Worlds Behind Words 6: LGBTQ+ Rights Rollbacks, Trauma, and Survival

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): The Good Men Project

Publication Date (yyyy/mm/dd): 2025/12/26

William Dempsey, LICSW, is a Boston-based clinical social worker and LGBTQ+ mental-health advocate. He founded Heads Held High Counselling, a virtual, gender-affirming group practice serving Massachusetts and Illinois, where he and his team support clients navigating anxiety, depression, trauma, ADHD, and gender dysphoria. Clinically, Dempsey integrates EMDR, CBT, IFS, and expressive modalities, with a focus on accessible, equity-minded care. Beyond the clinic, he serves on the board of Drag Story Hour, helping expand inclusive literacy programming and resisting censorship pressures. His public scholarship and media appearances foreground compassionate, evidence-based practice and the lived realities of queer communities across North America.

Scott Douglas Jacobsen speaks with William Dempsey, a Boston-based clinical social worker and LGBTQ+ advocate, about the psychological toll of rapidly shifting U.S. policies on queer and trans people. They discuss the Trump administration’s attempts to narrow Title IX, rollbacks of PREA protections for LGBTQ+ prisoners, and Arlington, Texas’s repeal of its non-discrimination ordinance. Dempsey links legal instability to heightened anxiety, trauma, and mistrust in institutions, especially for incarcerated trans people denied gender-affirming care. However, he also highlights hope in court decisions, like Georgia’s hormone-therapy ruling and the Supreme Court’s refusal to revisit Obergefell, as reminders that rights can endure.

Scott Douglas Jacobsen: Northwestern University and Northwestern Medicine have been caught up in the broader confusion that the Trump administration’s policies have created for transgender students and patients. The administration has pushed changes to how Title IX is interpreted. Title IX is the 1972 law prohibiting discrimination based on sex in educational settings. For years—especially under the Obama administration and then again under Biden—federal guidance and rules treated discrimination against transgender students as a form of sex discrimination under Title IX. Those interpretations have now been rolled back or blocked, and the Trump administration is moving to narrow the definition again.

The Trump political line has been that there are only two genders—male and female—and that federal policy should reflect this. That position has been echoed in speeches, campaign documents, and policy proposals. The administration is now using that stance to argue that prior interpretations of Title IX, which protected students based on gender identity, were unlawful expansions of the statute. A Biden-era regulation that explicitly extended Title IX protections to sexual orientation and gender identity took effect in 2024 but was vacated by a federal judge in early 2025, which cleared the way for this new restrictive approach.

I still do not even know how to frame this, because it is deeply incoherent from a rights perspective. People have lived for years under a growing expectation—backed by federal guidance and court decisions—that they are protected from discrimination based on their gender identity. Then an administration comes in and, through executive policy and agency interpretation, tries to erase that protection by redefining sex in a way that excludes them. It may not be a literal fifty years of uninterrupted, explicit legal protection. However, it is still at least a whole generation of people who have come of age with the assumption that the federal government is supposed to protect them, not target them.

So people’s fundamental concept of the government’s protection of them is being directly challenged. A patient comes to you; maybe they are mid–Gen X, maybe Gen Y, or Gen Z. This is now affecting everyone from young adults through middle age. What does this raise for them in terms of feeling unable to seek recourse when it is the government itself, through federal policy and courts, that is driving these changes?

Will Dempsey: For the queer community, and really any marginalized community in the United States, there is a long-standing understanding that rights granted by law or policy can be narrowed or revoked very quickly. There is a kind of psychological preparation among Gen X and older generations who remember, or have directly experienced, periods when these rights either did not exist or were much weaker.

Younger generations, because they have grown up with stronger formal protections and more affirming institutional language, are having a harder time wrapping their heads around the idea that rights can be rolled back after they have been granted. However, both the queer community and the Black community, among others, especially the older generations, share an understanding that legal protections can disappear or be hollowed out.

