Connecticut is one of only a handful of states without a law banning female genital mutilation and cutting, a human rights violation and one of the most extreme forms of gender-based violence. FGM/C, as the practice is often abbreviated, can be done for cultural reasons or a way to exert control over sexuality. It is most often performed on young girls without their consent, has no medical value, and can result in severe medical complications like obstructed childbirth and sensory deprivation.    

The practice is banned at the federal level, but advocates have been pushing for enhanced state laws that incorporate education, civil remedies and better health care for survivors. The Connecticut Coalition to End FGM/C has been working to get a law passed since its formation in 2020.

In March, a Connecticut General Assembly judiciary committee hearing on proposed legislation devolved into nearly three and a half hours of hostility and confusion. A bill that would protect health care workers who prescribed gender-affirming care was up for comment at the same time. In between Coalition members testifying about their experiences, detransitioners spoke out against gender-affirming care and rallied against the shield law. Some comments supporting the FGM/C ban clearly misinterpreted it as a ban on gender-affirming care. 

Lawmakers didn’t seem to meaningfully differentiate between consensual medical care and an act of gender-based violence. Then a committee member began saying that the FGM/C ban should include a gender-affirming care ban too, said Mariya Taher, a survivor and co-founder of Sahiyo, a nonprofit working to end FGM/C in the United States. 

It was a “weird dynamic,” Taher, who regularly shares her story in statehouses, said. “I’m in this position, I’m trying to be like, ‘No, FGM is not gender-affirming care,’ and so I’m trying to separate it, but I’m not trying to separate it and unintentionally cause harm to the trans community at the same time.”

FGM/C has historically been a bipartisan issue; President Donald Trump signed a law in 2020 closing loopholes in the federal statute. While aware of anti-trans activists using the term mutilation, Taher had encountered anti-trans activists in events focused on FGM/C only once or twice before this experience in Connecticut. 

But increasingly, Taher and other anti-FGM/C advocates are seeing their work be coopted by opponents of gender-affirming care. And the view that the two are the same is being backed by the White House, derailing a decades-old movement to stop a form of violence that primarily impacts young girls.

The World Health Organization defines FGM/C as “all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.” In the United States it happens most frequently in immigrant communities, but people of all races, genders and religions have encountered this form of violence. For instance, the “husband stitch,” a nonconsensual surgery performed on postpartum people, is an underrecognized form of FGM/C.  

Taher and other advocates saw how the language of their movement was going to be twisted soon after Trump was sworn into office. He signed an executive order on January 28 restricting gender-affirming care for youth, referred to as “chemical and surgical mutilation,” and directing the Department of Justice (DOJ) and state attorneys general to prioritize the enforcement of FGM/C bans. 

Multiple groups, including Sahiyo, quickly dispensed statements condemning the White House’s conflation of gender-affirming care and FGM/C. But the administration and Republican lawmakers have doubled down on this strategy. 

In May, Rep. Marjorie Taylor Greene introduced her latest iteration of the “Protect Children’s Innocence Act,” which would ban all gender-affirming care for minors and put doctors prescribing that care in jail for up to 10 years. The bill has been introduced in Congress several times and has never reached a full House vote. This time, its language is noticeably different: it seeks to revise a federal statute outlawing FGM/C to include gender-affirming care for minors — but still permits the nonconsensual genital cutting of intersex infants. 

Greene’s bill would redefine female genital mutilation in the United States code as the “genital and bodily mutilation of a minor” or the “chemical castration of a minor” — meaning that the legal definition of FGM/C in the United States would include gender-affirming care. Within her bill, gender-affirming treatments like puberty blockers and hormone therapy are equated to “chemical castration.” 

Under that definition, the bill could threaten families who travel to other states to access gender-affirming care for their child. If passed, it would subject anyone who “facilitates or consents to female genital mutilation of a minor” or who transports a minor for that purpose to the same 10-year sentence, or a fine.

These moves and others at the federal level are stymying real efforts to protect kids across the nation. The Connecticut bill passed unanimously out of committee, but to advocates’ frustration, it was never brought to the floor for a vote. Work in other states has been jeopardized too, as policymakers question whether this is the right time to revisit FGM/C laws when they could be weaponized into a vehicle for banning trans health care.

Most trans youth receiving gender-affirming care do not undergo surgery as a minor. A small number of  trans teenagers choose to undergo surgery, most frequently male chest reconstruction through a double mastectomy. But genital surgery on trans minors is exceedingly rare — and always done with consent of the patient, unlike FGM/C. 

