During the current COVID-19 pandemic, the Trump administration is continuing its campaign undermine transgender people of vital protections. The latest attack takes the form of an expected rewrite by the Department of Health and Human Services of Section 1557 of the Affordable Care Act, which protects trans people from discrimination in health care on the basis of sex.
The rule’s rewrite has been a long time in the making. In May 2019, HHS proposed allowing health care workers permission to deny care to LGBTQ patients for religious or moral reasons. A few months later, a 2019 ruling by a federal judge vacated protections for trans people that were present in Section 1557. Now, the HHS is looking to formally finalize this assault on the trans community.
With the rewrite, discrimination against trans people in health care would be legally permitted. In a survey conducted in 2017, 29 percent of trans people reported that a health care provider refused to see them due to their gender identity, and 12 percent reported being denied care related to gender transition services. Considering the level of discrimination that already exists, the revision of Section 1557 could potentially open up the floodgates of anti-trans medical bigotry across the country.
Capitalism and transphobia exacerbate pandemic
While this assault on trans rights is abhorrent and criminal under any circumstances, it is especially dangerous in the middle of the COVID-19 crisis. Trans people have higher rates of HIV and cancer than the general population–known risks for susceptibility to severe COVID-19 infection. On top of this, existing discrimination in health care makes trans people less likely to seek it out — even in dire circumstances.
At the same time, millions of people in the U.S. have lost their health insurance coverage in the wake of the pandemic, and trans people are undoubtedly among them. With loss of health insurance comes a potential loss of access to life-saving gender-affirming care like hormone replacement therapy. As such, many trans people will be placed in the dangerous situation of either stopping hormone therapy altogether, or being forced to illegally purchase hormones and self-administer them without proper medical supervision.
Anti-trans discrimination is systemic
LGBTQ people, and especially trans people, are at risk in other ways as well. Over 20 percent of LGBTQ adults live in poverty, with higher rates existing among people of color, women and trans people. Trans people face rampant housing discrimination, which places their access to secure shelter in jeopardy. In addition, a large number of the houseless population, especially youth, are LGBTQ, and are often not provided with access to shelters or other services. Without housing, sanitary supplies or the ability to physically distance, many poor and houseless trans people are facing serious threats to their safety.
Feminists and women’s organizations have sounded the alarm about the dangerous situation that many women are currently placed in, as stay-at-home orders leave them trapped with abusive partners. Trans women, of course, are certainly counted among these women, and many trans people in general have also been thrust into incredibly unsafe conditions. A recent Buzzfeed article highlighted trans college students who, due to the closure of schools across the country, have been thrown back into unsupportive home environments, forcing them to hide their trans identity or even halt their medical transition.
In prisons and jails across the country, we find trans people among those behind bars. In the 2015 U.S. Transgender Survey, nine percent of Black trans women and 12 percent of undocumented respondents reported having been incarcerated in the past year. Incarcerated trans people, in addition to facing the systemic violence of the criminal injustice system, are also subject to physical abuse, sexual assault, withholding of medical services and other inexcusable injustices because they are transgender.
Similarly, four percent of non-citizen respondents to the survey reported having been held in immigration detention facilities, where the majority of them experienced isolation or solitary confinement because they were trans. As COVID-19 ravages through jails, prisons and immigration detention centers across the country, the lives of our incarcerated and detained trans siblings are at exceptionally high-risk.
Broad right-wing offensive
In January, Liberation News reported on the wave of anti-trans bills that were introduced attacking trans youth’s access to health care. This right-wing offensive has only continued, both at home and abroad.
At the end of March, Idaho governor Brad Little signed into law two anti-trans bills. The first, HB 500, prevents trans youth from participating in sports as their true gender, while the second, HB 509, makes it impossible for trans people to amend their birth certificates to reflect their gender. Currently, the state is being sued over both of these laws.
The far right is waging war on trans people outside of United States, as well. On April 22, the United Kingdom’s Minister for Women and Equalities, Liz Truss, announced the UK’s plans to bar trans youth under the age of 18 from accessing gender-affirming care. Similarly, the far-right administration of Hungarian prime minister Viktor Orbán is pushing a bill that would end all legal recognition of trans people in Hungary by defining gender as “biological sex based on primary sex characteristics and chromosomes,” and banning trans people from amending their birth certificates.
Ruling class prioritizes bigotry
It is clear that the rewrite of Section 1557 of the Affordable Care Act is part of a broader war on trans people being waged by the far right. However, as COVID-19 continues to wreak havoc on communities across the United States, with tens of thousands of deaths already reported, it is only sensible to wonder why the Trump administration would prioritize a federal assault on trans rights at this time.
The ruling class has a long history of trying to divide the working class on lines of gender. Now, as the country is gripped by pandemic, the government has the opportunity to seize on the chaos and uncertainty by pushing their anti-trans agenda. This agenda, through denial of the basic rights of human dignity and respect, promises to further marginalize, terrorize and isolate trans people from their working-class siblings. In the middle of a crisis like the one we are facing, bigotry is one weapon in the arsenal of the elites to distract us from our real enemy: the capitalist ruling class.
Solidarity, not division!
The COVID-19 pandemic has revealed just who is essential to keeping our society running. It’s not the bankers, corporate executives, or other members of the ruling elite who are making sure the sick are taken care of, our grocery shelves are stocked or garbage is collected! Instead, it is the working class — the essential class — that makes the world run.
Trans people, of course, are an integral part of the working class. We are nurses and bus drivers, teachers and grocery store workers. We must recognize that when trans people are under attack, the working class is under attack. And we must fight back.
Our greatest strength lies in our solidarity. We need to not only defend our trans siblings from right-wing legislative assaults, but also build build the mass movement that can challenge capitalism, transphobia and all forms of bigotry at their core. We are the essential class, and together we can win our liberation.