The rule guts Section 1557 of the Affordable Care Act, an Obama-era regulation making it clear that discrimination against trans people by providers, hospitals, and insurers is illegal. The new regulations contradict federal law and two decades of court rulings and put up more unnecessary barriers between two million trans people in the U.S. and the health care and insurance coverage they need.
“Trans people should be able to seek medical care when we need help without being turned away or denied treatment because of who we are,” said Kris Hayashi, Executive Director at TLC. “This appalling move by the Trump administration puts the lives of trans people in jeopardy – especially trans people living with HIV, Black trans people and trans people of color, trans people with disabilities, and trans people living in rural areas and in Southern states.”
As a result of both federal and local governments’ failed response to the global health crisis caused by COVID-19, millions of people in the U.S. are struggling to access medical information, testing, and treatment. Trans people already face disproportionate discrimination in health care settings, including mistreatment by insurers and humiliation and harassment by doctors. By purporting to give a green light to discrimination today, the Trump administration is putting trans people’s lives at greater and more immediate risk.
This rule was also released in the middle of an epidemic of violence targeting Black people in the U.S., including the police murders of George Floyd in Minneapolis, Minnesota, Breonna Taylor in Louisville, Kentucky, and Tony McDade, a Black trans man, in Tallahassee, Florida, and the murders of two Black trans women, Dominique “Rem’mie” Fells in Philadelphia, Pennsylvania and Riah Milton in Cincinnati, Ohio. The rule was released on the fourth anniversary of the Pulse nightclub shooting, on a day known as Pulse Remembrance Day.
As a direct result of systemic racism, Black communities that are already most impacted by racist policing systems and practices have also been hardest hit by the COVID-19 pandemic. Black trans women and Black trans femmes are disproportionately impacted by all forms of discrimination which leads to higher rates of poverty, poorer health outcomes, and increased likelihood of experiencing violence in other areas of life.
In March, TLC and a national coalition of trans leaders launched the Trans Agenda for Liberation to serve as a community-led guide towards the world trans and gender nonconforming people deserve. The Trans Agenda, developed over years of community gatherings and conversations by primarily Black and Indigenous trans people, serves as a framework for responding to global crises like COVID-19, and more generally for rebuilding and reordering a society that for too long has marginalized and dismissed the visionary leadership and solutions of trans people.
“Solutions to the current global health crisis, as well as to the day-to-day harassment and discrimination that trans people face when accessing medical care, will come directly from those of us who are most affected,” said Mariah Moore, Organizing Program Associate at TLC. “Black, Indigenous, disabled, trans migrants, trans people living with HIV, as well as trans people living in rural communities and in the U.S. South have the experience and networks of support to lead the resistance to this cruel attack by the Trump administration.”
Last year, TLC and the National Center for Transgender Equality partnered to oppose this rule and gathered over 20,000 comments in opposition through the Protect Trans Health campaign. Overall, civil rights organizations collected over 132,400 comments in defense of trans health.