For the last few years, the GOP has coalesced around an idea that would short-circuit essentially all trans health care in America: banning federal funds from going to businesses that provide health care specific to changing one’s sex or gender identity, including hormones and surgeries. It would essentially signal to the private sector that if it wants federal dollars, it needs to stay away from sex- or gender-affirming care, and bow down to right-wing pundits who aim to, in their own words, “eradicate” and “erase” this form of health care.
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Bans like these can lead to the private sector discontinuing behaviors altogether — and once they are in place, they are hard to get rid of: The Hyde Amendment, enacted in the 1970s, led to most abortions no longer being performed in hospitals, and is continually renewed each year.
Medical groups and civil rights advocates in D.C. tell Rolling Stone they believe that if a Hyde-level ban on federal funding were enacted, many hospitals will simply prioritize federal dollars over continuing this highly specialized form of medical care. So much medicine is performed through hospital systems and universities that this could mean ending access for many.
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“I think if they had to make the choice of, ‘Do we provide this care and potentially have to close our doors to everybody,’ they probably won’t do it,” says Asa Radix, head of the World Professional Association for Transgender Health. “It’s very disturbing. Legislation like this — even if it hasn’t passed — creates an environment where people are incredibly afraid. This is the type of issue where people actually feel suicidal. Are we going to see folks dying by suicide because potentially of laws like this being passed?”
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Right now many in the LGBTQ+ advocacy community, as well as some Democratic lawmakers and staff, are quietly terrified the party might let Republicans enact it anyway, should they be forced to choose between funding the government or allowing the medical system to continue to provide this care unabated.
At a minimum, anxious Democrats and advocates believe that party leaders will capitulate on trans health care coverage in federal funding negotiations on the margins, allowing language that bans government-backed insurance plans from covering these services.
This conflict is actually playing out before Trump has taken office or the GOP controls the Senate. Democrats just this week compromised on a military authorization bill that will ban TRICARE and other Defense Department health plans from covering care for servicemembers’ trans children.