The Campaign

Dr. Annie Andrews is a pediatrician and mom. After working as a pediatrician at children's hospitals for 15 years, she decided to run for Congress and became the Democratic nominee in South Carolina’s first congressional district in 2022.  The campaign was vicious on the whole, but one issue - trans healthcare - grew so big that it dominated the headlines and involved Dr. Andrews' employer.  

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Michael Lee: [00:00:00] When We Disagree is a show about arguments, how we have them, why we have them, and their impact on our relationships and ourselves. Let's say you and I are talking about movies, and I offer this hot take. I don't think Scarlett Johansson is a very good actress. You, a huge fan of Johansson's, are blown away.

Michael Lee: I continue on, and I mentioned that I saw her in movies like Fly Me to the Moon and Asteroid City, and I didn't like her performance in either. You say, that's it? Those are the movies of hers you saw, and you came to that conclusion? And I say, yep, you got it. That's exactly right. You can probably see where my hypothetical criticism is going.

Michael Lee: I base my claim about Johansson on A, insufficient evidence, She has starred in dozens of movies since breaking out in Lost in Translation in 2003, and I've only mentioned two before kind of completely dismissing her. And then B, there's no rhyme or reason to my choice of the movies that I looked at. It seems [00:01:00] like I had just happened to see two fairly recent ones of hers, but I left out all the others.

Michael Lee: And I certainly left out other critically acclaimed ones, like Jojo Rabbit, or Marriage Story, or Her. And see, I don't have a standard for good or bad acting. All told, what my criticism of Johansson lacks is a method. And if we're trying to figure out What separates reasonable and rational arguments from those that are unreasonable and irrational?

Michael Lee: Looking at the method is very useful. A method should be predictable, a set, step by step course of analysis, and it should be reproducible by others. So if I came back to you and I said, I think Scarlett Johansson plays the same role over and over, and I came to that conclusion after watching all of her critically acclaimed starring roles in her career.

Michael Lee: We might still disagree, this is a matter of taste after all, but you might concede that I have some sufficient evidence, and I've been faithful at least to assessing her career, and you could replicate my study and see for yourself. [00:02:00] I'm Michael Lee, Professor of Communication and Director of the Civility Initiative at the College of Charleston.

Michael Lee: Our guest today on When We Disagree is Annie Andrews. She's a pediatrician, a mom of three, and the founder of Their Future PAC, our nation's first and only political action committee for kids. Annie, tell us an argument story. 

Annie Andrews: So I want to take us back to the fall of 2022, when I was the Democratic nominee for Congress in South Carolina's 1st District.

Annie Andrews: And this was really at the peak of the South Carolina GOP's attack on transgender youth. In our community and as a current candidate for Congress at the time, I was in the crosshairs of this attack, which was harmful to some of the most vulnerable children in our community and my opponent, our current Congresswoman, Nancy Mase.

Annie Andrews: Um, joined in on the attack and called me a child abuser and attack this community in ways that were deeply harmful. And at the time I was an [00:03:00] employee of the Medical University of South Carolina, and I looked to them to defend the evidence based care that we provide for these youth. And I asked them to do that.

Annie Andrews: And many people did, and they did not stand up for this vulnerable community. So we disagreed about how to protect these kids. 

Michael Lee: Your employer, you and not just you and the Republicans who are attacking you, but you and your employer. 

Annie Andrews: Correct. 

Michael Lee: Will you, will you talk a bit about, and I want to get to the, the dispute over evidence based care with the employer.

Michael Lee: Will you talk a little bit about what puts you in the political crosshairs of the, uh, aside from running for office? But on this issue specifically, 

Annie Andrews: so as a member of the American Academy of Pediatrics and a child advocate, I had previously advocated to protect this community that was under attack by Republicans in the state of South Carolina and all across this country.

Annie Andrews: And then during the campaign, Nancy Mase's. The first line of attack on me was to call me a child abuser for supporting gender affirming care, so it became really a center point [00:04:00] of my political campaign, and because I was an employee at our local children's hospital, the problem grew much bigger than that.

Michael Lee: In your estimation, having run for office and faced these withering attacks from the right on trans issues broadly, what is so activating to their audience, to their core audience about this issue? 

Annie Andrews: They don't understand trans people and they don't try to understand trans people. They are some of the most vulnerable members of our community.

Annie Andrews: And the GOP is always looking for a new cultural wedge issue. And because they have lost the American people on the abortion issue, they know that the vast majority of Americans are not with them on that issue. They searched for a new issue and that was attacking a vulnerable population, which is trans kids specifically.

Michael Lee: Yeah. You mentioned it's a lack of. understanding and ignorance. And I wonder if you think there's perhaps more too, because, you know, lots of us are [00:05:00] super ignorant about Norwegians, but Norwegians seldom come up in South Carolina politics, much less national politics. 

Annie Andrews: I mean, trans people make people uncomfortable.

