The way I read this is there’s nuance in the messaging of (as one example) “Gender Affirming Surgery for All Who Want Them!” and “All People Deserve to Get the Care That it’s Determined They Need by a Medical Professional!”
The first one is unpopular with the general population because it’s different and scary. Similar to the time before the Civil Rights Act was passed Civil Rights for black Americans was incredibly unpopular because the general populace is stupid. There are many messages like that, Pete Buttigieg’s “Medicare for All Who Want It” when he was running was the same thing. People are afraid if you tell them you’re taking away their insurance, but make it an option and an attractive one at that and you’ll get converts.
Sometimes massaging the messaging to de-center positions that are “scary”, is better in the long run to get the people elected that can actually bring about the change. This isn’t about throwing any group under the bus.