Alexssandra, I am delighted that you are writing about politics and law as it applies to transgender people. I'm a new subscriber. We sorely need more of this discussion on Substack. Right now many of us are rightfully excited and participating in Pride celebrations and writing about it. We do need something to be happy about and a break from the constant gloom. But behind the scenes the damage is being done, and my sense is that they are just getting started. I sure hope I'm wrong. We're getting excited about seeing legislation killed, but a lot has taken hold. We become celebratory when there's any scrap of good news. I think I speak for a lot of transgender people when I say I'm afraid and also very worried that the next 3.5 years are going to be brutal. Yes, there are midterms. And some court cases may be successfully won by litigation from the ACLU or other organizations that support transgender people.
I'm trying to catch up with my readings but there's just too much going on. But I was wondering, where we are at with the Trump Administration changing definitions or completely eliminating the classification of transgender care? For example, eliminating gender dysphoria as a legitimate condition and disability. Yesterday I was on the University of Miami website and my patient portal. And since they have a lot of info for patients, I thought I would punch in some key search words related to transgender care. I was taken outside of the website and linked to the National Database or the National Medical archives. Then I figured okay I'll look. Just to see how much they have wiped the databases and taken down articles. And sure enough they have. As most of us know, they are gutting databases and we have to instead get information from independent sources such as the Williams Institute or the Trans survey in this week's news. Or journalists such as Erin Reed. When looking at the government website there are remaining articles relating to transgender people. But there are a few only and are usually five or six years old at least (or random scraps which somehow slipped through the cracks from what they have already wiped wholesale style).
In your future coverage and writings I would love if you could address how they're trying to change the whole Paradigm and structure for transgender care (definitions and what's allowed). In places like Texas they have eliminated abortions and related care. Essentially criminalizing it. And so there's nothing saying Republicans and Trump won't continue to attempt the same thing for transgender care. That's just the direction we are heading based on the way it's gone so far. Unless pushback is organize well enough, with legal challenges. Like you said, in a way we're lucky that everything is not completely controlled by the federal government top down the way it is in other countries. But insurance companies are going to take the easy way out if given the chance. Here in Florida, nobody can get transgender care under FL Medicaid. The Medicaid providers follow the law which is to deny any coverage for transgender care. And the remaining Marketplace offerings from Cigna, Aetna, Blue Cross or a handful of companies is shaky. Anyway I'm saying a lot here but really we have to look at not just the Supreme Court but how they're gutting the entire system of transgender care as to definitions and treatment codes and all that. Many of you out there have completed your transitioning and just have to worry about continuing hormones, labs, and some related periodic care (such as mammograms if you're a trans woman). But the rest of us are going to have to find a way to get the meaningful coverage we require. Personally, for this to be happening in the middle of my transitioning is immoral and unethical. It's like somebody who has been waiting on a transplant list from a big hospital. And now the government steps in and says: oh, we're not doing those kind of transplants anymore. TFB. Oh, and try not to die. Right now we have some hospitals that are affiliated with religious organizations which will not perform a hysterectomy on a transitioning trans man, but have no problem doing it for a cisgender woman. So the structure for trans care has already begun to change, and is likely to get worse.
Hi Kenzie! Thank you so much for your comment (and for subscribing!)! I started Transitics not only because I wanted something realistic and not the depressing narrative that dominates political discussions in trans spaces, but also so I could give my two cents on everything that is happening in the country right now and how it affects us. Plus, I love writing and I have the time!
For a little background on me, I grew up in Texas. I realised I was trans at 15, in the midst of all these attacks against trans youth. Gender-affirming care for minors was de facto banned at that point…so I was forced to wait 2 years and 3 months until I turned 18 to start HRT. I finally started medically transitioning a little less than 8 months ago (October 22nd, 2024!) and it truly did save my life. I’m the happiest I’ve ever been!
Aside from that, I’m also going to be a student starting in September, majoring in political science at Northwestern in Illinois. To be honest, I’m just really thankful I get to leave Texas because I don’t feel safe here anymore. Although the bill to ban HRT outright died in committee this session, there’s no doubt that next year they’ll try it again and I do not want to be here for that. They already took enough of my life, I won’t put myself in a position where they can take more. And, I get to study what I love, which I’m really looking forward to!
As for your question about the classification of transgender care, I’ve covered the of the HHS report in another article. However, the ‘Big, Beautiful Bill’ seeks to do exactly what you mentioned: remove the requirement for insurance to cover it. That’s pretty much all they can do, but it might not pass after all. I would advise you to rest easy, as the Trump doesn’t have control over medical associations which make the guidelines in the first place. Standards of care will remain, and in a ton of states insurance companies will still be required, by law, to cover gender-affirming care.
I know I said this in this article and I say this a lot in others, but most of everything that may be passed at the federal level against trans people will be a removal of protections, not an imposition of restrictions. Red states—like you mentioned, Florida—will continue to deteriorate, which is terrible, but blue states will stay the same. And even then, the courts may reinstate some protections that are removed.
I will cover the restrictions red states are trying to place in the future, I’m just waiting on United States v. Skrmetti, which is essential to anything they may try to do. It going our way will be a massive roadblock for them, so be on the lookout for that.
Remember: we will get through this. I know everything seems dark and scary right now, but this period won’t last forever. Hate never wins.
