday!
I would write something about you being the last hope and your duty to your country, but that’s clearly no incentive, so here’s something that will hit.
You have a very small window to act before your name is on the Bad Guys list forever.
You must remove Trump before a) he goes undeniably off the rails or dies or b) another country’s investigation turns up his full involvement with Jeffrey Epstein and child sex trafficking. If you don’t, you,personally, go down in history as a willing toady to evil. Your name and your failure to act will be preserved forever. Family members will change their last names or claim no relation. Corporations will find hiring you too big a risk. No more political career, no cushy lobbying job, no lucrative TV punditry. Just burned relationships and strangers asking why the hell you didn’t stop it when you had the chance, right before they spit on you.
You see how Tucker is scrambling to position himself as A Guy Who Sees the Light and Wants to Stop Trump? Do you think he had a deep change of heart, or do you think he noticed the way the wind is blowing and is doing everything he could to save his own ass and future? You should study those instincts.
Tucker knows that he will need to be able to point, however ludicrously, however tenuously, to how he saw that Trump was dangerous and spoke up.
You need to do more than that. You must remove Trump from office before his own body removes him or you go on the Forever Trumpers list.
If you don’t have real moral fortitude, try to develop the sense and eyes that God gave a potato and read a few polls while you’re at it. Trump is losing, so you need to act like him one more time: Switch to the winning team and pretend you were always wearing that jersey.
Do it fast if you ever want to keep seeing your grandchildren after they’re old enough to understand this moment in history and what you failed to do.
Oh, there’s no evidence that Mr. Trump ever —
Look into your soul and be real for a moment. At best — at best — he knew exactly what Epstein was up to and winked at it. The birthday card. The famous quote where he said “He’s a lot of fun to be with. It is even said that he likes beautiful women as much as I do, and many of them are on the younger side.” The constantly changing stories about when and why Epstein was removed (was he?) from Mar-a-Lago.
We may never know everything, but we will know more. You can be one of the heroes who bravely stood up to stop Trump, or you can be one of the craven sleazebags who went all out to shield an aspiring dictator and bunch of wealthy child molesters. Every moment you don’t choose the first one will itself be a black mark against your name, so you might want to hurry up and flip a coin or something.
But I’m being blackmailed.
I have news for you: There has never been a better time to get out from under being blackmailed. The crimes in the Epstein Files are so heinous that even Swalwell and Gonzales’s horrifying conduct barely made a blip. Make your peace with your family, take some responsibility, and hope that whatever the regime has on you isn’t as hilarious as what someone had on Kristy Noem’s husband.
Need a little more incentive? Not that I am diagnosing anyone, but people who become disinhibited as a part of their cognitive decline have an increasing tendency to just … blurt things out. Do you want to have a nice, preplanned statement to the press about respecting your privacy during this challenging time, or do you want the most personal thing you can imagine barfed out randomly during an official statement on the soybean trade?
I will also mention that people with some types of dementia have a tendency to fill in memory gaps with invented details. Do you really want to explain to the nation that yes, the thing about the carnival is overall true, just not the part about the plate spinner and the Tilt-a-Whirl?
Besides, if enough of you move quickly and work together, you might just get off scot-free.
Surely you’ve heard the broad hints about Congressional Republicans being physically threatened.
I have news for you, Sparky: We are all being physically threatened. A man who has never in his life experienced a consequence has access to nuclear weapons and is eager to use them.
Move quickly. Get your family somewhere safe, choose a Democrat as a point person — do not trust your fellow Republicans, you know full well how craven they can be — and let the opposition party count up the votes. Move together, publicly report the threats, and save yourself by bravely impeaching the sumbitch.
But what if no one believes us? What if reporting gets us ridiculed or puts us more at risk?
Well, now you know what it’s like to be a victim of a powerful serial sex offender. Please use that perspective wisely in the future if you have any shreds of a political career left.
For real though — a lot of Trump’s power comes from the perception that he is powerful. Puncture that and the whole thing deflates.
