
Transgender patients and their health providers fear worsening discrimination
Kelly Houske was walking her dogs one morning when she developed stabbing pain in her back that brought her to her knees. Houske, who had survived her first heart attack only a year earlier, was worried she was experiencing a second.
When Houske arrived at a local emergency room by ambulance, she hoped for compassionate treatment. Instead, her doctor appeared cold and kept his distance, standing in the doorway without ever entering her room, Houske said.
An imaging technician ignored how much pain she was suffering and shouted at her, Houske said. Rather than help her out of the scanner, the technician barked at her to climb out of the machine herself.
'I was in so much pain I could hardly move,' said Houske, 67, whose back pain was later found to be caused by kidney stones. The technician 'kept saying, 'Come on, come on, come on,'' she recalled. 'He didn't offer to help.'
When Houske tried to stand on her own, she crumpled to the ground.
The tech stood over her impatiently, Houske said, but didn't help her off the floor. 'Eventually, someone else came into the room and helped me get up,' she said.
The 2017 encounter at a Tennessee hospital was one of many instances in which Houske, who is transgender, said she has been mistreated by a health care provider. Surveys show that mistreatment of trans patients is common — including verbal harassment or refusal of care — sometimes leading them to delay or avoid seeking care.
Many advocates for transgender people say they fear treatment of trans patients will suffer further under President Donald Trump, who has issued a slew of executive orders in recent weeks restricting transgender rights, including several that seek to limit access to transition-related health care.
In a report published in Psychiatric News last month, physicians who work with transgender patients said the executive orders have led to widespread distress among their trans patients.
And according to a report released last month from the UCLA School of Law's Williams Institute, an LGBTQ think tank, almost three-quarters of trans patients surveyed after the presidential election said they are concerned that the quality of their health care will decline under Trump. About 80% of respondents, who were surveyed before Trump took office, said they planned to make changes to their behavior, appearance or speech to downplay visibility as transgender people. One-third said they were socially isolating and avoiding public places and activities.
Shawn Reilly, a transgender community organizer in Nashville, Tennessee, said he is concerned that Trump will roll back protections for trans patients established by the Obama and Biden administrations. Reilly said they fear health providers will be allowed to withhold care from trans patients.
'Stripping transgender people and all sexual and gender minorities of protections while they are trying to access a basic human right — health care — is inhumane and unjust,' said Reilly, a former coordinator of the 'trans buddy' program at Vanderbilt University Medical Center in Nashville, which provides trained advocates to accompany transgender patients on medical visits.
Neither the Department of Health and Human Services nor the White House responded to requests for comment about the concerns of transgender people, along with their health care providers and advocates, about their treatment in health care settings.
Targeting transgender people
During his first term in office, Trump issued a policy that reversed an Obama-era nondiscrimination rule for transgender patients.
Although Trump hasn't yet issued a new rule on health care discrimination, a web page created by the Biden administration, which explained legal protections for transgender patients, is now blank.
Trump's actions in the first months of his second term have raised alarms, Reilly said.
In one of his first acts after he was inaugurated, Trump issued an executive order that denies legal recognition to transgender people. The order says that 'it is the policy of the United States to recognize two sexes, male and female. These sexes are not changeable.'
The word 'transgender' has disappeared from government websites, although some deleted web pages have been restored because of a court order. Trump has also canceled research grants for projects related to transgender health.
As part of the effort to fight what Trump calls 'gender ideology,' the Department of Veterans Affairs said last month that it will phase out coverage of gender transition care for veterans.
Through additional executive orders, Trump has tried to restrict access to gender-affirming care for transgender people under age 19, ban trans people from serving openly in the military, ban trans athletes from women's sports, require incarcerated trans women to be held in men's prisons and eliminate protections for trans students in elementary and secondary schools, such as allowing them to use the bathrooms of their choice.
Advocacy groups have challenged many of Trump's executive orders in court. Federal judges have issued temporary restraining orders on the gender-affirming care ban, the prison order and his ban on trans people enlisting or serving in the military.
Legal protections in flux
Legal protections for transgender patients are grounded in the Affordable Care Act, which bans discrimination in medical settings and health insurance based on race, color, national origin, age, disability and sex. People who have faced illegal discrimination can file complaints with the Department of Health and Human Services, which can withhold federal funds from institutions found to have violated the law.
Every president has interpreted the law differently, however. While Presidents Barack Obama and Joe Biden issued rules stating that the ban on sex discrimination also prohibits mistreatment based on sexual orientation or gender identity, Trump's first administration interpreted sex discrimination as applying only to 'the plain meaning of the word 'sex' as male or female and as determined by biology.'
Groups that disagree with those various interpretations have sued, leading judges to place sex discrimination rules issued by Obama, Biden and the first Trump administration on hold.