Some people in states that mandate coverage are covered under employer plans that are self-funded - Self-funded plans follow federal law and are not required to adhere to state mandates
Alexssandra, I am delighted that you are writing about politics and law as it applies to transgender people. I'm a new subscriber. We sorely need more of this discussion on Substack. Right now many of us are rightfully excited and participating in Pride celebrations and writing about it. We do need something to be happy about and a break from the constant gloom. But behind the scenes the damage is being done, and my sense is that they are just getting started. I sure hope I'm wrong. We're getting excited about seeing legislation killed, but a lot has taken hold. We become celebratory when there's any scrap of good news. I think I speak for a lot of transgender people when I say I'm afraid and also very worried that the next 3.5 years are going to be brutal. Yes, there are midterms. And some court cases may be successfully won by litigation from the ACLU or other organizations that support transgender people.
I'm trying to catch up with my readings but there's just too much going on. But I was wondering, where we are at with the Trump Administration changing definitions or completely eliminating the classification of transgender care? For example, eliminating gender dysphoria as a legitimate condition and disability. Yesterday I was on the University of Miami website and my patient portal. And since they have a lot of info for patients, I thought I would punch in some key search words related to transgender care. I was taken outside of the website and linked to the National Database or the National Medical archives. Then I figured okay I'll look. Just to see how much they have wiped the databases and taken down articles. And sure enough they have. As most of us know, they are gutting databases and we have to instead get information from independent sources such as the Williams Institute or the Trans survey in this week's news. Or journalists such as Erin Reed. When looking at the government website there are remaining articles relating to transgender people. But there are a few only and are usually five or six years old at least (or random scraps which somehow slipped through the cracks from what they have already wiped wholesale style).
In your future coverage and writings I would love if you could address how they're trying to change the whole Paradigm and structure for transgender care (definitions and what's allowed). In places like Texas they have eliminated abortions and related care. Essentially criminalizing it. And so there's nothing saying Republicans and Trump won't continue to attempt the same thing for transgender care. That's just the direction we are heading based on the way it's gone so far. Unless pushback is organize well enough, with legal challenges. Like you said, in a way we're lucky that everything is not completely controlled by the federal government top down the way it is in other countries. But insurance companies are going to take the easy way out if given the chance. Here in Florida, nobody can get transgender care under FL Medicaid. The Medicaid providers follow the law which is to deny any coverage for transgender care. And the remaining Marketplace offerings from Cigna, Aetna, Blue Cross or a handful of companies is shaky. Anyway I'm saying a lot here but really we have to look at not just the Supreme Court but how they're gutting the entire system of transgender care as to definitions and treatment codes and all that. Many of you out there have completed your transitioning and just have to worry about continuing hormones, labs, and some related periodic care (such as mammograms if you're a trans woman). But the rest of us are going to have to find a way to get the meaningful coverage we require. Personally, for this to be happening in the middle of my transitioning is immoral and unethical. It's like somebody who has been waiting on a transplant list from a big hospital. And now the government steps in and says: oh, we're not doing those kind of transplants anymore. TFB. Oh, and try not to die. Right now we have some hospitals that are affiliated with religious organizations which will not perform a hysterectomy on a transitioning trans man, but have no problem doing it for a cisgender woman. So the structure for trans care has already begun to change, and is likely to get worse.
Thanks.
Hi Kenzie! Thank you so much for your comment (and for subscribing!)! I started Transitics not only because I wanted something realistic and not the depressing narrative that dominates political discussions in trans spaces, but also so I could give my two cents on everything that is happening in the country right now and how it affects us. Plus, I love writing and I have the time!
For a little background on me, I grew up in Texas. I realised I was trans at 15, in the midst of all these attacks against trans youth. Gender-affirming care for minors was de facto banned at that point…so I was forced to wait 2 years and 3 months until I turned 18 to start HRT. I finally started medically transitioning a little less than 8 months ago (October 22nd, 2024!) and it truly did save my life. I’m the happiest I’ve ever been!
Aside from that, I’m also going to be a student starting in September, majoring in political science at Northwestern in Illinois. To be honest, I’m just really thankful I get to leave Texas because I don’t feel safe here anymore. Although the bill to ban HRT outright died in committee this session, there’s no doubt that next year they’ll try it again and I do not want to be here for that. They already took enough of my life, I won’t put myself in a position where they can take more. And, I get to study what I love, which I’m really looking forward to!
As for your question about the classification of transgender care, I’ve covered the of the HHS report in another article. However, the ‘Big, Beautiful Bill’ seeks to do exactly what you mentioned: remove the requirement for insurance to cover it. That’s pretty much all they can do, but it might not pass after all. I would advise you to rest easy, as the Trump doesn’t have control over medical associations which make the guidelines in the first place. Standards of care will remain, and in a ton of states insurance companies will still be required, by law, to cover gender-affirming care.
I know I said this in this article and I say this a lot in others, but most of everything that may be passed at the federal level against trans people will be a removal of protections, not an imposition of restrictions. Red states—like you mentioned, Florida—will continue to deteriorate, which is terrible, but blue states will stay the same. And even then, the courts may reinstate some protections that are removed.
I will cover the restrictions red states are trying to place in the future, I’m just waiting on United States v. Skrmetti, which is essential to anything they may try to do. It going our way will be a massive roadblock for them, so be on the lookout for that.
Remember: we will get through this. I know everything seems dark and scary right now, but this period won’t last forever. Hate never wins.
Some people in states that mandate coverage are covered under employer plans that are self-funded - Self-funded plans follow federal law and are not required to adhere to state mandates
I’m so glad this ended up being an optimistic article 🥺