Head of gender clinic at Children's Minnesota to lead Pride Parade amid controversies on trans youth

In the very first car of next weekend's Twin Cities Pride Parade will sit one of the state's biggest supporters of transgender teens and children.

Instead of shrinking from the politics of a moment when trans people feel under attack, parade organizers wanted to put their full symbolic support behind them. That's why they chose Dr. Angela Kade Goepferd, medical director of the Children's Minnesota Gender Health program, as grand marshal of one of America's largest Pride parades. Goepferd has been working to help transgender youth for more than a decade.

"Dr. Goepferd never wavers, and puts their patients and the protection of those patients above themselves," said Andi Otto, executive director of Twin Cities Pride. "It was a no-brainer to me because of everything they are trying to accomplish in a world that's trying to push back twice as hard."

Goepferd, who identifies as queer and nonbinary and uses they/them pronouns, believes next weekend's Pride Festival will have a more urgent tone than in years past.

"The trans community has been particularly targeted this year — and unfortunately, within that, it's really been focused on trans kids," Goepferd said. "It will be really visually powerful and affirming to see someone who cares for trans kids at the front of the parade. This year more than ever, that's really, really important."

The symbolism will be amplified by dozens of their colleagues from Children's Minnesota departments walking behind them.

Goepferd, 45, has testified several times at the State Capitol about gender-affirming medical care. The University of Minnesota Medical School graduate has been skewered in conservative media for the medical care they provide to trans and gender-diverse kids. At the same time, Goepferd has been lionized in progressive media for giving voice to a vulnerable population.

Twin Cities Pride is always a big, vibrant event; this year, 120 groups will join the parade. Since the first parade here in 1972, a few years after New York City's Stonewall riots sparked the ongoing fight for LGBTQ rights, it's grown into one of the 10 largest in the nation.

But as the event continues its growth — 620 vendors in and around Loring Park, up from 450 last year — a cloud will hang over this year's celebration.

The Human Rights Campaign, the nation's largest LGBTQ civil rights organization, declared a "state of emergency" this month for LGBTQ Americans after more than 75 "anti-LGBTQ+ bills" were signed into law this year, more than double the year before. This year, 19 states passed laws restricting gender-related health care for children and teens, following three others that had such laws earlier.

Political debates have run the gamut, from regulating drag shows to arguing what's appropriate for school libraries to determining whether transgender girls and women — people assigned male at birth who identify as female — ought to be allowed to compete on girls' and women's sports teams.

Even basic language can invite conflict; what one side calls a "transgender man," the other side calls a "biological female." When doctors like Goepferd speak about science behind "gender-affirming care," opponents signal skepticism or opposition by dismissing it as "gender ideology."

Otto wanted this year's Pride to focus on trans youth, especially as the mental health crisis among American youth is amplified among the trans population.

"We're trying to be loud and proud when so many people are telling you to be quiet and hide," Otto said.

Northfield City Council Member Davin Sokup, one of nearly 100 trans or nonbinary elected officials nationwide, said this parade will be especially powerful after Minnesota passed laws making the state a trans refuge.

His favorite part is always when members of PFLAG — parents, family and allies of LGBTQ people — walk by. A quiet descends. The audience claps.

"A lot of people don't have family members willing to do that, or have lost family members due to coming out," Sokup said.

On a recent afternoon, Goepferd sat inside their office at Children's Minnesota, wearing their signature bow tie and a "PROTECT TRANS KIDS" button. A parent to three elementary-age children, Goepferd considers the political focus on transgender people and gender-affirming care a manufactured controversy.

Goepferd has been a pediatrician at Children's Minnesota since 2007. Over time, they became known for specializing in LGBTQ care. Goepferd helped start the Minnesota Transgender Health Coalition, then, with an endocrinologist and psychologist, launched the gender health program in 2019.

For years, Goepferd's job hardly attracted notice. Their contemporaries seemed to be gaining momentum on research and access to care. Suddenly, over the past year or two, this medical subspecialty became the center of the cultural storm, and entire states shut it down.

"You got this patient population that's extremely vulnerable but was finally seeing a little bit of light through the doorway," Goepferd said. "And now the door has just been slammed shut."

Feeling cast as a villain has been disorienting, Goepferd said.

"Ninety percent of what I do is sit in rooms with families and have very long conversations," Goepferd said. "This is about helping affirm who a child is and get them the support and resources they need. Some of the time, that will involve medications. Not all the time — not even most of the time. And because we are a pediatric and adolescent care center, surgery is not a part of care for kids. ... It's not even something most transgender adults access."

Pressed on gender-affirming surgery among minors, Goepferd offered some context. Bottom surgeries — genital surgeries on transgender people — are exceedingly rare among adolescents, they said. They referenced a New York Times story about how top surgeries — removing or augmenting breast tissue to create a more masculine or feminine appearance — have been on the rise among transgender teens.

But it irked Goepferd that while gender-affirming surgeries have become the tip of the spear in the culture wars, there's virtually no controversy on top surgeries among cisgender teens. A 2020 study by the American Society of Plastic Surgeons showed about 8,000 cosmetic breast augmentation or reduction surgeries on cisgender people ages 13 to 19.

"Gender-affirming surgery is just not a part of the care we're routinely providing," Goepferd said. "It's been blown way out of context relative to what we really do with families, which is help them navigate questions, help them navigate schools, help them figure out how they have difficult conversations with their neighbors, their family members, their teachers. That's what we're doing."

"I'm in the room with parents who come to me with very different perspectives," Goepferd continued. "A lot of parents think this is a social contagion, or they don't believe their child, or they're unsure. What I say to parents is, 'Let's figure this out together.' If the belief is simply that transgender people don't exist and don't have a right to exist, then I'm not going to get very far. But if the fear is harm is being done to kids, or there's some agenda at play, I can talk through that pretty easily."