Yasemin Smallens has been an eyewitness to the ill effects of anti-transgender laws—and wants to raise public awareness about them.
Chicago-based Smallens, acting researcher in the LGBT Rights Program at Human Rights Watch, has traveled to a variety of places, including Texas and Botswana, to observe the harms of these laws.
“The impact is far greater than the news is reporting,” said Smallens, who is nonbinary and uses all pronouns.
In 2025, she published a 98-page report, “They’re Ruining People’s Lives: Bans on Gender-Affirming Care for Transgender Youth in the US.” The report was based on 51 interviews with trans youth, parents, health care providers, and activists across 19 states. Twenty-five states ban almost all forms of gender-affirming care for trans youth, while two others ban gender-affirming surgeries for people under 18.
Last year’s report detailed what Smallens called the “devastating” effects of bans on gender-affirming care. Among her interviewees, “parents or youth attested to seven accounts of attempted suicide or suicidal ideation related to transphobia, and in some cases, directly correlated to the passage or threat of a ban on gender-affirming care,” she wrote.
Eleven families said they had to travel out of state for their trans children to receive care, and one “relocated to another state to secure reliable access to care and escape an environment hostile to trans people,” Smallens noted in the report.
Four young people were unable to begin care due to legal, geographic, and financial obstacles. “People were uprooting their lives,” she told Windy City Times.
The report noted the extremity of laws in Texas, where Attorney General Ken Paxton—now the state’s Republican nominee for U.S. senator—has harassed many health care providers with investigations and lawsuits.
One such provider was against Dr. Hector Granados, one of only two pediatric endocrinologists in El Paso and its environs; it was eventually dropped, but Granados had to show he had ceased providing gender-affirming care to trans youth. Another doctor Paxton sued, May Lau of Dallas, had to surrender her medical license.
In her research for the report, she found that “entire communities, not just trans youth, lost access to care” because of the bans and harassment of doctors, she said in her WCT interview. “We should care about these laws because they impact trans youth and also have this ripple effect,” she added.
This year, she spent much of the spring and summer in Texas for a follow-up report, scheduled for next year. She plans to go into the effects of restroom restrictions, the rollback of legal gender recognition, education restrictions, drag bans and other types of anti-trans legislation. During her time in the state, she interviewed trans Texans and allies about the impact of these policies. “The real effect of these laws is excluding trans people from public life,” she said.
Then in August, she traveled to Botswana to document the need for legal gender recognition in that nation. There, she cohosted two meetings that brought together trans people and activists. “It was a wonderful experience to gather these people together,” she said.
The High Court of Botswana ruled in 2017 that trans people can change the gender marker on their official identification documents without resorting to litigation. But the government has yet to set up a policy to implement it.
Not having correct gender recognition can endanger people in many ways, Smallens said.
“You’re applying for a job and you have to show your ID—it will out you as trans,” she said. Such outing could take also take place in a doctor’s office or other settings, she noted. She will coauthor the Botswana report, set for next year as well.
To Smallens, political attacks are not only cruel but nonsensical. While politicians seek to further marginalize trans people, they’re ignoring the economic pressures many Americans are facing, like not being able to pay their rent or buy groceries, she said.
To overcome transphobia, as with overcoming other prejudices, “I place a lot of my faith in narrative change,” she said. Seventy percent of Americans, according to some estimates, don’t know an out trans person. “There’s just a major gap in understanding,” she said, but knowing someone who is trans can foster understanding.
“A whole lot of reframing has to be done,” she added, and trans rights have to be framed as basic human rights. Those include the rights to gender-affirming care, to nondiscrimination, to be free of harassment, and more, she noted. Also, she said, there needs to be discussion of the material harms of anti-trans laws and policies.
The latter is something seeks to advance through her work with Human Rights Watch, where she’s been for five years. Previously, she was with the Brennan Center, where she dealt with refugee policy and police surveillance; For the Many, working on voting reform; and the New York Civil Liberties Union, focusing on trans rights and police reform. Her recent articles include a look at an Amarillo, Texas, trans group distributing food to the needy of all identities, and one on the collateral damage of anti-trans policies.
Smallens was born and raised in New York City, and she was inspired to become an activist by her experiences growing up.
“I was struggling in school, and I was able to find a queer community at a young age,” she said. She was also exposed to differences in privilege within the queer community. Among other things, she worked on the documentary film Pier Kids, about unhoused Black and Brown trans youth.
Now, she said, she’s found a loving queer community in Chicago. “I’ve been gifted many opportunities in life,” she said.
She remains optimistic that despite all the anti-LGBTQ+ and especially anti-trans rhetoric and policies in the U.S. and elsewhere, positive change is on the horizon. “I do hope we are at a tipping point,” she said.