So this is not entirely surprising to many people who follow far-right or alt-right rhetoric. Some leaders in those circles, close to Trump politically, have spoken quite openly about wanting to roll back women’s rights as well, including even the right to vote, and they have supporters—including spouses—who publicly agree with them. When you see these kinds of conversations happening openly and, in interviews, they confirm that this is truly what they want and explain why in plain language, it signals to marginalized communities what the ultimate goals are. It prepares people, grimly, for the possibility of further rollbacks.

Jacobsen: The Department of Justice has moved to weaken protections for LGBTQ+ people in prisons that were designed to reduce sexual abuse. Under the Prison Rape Elimination Act—PREA—there were specific standards and practices meant to identify LGBTQ+ prisoners as especially vulnerable and to require prisons and jails to account for that in screening, housing, and searches. Recent DOJ directives and guidance have told inspectors and facilities that they no longer have to use some LGBTQ-specific standards when evaluating compliance, and related protections have been scaled back or put in legal limbo.

Advocates have called these changes reckless and dangerous, and many are being implemented immediately, even as some are challenged in court. We already know that the number of people who come forward after a sexual assault is extremely low, and even anonymous reporting underestimates the problem. Sexual violence in detention settings is underreported because it shatters people’s sense of safety and trust.

In prisons—particularly in the United States—the entire system is highly punitive, and the sense of trust in that system, both socially and institutionally, is already extremely low. Some people are incarcerated for crimes they committed, others are not, but that does not change the reality of their vulnerability. If you are a transgender or LGBTQ+ person in that context, you are already at dramatically higher risk of sexual victimization. When the government signals that it is stepping back from enforcement of LGBTQ-specific safety standards and simultaneously pursuing policies that restrict gender-affirming care or housing protections, it sends a chilling message about whose safety matters.

There are still constitutional protections, PREA itself has not been repealed, and some courts have stepped in to block the most extreme measures, like blanket bans on gender-affirming medical care. However, the ability to access those protections is minimal for incarcerated people. So you end up with a situation where, practically speaking, the avenues for recourse are shrinking while people remain trapped in a system they already do not trust. I genuinely do not know what that does to a person’s ability to survive psychologically, other than to say it compounds trauma on top of trauma.

Dempsey: Survivors of trauma, especially sexual trauma, are often reluctant to come forward. The rates of sexual assault we know about are far lower than the actual rates because survivors frequently do not feel comfortable reporting. There is often a lack of trust that the system will believe them. Psychologically, this reinforces the narrative that the system will not believe them, and any chance they might have had of coming forward is now even less likely.

For someone who is not coming forward about their experience, this can be detrimental. It can intensify symptoms of anxiety, depression, trauma, sadness, hypervigilance, persistent worry, and related concerns. To draw a parallel to a medical issue, it is almost as if something harmful is inside you and, without treatment or release, it continues to eat away at you. People often do not conceptualize trauma this way. However, psychologically, that is precisely what happens: if you hold on to this experience and do not talk about it or process it, it affects you in a profoundly negative way. So, when people who already struggle to speak about these experiences are further silenced, their mental health will continue to deteriorate.

Jacobsen: This is from Linda McFarlane, Executive Director of Just Detention International, a human rights organization. She says: “The proposed revisions to the PREA standards will lead to increased chaos and violence in prisons and jails, placing staff and incarcerated people in greater danger… It will allow rapists to act with impunity, and it is already sowing confusion among prison leaders who have worked for more than a decade to put in place common-sense rules to end prisoner rape.” She adds: “… They are already in grave danger. I have never met a trans person in detention who has not experienced sexual abuse or harassment while incarcerated.”

Dempsey: The other thing this made me think of is that it also opens the door for repeat offenders. That is pretty common, even if I do not have the statistics at hand.

Most of them are. Moreover, it is a tiny minority that operates this way. People become objects to them, and they target the vulnerable and select a category.

Jacobsen: A federal judge has ordered Georgia to continue hormone therapy for transgender inmates. A federal judge has permanently ordered Georgia’s prison system to keep providing certain forms of gender-affirming care for transgender prisoners. U.S. District Judge Victoria Marie Calvert ruled that denying hormone therapy to inmates violated the Eighth Amendment’s protection against cruel and unusual punishment. In her order, she stated: “The Court finds that there is no genuine dispute of fact that gender dysphoria is a serious medical need… Plaintiffs, through their experts, have presented evidence that a blanket ban on hormone therapy constitutes grossly inadequate care for gender dysphoria and risks imminent injury.”

