Knox Foster knew he was transgender at age 12, but didn’t decide to tell to his family until nearly four years later.
He can still recall how nervous he felt when he came out to his parents and classmates.
“I was pretty sure my parents were gonna be supportive, but on the off chance that they weren’t, I was really anxious,” Foster told Myrtle Beach Sun News Tuesday. His sister, he said, “didn’t really care,” but his Beaufort high school class group chat surprised him most.
“I remember one person was like, ’OK, cool,’’ Foster said when he told them he had a new name and pronouns. “And then less than five minutes later was like, ‘Hey do you have (the) homework for class?’”
In 2019, when Foster came out, nearly 20 bills targeting the transgender community had been filed in state legislatures across the country, according to the Trans Legislation Tracker, a site that keeps track of bills that impact trans Americans.
On Wednesday, a South Carolina Senate panel advanced legislation that transgender advocates say would unnecessarily harm trans youth by denying anyone under age 18 gender-affirming care and services and the ability to modify their birth certificates to reflect their gender identity.
The move came ahead of March 31, the annual International Transgender Day of Visibility, dedicated to recognizing the achievements of trans people while raising awareness about the discrimination they face.
In capitols all over the country, legislators have proposed bills targeting the transgender community, ranging from banning gender-affirming care to barring teachers from using students’ preferred pronouns.
Backers of the S.C. legislation argue it’s about protecting kids while they’re young, a decision they say that should be made as adults.
“I believe there needs to be a boundary to protect these children from, frankly, whim that they may not be able to reverse later,” Sen. Josh Kimbrell, R-Spartanburg, said last week as senators discussed one of the bills.
But the intense focus on the trans community, a small percentage of the population nationally and in South Carolina, could have a greater impact than people realize, including increasing the already elevated rates of suicide and depression among trans youth and teenagers, say critics of the legislation.
Foster, now 19, was one of 2,150 transgender teens between 13 and 17 in South Carolina in 2020, according to a 2020 University of California Los Angeles study, the last year the study was conducted.
“As my 7-year-old puts it, I was born with a girl’s body with a boy’s brain,” Jace Woodrum, a trans man and Columbia native, told senators Wednesday. “There was a time in my life where I didn’t understand that about myself and there was no one I could turn to. As a young person I felt alone, lost and misunderstood. So much so that I attempted suicide, and I’m lucky that I made it through,” Woodrum said before a panel of lawmakers this week.
Critics also say that, if passed, the bills targeting South Carolina’s trans community could put members at risk of discrimination and force young adults or kids to come out to families and strangers against their will.
”I am in a unique position that my son is safe through all of this,” Foster’s mother, Mary, told the Sun News Monday. “The parents who have kids who are under 18 are truly terrified.”
SC trans bills part of national push
Across the country, state legislatures have introduced legislation targeting trans Americans, particularly youth, who, some lawmakers say, are too young to make medical decisions.
On Wednesday, Kentucky legislature overturned their governor’s veto, putting into law sweeping restrictions for trans youth, similar to legislation proposed in South Carolina. And Georgia last week enacted a ban on gender-affirming care for minors.
While similar South Carolina proposals have a ways to go in the Legislature, last year Gov. Henry McMaster signed a bill prohibiting trans girls and women from playing on female sports teams from elementary school through college.
Since 2016, only five transgender athletes in South Carolina have applied for waivers to participate in high school sports, according to the South Carolina High School League.
After Foster came out to his parents, his mother, Mary, a Beaufort preschool teacher, said she immediately called her son’s pediatrician, who set him up with a psychologist, psychiatrist and a pediatric endocrinologist. Within a year, at 16, he started testosterone.
Under legislation being considered in South Carolina, teenagers would not be eligible for the same care that Foster received.
Foster said not every trans person wants to medically transition, which includes getting health care, including hormones or surgery, that match their gender. For him, it was “extremely important,” he said.
When Foster graduated high school, he chose to get chest masculinization surgery, which removed breast tissue from his chest. After waking up from surgery, holding his stuffed Perry the Platypus, he said, “I was never in pain. And, honestly, I was so happy that even if I was in pain, it was diminished by being happy.”
