Minneapolis becomes 'safe haven' for gender-affirming care

Minneapolis is now a safe haven for trans people and others seeking gender-affirming care.

On Friday, Mayor Jacob Frey signed an executive order establishing the sanctuary status of the city — believed to be the first in the state and at the vanguard of cities in the nation to erect a "rainbow wall" of protection from anti-trans policies.

"Here in our city, you're loved, you're protected, and we want to make sure you feel safe," Frey said shortly before signing the order in City Hall amid a backdrop of health care leaders and LGBTQ advocates.

Friday's action comes as trans rights — or a lack of them — have come to the fore in the so-called culture wars, with elements of society pushing back against an awakening to the idea that male-or-female gender definitions are inadequate, especially among younger generations.

Violence against trans people, including killings, hit record levels in 2021, according to the Human Rights Campaign, a national nonprofit that tracks hate violence.

The medical community, including the American Academy of Pediatrics and the American Psychiatric Association, has increasingly endorsed gender-affirming care, which can range from counseling to medications and surgery as people seek to live a life matching the gender with which they identify when it's in conflict with societal expectations.

"As doctors, we really like to work in science, and what we know from science is that gender-affirming medical care is lifesaving, period," said Dr. Kelsey Leonardsmith, a family physician in St. Paul who provides transgender hormone care. "When state governments are acting as bullies … that is nothing short of abuse, and we are here to stand between these young folks and their bullies."

Specifically, the order bars city personnel from prosecuting or imposing penalties on "an individual or organization for providing, seeking, receiving, or assisting another individual who is seeking gender-affirming care."

That's in direct response to the trend among conservative states to restrict or criminalize gender-affirming care, such as a law in Texas that could treat parents of children who seek such care as child abusers.

Legally speaking, Friday's order has little immediate effect. There are no current Minnesota or federal policies attacking gender-affirming care.

Some protections exist in state law, but if the laws were to change, Minneapolis' order would insulate the city — to the extent that a city can do so. For example, Frey said any such law in Minnesota would be enforced at the "lowest priority level," and the city would refuse to enforce another state's law that conflicts with the city's position.

Frey emphasized that the new order lays out a "clear directional state" for the city as a "safe haven."

City Council President Andrea Jenkins, who became one of the most senior elected officials in the nation who is openly trans when elected in 2017, praised the new order.

"To all gender nonconforming, trans-identified, gender-expressive, nonbinary, gender-creative young people, and our elders as well ... here at the city of Minneapolis, we see you, we feel you, we hear you, and each and every day we are trying to be responsive to the needs of this community."

In September, California became the first state in the nation to make itself a sanctuary for gender-affirming care, which is also protected in Connecticut and Massachusetts. At least 15 other states, including Minnesota, have seen proposals introduced in their state legislatures.

Minnesota's proposal, co-sponsored by state Sen. Scott Dibble, DFL-Minneapolis, had little chance of success when introduced last year in the Republican-controlled Senate. Next year, however, the Democratic-Farmer-Labor Party will control both chambers, significantly raising the prospects of the idea.

The legal weight of Friday's executive order is similar to an executive order Frey signed in August making the city a safe haven for abortion access.