You want to save your own tail? Help the Democrats start prosecuting him and his cronies immediately after impeachment. No professional courtesy, no putting this all behind us so we can move forward, no honoring the frantic pardons of a rogue President. Everything comes out and everyone gets real consequences. Seize and freeze assets, put Trump’s thugs and cronies on the no-fly list, and start the trials. Nobody squeaks by, not even the very wealthy ones.
Once you find some rudimentary bits of calcium spinning around your spinal nerve, you may even discover that you like using them in the service of something good.
But you must act immediately.
Trump is spinning out and trying to take the world with him. You can help put a stop to it, or you can forever be on the list of people who had the power but were too evil or craven to do anything about it.
You can choose the story that other people will tell about you.
It was a yesterday’s Wonkette tab, but I just got to that email over lunch. It’s a horrible story. Of course, the hospital likely is understaffed thanks to policies and practices of our government, but still. Here is this-
Cara Lynn Shultz is a writer-reporter at PEOPLE. Her work has previously appeared in Billboard and Reader’s Digest. People Editorial Guidelines
NEED TO KNOW
Conor Hylton’s family has filed a wrongful death lawsuit against Yale New Haven Health-Bridgeport Hospital
The ICU where Hylton was treated had no on-site doctors and relied on off-site telehealth monitoring, the complaint alleges
A representative for the hospital tells PEOPLE, “We are unable to comment on pending litigation”
A dental student died in a Connecticut ICU where he wasn’t being cared for by an on-site doctor, but instead, was monitored remotely by an off-site physician via video.
The family of Conor Hylton has filed a wrongful death lawsuit against Yale New Haven Health-Bridgeport Hospital after the 26-year-old died in the Milford Campus’s intensive care unit. According to the complaint obtained by PEOPLE, the site is a “tele-ICU meaning there are no qualified ICU intensivists on site.” The complaint further states, “ICU intensivists are located off-site at a centralized remote location, purportedly monitoring critically ill patients through a video screen.”
In a statement to PEOPLE, a representative for the medical group said, “Yale New Haven Health is aware of this lawsuit and is committed to providing the safest and highest quality of care possible, however, we are unable to comment on pending litigation.”
Hylton first arrived at the hospital at 11:08 a.m. on August 14, 2024, with abdominal pain and vomiting, per the complaint, which says he was admitted and diagnosed with “pancreatitis, dehydration, metabolic acidosis, and alcohol withdrawal.” His condition “continued to change and deteriorate over the evening.”
At 4:30 a.m., the complaint says, “Mr. Hylton slid down in bed, his eyes rolled back and he became unresponsive and exhibited seizure-like activity, vomited, became bradycardic and code was called. He was intubated, but he could not be resuscitated, and he was pronounced dead.”
The complaint states that although the pronouncement of Hylton’s death was said to be made by an on-site doctor, it was actually done by a ‘tele-health’ provider on a video screen.”
According to the complaint, an on-site doctor was called to intubate Hylton, but “the provider summoned to perform the intubation did not know how to find the ICU and had to find someone else to show him where it was located. This led to a delay in [care].”
An expert medical opinion included with the lawsuit wrote, “no on-site doctor assessed Mr. Hylton from the time he was admitted to the ICU until after he exhibited seizure activity at 4:30 a.m.”
Joel T. Faxon, partner at Faxon Law Group, which is representing Hylton’s family, said in a press release: “It’s alarming to think in a supposedly intensive care setting: Where is a doctor? Where are the nurses? How does the emergency doctor not know how to get to the ICU to provide life saving care?”
Faxon confirmed to PEOPLE that neither Hylton nor his family were informed there were no on-site doctors at the ICU. As Faxon told PEOPLE exclusively, “If the Hylton family knew that their son was being placed in a fake icu with no doctor present they would have demanded he be transferred to a hospital that could properly treat him. They were never given that option and, tragically, Conor died as a result.”
