Trump's debate comment on 'transgender operations' in prison, explained

In their televised debate of the presidential election, Republican nominee Donald Trump claimed Kamala Harris endorses gender-affirming care for undocumented immigrants in US custody, inspiring a slew of posts and memes on social media. Harris expressed support for the policy while running in the 2020 Democratic primary, but her campaign has said it is not part of her 2024 platform.

"Now she wants to do transgender operations on illegal aliens in prison. This is a radical left liberal that would do this," Trump said during the September 10 debate hosted by ABC News in Philadelphia.

Within minutes, social media users took to X to share their reactions and memes about the eye-popping claim.

Image

Screenshots from X taken September 13, 2023

The debate kicked off a final sprint to November as Harris and Trump aim to sway undecided voters and take the lead in an election locked in a dead heat. Both candidates made false, misleading and exaggerated claims.

Trump's comment about gender-affirming care references his opponent's response to a 2019 American Civil Liberties Union (ACLU) questionnaire for presidential candidates, which CNN wrote about one day before the debate (archived here).

The document asked if Harris would use "executive authority to ensure that transgender and nonbinary people who rely on the state for medical care -- including those in prison and immigration detention -- will have access to comprehensive treatment associated with gender transition, including all necessary surgical care" (archived here).

Harris selected "yes," writing:

"It is important that transgender individuals who rely on the state for care receive the treatment they need, which includes access to treatment associated with gender transition. That’s why, as attorney general, I pushed the California Department of Corrections and Rehabilitation to provide gender transition surgery to state inmates. I support policies ensuring that federal prisoners and detainees are able to obtain medically necessary care for gender transition, including surgical care, while incarcerated or detained. Transition treatment is a medical necessity, and I will direct all federal agencies responsible for providing essential medical care to deliver transition treatment."

The Democrat's answer alluded to a 2015 settlement that pushed California officials to allow inmates to receive gender-reassignment surgery -- a first for a state prison system.

Harris, who was a US senator when she responded to the ACLU questionnaire, also expressed support for sweeping cuts to Immigration and Customs Enforcement (ICE) funding and operations.

But Harris spokesperson Michael Tyler told Fox News on September 10: "That questionnaire is not what she is proposing, this is not what she is running on" (archived here).

AFP contacted the Harris campaign for additional comment on her position, but a response was not forthcoming.

Access to care

The Federal Bureau of Prisons has fewer than 2,300 transgender people in its custody, constituting less than two percent of those incarcerated in federal prisons (archived here).

ICE reported in August 2024 that 52 people the agency had detained in the 2024 fiscal year self-identified as transgender, although advocates argue that is likely an undercount (archived here).

Amid US legal battles over transgender rights, detained and incarcerated individuals are routinely denied or offered limited access to gender-affirming care. Many have sued to receive it.

ICE spokesperson Mike Alvarez told AFP the federal agency "recognizes that detained transgender non-citizens have unique needs while in ICE custody."

"In response to those needs, we have developed structures within our operation to safeguard their rights and ensure their emergent care needs are met from the moment they arrive and throughout the entirety of their stay," he said in a September 13 email.

ICE guidelines say migrants who were already receiving hormone therapy before detention will continue to have access (archived here). Those who were not will be assessed and treated "if deemed medically necessary and safe in the context of their other medical conditions."

The agency's policies do not mention transition surgeries.

Gender-affirming care encompasses a wide range of treatments for gender dysmorphia, including surgical, nonsurgical and mental health services (archived here). Major US medical associations, including the American Academy of Pediatrics and the American Medical Association, say such care can be life-saving, without which individuals may suffer from anxiety, depression and suicidal ideation.

More of AFP's reporting on misinformation about the 2024 election is available here.