President-elect Donald Trump has made attacks on transgender people a key issue in his election campaign. His campaign and conservative groups spent tens of millions A few bucks for anti-trans advertising. He calls gender-affirming care provided to young transgender people “left-wing gender insanity” and “child abuse,” and falsely claims at rallies and events that children are undergoing gender-affirming surgery. I did. school.
Now, as President Trump prepares to return to the White House, gender-affirming care providers are bracing for an administration that could overturn evidence-based standards of care for transgender people. There is.
It is difficult to predict what policies the Trump administration will pursue, but his platform includes ending all federal funding for gender-affirming health care and closing hospitals that provide care to minors. It included a pledge to kick them off Medicare and Medicaid. President Trump also said he would ask Congress to enact legislation that would recognize only the two genders assigned at birth: male and female.
“I think we have to take the Trump administration’s platform at its word,” said Meredith McNamara, an assistant professor of pediatrics at Yale University who also sees patients at a local community health center. “It is up to the profession to be incredibly realistic about what will happen if our patients continue to be politically targeted.”
Early Wednesday morning, McNamara had already begun receiving messages from young patients worried about access to treatment for gender nonconformity. The Trevor Project, a suicide prevention organization for LGBTQ+ youth, told STAT that the number of calls, chats and text messages to its crisis line increased by nearly 700% the day after the election compared to weeks earlier. spoke. Many people in crisis addressed the election results directly.
FOLX, a gay telemedicine platform, saw a 75% increase in messages to medical teams the day after the election. This comes as people raised questions about refills and concerns about accessing health services in the future. The company also reported a 115% increase in messages on its community platform.
Before President Trump takes office in January, McNamara said, health care providers and hospital systems should improve patient privacy policies, conduct medical law training and work with legal experts who understand the nuances of treatment bans. He said he needed to prepare. Even people who work and live in states with progressive policies should not assume they can continue to provide care without interference at any time, she noted. Some states have passed “shield laws” to protect both patients and health care workers from persecution by restrictive states. But there has yet to be a legal contest to test the strength of these laws, McNamara said.
“The very solid blue states are not going anywhere,” said Kate Steinle, FOLX’s chief clinical officer. “They will fight even harder.”
FOLX is already being tested to see if it can provide transgender health care in states with restrictions. A recent law in Florida requires doctors to prescribe sex-affirming hormones for adults directly. Once the law went into effect, FOLX opened in-person clinics in five Florida cities, although it previously had no physical presence in the state. Then there was a surge in registrations from transgender people who no longer had access to their previous providers because they weren’t doctors or were telemedicine prescribers. This growth has offset the cost of opening in-person clinics, Steinle said.
“We don’t have to do this state by state, but if we have to, we will,” Steinle said. “We’re going to follow all the rules.” [restrictive] says. ”
Some healthcare providers are thinking differently about how to provide care in the next era.
“Collective resistance is the best solution,” said Crystal Beer, a physician and founder of QueerDoc, which provides telemedicine to gay men in 10 states. They hope the entire medical profession can come together to support gender-affirming care and resist bans on evidence-based care through civil disobedience. “Organized resistance allows individual advocates to make terrible decisions. It’s scary to break the law. It’s scary to risk losing your life, it’s scary to risk your way of paying your mortgage.” It’s scary too.”
A common refrain from those in the trans community who face discrimination is that transgender people have been around forever. That will not change even with the new administration.
“Since 1969, we have adapted and persevered through every shift in the political landscape to ensure our communities receive the life-saving and affirming care they deserve,” LGBTQ+ Community Health Center of New York said Patrick McGovern, CEO of Cullen Lord. said in a statement. “Our mission will not change with political winds.”