On Easter Sunday, Donald Trump posted to Truth Social, “Tuesday will be Power Plant Day, and Bridge Day, all wrapped up in one, in Iran. There will be nothing like it! ! ! Open the Fuckin’ Strait, you crazy bastards, or you’ll be living in Hell – JUST WATCH! Praise be to Allah. President DONALD J. TRUMP”
Trump supporters, including the evangelicals, don’t care how vulgar he is, how insane he is, or that he is threatening to commit war crimes. They don’t care that he unleashed his tirade on Easter Sunday. They don’t care that he has gone back and forth with his demands regarding the Strait of Hormuz, from wanting to get it open, to demanding help from NATO, to saying it will open up naturally, back to demanding that Iran open it, or he will bomb them straight to hell. (snip-MORE)
Trump unhinged
Another truth social posting by the tangerine monster
Ann Arbor (Informed Comment) – On Easter Sunday, God’s chosen in the White House issued a vulgar and unbalanced posting on his “Truth Social” that epitomizes the insanity of his Iran War. Attending to it closely will help us understand how Trump has strengthened the government of the Islamic Republic and put it in control of global energy. Trump fondly imagines that he can dislodge Iran from this new ascendancy, but he is wrong, since it depends on sabotage, a sabotage that cannot be policed.
This is embarrassing, Delete it, President @realDonaldTrump – unless you want everyone to think you’ve lost your marbles.
The foul language and clear mental imbalance visible in this announcement sparked a further round of calls for Trump’s removal under Article 25 of the Constitution, which is nothing more than an internet meme since Trump has surrounded himself on his cabinet with people even more certifiable than he is, and who wouldn’t dare move against him.
Trump, having imbibed whatever substance it is that makes him manic, announced that “Tuesday will be Power Plant Day, and Bridge Day, all wrapped up in one, in Iran. There will be nothing like it!!!”
He is repeating a threat he made previously, to bomb Iran’s civilian electricity-generating plants as well as its civilian bridges.
Iran has 98 major power plants fueled by fossil gas, which generate 85% of the country’s electricity. The largest, the Damavand power plant south of the capital, Tehran, has a generating capacity of over 2.8 gigawatts.
One of Iran’s power plants is nuclear, at Bushehr. If Trump or Israel bombs it, the consequent radiation pollution will deeply harm the Arab Gulf states, not only through airborne particles but also by contaminating sea water, which is drawn on by the region’s desalinization plants. This exposure to radiation would certainly increase cancer risk in the region. There are mountains between Bushehr and the Iranian interior, so the radioactive particles would be blown west toward other countries such as the United Arab Emirates, Saudi Arabia and Qatar.
Striking civilian power plants, and above all nuclear ones, endangers the noncombatant population of children, women and unarmed men and violates International Humanitarian Law.
In fact, the International Criminal Court in the Hague issued “warrants of arrest for two individuals, Mr Sergei Kuzhugetovich Shoigu and Mr Valery Vasilyevich Gerasimov, in the context of the situation in Ukraine for alleged international crimes . . .” on June 24, 2024. They were indicted for “for the war crime of directing attacks at civilian objects (article 8(2)(b)(ii) of the Rome Statute) and the war crime of causing excessive incidental harm to civilians or damage to civilian objects (article 8(2)(b)(iv) of the Rome Statute), and the crime against humanity of inhumane acts under article 7(1)(k) of the Rome Statute.”
Among the “civilian objects” that these Russian officials ordered attacked in Ukraine were power plants and structures such as the Kryukovsky Bridge.
So Trump is talking like a war criminal, which tells you why he has placed sanctions on International Criminal Court judges.
Trump already struck the unfinished B1 bridge linking Tehran to Karaj. Since it was not finished, it could not possibly have had a military purpose, contrary to the lies of the lying liars in the Trump administration who gave that as the excuse for hitting it.
Trump continued, “Open the Fuckin’ Strait, you crazy bastards, or you’ll be living in Hell– JUST WATCH!
It is not clear how a body of water such as a strait could copulate. However, it can engender revenue, and does so for Iran. A lot of revenue.
Iran has not actually closed the Strait of Hormuz entirely. It is exporting its own petroleum through that narrow aperture, mainly to China. Trump has been forced by the global oil shortage to lift sanctions on the Iranian tankers, and so Iran is also selling again to India. Before Israeli Prime Minister Benjamin Netanyahu rushed Trump into war on Iran on February 28, Iran was exporting about 1.4 million barrels a day to China. The price of petroleum was about $67 a barrel then, but Iran had to offer a steep discount to offset American sanctions, and so was probably only getting $57 or less a barrel. So Iran was getting something like $29 billion a year for its petroleum from China and a few other customers (90% goes to China).