Finding a health care provider in South Carolina can be difficult, as lawmakers heard this week.
Kristen French, of North Charleston, described the process to the Sun News as “horrific.” French has met with legislators at least four times since her then 14-year-old daughter came out as transgender in October.
French said other parents recommended the pediatric endocrinology department at the Medical University of South Carolina, where Foster went. But the hospital stopped hormonal therapy for anyone under 16 after lawmakers attached a measure to the state budget last year banning the state hospital from doing so.
After a particularly disappointing appointment where French said the provider was ill-informed on trans health care issues, French remembered her daughter saying, “I expected a doctor who would know more about this than I do.”
GOP lawmakers push bills aimed at trans youth
During last couple of months, Mary Foster has been making the trip from her home in Beaufort to the State House to testify.
“What I truly cannot understand is how my son receiving the care he did has harmed anyone in this room or in this state,” she told senators Wednesday. “This transition enabled him to be happier and healthier, and therefore more fully engaged and contributing members of society.”
A growing number of Republican-controlled state legislatures across the country have introduced and passed copy-cat legislation, against the guidance of major medical associations, including the American Academy of Pediatrics and the American Medical Association.
Under one proposal being considered by senators, S. 627, any medical professional, including mental health care workers, who provides a minor with gender-affirming care could lose their license to practice as well as be sued by the patient.
“We can support the children without affirming their desires,” Sen. Dwight Loftis, R-Greenville, said Wednesday. “But if affirming means (telling the child), ‘It’s OK, whatever you want,’ that’s not, in my mind, good parenting.”
Currently, in order to receive a hormone prescription, a child and their parent have to consult with various health professionals.
“You don’t go to the corner drugstore and buy testosterone willy nilly,” Mary Foster said Monday. “I mean, this is a complex process that is well thought out and overseen and evidence based.”
Gender-affirming care, including surgery, is not expressly banned for for minors in South Carolina. However, doctors told lawmakers that medical providers choose not to perform surgery on minors.
“There’s not a problem here,” Sen. Brad Hutto, D-Orangeburg, said Wednesday. “There is no problem (S. 627) is addressing.”
Trans adults, teens say impacts are real
Advocates say that passing bills aimed at trans adults, teens and kids is dangerous.
In one example, S. 627 would require that school officials notify a child’s parents if they know or suspect the child is questioning their gender identity.
“This bill would force kids to be outed,” said Phil Ford, who lobbies for the S.C. United for Justice and Equality. ”I’m glad I wasn’t outed as a child. I take this part very personally.”
Niko Reed, an 11-year-old trans child from Clemson who plans to receive gender-affirming care soon, traveled hours Wednesday to tell lawmakers about his story.
“It is not a choice, it’s just who I am,” said Reed, who wasn’t able to testify Wednesday but spoke to a crowd of supporters outside the State House.
“My body doesn’t match who I really am. And I have spent hours and hours crying over something, something I thought I couldn’t change. I felt as though I couldn’t escape myself, and that was difficult, and still is.
“But, when I discovered gender-affirming care, I realized that there was a light at the end of the tunnel. Gender-affirming care could help me be who I always knew I was, and doctors, therapists, psychologists, they all agreed that it was best for my health.”
Jace Woodrum, a trans man, said after high school he left South Carolina and moved to Colorado, where he began to transition.
“It wasn’t until I started my transition that I found peace and acceptance, joy and confidence,” Woodrum said.
After 12 years away, he said he returned to South Carolina to serve the state’s trans community as the executive director of the ACLU of South Carolina.
“My wife wasn’t so sure about coming back here because she was worried about bills” that target trans residents, Woodrum said. But he returned because “I wanted to try to make a difference for transgender people living in South Carolina,” he said.
Unlike Woodrum, Foster isn’t sure whether he’ll return to South Carolina.
He is currently a sophomore at the University of British Columbia in Vancouver, and is considering whether to become a high school teacher or an anthropologist.
“To do actual ethnographic research into how South Carolinians look at gender, how they look at hate crimes, I think that’d be fascinating,” he said. “But if they pass these laws, I’m never going back.”