Transphobic Health Care Providers Were Just Given an “Administrative Shield”

"Accessing quality health care is literally a matter of life and death for transgender Southerners," writes Ivy Gibson-Hill.

Across the South every year, transgender and nonbinary people face discrimination, harassment, and hostility when seeking health care, often struggling to find health service providers that will competently treat them with dignity and respect.

This disparity in adequate and safe health care has long been the reality for trans Southerners. But this month, new regulations from the Trump administration are seeking to underline that disparity in bold black paint and give discrimination a blanket thumbs-up.

One regulation grants workers in the health sector the ability to refuse care that may conflict with their religious or moral beliefs, opening the door to further discrimination against LGBTQ people and others. A separate proposed regulation removes language explicitly protecting transgender people from discrimination in health care programs and activities.

For so many trans people, discrimination in health care has been happening to us for as long as we have been out. According to the 2015 U.S. Transgender Survey, one-third of transgender people who saw a health care provider reported having at least one negative experience related to their trans identity. The idea that health service providers would cite their religious beliefs to discriminate against trans people is nothing new.

What is new in these new policies from the Trump administration, however, is that harassment and mistreatment are sanctioned with a legal stamp of approval. The policy will embolden more health care providers to treat trans people with derision and give them an ugly administrative shield to hide behind. It’s why we need to keep up our work toward changing hearts and minds—and helping health service providers become more welcoming and knowledgeable about trans Southerners’ unique needs.

That’s something we’re laser-focused on at the Campaign for Southern Equality. Throughout 2018 we traveled the South talking to dozens of trans folks about the barriers they face in accessing health care for the 2018 Trans Health Focus Group Project. Throughout, we heard stories that broke our hearts in small and large towns alike.


We heard from one participant whose doctor of over a decade told them that she would no longer provide care for them, simply because they are transgender. The patient had to sacrifice the quality of care that comes with having a long-standing relationship with a provider when they came out.

We heard from a young trans person whose pronouns were dismissed repeatedly and intentionally. They were passed from provider to provider within the practice they were referred to because the doctors didn’t want to work with them—just because they were trans. As a result, the injury they were being seen for never healed correctly, and today, they deal with chronic pain.

We heard a story from another participant who hurt their back so badly they could not physically move and had to go to the hospital. Once they arrived, they were left in the hallway while other people came and went from the rooms around them. Doctors and staff passed them by and completely ignored them while speaking surrounding patients. They were consistently misgendered by staff and were discharged without being treated for their injury.

We heard from a trans woman whose friend—their relationship so close she referred to her as her sister—was left unattended in the waiting area of an emergency room. Doctors and clinical staff were uneducated and uncomfortable treating trans people. She died in the waiting room that night.

Accessing quality health care is literally a matter of life and death for transgender Southerners. The Department of Health and Human Services knows that, but with this policy, it’s stating clearly that it’s choosing not to care. It’s saying that health workers’ religious beliefs are more important than patients’ well-being.


The policy exacerbates the need for trans Southerners to keep doing what we have been doing for years: Find ways to bridge the gap between the care that we need and that which is available right now in our communities.

For so many years, trans Southerners have been valiantly filling in these gaps, caring for each other when so few others would. The heroes in this story are the trans community leaders who no one knows. The ones who are bringing HIV testing to nightclubs. The ones who are bringing medical providers to Pride festivals. The ones who are empowering other trans folks in their communities to train more providers in culturally competent work.

These aren’t the folks who are grabbing the headlines today, but they should be. Today and every day. With this latest attack from the Trump administration, let’s not just celebrate these folks—let’s join them. Let’s fight for a country where all transgender people can access their basic human rights, including their right to health care without leaving their hometowns, no matter where they live.

Ivy Gibson-Hill (they/them/theirs or ze/hir/hirs pronouns) is the Director of Community Health Programs for the Campaign for Southern Equality and the Executive Director for Gender Benders.