China is now likely having to pay $110 a barrel for Iranian petroleum.
Iran’s oil income just went up to $55 billion a year if these prices and this volume of trade persists, which is plausible. So the “crazy bastards” in charge of Iran have nearly doubled their income off the Netanyahu-Trump war because of the fertility, under their control, of the “fuckin’ Strait.” The Iranian oil industry is state-owned, so all the money goes to the clerics and the Iranian Revolutionary Guards Corps, as well as to the conventional army and the elected institutions, the parliament and president. This extra income helps the government tamp down resistance, strengthening it against civil society. In any case, many Iranians under foreign attack are rallying around the flag. Of course there are also tax losses from the economic disruption of the war, but the vastly increased oil income helps make up for them as far as the government is concerned. If the price of oil goes to $200 a barrel, as it may well, Iran’s government could get $100 billion a year for its petroleum.
Not only that, but Iran has instituted a toll system, wherein countries that have good relations with Iran and pay a fee can transit the Strait without fear of an Iranian drone attack. In contrast, countries that Iran believes contribute to the American war effort against Tehran such as the Emirates and Kuwait, are blockaded by the threat of such strikes. These tolls could be an ongoing and lucrative source of income for the government. Before the war, 138 ships transited the Strait daily. If that traffic resumes but each has to pay Iran a $2 million toll, that would bring in $96 billion a year, i.e. four times what Iran was getting for its petroleum before the war.
So here’s the thing. With the advent of Iran’s Shahed drones, which can be manufactured inexpensively and of which it has tens and thousands, there is no way for anyone, including Trump and the US military, to stop Iran from sabotaging ships that won’t pay the $2 million. At least, I don’t see how it could be done. You’d need tens of thousands of interceptors, and we hardly have any left. Moreover, interceptors cost $1.5 million apiece, so it makes much more sense to allow each ship to pay Iran the $2 million.
Container ship in Strait of Hormuz. (U.S. Navy photo by Mass Communication Specialist 2nd Class Indra Beaufort).Public Domain. Via Picryl .
Trump has shown Iran how it can go into the protection business in the Gulf for the long term. Nice oil shipping industry you have here, it would be a shame if anything happened to it. And off that, Iran actually increases its GDP substantially.
If Trump takes out Iran’s electricity and bridges, he can interfere with its economy and its society in a big way. But he can’t stop the drones or the protection racket that way. Moreover, Iran has made it clear that its response will be to take out the power plants in the Gulf Arab states as well as in Israel. Since the US and Israel are running low on interceptors, and since even small Shahed drones have great range and can do a lot of damage, Iran’s threat is credible.
If Trump takes out Iran’s petroleum-production capability, Iran will crash oil production in the Gulf, taking 20 million barrels a day off the market for years to come. That would certainly be another Great Depression and likely would spell the end of the oil industry, since everyone in the world would migrate to electric vehicles quickly.
So although Trump meant the phrase ironically and blasphemously, the Iranian authorities may well end up saying “Praise be to Allah” over Trump’s monumental stupidity.
Abraham Lincoln’s faith in the Declaration of Independence ultimately influenced Walt Whitman’s harsh but optimistic appraisal of the American experiment.
Walt Whitman and Abraham Lincoln (Library of Congress)
“The United States are destined either to surmount the gorgeous history of Feudalism, or else prove the most tremendous failure of time,” wrote American poet Walt Whitman in his 1871 work, Democratic Vistas. Despite writing in the wake of a brutal civil war and a failing Reconstruction Era, Whitman remained optimistic. “Not the least doubtful am I on any prospects of their material success.”
Known more for his poetry, exemplified by Leaves of Grass (1855), Whitman’s dark 1871 treatise on the nation remains a harsh but ultimately optimistic appraisal of the American experiment. It serves as a useful tool for thinking about the nation’s current state on the 250th anniversary of the Declaration of Independence.
