Clark A. Pomerleau

Grappling with Shifting and Shifty Alliances in Support of Trans and Disabled Children

Content warnings for references to transphobia, ableism, racism, and specific denials of life-saving care through political attack and medical abuses.

Refuge Niches

(listen to the poem read by the author)


Whether fertilized into full bloom
Or scrabbling to live
Survivable conditions can be harsh
The breadth of a fundamental niche
Assaulted by parasites and predators
Whose attacks make them seem inhuman
When they undercut our right to
Authentic living

Going after the youngest and weakest
With school harassment and
Cyber goads to suicide
With threats to rip away loving parents
Progenies’ very air and buffer against life-ending
Going after the un-conceived
With research into gay genes and prenatal disabilities
That rounds out a century of eugenics

From all sides, those who want us dead
Advance to shrink our realized niche
But we are spread worldwide
Contiguous states as permeable
As the seas are crossable
We come and go and
Love and imagine ourselves
Into epochs of being

Somewhere there will always be refuge
You can expand habitable space to hem in
Those who seek local extinction
Their politics, media, science, evangelizing,
Taking over positions of power
Find us pouring back in
Both young and survivors
They cannot eradicate our refuge niches.

Manifesto: Grappling with Shifting and Shifty Alliances in Support of Trans and Disabled Children

Within the past decade in the U.S., a backlash has swelled against seeming gains in national equity for historically underrepresented groups. We reject the mentalities that undergird norming children and denying people loving care when they do not fit those norms. Discrimination against trans children and disabled children, two overlapping vulnerable groups, highlights the problem of judging people by a constructed “normal.” Championing the rights of underrepresented groups forges uneasy alliances with medical, psychiatric, and governmental bodies that also have histories of direct harm.

In February 2022, the Texas governor and attorney general directed school and medical officials to report parents as child abusers if they support their transgender children with age-appropriate social transition. Redefining child abuse to include loving parents who affirm their children’s gender identity threatens to remove trans children to a foster care system that has already been found guilty of abusing children and is still under investigation. In the Texas state system “most foster care services are currently provided by the private sector.” Social transition for minors involves affirming a name, pronoun, and gender expression that matches the gender the child knows themselves to be. After an intensive gate-keeping process, social transition could include hormone blockers to delay puberty. We who affirm trans children condemn the spread of misinformation about social transition to attack LGBTQ+ Americans that terrorizes transgender children and their affirming parents.

An evidence-based understanding can partner us today with medical-psychological-psychiatric (med-psych.) authorities who listen to trans people of all ages against politicians who weaponize transphobia for political gain. All the leading national professional associations recommend social transition as best practice. They have included clients’ self-knowledge and well-being in research findings about medical and psychological care for trans children. The American Academy of Pediatrics (est. 1930), the American Medical Association (est. 1847), and the American Psychological Association (est. 1892) all oppose the flurry of bills in state legislatures that try to prevent trans children from living authentically and participating fully at school. Each organization has debunked the sensationalist misinformation anti-trans activists and politicians perpetuate that inaccurately describes social transition. The AAP, AMA, and APA warn that anti-LGBT legal maneuvers contribute to a hostile climate for LGBTQ+ people.

Our alliance with med-psych. authorities is a shifting one with shifty bedfellows. By not heeding marginalized people’s lived experience, med-psych. authorities have histories of neglect and abuse of LGBTQ+ people, disabled people, poor people, and Black, Indigenous, and other people of color (people of color here meaning all people not designated white within white supremacist ideology). Diagnoses and resulting practices biased by white, heteronormative, ableist assumptions continue to frame people as problems to “fix.”

As we affirm the lived experience of trans children and their supportive parents, we simultaneously acknowledge the generations of harm that medical and psychological associations and practitioners have caused and colluded in against trans and queer children (across identities, with and without disabilities). After gay and lesbian activists succeeded in getting the American Psychiatric Association to stop labeling homosexuality a mental disorder in 1973, for the next version of the Diagnostic and Statistical Manual of Mental Disorders (DMS-III in 1980) the association invented a new “psychosexual disorder” called Gender Identity Disorder of Childhood. This new psychiatric label and related so-called “psychosexual disorders” created a narrow, approved way of being trans based on binary gender stereotypes and assertions that patients were hostile toward their own anatomy. The DSM, including the current one, has upheld normative societal beliefs that being trans is a mental illness despite also creating the route to access medical transition.

