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On February 22rd, Pres. Donald Trump signed an executive order reversing Pres. Barack Obama’s earlier order protecting transgender youths under Title IX from so-called “bathroom” bills may be the most odious. In short order, the Supreme Court ordered a pending case involving Gavin Grimm, a self-identified male student prohibited from using the boys’ bathrooms at his Gloucester Country, VA, high school, returned the local federal court. Sadly, the outcome of looks bleak given Trump’s nomination of a strict conservative to the Court and his February 22rd executive order.

As of January 2017, the National Conference of State Legislatures reports that 14 states were considering bills to restrict access to multiuser restrooms, locker rooms and other sex-segregated facilities. Bills introduced in these states — Alabama, Illinois, Kansas, Kentucky, Minnesota, Missouri, New York, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington and Wyoming – seek to restrict bathroom access based on one’s gender assigned at birth or “biological sex”; similar bills were defeated in South Dakota and Virginia.

The troubling unasked – and unanswered — question in why Trump targeted transgender youth?

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Two knowledgeable specialists suggest very different — but complementary –answers to the question.

Jack Drescher, MD, is a psychiatrist and psychoanalyst in private practice as well as a clinical professor of psychiatry & behavioral sciences at New York Medical College and adjunct professor at New York University’s postdoctoral program in psychotherapy and psychoanalysis. “The religious social conservatives having lost the gay marriage war,” he points out, “and have started to take it out on the transgender community, especially trans kids and bathroom bills.” He notes that gay rights evolved slowly with time and now more and more heterosexuals accept gay people because they know gay people, whether family member, neighbors or coworkers. “Awareness has led to acceptance and tolerance.”

The transgender population in the U.S. is but a tiny segment of the American public. UCLA’s Williams Institute estimates that less than 1 percent (0.6% or about 1.5 million) of U.S. adults identify as transgender and only an estimated 350,000 youths aged 13 to 17 identify as transgender. So, why has Trump singled-out transsexual young people as a target in his political agenda?

Howard Lavine, PhD, is professor of political science and psychology at the University of Minnesota, director of the Center for the Study of Political Psychology and editor-in-chief of the journal, Advances in Political Psychology. He offers a more sanguine assessment. “Trump is targeted low hanging fruit,” he says. “I’m sure that Vice President Mike Pense, an anti-gay hardliner, probably told him he had to do it. And he did it to appease hardliners in the party – and it was an easy way to gain support among Republicans. I don’t think there’s anything psychological about his action.”

The modern culture wars were launched in 1972 by Phyllis Schafly, a lawyer and conservative activist, when she led a successful campaign to block the adoption of the proposed Equal Rights Amendment (ERA). She and other Christian conservatives were infuriated by ‘60s political and cultural radicalism, of calls for Black Power, mounting anti-Vietnam War protests, a nascent feminist movement and a counterculture celebrating sex, drugs and rock-&-roll.

In 1973, Schafly and others, including many fundamentalist Protestants and the Roman Catholic Church, were infuriated when an all-male Supreme Court ruled in Roe v. Wade that a Texas woman had the right to an abortion. They were further incensed when, that same year, the American Psychiatric Association (APA) reclassified homosexuality, dropping it as a mental disorder from the revised Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-3).

Drescher, who edited the Journal of Gay and Lesbian Mental Health and has edited and co-edited more than a score of books dealing with gender, sexuality and the health and mental health of LGBT communities, served on the APA’s DSM-5 Workgroup on Sexual and Gender Identity Disorders. He explains that the term “transgender,” like “gay,” is a non-scientific concept but “a term used by a community of individuals whose gender expression may not match their birth sex to define itself.“ He adds, “no one know why people are trans, let alone why people are gay.” The revised, DSM-5, published in 2013, includes a diagnosis of “gender dysphoria” which has been applied to some, but not all, transgender people who are very uncomfortable with the bodies they were born with.

The religious right’s war against homosexuals and, by extension, transsexual youth, runs deep – back to the Puritans and the nation’s founding. More recently, in 2001, James Dobson, founder of Focus on the Family, claimed that the growing gay-rights movement was targeting schools. Two years later, Louis Sheldon, head of the Traditional Values Coalition, argued that “homosexual militants are pushing for aggressive recruitment programs in public schools.” This attitude seems to have contributed to a rise in bullying within American schools over the last two decades; it declined during Obama’s presidency.

Bullying has long been an endemic feature of the lives of school-age children. Sadly, the targeting of young people who do not adhere to strict conventions of gender identity often has terrible consequences. Drescher links the current campaign against transgender youth to the bullying of gay kids in schools. In a 2010 New York Times Letter-to-the-Editor, he wrote: “Avoiding discussions of homosexuality and gay families serves its own political agenda: maintaining an intolerant status quo where bullying can flourish and schools become unsafe for gay youth to come out.”

In 2008, the Suicide Prevention Resource Center reported that lesbian, gay and bisexual youth were “nearly one and a half to three times more likely to have reported suicidal ideation” and “nearly one and a half to seven times more likely than non-LGB youth to have reported attempting suicide.” The following year, the Gay, Lesbian and Straight Education Network’s National School Climate Survey found over four-in-five (nearly 85%) of LGBT students reported harassment because of their sexual orientation or gender identity, and nearly one-in-five (20%) reported “being physically assaulted at school in the past year because of their sexual orientation.”