Whitman’s revolutionary patriotism had long been part of his worldview. He celebrated the Declaration of Independence and the Revolution in the preface to Leaves of Grass, noting that a poet must “enter the essences of the real things and past and present events,” among them “the haughty defiance of ’76, and the war and peace and formation of the constitution.”
But for all his celebration of the Declaration and the nation’s founding, he did not mince words regarding the nation’s failings. He wrote of a “hollowness” at the center of American life at the time, calling the business classes depraved and the government saturated in corruption. (snip-go see the rest!)
Donald Trump is threatening to bomb Iran back to the Stone Age, which, if he does, would be a war crime.
Trump’s chosen war is with the government of Iran, not the people, yet he continues to threaten to destroy its infrastructure. The more Donald Trump and Pete Hegseth brag about their success in the war, the more it seems that Iran fights back.
Trump tells us that the war is won and that Iran’s ability to wage war is nearly depleted if not already destroyed, yet missiles still rain on Israel and our other allies in the Gulf. And if Iran doesn’t have any weaponry left, then how did they shoot down two American jets? If the war is already won, then why are we still fighting? (snip-click on the title to get the rest!)
The largest medical association in the United States supports gender-affirming care — a stance it has reiterated in different ways over the last 10 years. But as Republicans press leading medical organizations on health care for transgender youth, the American Medical Association (AMA) is the latest group caught between political rhetoric and the complex realities of specialized care that few people receive.
As patients, families and doctors navigate this care in an increasingly confusing and hostile landscape, what medical groups say matters. But lately, what they’ve had to say — and how politicians interpret it — has only caused more uncertainty.
The AMA’s stance was already in question after a January meeting between leaders of major medical groups and Dr. Mehmet Oz, the head of the Centers for Medicare and Medicaid Services. After that meeting, which was first reported by The New York Times, one group in attendance — the American Society of Plastic Surgeons (ASPS) — muddied the waters about whether it had taken a more restrictive stance on gender-affirming care.
Questions soon followed for the AMA, the nation’s most prominent organization representing doctors.
Twenty Republican state attorneys general are pushing for the AMA to broadly oppose gender-affirming care for minors, in response to news coverage about their recommendations around youth surgeries. The attorneys suggest that the AMA may be violating state consumer protection laws by confusing, or even misleading, medical providers and patients about their stance. They mention wanting to “avoid a formal investigation” into the issue.
The attorneys, led by Steve Marshall in Alabama, wrote a letter in February asking whether the group recommends hormone therapy or puberty blockers to treat gender dysphoria in minors.
“If you agree that there is insufficient evidence to support using surgical interventions to treat gender dysphoria in minors — as your recent statement indicates — we do not understand how you can find that there is sufficient evidence to support using hormonal interventions to treat gender dysphoria in minors,” their letter reads.
This is an escalation of a familiar tactic, said Khadijah Silver, director of gender justice and health equity at Lawyers for Good Government. And if it works, it will be a major weapon in the political fight to delegitimize gender-affirming care, they said.
“If you can convince the public that they have shifted stance, that’s extremely powerful,” they said, referring to the AMA.
In some ways, that impact is already being felt.
In a recent congressional hearing on rising health care costs, the board of trustees chair for the American Medical Association was asked about how patients across the country are struggling to find doctors. Two hours into the hearing, he was also asked about gender-affirming care for trans youth — a topic that affects few Americans, but takes up a lot of political air.
Rep. Erin Houchin, a Republican from Indiana, asked why the medical group changed its position on surgeries for trans youth.
But the AMA maintains that it has not changed its position.
“In surgery and minors, our belief is that it should generally be deferred until adulthood. But, we respect the physician-patient-family relationship in determining that,” Dr. David H. Aizuss answered in response to the question from the congresswoman.
That exchange took only a few minutes out of a hearing that spanned the gamut of crises facing the U.S. health care system, like skyrocketing insurance premiums and a worsening physician shortage. But it represents a growing tension between Republicans and medical groups, as elected officials who oppose gender-affirming care push for major health care organizations to do the same.
