Washington state's Initiative 638 would require all girls who want to compete on school sports teams to prove their sex through genetic or hormone testing, or a genital examination. Boys face no equivalent requirement. More than 140 healthcare providers have publicly opposed the measure, calling it invasive, medically unjustifiable, and harmful to all girls, not only trans ones.

Strip away the language, and look at what the policy does

When politicians talk about banning trans girls from sport, they tend to use the word "protect". Protect fairness. Protect female spaces. Protect girls. It sounds reasonable until you read what Washington's Initiative 638 actually requires, and then the word becomes very hard to use with a straight face.

Every girl who wants to compete on a school sports team would have to prove her sex. Not through a birth certificate, which is already how most of us think of legal sex. The initiative explicitly overrides that. She would have to pass a genetic test, a hormone test, or a genital examination. Boys would not. There is no equivalent requirement for them, none at all.

Kelsey Gellner, a paediatric nurse in Seattle and a board member of the Washington State Nurses Association, put it plainly: "I tell my kids and patients that my number one job is to keep them safe. I can say with confidence that girls do not want to have an unnecessary exam that creates an unsafe barrier."

She is not speaking in abstractions. A sports physical checks heart health, vision, general fitness for play. It does not require a child to remove her clothing. A genital examination does. These are not the same thing, and the people who wrote this initiative know that.

Who is this actually targeting?

The Washington Interscholastic Activities Association says it is aware of around ten trans student athletes in a state with more than 200,000 students competing in school sports. Ten. The legislation being proposed, and the medical procedures it would impose on every girl who wants to run, swim, or play basketball, is a response to ten children.

Libby Loft, a family doctor in Spokane, said what many of her colleagues are thinking: "I don't see this as a way to level the playing field for girls, and we're making a villain out of trans girls who are children."

She is right. And the cruelty of that framing, the idea that a trans girl is a threat simply by existing, by wanting to run cross-country with her classmates, is something that deserves to be said out loud. These are children. They are not a competitive strategy. They are not a loophole. They are kids who want to play sport.

The safeguarding argument cuts the other way

Gellner raised something that more people need to hear. In arguing against the measure, she pointed to the case of Larry Nassar, the USA Gymnastics doctor convicted of sexually abusing girls for decades. Her point was not that every doctor is a predator. Her point was that writing legislation requiring adults to examine children's genitals, creating that access by law, is not a safeguarding measure. It is a safeguarding risk.

"Writing legislation that opens the door to predators is just not responsible," she said.

The people promoting this measure claimed in the voter guide that such sex-verification requirements are endorsed by the American Academy of Pediatrics. The AAP has publicly rejected that claim. Let's Go Washington, the political action committee behind the initiative, is funded by Brian Heywood, a multimillionaire hedge fund manager who has bankrolled a string of conservative ballot measures in the state. The AAP's rejection of the claim has not led to a correction.

The people fighting back

More than 140 healthcare providers have signed a statement opposing Initiative 638. Unions including the Washington Education Association and the American Federation of Teachers are mobilising members. The No Hate in Washington State coalition has nearly 600 endorsers, more than 6,300 volunteers, and is running up to four phone-banking sessions a week.

Campaign manager Libby Watson said the messages that land hardest with voters are the ones about fairness: only girls would face this requirement, and the invasiveness of the exam itself. People understand, when it is put to them plainly, that this is not protection. It is punishment.

John Gallagher, a Seattle high school teacher and former cross-country coach, put it simply: "It's a lot of effort to exclude a very small population of kids who are just trying to be themselves."

There is also a second measure on Washington's ballot that would expand parents' access to school records, with consequences that school counsellors say would force them to out LGBTQ+ students to parents who may not be safe. Jaime Fineman-McKinney, a counsellor in Tacoma, said: "If they're coming to me as a trusted person and I have to then out them, I just put them in a very unsafe situation." The two measures together form a co-ordinated effort to strip away the protections that keep queer young people alive.

What this is really about

I have spent years listening to trans people and their families describe what it costs to live in a world that treats their existence as a problem to be solved. What Washington's initiative makes visible, for anyone willing to look, is where that logic ends: in a law that requires a child to be examined before she is allowed to play sport, while the boy in the lane next to her is waved through without question.

That is not protection, and it is not fairness; it is what happens when "protecting women and girls" becomes a phrase that exempts itself from scrutiny, and trans girls are not counted as girls worth protecting at all.

Loft said it does not surprise her that medical professionals have come out in numbers to fight this. "We all have the goal of helping our kids live healthy lives." That is the whole of it, really. Healthy lives. All of them. Including the ten.

If there is a news story you would like me to cover then just let Sammy know.

Dr Helen Webberley is a Gender Specialist, Medical Educator, and advocate for trans rights and gender diversity.