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How Barriers to Medical Care Harm Transgender People

Over the past several years, healthcare access for transgender individuals has been a hot topic. From the federal government re-defining anti-discrimination laws to exclude trans people to state governments prohibiting gender-affirming treatment for transgender youth, a fierce debate has raged about the rights of transgender people to access medical care. At its core, these arguments demonstrate just how prevalent discrimination against transgender people is — and just how much work there is to be done in the fight for equality.

Until 2016, there were no specific protections for transgender people when it came to medical care. Under Section 1557 of the Affordable Care Act, healthcare providers are prohibited from discriminating against patients on the basis of their race, color, national origin, sex, age, or disability status. In 2016, this section of the ACA was defined as applying to gender identity. As a result, both insurance companies and healthcare providers that receive federal funding were required to provide the same access to coverage, services and care to transgender people as they would to cisgender people. In 2020, the Trump administration finalized a rule that would reinterpret Section 1557 to only include discrimination on the basis of biological sex. A federal judge blocked this rule from taking effect in August 2020. The Biden administration announced in May 2020 that it would reverse this rule, ensuring protections for transgender people.

Importantly, this law is relatively limited in scope, as it only applies to insurers and healthcare providers that receive federal funds. Medical discrimination against trans people is still rampant throughout the United States. Many health insurance policies and programs specifically exclude transgender people from accessing care — such as the New York State Medicaid program. More disturbingly, several states have recently passed laws that ban gender-affirming medical care for young people.

Healthcare discrimination is incredibly harmful to transgender people of all ages. According to the United States Department of Health and Human Services (HHS), 25% of LGBTQ+ people who have faced discrimination have postponed or avoided receiving necessary medical care because they feared additional discrimination.

Transgender people are one of the most at-risk populations in the United States. Of the approximately 1.7 million trans people in the United States, 39% report having low incomes, which can have a negative effect on health. Nearly half (48%) of trans people in the United States have postponed medical care because they could not afford it.

Transgender people are also more likely than cisgender people to face discrimination, which can have a negative impact on both their physical and mental health. Transgender individuals are much more likely than their cisgender peers to report having anxiety, depression, poor physical health, and substance abuse problems. While just 4.6% of the population as a whole has made a suicide attempt, 40% of transgender people have attempted suicide.

It is unsurprising that so many trans people avoid healthcare, given the high levels of discrimination that they often face. 28% of trans individuals have reported experiencing verbal harassment in a medical setting. 19% of trans people have reported being refused medical care because of their gender identity. Even when transgender people do get medical care, their doctors are often woefully undereducated about their specific healthcare needs.

It is clear that access to healthcare — and ending discrimination in healthcare — is vitally important to the health and well-being of transgender people. Our physical and mental health affects every aspect of our lives. Each and every person should have equal access to safe, non-discriminatory treatment.

At Blackburn Center, we are committed to providing services to anyone who has experienced gender-based violence. We also offer a range of services to the community as a whole, with a goal of transforming our society — so that this type of violence ends. If you need help, we are here for you 24 hours a day, 7 days a week. Our hotline is always free of charge and can be anonymous: 1-888-832-2272.


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