This is the first year I’m spending Pride truly out to myself and the world. I am transgender and non-binary. In essence, I am not the gender I was assigned at birth, but I’m not comfortable being described as either man or woman. I am queer in the truest sense of the word.
Transitioning, for me, means shifting the way I present to the world away from “woman” and more towards something like “masculine-ish”. I’ve got a rough checklist of physical changes I’d like to make and have already started on some. So far, transition has been a joyful, liberating experience.
Now, imagine the panic I and many other transgender individuals felt when news broke of a legal change that will hinder the ability of many trans folks to receive healthcare — transition-related or not. And yet as horrified as I am, I can’t say I’m really surprised by the announcement.
The Trump administration just took a major step toward removing critical protections for LGBTQ+ individuals to receive healthcare. This blow came in the form of a reversal of an official interpretation of Section 1557 of the Affordable Care Act. This section, which outlines official anti-discrimination protections, had been previously interpreted by the Department of Health and Human Services (HHS) to include the protection of gender identity under the definition of sex. Now, this is no longer the case.
The distinction between gender identity and sex is a crucial but largely misunderstood one. Gender is widely understood to be inherent and personal. It has much more to do with how a person views themselves and interacts with society than any physical traits. Sex encompasses many physical characteristics from chromosomes to hormones. The disconnect that can exist between gender and sex is what leads to dysphoria and is best helped by transitioning.
I’ve been on a low dose of testosterone for almost a month. It’s not a high enough dose or a long enough time for major changes to have kicked in yet, but it’s been life-changing already. For me, the feeling is best described by the moment when, after staring at something unfocused for a long while so that the object appears double, you focus again, and everything slides together into one cohesive image. It feels as though my mind and body are reaching a similar clarity.
For the first time in my life, my body is beginning to feel like it belongs to me, and it’s an incredible sensation. I still experience a great deal of dysphoria about some parts of it, but at least I’m starting to feel like I can find a sense of equilibrium eventually. I’m hopeful for the future and beyond excited to be able to continue to figure out who I am and reconfigure my body to better fit my feelings of gender.
This has been the first step of what will be an ongoing process, but it’s been so, so critical. For me, accepting and embracing my trans identity has been a lifelong journey. Much of what kept me hiding from myself, however, was the fear of having to navigate a world that is overwhelmingly structured to support cisgender and binary identities. In other words, the lack of gender-neutral bathrooms is only the first of many dilemmas.
As I move forward in my transition, I’m forced to reconcile my desire for change with the fact that I will no longer fit neatly into one assigned box. At best, I’m likely to face misunderstanding and confusion caused by my non-binary identity. At worst, I may be turned away or denied appropriate care because I am transgender.
Although the HHS interpretation laid out in 2016 has faced multiple attacks since its inception, it had nonetheless offered one of the most straightforward anti-discrimination protections for transgender folks. By totally removing all reference to gender identity from the legal framework, the door is open for practitioners to claim once again anything from religious exemption to plain unwillingness in order to deny healthcare to transgender patients.
Access to appropriate and affirming healthcare is all too often a major hurdle for transgender individuals not only seeking to transition but even in getting basic medical treatment. Legal protections for LGBTQ+ Americans vary wildly across states. For many, limited federal protections may be one of the few ways they are shielded from discrimination. The removal of these safeguards is nothing short of a direct attack on the lives of LGBTQ+ people across the nation.
We don’t have to speculate at the possible harm that could come from this. We’ve already seen far too many cases of LGBTQ+, especially transgender, individuals harmed or even killed by ignorance and negligence. Many trans people report experiencing difficulty in finding a doctor willing to treat them even for basic, non-transition services. Sometimes it’s because the doctor is unwilling to prescribe medication to a patient already on hormones. Other times the staff at the facility simply aren’t trained to give appropriate, gender-affirming care to a transgender patient. Oftentimes, transgender people must travel hours, even going out of their home state, in order to find a doctor willing to treat them.
Unfortunately, none of this is new, nor unexpected. The interpretation of Section 1557 that included gender identity had been confronted previously in a court case that sought to answer the question of enforcement in regard to religious medical centers. The result of that case, Franciscan Alliance, Inc. et al v. Burwell, was a permanent injunction made in October 2019 that barred Section 1557 from continuing to apply in cases of gender identity. Effectively, what this latest ruling has done is made this exclusion permanent.
Ultimately, the changes to the Section 1557 rule are one more attack from an antagonistic government. Despite claims to the contrary, the Trump administration has been thoroughly unsupportive of the LGBTQ+ community. Whether it’s restricting the rights of LGBTQ+ Americans in the workplace, banning trans citizens from joining the military, or appointing numerous officials who espouse passionate and public bigotry toward the LGBTQ+ community, there has been little done to move forward and much done to reverse positive changes that were made in the previous administration. Organizations like GLAAD and HRC have documented the entire timeline of changes made since President Trump’s first day in office, and the list is exhaustive.
I’ve written this piece knowing that I come from a place of great privilege. I’ve been extremely fortunate in coming out to friends and family that are supportive and loving. I’ve had doctor visits and medications covered by insurance without any hassle. If I visit a new medical practitioner, I won’t face discrimination because of the color of my skin in addition to my identity. I am unlikely to ever have to make the painful choice between gender-affirming healthcare or other basic necessities because of finances. Knowing all this is why I choose to speak out. I can weather this storm relatively well, but there are so many others that won’t be able to.
For allies looking to learn more or help, the following are suggestions for ways to contribute:
- Sign petitions. There is strength in numbers, and petitions serve as valuable tools for demonstrating the extent of public opinion. A direct petition to the White House has been made, and at the time of writing, has yet to reach its goal.
- Contact your representatives. Let them know that you want to see the creation and protection of legislation to safeguard LGBTQ+ rights. Find information about your representatives and how to reach out to them here.
- Vote for state and federal representatives that support the LGBTQ+ community, not just in their words but actions as well.
- Attend protests, safely, when possible. Be mindful of the current risk posed by COVID-19 and take necessary precautions.
- Listen to and uplift transgender voices, especially those belonging to trans POC. Black trans women have historically faced some of the highest levels of violence and discrimination among the entirety of the LGBTQ+ community, and it’s well past time to take a stand for their safety.
- Donate to support trans healthcare access. The most direct way to do this is by contributing to any of the numerous fundraisers on sites like GoFundMe put up by transgender people to raise money to cover transition-related expenses. There are also many reputable organizations that provide assistance to trans folks who need it.
At the end of the day, all any of us want is to be able to live authentically as ourselves. The question of whether or not we should be treated with dignity and granted basic human rights should not be a political debate. Trans rights are human rights. I urge everyone to remember the transgender community as they go to cast their vote in November. The least you can do is to not vote for anyone who actively opposes and seeks to legislate away our very existence.
