fresh voices from the front lines of change







We know the numbers: 14 million people will be pushed off their plans by next year, with that number rising to 24 million over a decade. The White House projects that number to be even higher: 26 million losing coverage over 10 years.

What does this mean for marginalized groups like trans people in America?

In health care as elsewhere, trans people are structurally disadvantaged by implicit biases and discriminatory practices that inflict material harm on their lives.

Prior to the Affordable Care Act (ACA), many trans people were denied health care - even if they could afford insurance - simply for being trans. The ACA introduced protections for trans people in America for the first time in history: Section 1557 of the ACA prevented trans people from being denied health care due to their gender identity or expression.

The doctor’s office has always been a contentious, and often dangerous, place for trans folks. A 2010 survey conducted by the National Center for Transgender Equality and the National Gay and Lesbian Task Force found that 28 percent of trans people were harassed in a medical setting and that half of them had to teach their providers about trans-competent care. The survey also found that 25 percent of trans people reported being fired for not complying with gender norms and 90 percent endured gender-based discrimination at work.

The struggle for health care has to be situated within the context of anti-trans sentiments and discrimination at large. Some of the foundational pillars of a person’s livelihood -- their physical well-being and a sustainable source of income -- can be out of reach for many trans people, leading them to precarious methods of survival.

The health of an individual is linked to the resources they’re afforded in their life and the violence they face. Because trans people face injustice in so many spheres of their lives, they have some of the highest rates of HIV. Findings from 29 published reviews reported a staggering 22 percent of trans women were living with HIV, as compared to the 0.3 percent of the general American population.

The ACA took a small step in relieving the struggles of trans people, especially trans women living with HIV, by preventing insurance companies from discriminating against those with pre-existing conditions (at this point, many insurance companies considered being trans a medical condition in and of itself).

Under the GOP health bill, those with preexisting conditions could face a 30 percent hike in premiums. And those who are poorer and older could face a 750 percent increase in premiums under the Republican bill. So many trans people can hardly afford to survive as it is; how could they survive under this GOP nightmare?

With the repeal of the ACA and Section 1557 along with it, trans people could again be rejected altogether by medical providers, with no recourse from the federal government.

We need to be reminded about what we deserve: all people should have the right to health. A vision of health care that we deserve is one in which none of us have to worry about dying because we don’t have the resources to stay alive. The Republican bill is going to make health a privilege for the few when health should a universal right.

We know millions will lose coverage over the next year if the bill passes; this information is crucial. But numerical data can make it easy to forget the human beings behind the numbers. Every person encompassed within the 14 million who may be pushed off their plans has a life, has a story, comes from a family, and has unique dreams and aspirations.

There are trans people among the 14 million who are unable to actualize their dreams because they aren’t cared for. They aren’t afforded resources that ensure their fundamental well-being.

What the repeal of the Affordable Care Act would do is trap trans people in an endless cycle of violence: many trans people live in conditions that make us vulnerable to HIV, we are then denied health care to alleviate this violence because we can’t afford it (whether we are living with HIV or not), we are pushed further towards the margins because health is paramount to all other aspects of our lives, and so the cycle continues.

It is no exaggeration to say we have to “kill this bill before it kills us.” We have to fight for our survival. We have to commit to fighting for a world that uplifts those in the margins.

Here’s a step we can all take: Go to our People's Action page and tell your member of Congress to vote "No!" on cutting health care and endangering the lives of millions of people.

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