Last Wednesday, Rachel Levine, a transgender pediatrician, had her Senate nomination hearing to become the Assistant Secretary of Health. Senator Rand Paul grilled Levine over her support for Hormone Replacement Therapy (HRT) for transgender people, referring to sex reassignment surgery (SRS) as “genital mutiliation” and insisting that Levine supported such surgeries for minors.
Putting aside the fact that SRS is rarely, if ever, performed on minors, Paul’s line of questioning reveals the rotten core of American libertarianism. Paul, associated with the libertarian movement through his father, Ron Paul, has accepted and rejected this label in the past. Whatever his personal affiliations may be, Paul is a figurehead for much of the libertarian movement. Young Americans for Liberty (YAL) groups often invite him to campuses to speak on issues of “liberty”, and he would presumably claim to support individual liberty. Despite these affiliations, his recent statements from the hearing support the belief that transgender people should not be allowed to pursue personal medical interventions. Restricting this individual capacity fundamentally opposes individual liberty.
This blindspot is indicative of the results of a libertarian movement which made a devil’s bargain with Republicanism. The 20th century birthed “fusionism”, a tenuous coalition formed between religious conservatives, paleoconservatives, and libertarians. Libertarians believed the Republican party was the best path forward for promoting liberty. Ron Paul ran as a Republican, and Barry Goldwater, arguably one of the first major libertarian politicians, also ran as a Republican. Chicago School economists and libertarian intellectuals, despite any reservations, bit their tongues and backed the Republicans who supported tax cuts and free market policies. Milton Friedman famously said “I am a libertarian with a small ‘l’ and a Republican with a capital ‘R.’ And I am a Republican with a capital ‘R’ on grounds of expediency, not on principle.”
This emphasis on “expediency” captures the heart of the issue. However, for the sake of expediency, libertarians had to look away when Ronald Reagan strengthened the War on Drugs and derided the LGBTQ community. Libertarians like Charles Koch had to look away as Republicans (and Democrats) created our modern mass imprisonment system; as Republicans pushed further and further right on immigration issues, and, today, as transgender people become another victim of Republican backlash politics.
The trans community is facing an onslaught of bills that attacks our ability to access healthcare and participate in sports. Putting aside “religious exemption” bills, do transgender people not have the individual liberty to pursue medical procedures they believe to be medically necessary? Do the parents of transgender children not have the right to make medically informed decisions with their children? (Especially considering these decisions basically never include surgical interventions, and are largely focused on hormones and therapy.) From the people who preach school choice, who believe parents can make decisions about their children better than the state can, will they support the ability of families to make medical decisions without the threat of state intervention? Oklahoma’s proposed bill wants to make it a criminal offense to provide gender-affirming care to anyone under the age of 21. Do not even 18, 19, 20 year-old adults have the capacity to make decisions for themselves?
Obviously many libertarians have stood on the side of LGBTQ liberties, and I will not dismiss that. However, for libertarians to stay true to their beliefs in individual liberty, they, firstly, have to cut themselves off from the Republican party. Trans issues aside, there is no room in Republican party for open borders, civil liberties, and many of the issues libertarians hold dear. But more than that, libertarians have to be better to the people who are at high risk of state oppressions, including transgender people. This culture war will not end soon, and major libertarian leaders, thinkers, and institutions need to speak out against this bigoted backlash.
At the heart of the issue is this: if the state can tell you what medical choices you can make for your own body, for your own family, what can it not tell you to do?