A person who identifies as non-binary femme stands in a gender neutral bathroom.

A person who identifies as non-binary femme stands in a gender neutral bathroom.

Potential changes to the Affordable Care Act again made headlines last week. But it wasn’t about an individual mandate, or “if you like your plan you can keep it.” This change could affect 1.4 million Americans who identify as transgender.

In this case, the Trump administration proposed changes to Section 1557, which is the part of the ACA that bans discrimination on the basis of sex.

Previously, the Obama administration interpreted “sex” to mean gender identity. But the Trump administration would like to stop that practice, and go further, to state that assuming one’s gender identity based on sex is no longer discriminatory.

Here’s reporter Katelyn Burns, writing for The Washington Post’s Perspective about the potential impact of this change:

This administration has attacked the trans community constantly in President Trump’s two years in office: the military ban, rolling back trans student protections, the trans erasure memo, new trans prison regulations, even last week’s Housing and Urban Development rule regarding trans homeless people. But this proposal is the most sweeping and devastating of them all. It also essentially completes the Trump administration’s attempt to undo legal gains we had made: As ThinkProgress reported Friday, nearly all of the political advances trans people made under President Barack Obama are now gone. Suddenly, it’s 2008 again for trans people here.

These proposals follow the development of “conscience” rules that allow healthcare providers to refuse care to people due to religious beliefs. There are also exemptions to Title IX that allow some religious universities to discriminate based on sex.

Writing for ThinkProgress, Zack Ford analyzed the results of these policy changes and concluded, “In so many of these attacks, the changes have been based entirely on nonsensically interpreting the word ‘sex’ in a way that completely erases transgender people’s lived experiences.”

How have trans people been affected by the Trump administration?

Produced by Morgan Givens.


  • Liz Coston Instructor, Virginia Commonwealth University; @lizcoston
  • J Mase III Poet; educator; author, "And Then I Got Fired: One Transqueer's Reflections on Grief, Unemployment & Inappropriate Jokes About Death"; co-editor "The Black Trans Prayer Book"; @jmaseiii
  • Dean Spade Associate professor, Seattle University School of Law; author, "Normal Life: Administrative Violence, Critical Trans Politics and the Limits of Law", founder, Sylvia Rivera Project @deanspade
  • Susan Stryker Professor, Gender and Women's Studies, University of Arizona; author, "Transgender History: The Roots of Today's Revolution"

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