MMichael Haller, a professor and chief of pediatric endocrinology at the University of Florida, has experience dealing with threats to gender-affirming medicine. He has represented the state of Florida and advocated for transgender youth. Prohibition of gender-affirming care The restrictions are for transgender people under 18, and the new restrictions for adults are subject to litigation.
In August, human rights campaign reported that 26 states have bans or policies on gender-affirming care for minors and that 39% of transgender youth live in states that have passed bans on gender-affirming care. .
Haller and other gender-affirming caregivers in states like Florida, which already live under restrictive laws, are currently unable to provide services like hormone therapy to transgender youth. I’m taking a strategy.
“We’re working to find ways for patients to travel to other states to receive treatment, and that’s what’s happening for many patients,” Haller said. “But sadly, many families and patients do not have the means to travel, making it illegal for them to receive medical care.”
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With President-elect Donald Trump poised to return to the White House, gender-affirming health care providers in states across the country are bracing for the impact.
“We are well aware that the incoming Congress and administration have a hostile view of the LGBTQ+ community, particularly towards gender-affirming care and the transgender and non-binary community,” Planned Parenthood Greater New York said. Wendy Stark, president and CEO of “Therefore, we recognize that, unfortunately, attacks on transgender and non-binary people and their access to basics such as livelihoods, health care, and toilets are likely to continue. ”
Here are the main ways gender-affirming health care workers are preparing for Trump’s second term in office.
Maintain focus and understanding of President Trump’s proposals
President Trump has made it clear that he intends to follow the lead of states that have restricted medical care for transgender people. On his official website he says: 20 point platformhis roadmap to “Make America Great Again” called Agenda 47 includes a plan to eliminate access to gender-affirming care for minors. phone His “plan to stop the chemical, physical, and emotional mutilation of young people.”
While some of the concepts in President Trump’s plan are vague, such as the call to “terminate all programs that promote the concept of sexual and gender transition at any age,” there are more specific and truer concepts. Some suggest policies that may be implemented in the future. End Medicaid and Medicare funding for gender-affirming care.
President Trump does not have the power to completely transition access to health care on his own.
“It’s important to understand that legislation like what we’ve seen in Tennessee and other states across the country is not something that can be done unilaterally by the executive branch of the federal government. That doesn’t mean it’s not.” The government cannot try to ban gender-affirming care for minors, and the president cannot unilaterally do so,” said Elizabeth Sepper, a health law professor at the University of Texas at Austin.
Still, President Trump’s nominee for Secretary of Health and Human Services, Robert F. Kennedy Jr., is likely to advance Trump’s plan if confirmed by the Senate. President Kennedy has garnered attention for his skeptical stance on vaccines, but he has also expressed opposition to gender-affirming care.
in a shared post on X President Kennedy said in May that he was “troubled” by practices that “disrupt young people from adolescence.”
“People with gender dysphoria or who wish to change their gender deserve compassion and respect, but these vital procedures should be deferred until adulthood,” he said. I’m writing. “We have to protect our children.”
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Importantly, puberty blockers Not just used Although it has been used with transgender children, it has also been used for decades in cisgender children and in children who go through puberty too early, or in some cases very early. It has been used.
Kate Redburn, an academic fellow at Columbia University Law School and co-director of the center’s Gender and Sexuality Law Center, said education about aspects of transgender health, including puberty blockers, is critical. I’m thinking.
“There is a critical lack of information about the health of trans people, and there is a need to broadly educate trans health care primary care providers and other professionals,” they say.
The “elephant in the room,” Sepper says, is the fate of Tennessee’s ban on gender reassignment care for minors.United States vs. Scumetti—The case was challenged in the Supreme Court earlier this month. The decision could have far-reaching implications as nearly half of U.S. states have enacted laws restricting access to various aspects of gender-affirming care, including hormones, puberty-blocking drugs, and surgery. Trump’s inauguration could change the impact on transgender people. people. With all the judges Apparently they don’t like being overthrown. Tennessee’s ban could pave the way for more states to enact such laws.
Initiatives for anti-discrimination laws
Beyond Medicaid and Medicare, Sepper also said President Trump could work through HHS to change Section 1557’s nondiscrimination regulations under the Affordable Care Act to include gender identity. It pointed out that there is, and this is something that the Biden administration has been working on implementing. At the beginning of this year.
In certain states, efforts to roll back antidiscrimination regulations are likely to encounter statewide opposition. Just in New York ballot initiative It enshrines anti-discrimination protections in the state constitution for a variety of people, including transgender community members.
Stark said the New York state family planning system is prepared to fight for these individual rights under the new Trump administration, especially since insurance and programs like Medicaid and Medicare are also partially state-funded. He said he is also aware of the inequalities that can occur from state to state. .
“This is just another example of people having access to something that they feel will protect them, but is actually dependent on having resources, and it’s a very unfair situation. ” she says.
And with less and less medical care available to transgender people in other states, it could further strain endocrinologists and resources in states like New York.
“Very few endocrinologists have the knowledge and experience to provide care for transgender people,” Haller says. “Eliminating access for transgender people living in states that make care illegal or impractical means that those people have to go somewhere else, leaving the waiting list for people in protected states. It’s going to take longer. This is a major logistical problem and it’s only going to get worse.”
But as we look for ways to prepare, there are ways health care workers can strengthen themselves. Haller said health care providers have a responsibility to push back as President Trump and his allies try to target transgender health care.
“Gender-affirming health care providers need to have a voice. They need to be active participants in the legislative process,” Haller said. “I didn’t go into medicine to be a lobbyist or a legal expert, but I almost had to be both to effectively protect my patients.”
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Stay the Course and Unite
Attacks on certain types of health care are not new to many health care providers, including Stark and Planned Parenthood; Reproductive rights. Stark plans to “keep going,” drawing on the abortion care strategy.
Redburn agrees. “In general, health care professionals are at this point in the process of listening to their patients, consulting with them, providing the best possible care, and making treatment as easy as possible. “We can and should continue to implement what I think is best practice and is considered necessary,” they say.
Sepper said this means ensuring that health care providers protect their patients, and that the Trump administration has moved to sue parents who try to help their children receive gender-affirming care. It also means refusing to become a member of the police system if the person does so.
“What providers can do, and obviously what they can do as a matter of system-wide policy, is that they don’t actually have to collect some of the information that they may be collecting,” Sepper said. I say. “There is certainly no need to provide medical facilities to police and law enforcement.”
For many healthcare providers, being prepared means reaching out to each other for assistance.
“The important thing for people to remember is that no matter how hard the government tries to make health care available, transgender people are not going anywhere,” Redburn says. “Transgender people were transitioning before anti-discrimination laws and medicine existed.”
