Healthcare disparities in the Transgender community

by Navya Chamijaru

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Transgender people have faced a long road of injustice in hopes of feeling equal to others. But, this discrimination and injustice is not only seen through hate crimes and dirty looks; it is also prevelant in the healthcare system. Different states have placed different policies into action to prevent discrimination against transgender people within healthcare. For example, The Health Insurance Portability and Accountability Act (HIPAA) further protects the privacy of patients including a person from a minority background, such as people of the transgender community. Even with such measures taken, many transgender people feel magranilized when they reach out for care. Medical care coverage linking the care to transition is not covered under most policies, and due to work-related and other discrimination, transgender people are statistically more likely to find themselves without coverage (2). As a result, one in five transgender people postpones getting healthcare every year (6). One June 12, Section 1557 of the Affordable Care Act, which prohibited discriminaton based on race, color, nationality, sex, disbaility, or age for healthcare, was rewritten by the Trump administration. June was not only pride month but the 12th of June also marked the anniversary of the mass shooting at The Pulse, a gay bar in Florida. However, just a few days after the announcement from the administration, the Supreme Court ruled trans people were protected from employment discrimation. The movement towards equality for trans people seemed to be gaining a lot of momentum and achieving more equality. However, there are times like this when the movement takes one step backwards and the progress is questioned.

This new issue only adds to the already discriminatory and poor healthcare most transgender people in the United States recieve. In 2016, healthcare providers and insurance companies that received government funding were required to provide the same services, coverage, and care for everyone. However, 75% of transgender people reported needing to educate their healthcare providers on LGBTQ-specific health needs and still felt discriminated against (4). Healthcare visits are causes of distress to many trans people and can create or worsen mental health issues. With the protections of  Section 1557 revoked for trans people, they may feel more discrimination, which would lead to a greater avoidcance of healthcare. This means more unmet medical concerns (5). With trans people being an already more at-risk group, and in the light of the COVID-19 pandemic, the situation becomes more complicated and dangerous. The action taken by the Trump administration will make it more difficult for trans people to not only receive general healthcare but also be tested and treated for COVID. The timing of this rule is devastating as this could lead to many members of an at-risk group falling ill and potentially dying for no reason. 

Even before the pandemic, there were around 1.7 million trans people in the United States alone that faced significant hardships that resulted in receiving poor healthcare. Around 39 percent of the trans community reported earning less that $30,000 a year, which contributes to the gap in healthcare services (3). Outside of healthcare, many people from the trans community, especially people of color, face discrimination in the workplace, abuse and harassment by the police and general citizenry, and assault. The benefits of a good healthcare system and equal access could help relieve the stress and harm different environments cause trans people. Unfortunately, many trans people report that the hospital only adds to their general distress. Insurance companies also play a big role in providing a poor healthcare experience for trans people. One in four trans adults is uninsured and almost half skip healthcare services because of the expenses. Even the ones who are insured now do not have a gurantee of being treated or treated with the same quality as their cis counterparts. 

Transgender people are discriminated against and treated differently for the sole reason of being transgender.. Even with multiple policies designed to protect trans people, they are becoming more marginalized in the healthcare system due to these policies not being fully effective in practice. The H.Res.960 resolution Introduced in 2018 to the 115th congress expressed support of HIV pre-exposure research, education, and usage. This also addresses the barriers to receive treatment, especially for racial and gender minority communities. However, many trans people are still too scared to or unable to afford the healthcare services they are in such dire need of, such as HIV treatment, COVID-19 testing, and general health concerns. The issue of discrimation in the healthcare system has become amplified due to the action of the Trump administration, the Black Lives Matters Movement, and the COVID-19 pandemic. It is becoming disgustingly easier for providers to refuse treatment to trans people, especially people of color. This is due to the fact that the Affordable Care Act and other policies that protect the rights of minorities have been revoked or the enforcement of said policies has been lax. And it is becoming harder for trans people to take the necessary precautions to ensure their own safety. This is all due to the fact that their gender identity is different from the majority. The decision recently passed by the Supreme Court was a win for the LGBTQI+ movement and a step in the right direction. However, it is repulsive to see how many national decisions and even local ones push the movement back and reverse all the progress so many people fought so hard for. This movement is a push and give, but the healthcare system in the United States and the revision of the Affordable Care Act was too much to give and is putting a lot of Transgender people at-risk.