Anti-discrimination policies still exert powerful effects, said Elana Redfield, federal policy director at the UCLA School of Law's Williams Institute.
The Obama and Biden administrations' policies helped institute 'cultural norms requiring health providers to consider the needs of trans patients, even in places where state-level protections were not in existence yet,' Redfield said.
Trump could also cause harm by rolling back legal protections for transgender patients, Redfield said, because health care providers might feel emboldened to deny them care.
'If the federal government permits, or even condones, discrimination, it is likely that would galvanize those who already don't want to treat trans people,' Redfield said.
Without a federal rule protecting their rights, transgender patients could lose the ability to file complaints against health care providers with the Department of Health and Human Services. They could still sue health care providers or insurance companies in court, but that process is 'much more burdensome' than filing complaints with the federal health agency, Redfield said.
A small number of transgender patients have successfully sued health care providers for discrimination based on the language in the ACA, said David Stacy, vice president of government affairs for the Human Rights Campaign, which advocates for LGBTQ rights.
'It is crucial that we continue to protect transgender patients, who already face immense obstacles when accessing care,' Stacy said. 'Our leaders should be committed to ensuring that everyone can get the health care they need safely and without the fear of being mistreated.'
Some states, such as California, have their own laws protecting transgender patients from discrimination, Redfield said.
But others are already following Trump's example in restricting or trying to restrict the general rights of transgender people. In late February, Iowa struck gender identity from the state's civil rights law, making it the first state to remove civil rights from a previously protected class.
About 0.6% of U.S. adults identify as transgender, according to the Pew Research Center. Transgender patients suffer from worse physical and mental health than other patients and are less likely to have health insurance.
Houske said she can understand why some trans patients delay or avoid care.
'It's a lot of work emotionally' to see a doctor, Houske said. 'If you're doubting yourself at all, it's really hard. It's going to cause you not to seek the care you really need.'
Threats to educational efforts at hospitals
Houske said she sometimes tries to break the ice with new doctors by asking whether she is the first transgender person they have treated.
'I just try to address the elephant in the room,' said Houske, who now lives in Ohio.
Dr. Alison Haddock, president of the American College of Emergency Physicians, said health professionals should 'deliver maximally compassionate care' to all patients, including those who are transgender.
'It is absolutely foundational to emergency medicine that our door is open to anyone,' Haddock said. 'We need to make sure that we are always delivering care that is consistent with that ethos.'
Some medical schools and professional societies, such as the American College of Emergency Physicians, offer training in the health needs of LGBTQ patients, Haddock said.
'I can attest to this being a much stronger part of the curriculum than when I was in medical school,' said Haddock, who is also a dean at Washington State University's medical school.
Yet critics say medical schools aren't adequately educating the next generation of doctors to care for LGBTQ patients. Many practicing doctors say they have had little training in transgender health issues and feel unprepared to treat trans patients.. Of all the state-level medical boards in the country, only the District of Columbia's requires doctors to receive continuing education in treating LGBTQ patients, according to the Federation of State Medical Boards.
And while the American Medical Association and the American Society for Health Care Risk Management offer educational courses about LGBTQ health and reducing bias, some health care leaders say other efforts could be throttled by Trump's campaign against diversity, equity and inclusion, or DEI. Many universities and private companies, for example, are ending DEI programs for fear of losing funding or contracts.
'The political environment is making it really difficult' to include sexual orientation and gender identity in medical school courses, said Dr. Atul Grover, executive director of the Association of American Medical College's Research and Action Institute.
'We have lawmakers at the state and federal level who are convinced that incorporating the concepts of inclusion, health equity and diversity is taking away from the scientific content of what we're teaching,' Grover said. 'But it does not. These concepts aren't mutually exclusive.'

