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A growing number of Americans believe that gender-affirming care will become less accessible in their lifetime, a new 19th News/SurveyMonkey poll finds — reflecting a political landscape that has become increasingly hostile toward transgender health care. 

Nearly 4 in 10 Americans think gender-affirming care will become less accessible over the course of their lifetime. A year ago, The 19th and SurveyMonkey found only 20 percent of Americans felt that way. But since President Donald Trump returned to office, the federal government has subpoenaed doctors for trans patients’ private data and pressured hospitals in blue states to close their clinics that provided gender-affirming care to minors. The administration has pledged to investigate the care as medical fraud, despite the medical community’s broad endorsement of gender-affirming care as an effective treatment for gender dysphoria, which is persistent distress felt when one’s body is out of sync with their identity.

Thirty-one percent of Americans believe gender-affirming care will become more accessible in their lifetime, down from 48 percent in 2024. Women are generally more likely than men to think access will expand —  except for Gen Z. 

The SurveyMonkey poll, conducted online from September 8 to 15 among a national sample of 20,807 U.S. adults, provides a detailed window into what Americans believe about trans health care, after conservative groups have poured millions of dollars into anti-trans campaign ads. The survey had a modeled error estimate of plus or minus 1.0 percentage points.

A majority of Americans (53 percent) believe transgender adults should have access to gender-affirming care, while 37 percent believe that trans minors should have that same access. But they’re divided on whether politicians should intervene: Half of Americans oppose lawmakers banning or restricting care for transgender youth. 

Many Americans across the political spectrum would prefer that politicians avoid focusing on trans issues at all. Four in ten Americans — with an even split between Democrats and Republicans — think politicians should not focus on transgender issues. This alignment marks a notable difference from 2024, when 33 percent of Democrats agreed with this hands-off stance compared with 53 percent of Republicans. 

The past year has seen significant hand-wringing within the Democratic Party on trans rights. Some have argued that Democrats let Republicans dominate the public’s perception of trans people during the 2024 election — and lost voters in the process. 

The share of Republicans who believe politicians should focus on restricting gender-affirming care has risen since last year (49 percent versus 35 percent), while the share of Democrats who believe politicians should focus on protecting transgender people has dipped (52 percent versus 58 percent). 

Among parents, only 31 percent of those with kids under 18 support gender-affirming care access for trans youth — compared with 47 percent of non-parents. Overall, mothers are more likely than fathers to be in favor of such care. LGBTQ+ parents are also more likely to be supportive of trans youth accessing the health care. 

Trans minors and trans adults go through very different processes to receive gender-affirming care. Young kids socially transition, meaning they change their outward appearance to match their gender expression by getting a haircut or wearing masculine or feminine clothes. If they feel affirmed through that social transition, further options for care include puberty blockers or, for adolescents, hormone replacement therapy. Both of these options alleviate gender dysphoria and require ongoing doctor’s appointments to monitor treatment, as well as parental consent. The majority of trans youth do not undergo surgery. 

The survey also indicates that one dynamic may be shifting, at least among Republicans. Past polling, including from The 19th and SurveyMonkey, showed that people who know trans people are less likely to oppose access to gender-affirming care. While this year’s data shows that is true for Democrats, among Republicans, knowing a trans person made no difference when it came to care for minors and a small one when it came to care for adults. Still, 48 percent of Republicans who know a trans person strongly oppose access to gender-affirming care for adults, versus 56 percent who do not know a trans person.

LGBTQ+ advocates have long relied on sharing the personal stories of transgender people as a tool to push for protective policies and to oppose discriminatory ones. But as conservative media outlets and politicians have amplified more misinformation about trans people and their health care, that strategy may not be as effective as it has been in the past.