Likewise, we acknowledge the continued harm that normative med-psych. perspectives have in framing disabled children and adults (across genders and other identities) as problems to “fix.” Practitioners enact direct harm when they withhold needed treatment because they conclude that disabled children do not have a quality of life “worth” medical intervention. Into the twenty-first century, pediatricians deny organ transplants to children with disabilities. This malpractice violates the Americans with Disabilities Act, yet family members have had to campaign state by state with and for loved ones with disabilities. In May 2021, the Texas governor became one of what are now thirty governors to sign a law prohibiting health care providers from preventing someone from getting an organ transplant based on their disability. To have an ally in the Texas governor on this count while he tries to deprive trans children of loving parental care is nauseating.

Since the COVID-19 pandemic, too many health professionals have rationed health care by denying life-saving care to people with disabilities despite the Health and Human Services’ guidance that providers are obligated to care for people with disabilities in crisis situations. For example, in December 2020, a doctor at CHI St. Anthony Hospital in Pendleton, Oregon denied a COVID-19 positive woman a ventilator because she has an intellectual disability. He cited her “low quality of life” while pressing her to sign a legal form that would allow the hospital to create do-not-resuscitate and do-not-intubate orders for her. Hospital staff further directed the woman’s group home to fill out DNRs for their other residents in case any of them came to the hospital. Staff at her group home involved Disability Rights Oregon who found another hospital for the woman. There the woman went on a ventilator. She recovered and returned home. But there was no sanction against the denying physician or the hospital where he worked. This was just one of many cases.

The attacks on trans children and the denial of care to disabled children are part of a long-standing use of inventing hierarchies of worth that create disadvantaged children and justify the neglect, harassment, and abuse of those children. Mainstream society has tried to segregate and under-resource trans children, disabled children, Black, Indigenous, and other children of color, and poor children by constructing them as ideological threats. The threat to supremacist ideology is that the presence and equitable treatment of trans, disabled, racialized, and poor children will inform idealized children that equity and belonging are appropriate when conservatives want to cordon off marginalized children as deficient. Conservatives thereby pose youth who are any combination of trans, disabled, kids of color, and/or poor as some sort of direct threat to cis, white, able-body-minded kids’ educational advancement, well-being, or safety. In the history of segregation, a founding assumption of resourcing schools based on their racial and socio-economic compositions imagined children of color and poor children as academic and behavioral drags on what segregationists have wanted to be all-white classrooms and wealthier parents have wanted to be (white) middle- or elite-class schools. Racists have recognized that anti-miscegenation ideologies break down when white children grow up integrated with children of color and with teachers of color and other adults of color in high-status positions. Inegalitarian perspectives can collapse when we recognize that all people deserve equal respect and full access to public life. Trans people and disabled people are part of human variation.

The current neglect of and attacks on trans and disabled children are part of a long history of white, ableist, classist, cis-heteronormative designs for who ought to reproduce and at whose expense. Medical doctors’ gynecology was made possible by exploiting the bodies of enslaved women while attacking the economically marginal midwives who helped women across economic statuses. Involuntary sterilization targeted people incarcerated for being disabled, women and girls of color, and the poor. In the 1950s, while forced sterilization rates were highest among Native, Black, and Latina cis women, scientists tested oral contraception on Puerto Rican women. Today, mainstream society continues to punish impoverished parents with work requirements while balking at disabled, queer, and trans people having children.

We cannot truly be committed to inclusion, diversity, equity, and access until we reject the white, ableist, classist, transphobic, heterosexist mentalities that undergird norming children and denying them loving care when they do not seem to fit normative expectations.

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About the Author

Clark A. Pomerleau (he/him) is a writer and teacher from Washington State whose work features memory, place, nature, queer aesthetic, and transformative agency. His first full-length poetry book is Every Day, They Became Part of Him (Finishing Line Press, 2023), and Finishing Line Press published his chapbook, Better Living through Cats, in 2021. Other poetry appears in Wordgathering: A Journal of Disability Poetry and Literature, Peculiar: A Queer Literary Journal, Beyond Queer Words, About Place Journal, Lupercalia, Poached Hare, Coffin Bell Journal, and the poetry anthology, Welcome to the Resistance (2021). Pomerleau’s scholarly essays and book (Califia Women, 2013) historicize feminist diversity education, feminist views on sexuality, and trans-inclusive praxis.