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The problem is, when you decide to side with the school board, there are tons and tons of schools with no regard at all for a trans kid that would never offer this solution. They sure as hell wouldn't listen to a shrink either. As a great example, it's not like the politicians who came up with HB2 mandated that a unisex bathroom is built everywhere. It's actually a bigger problem for adults who have transitioned and required by law to use the opposite sex bathroom. Right away there were transgenders afraid to use any bathroom
So that is why, politics aside, the department of ed or whatever can reasonably conclude the only solution is to force the issue, to take away those schools' ability to neglect the minority. Then those schools where there would remain problems like you mentioned will have to compromise and allow the kid to use the nurse's office, just to prevent the kid from using what they see as the "wrong" bathroom
Schools do have to listen to a "shrinks" recommendation. It carries with it the same weight as that of a medical doctor. If a medical doctor says, "Johnny can't take PE because he's got a sprained leg" the school can't say, "well, we don't agree, so Johnny has to take PE, anyway". That could bring on a lawsuit, the last thing that a school district wants... especially since they'd lose, as in a court of law, the court would find for the medical practitioner assessing a medical issue over a school district who would have no official medical training. I have never once had a school refuse to allow the accommodation. I would have no issue with the Department of Ed. creating a policy, but the policy needs to be more of a compromise so that everyone's issues are considered.
No, the law lagged behind popular sentiment, as it usually does. I mean even Minnesota had legalized gay marriage via ballot. I don't think Obergefell changed any minds. Where the law assists is what it does literally - gay couples can now marry in the south and midwest. But then extremists just moved onto and continued other tactics, such as the "RFRA" fiasco and HB2, or just vowing to undo Obergefell like every republican. But those attempts have by and large died faster than courts can hear the case, due to all the backlash. So what i'm saying is what changes over time (really, they've been doing this for centuries, don't expect it to stop soon) is not their effort to oppress, but their ability to get away with it
Attempts have died MUCH faster since Obergefell than before. The power of law caused that.