Donald Trump’s “transgender operations” line during this week’s presidential debate is already the talking point that launched a thousand memes — but what may have sounded like word salad managed to contain the barest hint of a real, honest-to-goodness fact.
During Trump and Vice President Kamala Harris’ first and potentially only debate on Tuesday evening, Trump accused the sitting vice president of approving “transgender operations on illegal aliens that are in prison.” Trump was ostensibly responding to a question about hydrofracking, though he veered wildly between other claims, including sensational and misleading allegations that protestors “burned down Minneapolis” in 2020. But for once, Trump’s comments about trans people weren’t entirely fabricated — although calling them “accurate” would be a stretch.
Trump’s claim about “transgender operations” can likely be traced back to a 2019 survey from the American Civil Liberties Union (ACLU), which the organization says it sent to all presidential candidates that year, CNN’s KFILE reported on Monday. In that survey, candidates were asked if they would use presidential authority to ensure that all trans people, including incarcerated people and undocumented immigrants, received “comprehensive treatment” for their transition “including all necessary surgical care.” Harris said she would do so.
“I support policies ensuring that federal prisoners and detainees are able to obtain medically necessary care for gender transition, including surgical care, while incarcerated or detained,” Harris wrote in response to the 2019 survey. “Transition treatment is a medical necessity, and I will direct all federal agencies responsible for providing essential medical care to deliver transition treatment.”
Harris’ line specifying that “federal prisoners and detainees” should receive gender-affirming care, including surgeries, would seem to include those held by Immigration and Customs Enforcement (ICE), a division of the Department of Homeland Security. ICE currently operates at least 92 detention facilities across the U.S., according to its official website. Per official records monitored by Syracuse University’s Transactional Records Access Clearinghouse (TRAC), more than 36,000 immigrants were held in ICE detention as of August 2024. (In the 2019 survey, Harris also pledged to reduce ICE funding and close detention centers, but has since adopted a harsher stance.)
Although incarcerated people in the U.S. are routinely denied necessary medical care, that doesn’t mean guaranteeing access to care is a radical position. “Saying you will provide health care to detained people is a constitutional floor,” ACLU attorney Chase Strangio wrote on Instagram on Wednesday in response to a New York Times post that called Trump’s outburst the “wildest sounding attack line that was basically true.”
“People held in cages by the government — whether civilly or criminally detained — have a right to health care [...] this just builds upon the ongoing investment in positing trans people and our bodies as grotesque,” Strangio wrote.
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Of course, gender-affirming surgeries are rarely approved for prisoners and detainees in the U.S. regardless of their immigration status. The first known gender-affirming surgery for a trans prisoner was carried out just last year, and in California, prisoner requests for such care have piled up into the hundreds.
But after Harris’ survey resurfaced this week, attracting coverage from right-wing publications like the National Review and the New York Post, the Trump team leapt to use her response as an attack. On X, formerly Twitter, Donald Trump Jr. accused Harris of pushing to “give free taxpayer funded trans surgeries to illegal immigrants” on September 9, the day before the debate.
Making gender-affirming medical treatment available for everyone, including federal prisoners, would be a notably progressive (though, again, hardly radical) policy proposal for the Harris campaign. But in fact, her platform mentions LGBTQ+ rights only sparingly, and does not specifically mention transgender people at all. Campaign surrogates have touted the record of Harris’ running mate, Minnesota Gov. Tim Walz, whose history of support for queer and trans youth may bolster support for Harris among voters who feel that her image as an anti-trans, anti-sex work California prosecutor lingers on.
That said, LGBTQ+ support for a Harris-Walz administration is already robust, with more than 1,000 people attending a “Trans Folks for Harris” Zoom call last month, hosted by the nonprofit Advocates for Trans Equality.
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