The issue of transgender youth came to a head in 2013 when the Colorado Civil Rights Division ruled that Cory Mathis, a 6-year-old transgender student, could use the girls’ bathroom at her elementary school. The decision precipitated a panic among conservative religious politicians in states across the country.

In 2014, the Southern Baptist Convention — the largest Protestant group in the U.S. with 16 million members — approved a resolution, “On Transgender Identity,” claiming that “gender identity is determined by biological sex and not by one’s self-perception.” It also dismissed transgender and intersex people as, respectively, “psychological” and “biological” manifestations of “human fallenness.” It opposed all efforts at physical gender transition and rejected any governmental or cultural validations of transgender identities.

The following year, the Association of Certified Biblical Counselors (ACBC), an organization representing conservative Christian counselors, hosted what it claimed was the “first-ever” evangelical conference on “transgenderism” in Louisville, KY; the event was co-sponsored the Council on Biblical Manhood & Womanhood. One session was called, “Transgender Confusion and Transformational Christianity.”

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So, why did Trump target transsexual young people?

University of Minnesota’s political psychologist Howard Lavine argues that the answer is simple. “It’s nothing but politics,” he says. “It was very easy for Trump to do it. He signs an order and it was done.” Going further, he points out: “Any Republican president would have overturned [Obama’s] executive order. There is no skin off his back. It’s a clear win.” Chuckling, he poses a more pointed question: “I would be shocked if he didn’t do it – and that would have been a real story.” He adds, “It’s a clear win for him, politically. He doesn’t lose anything by doing it. He isn’t spending much political capital.”

“Remember, during the campaign homosexuality and transsexuals was not a major issue for him,” Lavine reflects. “Trump seemed to care more about immigration and terrorism than this issue.” He adds, “Trump said that Caitlyn Jenner could use any bathroom at Trump Tower.” In reaction to Trump’s order, Jenner challenged the president in a video posted on Twitter: “I have a message for the trans kids of America: You’re winning. I know it doesn’t feel like it today or every day, but you’re winning.” Lavine laments, “This is a disaster, and you [Trump] can still fix it … protect the LGBTQ community.”

As a political scientist concerned with the issue of political power, Lavine said that Trump’s action was not an issue of the weak vs. strong, but how a group works as part of a political alignment. “It’s a lot easier to pick on poor,” he notes. “The poor are less active, don’t contribute money, not well represented when their interests collide with those with power.”

The New York Medical College psychiatrist, Jack Drescher, believes that Trump’s executive order “was a bad policy decision.” He is concerned “how it might adversely affect the well-being and mental health of transgender kids.” “Trans presentation is much rarer than gay presentation,” he points out. “Most Americans have never met a trans person – or if they have, they likely don’t know it. Most people’s images of a transgender person come from TV & movies or personal fantasies which makes people anxious, if not frightened, about trans people.”

Drescher opined, “I think everyone, regardless of political affiliation, should be concerned when those with the most power target the most vulnerable populations.” Because there are fewer transgender people out in society, they are less known. He notes, with a sense of irony, that for most Americans fear of transgender means fear of a man in women’s clothing entering a women’s bathroom. “If bathroom bills were to be enforced, a common consternation will be trans be men with beards using the women’s bathroom and the trans women in the men’s room,” he jests.

There is yet another possible answer to the troubling question as to why Trump targeted trans youth and other marginal groups. There’s a growing perception that Pres. Donald Trump is mentally “sick.” Public figures have begun to question Trump’s sanity, including Rep. Ted Lieu (D-CA) and Richard Friedman, MD, professor of clinical psychiatry and the director of the psychopharmacology clinic, Weill Cornell Medical College. Paul Krugman went so far to declare, “An American first: a president who was obviously mentally ill the moment he took office.” A Change.org petition claiming that Trump has “a serious mental illness” was endorsed by 20,000 people.

The most critical diagnostic assessment of Trump’s apparent psychological state was presented shortly after his 2016 electoral victory. Three highly-respected academic psychiatrists — Judith Herman, MD, Harvard Medical School; Nanette Gartrell, MD, University of California, San Francisco (1988-2011); and Dee Mosbacher, MD, PhD, University of California, San Francisco (2005-2013) – published an open letter to Pres. Barack Obama in the Huffington Post. They present, in scrupulous detail, a clinical, psychiatric evaluation of the president-elect, arguing that, in term of APA’s DSM-5, Trump suffers from a Narcissistic Personality Disorder.

Their diagnosis, along with those offered by others clinical professionals, may violate what is known as the APA’s Goldwater Rule. The rule is part of the organization’s code of ethics and named after former Sen. (and presidential candidate) Barry Goldwater and in an uninformed and highly-critical diagnosis made of the candidate by a psychiatrist. The rule states it is unethical for psychiatrists to give a professional opinion about a public figure they have not examined in person, and obtained consent from, to discuss their mental health. In any case, one can only speculate as to Trump’s apparent mental health and the role it played – if any — in his targeting of trans kids.

From the perspective of many ordinary citizens, there seems to be something wrong, “sick” (in a non-clinical sense), about Trump, his closest associates and his misbegotten Cabinet. Collectively, they seem irrationally mean-spirited, if not immoral or simply evil. They all seem out for themselves, whether it’s in terms of furthering the business interests of the 1 percent or imposing their moral beliefs on all Americans. Trump’s order revoking bathroom protections for transgender youths in public schools is among the most punitive of his still-early presidency. One can expect it to only get worse.