Trans Healthcare Bans Now Target Adults

As most trans activists and advocates feared, the passing of several state laws banning trans healthcare access to minors is now being expanded to restrict adult access as well. Bills being introduced in Florida, Texas, and Tennessee aim to prohibit insurance providers, even private ones, from covering “gender clinical care.” While other states have begun proposing that trans health care be restricted to those under 21, instead of 18.

Throughout this article, I will be referring to any gender-affirming care provided to trans individuals as “trans healthcare” including hormone blockers, hormone replacement therapy, and gender-affirming surgeries. I will use this language instead of “gender-affirming healthcare,” as these bans specifically target trans people seeking medical procedures and treatment, and do not explicitly block cis-gender people from receiving the same care. Cis-gender people have and do elect to receive hormone therapy, and gender-affirming surgeries for a variety of reasons. All of the legislation talked about within this article specifically blocks transgender individuals from receiving this type of health care.

Florida HB1421 targets insurance providers, effectively prohibiting them from covering trans health care services. “A health insurance policy may not provide coverage for gender clinical interventions,” the bill states. Florida previously introduced legislation that would require businesses that do cover trans health care to also cover de-transition services. A 2015 study found that only 8% of transgender individuals de-transition, and of those 62% reported that they only did so temporarily due to societal and family pressure.

The Florida bill resembles a newly passed law in South Dakota; both include a clause that requires medical providers to “gradually discontinue” trans health care for minors, forcing the state’s trans youth to de-transition. Though there hasn’t been much research on the mental health effects of forced de-transition, one could infer that the experience would be quite traumatic. Every major medical institution suggests that providing trans youth with gender-affirming health care is critical, and has shown positive linear effects on depression and suicidal ideation.

Tennessee HB1215 is similarly targeting insurance providers from covering trans health care. Depending on the person, trans health care can cost thousands of dollars out of pocket. Transgender people are significantly more likely to be unemployed, have lower household incomes, and experience higher rates of poverty than their cis-gender counterparts. Laws prohibiting insurance providers from covering trans health care would restrict access to essential health care for a majority of transgender individuals within those states. 

Other states are looking to ban access to trans health care for adults outright. Oklahoma and Texas have both proposed bills that would prohibit medical professionals from providing trans health care to individuals under the age of 26. Kansas and South Carolina have proposed bills that would restrict access to those under 21.

“They are trying to bring about conditions that will result in the mass loss of life and inability to participate in public life among transgender people,” transgender writer and activist Erin Reed told VICE News last year.

Make no mistake, the current anti-trans legislation being passed at the state level is indicative of the early stages of state-sanctioned genocide. According to the UN Genocide Convention, there are five main acts of genocide:

1. Killing members of the group.
2.  Causing serious bodily or mental harm to members of the group.
3. Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part.
4. Imposing measures intended to prevent births within the group.
5. Forcibly transferring children of the group to another group.

Currently, various state governments are participating in all but the first of these acts by restricting access to life-saving care, forcing hysterectomies and other sterilization procedures on trans people who seek gender-affirming care, and most recently, enacting legislation that would separate trans youth from accepting parents or guardians.

“We shouldn’t have to reach the point of literal gas chambers to call out the genocide happening in front of our very eyes,” trans writer and activist Alex Mell-Taylor wrote in an article published in Prism & Pen.

“We are already in the middle of a movement to exterminate the trans community. The question is how bad things will get. Nothing is ever an inevitability. We do not have to accept the calls of death we are hearing… We, however, must first recognize that this is what the road to trans genocide looks like, and it’s paved with ‘calls for safety,’ ‘decency,’ and ‘the common good.’”