Since Donald Trump assumed the office of the presidency in January of 2017, his administration has issued a dizzying list of harmful policies and legal maneuvers against transgender Americans, spanning the realms of education, housing and healthcare. The administration’s earliest move, in February 2017, was to withdraw a 2016 set of guidelines from the Departments of Education and Justice regarding how schools were obligated to protect transgender students under Title IX regulations.
In the remainder of 2017 alone, policies seeking to prevent healthcare discrimination against transgender individuals were rolled back by the Department of Health and Human Services, the Centers for Disease Control and Prevention was instructed to stop using the word “transgender” in official documents and Trump directed the Defense Department to begin discharging transgender service members.
More recently, the Bureau of Prisons adopted a policy of housing transgender individuals in federal prisons designated for the sex they were assigned at birth rather than their gender identity, the Department of Health and Human Services’ Office of Civil Rights granted permission to adoption agencies to discriminate against LGBTQ caregivers and the Department of Housing and Urban Development announced a future rollback of non-discrimination policies designed to protect transgender individuals in HUD-funded homeless shelters.
Of the various discriminatory actions taken against transgender people by the Trump administration, issues involving housing, incarceration and healthcare are likely to cause the most widespread and pernicious difficulties for transgender Americans. According to the National Center for Transgender Equality, “one in five transgender individuals have experienced homelessness at some point in their lives.”
The disproportionate representation of transgender individuals within the homeless population adds an extra level of injury to the Department of Housing and Urban Development’s recently announced plan to modify the Obama administration’s 2016 Equal Access Rule, which required homeless shelters to allow individuals to enter sex-segregated facilities based on their gender identity rather than the sex they were assigned at birth. Given that transgender women of color in particular are disproportionately likely to experience violence at the hands of men, forcing them to stay in “male-designated” facilities will certainly expose them to even greater threat of bodily harm. The Bureau of Prisons’ policy to house prisoners in facilities designated for the sex they were assigned at birth poses a similar problem.
Although the Department of Health and Humans Services’ repeal of healthcare discrimination is often pitched as a way to prevent healthcare professionals who oppose transgender identity on religious grounds from being forced to provide hormone therapy and gender-affirmative surgery, in practice the new guidelines will allow healthcare providers to deny any sort of medical care to transgender patients based on their identity alone. Of course, healthcare discrimination against transgender patients was not solved or eradicated by the Obama administration’s issuing of non-discrimination policies, and denial of care or hostile treatment by healthcare providers is a common occurrence for many transgender people across the country. However, as Ames Simmons, director of Trans Policy at the statewide LGBTQ advocacy organization Equality North Carolina, explains, “the threat of anti-trans discrimination in healthcare, while nothing new, might bring up fears of losing access to hormone replacement therapy and the gender dysphoria that could result.” While the administration’s explicit repeal of these protections is sobering, transgender North Carolinians should know that North Carolina Medicaid still currently covers transgender-related healthcare for individuals able to attain medical documentation from their healthcare providers attesting to the medical necessity of this care, and many low-income transgender residents may be eligible for Medicaid. Simmons encourages all Medicare recipients to pay extra attention at this time to mail they receive from Medicaid, as policies will be changing beginning in the Fall.
Of course, there has been considerable legal resistance to the Trump administration’s anti-trans actions on the national level, although the most prominent cases tend to deal with military and educational discrimination rather than housing, healthcare, and incarceration. A ruling is imminent in a case opposing the ban on transgender service members led by Lambda Legal in the 9th Circuit Court of Appeals, and the American Civil Liberties Union will soon begin defending an Oregon school district’s right to retain its long-standing transgender-affirming bathroom policies, also in the 9th Circuit.
On the state level, two recent judicial and legislative developments are cause for optimism about the treatment of transgender individuals in North Carolina. On June 3, Gov. Roy Cooper and a coalition of LGBTQ activists submitted a consent decree to the U.S. District Court in the Middle District of North Carolina that seeks judicial confirmation that House Bill 142, the successor to the HB2 “bathroom bill,” should not be interpreted as prohibiting transgender individuals from using public facilities that align with their gender identity. Additionally, the current state legislative session includes the first ever bill introduced in North Carolina that would ban conversion therapy for children and vulnerable adults.
Perhaps even more important than judicial and legislative attempts to remedy harmful anti-transgender legislation and executive action are the on-the-ground efforts by and for transgender North Carolinians taking place across the state. As Simmons states, “Community-based solutions to end violence and get resources to the transgender community are everywhere in our state, because transgender people are everywhere in our state.” For transgender North Carolinians looking to protect and educate themselves during this time, Simmons recommends a number of organizations and resources, including the Campaign for Southern Equality’s “Trans in the South” guide for an overview of medical and legal resources, transhealthnc.com for a directory of transgender-friendly healthcare providers throughout the state and, for immediate crisis assistance, the Trans Lifeline at 877-565-8860. Transgender Charlotteans can view a directory of transgender-friendly healthcare providers in the city through the Charlotte Transgender Healthcare Group at cthcg.org, learn about available support groups at transcendcharlotte.com and, for youth between the ages of 11-20, access a variety of resources through the Time Out Youth Center.
Although it can be tempting to feel disheartened at the defeated by the violence directed at transgender people by the government, anti-LGBTQ organizations, and even our friends and peers, transgender North Carolinians should know that many people across the state are fighting for their safety and well-being. Despite the dizzying amount of hostility towards transgender people emanating from the executive, national legislative and state legislative branches, transgender North Carolinians have many options for defying anti-trans advocates’ attempts to deny them the care and safety they deserve. As Simmons states, “The resistance is alive and well in North Carolina.”