The World Professional Association for Transgender Health (WPATH), the international body that publishes research-backed standards of care, recommends that adolescent patients meet extensive criteria before receiving surgery — including a full understanding of reproductive side effects, a year’s worth of hormone replacement therapy, emotional and cognitive maturity, and sustained gender incongruence, among others. Surgeries like phalloplasty and vaginoplasty require extensive planning, prior treatment and documentation. They have no comparison to FGM/C, which is nonconsensual and has no medical value. 

Gender-affirming care is broadly endorsed by the medical community as an effective treatment for gender dysphoria, which is persistent distress felt when one’s body is out of sync with their identity. It is based on evidence-supported guidelines, said Dr. Marci Bowers, a gynecologic and reconstructive surgeon. She is the immediate past president of WPATH and the co-founder of a nonprofit that provides free reconstructive surgeries to survivors of FGM/C.

In contrast, FGM/C “is culturally practiced, completely done without consent of the individual, and involves often major medical complications,” Bowers said.   

This July, while outlining various actions the agency is taking to restrict gender-affirming care, the Justice Department said it is working with Congress on existing criminal laws related to female genital mutilation to “more robustly protect children from chemical and surgical mutilation.” The Justice Department and the Federal Trade Commission have used similar language as they seek to investigate gender-affirming care as medical fraud.

Legislators, once easy to contact about a bipartisan issue, have started to stonewall or dodge calls from anti-FGM/C advocates.

Kaitlin Mitchell, the policy and advocacy coordinator at the U.S. End FGM/C Network, has seen enthusiastic legislative support dwindle, partially because “because they’re seeing us unapologetically supporting the trans community.” 

A potential funder told Caitlin LeMay, the executive director of the U.S. End FGM/C Network, that the work her nonprofit was doing was important but it was “too risky” and “controversial” right now. Meanwhile, LeMay and her fellow advocates have needed to devote significant energy and resources to educating their networks about the differences between FGM/C and medically necesary trans health care. 

Much of their time has been spent trying to raise awareness of the dangers of Greene’s bill. 

“We’re doing more and more work with less and less funding, and we’re having to put out all of these fires at the same time,” LeMay said.

After the July statement by the DOJ, the U.S. End FGM/C Network, Sahiyo and Equality Now released a joint statement with WPATH condemning the Trump administration’s actions conflating gender-affirming care and FGM/C. Solidarity with queer communities in fundamental to the battle against FGM/C in the United States: Nonconsensual genital cutting was used as a treatment for hypersexuality, “hysteria” and lesbianism, LeMay said.

Greene’s “Protect Children’s Innocence Act” is also a “huge slap in the face” to the intersex community, said Sylvan Fraser Anthony, legal and policy director for interACT, a nonprofit advocating for intersex rights.

The bill states that “genital or bodily mutilation or chemical castration” is allowed in cases where the patient has both ovarian and testicular tissue, or if the patient “does not have normal sex chromosome structure.” Those definitions apply to many intersex people, as “intersex” is an umbrella term for differences in sex traits or reproductive anatomy. 

Surgeries performed on intersex infants, including vaginoplasty and clitoral reductions, cause lifelong complications and are often kept secret from the children, who have no ability to consent. For years, state laws banning gender-affirming care around the country have allowed this practice to continue. 

“Intersex infants and young kids who are being subjected to these nonconsensual surgeries are suffering the exact harm that is being falsely claimed about gender-affirming care, and meanwhile, no one in the administration cares to do anything about it,” Anthony said. 

Greene’s office did not respond to a request for comment. The White House did not respond to a request for comment beyond an automated message that replies would be delayed due to the shutdown.

Taher said that had she not been fighting misinformation, she would have spent that time creating more community resources, running more workshops for survivors, or strengthening their burgeoning alumni support network. She has also been raising awareness about the “husband stitch.” 

The Connecticut Coalition plans to continue pushing for a comprehensive state law. Rep. Jillian Gilchrest, the Democrat who introduced the bill this session, committed to reintroducing it next session in a comment to The 19th. But next year the legislature meets for only three months, leaving less time to reach a floor vote. 

Now that the conflation between gender-affirming care and FGM/C is more mainstream, it feels like a turning point for all FGM/C activism going forward. Mitchell hopes it isn’t the case, but “I think it’s definitely here to stay in the current moment and in the coming years in the policy space.”