During debate over the National Defense Authorization Act this week, something more than policy was laid bare: the depths of prejudice and unprofessionalism in how some lawmakers treat transgender rights. Rep. Sara Jacobs of California was making a point rooted in fairness when she said that common cosmetic procedures like “boob jobs,” fillers, and Botox, the sorts of things cisgender people get all the time, are also forms of gender-affirming care. The idea was simple: if certain medical procedures are defended when done for cosmetic reasons, denying similar procedures for transgender people seems inconsistent.
That is when Rep. Nancy Mace of South Carolina lost it. From her seat, though she was not recognized to speak, she cut in to call Jacobs “disgusting” and “ridiculous,” asked, “What the hell is your problem?” and accused Jacobs of being insulting. She then took to social media to mock Jacobs further, even bragging about having “a good surgeon if you ever want to get your nose done.”
The insults did not stop there. Mace has a pattern of using slurs about transgender people, calling them “freaks,” “weirdos,” or “mentally deranged.” This was not an isolated shouting match but part of a recurring strategy to provoke, stigmatize, and gain attention while deflecting examination of her own logic.
Jacobs, who has personal stakes in this fight since two of her siblings are trans or gender nonconforming, responded by pointing out that the outburst was not just a misunderstanding. She called it intentional targeting of a vulnerable group. She described it as cruel, malicious, and part of a deliberate style Mace has adopted.
This moment matters for a few reasons. First, decorum is more than politeness. It keeps debates focused on policy rather than devolving into shouting matches and harassment. When a lawmaker reacts by demeaning another person instead of addressing the substance of their argument, the public loses out on clarity and respect. Second, transgender people already face stigma in healthcare, public life, and politics. Every time a lawmaker uses slurs or disparaging language, it reinforces that stigma. And when those same lawmakers are in positions to decide who gets access to medical care, it is especially chilling.
Finally, Jacobs’ point about the overlap between what are often called “cosmetic” procedures and gender-affirming care cuts to the core of the hypocrisy in many of these debates. If breast augmentation or Botox is considered legitimate and legal for cis people, denying access for transgender people on a moralistic or ideological basis becomes much harder to justify without revealing bias.
Nancy Mace’s approach in this incident did not simply fail the test of basic respect. It also revealed how debates about gender-affirming care are, for some, less about care and more about spectacle, shame, and control. For readers of TransVitae, this is not just a political skirmish. It is a reminder that when rights are framed through anger instead of understanding, the people who suffer most are those whose lives depend on access to care and dignity.
