The recent spate of anti-transgender bills in the USA has created challenges for transgender and gender-diverse students' health. While actions to promote conservatism over research-based guidance and ethical commitments to students are not new, the pace and vitriol of recent political changes is concerning. Even in states with strong civil rights protections for LGBTQIA+ people, the pace of anti-transgender legislation and policies being proposed and enacted has increased. In this context of rapid conservative backlash, it may be worth returning to equity-based strategies that focus on health concerns. While some scholars have argued that the political argument for gender-affirming policies, programmes and practices should move beyond health issues, health-based approaches may be tactically useful even if they may seem to imply a return to baseline arguments for respect and the value of diversity. This article begins with a short history of the complications arising when using research-based health information to counter socially conservative political tendencies. In contexts where conservatives have tried to make their personal values the values of their state, conservative policymakers and voters have ignored the rights of non-conservative families to have educational and political institutions also provide support their children. These policymakers have also neglected key findings from education and health research concerning gender-diverse youth. Within this context, health policymakers, professionals, practitioners and educators alike should work together to stand up and support youth.