Annie Andrews: People who aren't willing to open their mind and learn about something that they're not familiar with. They're such an easy target. They have been demonized in mainstream media. And it's, you know, but they're humans. I always say I support trans kids because I support all kids. They're just kids. They're people.

Annie Andrews: And to me, the default should always be to defend vulnerable, vulnerable people. But that, you know, on the other hand, other people see that as an opportunity for attack and opportunity to gain votes, to get clicks on social media. And it's frankly, it's just disgusting. 

Michael Lee: In the context of these attacks and in the context of this contentious election, you said you'd look to your employer to provide some defense against their attacks.

Michael Lee: What were you hoping they would say? 

Annie Andrews: All I was searching for was a public statement saying that [00:06:00] as a children's hospital we are tasked with serving all children in South Carolina and part of that includes serving transgender youth in South Carolina and we follow evidence based practice. When we treat these youth, just like we do for all the other youth.

Michael Lee: And then in that moment, when they didn't issue the statement, I presume described the kind of conflict, both interpersonally, morally, ideologically with you and your employer. 

Annie Andrews: So I think I was I know I was naive at the time, and it was one of those situations where I thought, well, if I just go meet with the leaders and explain why I think it's so important for them to do this.

Annie Andrews: come around. Surely there's some secret plan I don't know about for them to step up and rise to the occasion and defend these patients. And I had meetings with leaders and what I was told is we can get involved because it's a political campaign, which is, you know, I wasn't asking them to say we defend any Andrews against Nancy Mace.

Annie Andrews: I was asking them to defend this vulnerable population. Um, they said that the reason they were staying [00:07:00] silent was so that they could Protect their ability to give these children care. And as I'm sure you are aware, they don't do that anymore. So that's not what they were doing. They, they also abandoned the patients and no longer provide gender affirming care.

Annie Andrews: So if they were staying silent so that they can continue to provide this care, then, you know, they failed. 

Michael Lee: Did you feel, I mean, I'm, I'm putting words in your mouth, but, and feel free to disagree, I'm, I, if I was there, I can imagine you come to these meetings with the kind of faith in reason, that the, the force of the better argument to, to take a term.

Michael Lee: Um, would win the day, that they would see the light of your case, the morality of your case, the sensibility of your case, and have no choice but to do the right thing. And so, describe your feeling. I call it disillusionment, but perhaps it's something else. I 

Annie Andrews: think it's start, I think it was experience. It was [00:08:00] disappointing and heartbreaking.

Annie Andrews: And now that I have some distance from it, incredibly alarming because we have seen this infiltration of politics into healthcare, healthcare, there should be a wall between healthcare science and politics. And I really just couldn't believe it because I had spent near 15 years working for that institution.

Annie Andrews: And I believed in the institution and I thought they believed in me. And I thought we were on the same page about. serving all children and it was just so disheartening and I still don't think I've processed the whole thing. Honestly, I tell this story sometimes and I still, I see other people's reactions and I just don't think there's so much here that I haven't even dealt with internally.

Michael Lee: Clarify what you mean by you would favor a wall between healthcare science and politics, meaning that healthcare science should not be part of a political football that's kicked around during an election or that healthcare science shouldn't be the province of regulation. 

Annie Andrews: The first one that I see [00:09:00] politicians infiltrating our once lauded medical institutions, which should be guided solely based on data evidence, you know, evidence based policy.

Annie Andrews: And that's how they should decide how they treat patients. But rather now we have one political party that is telling the healthcare providers how they can treat patients, even when it flies in the face of what our tells us to do. 

Michael Lee: What do you think the The leadership at your employer was trying to avoid.

Michael Lee: In other words, they ended up, it sounds like, changing their practices anyway, even though they claimed that this was protective, it was avoidant. So what were they trying to do? Who were they trying to pacify? 

Annie Andrews: I ask myself that all the time and I tell people if someone's telling you to be quiet or to stop advocating for what you're advocating for when you're protecting vulnerable people, who are the people, who are they trying to protect?

Annie Andrews: And they're trying to protect their [00:10:00] relationship with the South Carolina GOP. You know, there's a relationship between the Freedom Caucus and the Board of Trustees at MUSC. And they listen to them and they're trying to maintain that relationship. They may say they're trying to stay out of legal trouble, but the reason they get into legal trouble is they don't show up at the state house and advocate against these non scientific abortion bans against these non scientific.

Annie Andrews: gender affirming care bands. And so they, they make themselves politically powerless by bowing down to the politically powerful and they just get rolled over. And they just, I was looking for someone in the room to be brave for these kids and no one stood up and did that. For 

Michael Lee: those members of our audience who are not as close to this issue as you are, can you talk a bit about the, what evidence based care is and what the attacks on it are?

Annie Andrews: Specifically for gender, for trans kids? Yeah, exactly, as you've 

Michael Lee: used it, yeah. 