Any thoughts?

Dempsey: I would be curious what the imminent injury refers to.

Jacobsen: I do not know. What a week. As we saw several weeks ago in the charts outlining the states with the highest number of anti-LBGTQ bills introduced—whether they became law is a different question—Texas was far and away the leader.

So, the city of Arlington, Texas, has effectively eliminated LGBTQ protections by rescinding its LGBTQ non-discrimination ordinance, which reportedly involved approximately $70 million in federal funds connected to compliance issues. It became a contentious public relations campaign and a dispute over language, and it was ultimately shut down in the Arlington City Council by a vote of four.

Dempsey: What was the language they were disagreeing about?

Jacobsen: The ordinance has been suspended since September. They halted an ordinance that would have protected LGBTQ residents by embedding protections into the city code. Some residents claimed Arlington could lose state and federal funding for keeping it on the books.

The ordinance was initially passed in 2021. It explicitly prohibited discrimination within city limits based on sexual orientation and gender identity—essentially standard, widely used American non-discrimination language.

Arlington is now one of the first cities in the country—not just Texas—to repeal a non-discrimination ordinance out of fear that it would conflict with the Trump administration’s stance. This has led to a month-long conflict between the city government and LGBTQ+ advocates.

Damian Rigoza, a transgender resident of Arlington, recalled the 2021 murder of a Black transgender woman, Keira Solomon, and urged council members to keep the ordinance to help prevent violence against LGBTQ residents.

It does not even seem complicated. It was a basic anti-discrimination ordinance protecting people classified under American law as sexual-orientation and gender-identity minorities. However, it was shut down by four council members, despite having been enacted in 2021—likely during the early Biden period—and revoked this year after a prolonged fight.

Any thoughts?

Dempsey: Arlington, for context, is not far outside Dallas. Dallas and Austin tend to be the more liberal areas of the state, with Austin being one of the more liberal cities in the country, especially within conservative states. So this does not entirely surprise me. In a state like Texas, or even Florida, you often see this push and pull between big-city liberalism and statewide conservatism.

As we often talk about, this is a micro-level version of what exists nationally: marginalized communities—in this case, trans people—not feeling safe where they live simply for being who they are and seeking what many would consider fundamental rights and acknowledgment of personhood. Not being able to obtain that, or having had it briefly and then seeing it rescinded, reflects the same fear we discussed in the earlier article: an expectation of rollback, even if the community hopes it will not happen. Continued rollbacks of rights and opportunities are the concern.

I do not know whether we discussed the Supreme Court’s denial of Kim Davis’s petition asking the Court to revisit Obergefell.

Jacobsen: That came up in at least one earlier session—maybe one of yours, maybe not—but it is worth addressing. Any thoughts on the Court turning away her petition? What was her challenge? What happened? How does it make you feel? We can close on that.

Dempsey: The initial issue was that she refused to issue a marriage license to a same-sex couple, as most people now know. She later filed a petition seeking to reverse the rulings against her and to recover her legal fees, claiming damages, including mental-health damages, stemming from the original case. From my understanding, it was a broad claim of personal harm tied to the consequences of the court’s decision against her.

In the context of the broader concerns we are discussing—fear of rights being overturned—this was a significant win. It is representative of the fact that even a highly conservative Supreme Court, appointed mainly by a highly conservative—and some would say self-serving—president who has been intent on attacking the rights of marginalized communities, still declined to use this case as a vehicle to undermine Obergefell.

That outcome gives hope. It suggests there remains an opportunity for the community to retain the rights that have been secured, and that even if those rights are threatened or narrowed in some circumstances, they can be reinstated and upheld. That is needed right now, mainly as we discuss, week after week, escalating efforts to roll back rights. This serves as a reminder that attempts at revocation do not always succeed, and that overturned rights are not always gone for good.

Jacobsen: Thank you for the opportunity and your time, Will.

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