The American Medical Association declined to comment on the attorneys general’s letter, which had asked for a response by March 25. In a broader statement, the medical group said it supports gender-affirming care.
“We support evidence-based treatment for medical care, including gender affirming care,” an AMA spokesperson said in an email. “Currently, the evidence for surgical intervention in minors is insufficient for us to make a definitive statement. In the absence of clear evidence, surgical interventions in minors should be generally deferred to adulthood. Treatment decisions should be made between the physician and the patient (and family) based on the best medical evidence and clinical judgment.”
That position aligns with the World Professional Association for Transgender Health (WPATH), an authority on medical care for trans people. WPATH recommends that patients generally wait until adulthood before seeking surgery. Trans youth rarely undergo surgery of any kind; of the small number performed on adolescents, the majority are mastectomies.
If an adolescent does need surgery, WPATH recommends they meet extensive criteria — including a full understanding of reproductive side effects, a year’s worth of hormone therapy, sustained gender incongruence, plus emotional and cognitive maturity.
The questions surrounding surgery come on the heels of the American Society of Plastic Surgeons’ response to the January meeting with Oz. In what the Times described as a “tense” meeting, Oz pressed leaders of organizations including the AMA and the ASPS on why they recommend gender-affirming care for trans youth. At that meeting, the surgeons group said it would be changing its position, per the Times.
Weeks after the meeting, ASPS released a nine-page statement saying that gender-affirming surgery should be delayed for minors until a patient is at least 19. The surgeons’ group cited insufficient evidence that benefits for surgery outweigh risks, and pointed to a controversial report created by the Trump administration to back its position.
The surgeons group noted that it still opposes criminalization of such medical care. The Trump administration celebrated the announcement.
“Today marks another victory for biological truth in the Trump administration,” said former Deputy Health and Human Services Secretary Jim O’Neill, in a press release. Oz, who has compared gender-affirming care for minors to lobotomies, applauded the American Society of Plastic Surgeons “for placing itself on the right side of history.”
In the following days, the surgeon’s group appeared to backtrack. The American Society of Plastic Surgeons reportedly told NPR that its position “does not include a blanket recommendation for surgery for minors.” The ASPS did not respond to a request for comment on this story.
The AMA has had its own trouble communicating its position. In a recent internal newsletter from the board chair, the association said that its policy on gender-affirming care has not changed at all; and that it requested a correction from The New York Times in response to the outlet’s coverage of its initial statement on youth surgeries. However, the Times says it has received no such requests.
This back-and-forth is taking place against an intense political backdrop: Six states have made it a felony for doctorsto provide gender-affirming care to trans youth. Hospitals across the country have shuttered gender clinics in response to pressure from the administration. As a result, some young patients are cut off in the middle of treatment and medical professionals are grappling with how the law impacts them.
And despite ample news coverage, gender-affirming care is still not widely understood.
Very few transgender youth seek and access surgeries. More rely on hormone therapy and puberty blockers to treat gender dysphoria, which is a medical condition that can cause significant distress for trans people.
Puberty blockers delay the hormones that cause kids to go through puberty, which can be an intense and emotionally fraught time for trans youth. Many families say this treatment is crucial for their child’s wellbeing and prevents distress caused by dysphoria. There are potential risks, like decreased bone density, which is monitored by medical providers. Some providers recommend weight-bearing exercise or diet optimization to boost calcium and vitamin D levels while on puberty blockers.
Hormone therapy, which involves taking testosterone or estrogen to cause physical changes that align one’s body with their gender identity, is another treatment that some trans youth receive to alleviate dysphoria. As with puberty blockers, clinics require a mental health assessment as well as parental or guardian consent for the treatment.
The Endocrine Society and the American Academy of Pediatrics are under federal investigation over their support for gender-affirming care. Both medical groups have sued, as the government seeks information to determine if they have made “false or unsubstantiated representations” regarding the care.
The attorneys’ general letter to the American Medical Association is leveling up that pressure on medical groups, Silver said.
“Because the care is so politicized, any association that stands up and asserts its support for physicians who provide the care, will be made an example of,” they said.
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