Annie Andrews: Yeah, so I mean, gender affirming [00:11:00] care simply means creating a welcoming environment for gender nonconforming youth so that they have a safe place to go and seek medical care and so that the parents together with the child can talk through what's happening.

Annie Andrews: And maybe it's. It starts with a little, you know, a little boy who was born a male and starts identifying as a female wanting to present, you know, in a more feminine way and they need someone to talk to whether it's a mental health professional or their pediatrician and the bulk of gender reforming care for youth is simply that.

Annie Andrews: And I, you know, I crudely say it's not being an a hole to kids. It's creating a self and welcoming, a safe and welcoming environment for these kids. And then as they reach puberty, gender affirming care, evidence based gender affirming care can include the prescription of, um, Hormone blockers so that they don't go through puberty as the gender that they do not identify as and then cross sex hormones later.

Annie Andrews: But that is a subset of these kids that, you know, that is always happens after [00:12:00] many, many, many meetings with pediatricians, endocrinologists, mental health providers. And that is what gender affirming care looks like. And I think it's really important to say that no youth in South Carolina has ever had gender affirming surgery.

Annie Andrews: That is not a thing that happens in South Carolina. It never has been. 

Michael Lee: And then you were called a child abuser. What is the rationale, if there is one, for that allegation? I 

Annie Andrews: guess it's that their, their talking point is that, you know, doing what I just said, providing this care, which I should also say, the reason it's evidence based is because it's been shown to reduce the incidence and frequency of suicide and suicidal ideation in trans youth.

Annie Andrews: And so it's, it's not just, there's so many important reasons to do this care. Yeah. 

Michael Lee: So that's the argument then is it's not, it's not just about [00:13:00] fulfilling. desire. In other words, I would like to present more femininely. But instead, we know from evidence based research that suicide, suicidal ideation, mental health problems, et cetera, isolation, withdrawal are much higher in this vulnerable population.

Michael Lee: And so we need ameliorative remedial care here, and that is what evidence based care is in this case, in this case. 

Annie Andrews: That's exactly right. And like I said, I support trans kids because I support all kids, but I'm also so passionate about this issue because me and my colleagues are the ones who take care of these kids when they do try to harm themselves and they show up at a children's hospital.

Annie Andrews: And that because they're being bullied by an adult in their life, or they don't have an adult to support them. So I'm the one who has to stand at their bedside after they've taken a giant handful of Tylenol trying to end their life. And this is, you know, these are real people in our community. And that's why I was so, I think, broken hearted to see the way my employer did not stand up for them.

Annie Andrews: And the way our Congresswoman was [00:14:00] willing to just throw this population under the bus to score political points. 

Michael Lee: What are the potential consequences of bans on this kind of evidence based care? 

Annie Andrews: So specifically for youth, it's, you know, isolationism, like you said, an increase of suicidal ideation and suicidality and suicide attempts.

Annie Andrews: Logistically, they're just, you know, they have to now seek care in other states. And then the disparities widen because you have to have a certain amount of resources and wherewithal for your parents to be able to identify a provider outside of the state of South Carolina who can continue to give this care.

Annie Andrews: And, of course, South Carolina has stopped, MUSC has stopped all gender affirming care, including for adults. So we have adults in our community who are scrambling to find a provider outside of South Carolina who can continue their medications that they've been on many times for years. 

Michael Lee: As we close, I'm noticing that, I mean, there are at least three [00:15:00] different massive and intertwined arguments going on at the same time here.

Michael Lee: One, of course, is the, your being in the crosshairs in a contentious election for national office. Another is with you and your employer over validating existing care practices in public. And then a third one, of course, is the ideological and moral issue over this kind of care much more broadly. As you, as you think about each of these three and your experience in this election, just a few years ago, what are some of the lasting lessons that stick with you?

Annie Andrews: We have to be brave, specifically for our kids when they are the subject of these attacks. We have to be willing to lose some things if it's a fight that's important enough for us. And You know, if you're and I think very specifically this applies to everybody, your job [00:16:00] won't love you back. Like, no matter what you feel like you've given to your employer, no matter how hard you work, no matter how dedicated you are, none of that matters because politics is politics and business is business and so you have to make decisions and take actions that you can sleep with at night that can allow you to sleep peacefully at night that can, you know, allow you to feel proud of how you acted in this incredibly bleak.

Annie Andrews: contentious moment in national politics, that our Children can ask us what we did in this moment and that we can be proud and confident in what we did, and that we have the power to stand up for vulnerable people. All of us, not just me because I was running for office, but all of us can use our voices to protect vulnerable people who are being attacked by, you know, non well meaning politicians, 

Michael Lee: any Andrews.

Michael Lee: Thank you so much for being on When We Disagree. 

Annie Andrews: Thank you for having me.

Michael Lee: When We Disagree is recorded at the College of Charleston with creator and host Michael Lee. [00:17:00] Recording and sound engineering by Jesse Kunz and Lance Laidlaw. Reach out to us at whenwedisagree at gmail. com.