Though there have been recent gains in support for transgender Americans, including several welcome initiatives by the Biden-Harris administration, there has also been increased anti-LGBTQ legislation, with 2021 setting a record as the worst year in recent history for anti-LGBTQ legislation at the state level. Some of this legislation specifically targets gender-affirming health care, such as a ban in Arkansas against treatment for young people (which has since been blocked by a federal court). Such laws that codify discrimination have a devastating impact on the health of the transgender community and on efforts to end HIV.
Additionally, there has been a continued rise in violence against people of transgender experience. Human Rights Campaign (HRC) recorded 44 deaths of transgender and gender non-conforming (TGNC) people in 2020, more than any year since the organization began tracking this violence in 2013.
Transgender Awareness Week, which helps raise the visibility of TGNC people and address the issues faced by the community, takes place between Saturday, November 13 and Friday, November 19. The week ends with Transgender Day of Remembrance on Saturday, November 20, an observance of lives lost in acts of anti-transgender violence.
The Importance of Gender-Affirming Care
Transgender Americans experience many health disparities, including higher rates of HIV, with transgender women estimated to be 49 times more likely to be living with HIV compared with the general population. Because of discrimination and other socioeconomic factors, transgender people don’t always receive quality health services. Many transgender patients report having to educate their medical providers about transgender health issues, including awareness about post-operative care. And nearly one-third report having been harassed in a doctor’s office. As a result, transgender people are more likely to avoid health care altogether. We are actively working to change this reality.
Amida Care is breaking new ground in our efforts to help New Yorkers as they transition to become their fullest selves; 20% of our members are transgender. Amida Care’s model of care works to address non-medical needs that impact health, such as stable housing, nutritious food, unemployment, and transportation. Each member of our health plan is surrounded by an integrated care team of providers, social workers, health navigators, behavioral health specialists, and a designated health home, which work together to address the needs of the whole person.
Medicaid Special Needs Health Plans like Amida Care help TGNC New Yorkers access the gender-affirming health care they need. It’s vitally important to create a comprehensive plan within Medicaid to address and adequately fund gender-affirming care, which will help the transgender community live their best lives Studies have shown that gender-affirming surgery among transgender people living with HIV is associated with achieving viral suppression. Of Amida Care’s transgender members living with HIV, 94% are virally suppressed, and Amida Care has connected 25% of our HIV-negative transgender members to highly effective HIV prevention tools like pre-exposure prophylaxis (PrEP). To date, 1,100 of Amida Care’s transgender members, most of whom are people of color, have had gender-affirming surgeries.
Watch this video featuring Amida Care members who are transgender discussing their experience:
Fighting Against Transgender Violence and Discrimination
Just as concerning is the continuing rise in violence against TGNC people, mainly women of color, much of it gun-related. According to a 2020 report from HRC, Everytown for Gun Safety Support Fund, Giffords Law Center and Equality Florida, “Remembering and Honoring Pulse: Anti-LGBTQ Bias and Guns Are Taking Lives of Countless LGBTQ People,” there has been a marked increase in anti-LGBTQ hate crimes, especially against transgender people. According to the 2017-2019 Transgender Homicide Tracker, three-fourths of confirmed homicides against transgender people have involved a gun, and nearly eight in 10 homicides of Black trans women involve a gun.
To help counteract these terrible trends, we must ask elected officials at the local, state and federal levels to reject harmful anti-transgender legislation, which can trigger acts of violence. Fatal violence disproportionately affects transgender women of color, especially Black transgender women, the result of a deadly intersection of racism, transphobia, and sexism. We must work together to reject hate and stigma.
To this end, HRC has launched the “Count Me In” campaign, which encourages everyone—both LGBTQ people and their allies—to get loud, get visible and spread awareness on behalf of TGNC people. The more people who show they care, the more hearts and minds will be changed.
For more information about HRC’s transgender justice work, visit hrc.org/transgender
Amida Care’s Guide to Transgender Resources and Services in NYC
Amida Care’s Breaking Barriers to Transgender Health Care