President-elect Donald Trump has made a pointed focus on transgender issues, particularly through harsh criticisms and characterizations of gender-affirming care. His campaign, alongside conservative groups, has invested tens of millions in anti-trans advertisements aimed at shaping public perception. During rallies and various campaign events, he denounced gender-affirming care for young transgender individuals, labeling it as “left-wing gender insanity” and “child abuse.” His statements included unfounded claims that children are undergoing gender-affirming surgeries within schools, highlighting a dramatic distortion of the reality surrounding healthcare for transgender youth.
As Trump prepares for a potential return to the White House, providers specializing in gender-affirming care are bracing for an administration that might significantly alter established, evidence-based standards of care for transgender populations.
Although the specifics of potential policies remain uncertain, Trump’s platform includes a commitment to eliminate all federal funding for gender-affirming care and proposes penalties for healthcare institutions that administer such care to minors through Medicare and Medicaid. Furthermore, Trump has indicated his intention to seek Congressional support for legislation that would legally recognize only two genders—male and female—as assigned at birth, disregarding the complexities of gender identity.
“I think we have to take the Trump administration’s platform at its word,” remarked Meredithe McNamara, an assistant professor of pediatrics at Yale University and a practitioner at a community health center. “It’s a professional responsibility to be incredibly realistic about what it’s going to look like if our patients are continually put in political crosshairs.”
On the morning following the election, McNamara began to receive an influx of messages from young patients expressing concern regarding their access to essential care for gender incongruence. The Trevor Project, a crucial suicide prevention organization for LGBTQ+ youth, reported that inquiries to its crisis line surged nearly 700% the day after the election compared to the weeks prior. Many individuals in crisis explicitly connected their distress to the election outcomes.
FOLX, a dedicated telehealth platform serving queer individuals, documented a staggering 75% increase in communication with its care team following the election as users sought information regarding prescription refills and expressed anxiety about ongoing access to care. In addition, the platform noted a 115% rise in community engagement messages.
Prior to Trump’s anticipated inauguration in January, healthcare providers and hospital systems are advised to revise patient privacy policies, enhance medical legal education, and collaborate with legal experts who are proficient in navigating the intricacies of care bans. McNamara emphasized the importance of vigilance even in states known for progressive stances, illustrating that providers should not assume uninterrupted service. Some states have enacted “shield laws” intended to protect both patients and practitioners from repercussions inflicted by more restrictive jurisdictions. Nevertheless, McNamara cautioned that the strength of such laws has yet to be tested in the courts.
“Very solid blue states are not going anywhere,” stated Kate Steinle, FOLX’s chief clinical officer. “They’re going to fight even harder.”
“We don’t want to have to do this state by state, but we will if we need to,” Steinle affirmed. “We are going to follow all the rules in [restrictive] states.”
Some healthcare providers are reevaluating their approaches to delivering care amidst these changing dynamics.
“Collective resistance is the best solution,” advocated Crystal Beal, a physician and founder of QueerDoc, which offers telemedicine services in ten states. They expressed hope that the medical community would unite to uphold gender-affirming care standards and challenge bans on evidence-based healthcare through civil disobedience. “Organized resistance is what allows individual support to make a scary decision. It is scary to break a law. It’s scary to risk losing your life, and it’s scary to jeopardize how you pay your mortgage.”
A widely acknowledged sentiment among transgender communities facing discrimination is that transgender individuals have existed throughout history. That reality remains unchanged regardless of political shifts.
“Since 1969, we have adapted and persevered through every shift in the political landscape to ensure our communities receive the life-saving, affirming care they deserve,” asserted Patrick McGovern, the CEO of Callen-Lorde, an LGBTQ+ community health center based in New York. “Our mission does not change with the political winds.”
**Interview: The Impact of Trump’s Election on Transgender Rights and Healthcare Access**
**Interviewer:** Welcome, Dr. Meredithe McNamara, assistant professor of pediatrics at Yale University and a provider of gender-affirming care. Thank you for joining us today.
**Dr. McNamara:** Thank you for having me. It’s a critical time to discuss these issues.
**Interviewer:** Following Donald Trump’s election, many in the transgender community are expressing concerns about their healthcare access. Can you elaborate on what specific changes to care might be expected under his administration?
**Dr. McNamara:** Certainly. Trump has made it clear that he intends to eliminate federal funding for gender-affirming care and impose penalties on healthcare institutions that provide such care to minors. If these policies come to fruition, they would dramatically affect access to essential healthcare services for transgender youth.
**Interviewer:** You’ve mentioned that your clinic has received an influx of messages from patients since the election. What are some of the concerns that young patients are expressing?
**Dr. McNamara:** Yes, we began receiving messages almost immediately. Many patients are anxious about their ongoing access to hormone therapy and other support services. They are worried that they won’t be able to continue the care they need, and it’s deeply distressing for them. The day after the election, we witnessed a stark rise in anxiety and concerns about access, both from our patients and from organizations like The Trevor Project.
**Interviewer:** It’s alarming to hear about the 700% increase in inquiries to The Trevor Project. How do you think healthcare providers should prepare for potential policy changes that could impact transgender care?
**Dr. McNamara:** Providers need to take proactive steps. This involves revising patient privacy policies, increasing legal education about potential changes in care laws, and collaborating with legal experts in this area. We cannot assume that progressive states will remain unaffected, as we’ve seen varying levels of risk and resistance across the country.
**Interviewer:** What’s your message to the transgender community at this time?
**Dr. McNamara:** I want the community to know that they are not alone in this fight. It’s crucial for us all to remain vigilant and take collective action to advocate for equal rights and access to care. Healthcare providers are committed to protecting and supporting our patients, regardless of the political climate.
**Interviewer:** Thank you, Dr. McNamara, for your insights and for your dedication to your patients. This is a critical moment, and we appreciate you shedding light on the issues facing the transgender community.
**Dr. McNamara:** Thank you for having me. Staying informed and advocating together is essential for protecting the rights and well-being of all individuals.