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles


The Independent
6 hours ago
- The Independent
RFK Jr reveals his plan for vaccine committee after he fired entire panel sparking ‘anti-vaxxers' concern
Health and Human Services Secretary Robert F. Kennedy Jr. has revealed that he doesn't plan on placing 'anti-vaxxers' on a federal vaccine policy advisory committee after removing all its previous members, sparking concerns about who he may appoint next. 'None of these individuals will be ideological anti-vaxxers,' Kennedy wrote in a long post on X. 'They will be highly credentialed physicians and scientists who will make extremely consequential public health determinations by applying evidence- based decision-making with objectivity and common sense.' The Advisory Committee on Immunization Practices (ACIP) makes recommendations on the use of vaccines to the Centers for Disease Control and Prevention (CDC). Kennedy said he would announce the new members of the panel in the coming days and that they will be in place before the committee's next meeting, set for June 25. The X post came about a day after he removed all 17 members of the committee, signaling a dramatic change in American vaccine policy. Kennedy, who ran as a Democrat and then as an independent in the 2024 presidential election before dropping out and endorsing Trump, has become known as an anti-vaccine activist. He has made a number of false claims about the damage vaccines can do, such as the measles shot being connected to autism. The secretary claimed that removing all members of the panel was necessary to restore trust in vaccines as well as the CDC. Kennedy attempted to argue on Tuesday night that there had been 'historical corruption' at the committee. 'The most outrageous example of ACIP's malevolent malpractice has been its stubborn unwillingness to demand adequate safety trials before recommending new vaccines for our children,' Kennedy claimed. The secretary tried to connect childhood vaccines that 'modify the immune system' to an 'epidemic of autoimmune diseases' and suggested that vaccine makers don't test their vaccines for safety because they're not part of placebo-controlled trials. 'No one can scientifically ascertain whether these products are averting more problems than they are causing,' said Kennedy. Former CDC Director Dr. Tomas Frieden told PBS News, 'We're already seeing a decreased immunization rate.' 'When Secretary Kennedy says he wants to restore trust, the fact is that his activities over many years have been one of the main reasons there are questions about vaccines,' he added. Frieden argued that lower vaccination rates will lead to struggles to control measles, which he noted was eliminated in the U.S. in 2000. 'We're now having more cases and more deaths than we have had in many years, and whooping cough, which is increasing,' he said. The former CDC director told PBS News that Kennedy is 'undermining and stopping a process that has been transparent, effective, and fact-based, and replacing it with we don't know what, but based on untrue statements, misinformation, and, frankly, fringe beliefs.'


The Independent
6 hours ago
- The Independent
Speculation mounts that Trump is using a ‘hidden leg brace' in the wake of his Air Force One fall
People are speculating that President Donald Trump is using a 'hidden leg brace' following his stumble on the steps of Air Force One. The unsubstantiated claims are doing the rounds on social media, as users have zoomed in on images of the president's legs taken after the fall, which occurred Sunday as Trump was walking up the stairs to board the plane. Steven Cheung, White House communications director, dismissed the claims as 'conspiracy theories peddled by demented individuals hiding behind social media' in a statement to The Independent. ' The President has been the most transparent president in history, and the recent medical report that was released clearly and unequivocally shows he is in peak condition,' Cheung said. People on social media commented on what appeared to be markings on the president's pants. 'Trump is not well. His fall on Air Force One, his braces on his both legs under his knees, show signs of a very sick man,' one post that had reached more than 17,000 people said on X, without evidence. A prominent account 'dedicated to exposing right-wing extremism' shared close-ups of the president's legs in the Rose Garden on June 9, a day after the stumble. 'What's going on here?' the poster asked, sharing pictures of what appear to be bulges on Trump's legs. The photos were taken when Trump was surveying the construction project on the South Lawn. 'Trump isn't stable enough to walk on the thick grass. He needs a flat surface. Leg braces and no one is asking him directly,' another person reacted. Photographs taken from the same scene show the president walking back to the White House on the grass. Others speculated that the supposed markings on Trump's pants suggested he is wearing a Foley catheter. 'Fidel Castro used to wear this leg catheter to be able to give his hours long speeches,' another person reacted. 'It's a politician thing.' The group Republicans Against Trump shared a photo on X of the president at Saturday's UFC 316 in New Jersey. 'Is Donald Trump wearing a Foley catheter?' the account asked its 900,000-odd followers. The White House dismissed the claims as 'fake news.' 'These conspiracy theories peddled by demented individuals hiding behind social media, and now being given a platform by the fake news, clearly suffer from a debilitating case of Trump Derangement Syndrome,' Cheung said in a statement. 'These are the same people who have been caught trying to gaslight the American people for years by saying Joe Biden was cognitively fine, when in fact, he was in much worse condition than thought.' Speculation over the president's health comes following his own scrutiny of former President Joe Biden. Following his slip-up on the steps of Air Force One, where Secretary of State Marco Rubio also lost his footing, it was noted that Trump frequently mocked Biden for the stumbles he took during his time in office. In the summer of 2023, Trump mocked Biden for falling at the Air Force graduation ceremony in Colorado. He said it was 'not inspiring' for the graduates to have seen the then-president take a tumble over a sandbag.


NBC News
13 hours ago
- NBC News
Democratic governors seek to roll back state-funded health care for undocumented immigrants
A trio of states with Democratic governors viewed as potential 2028 presidential candidates have taken steps in recent weeks to freeze or cut government-funded health care coverage for undocumented immigrants. Democratic Govs. Gavin Newsom of California, JB Pritzker of Illinois and Tim Walz of Minnesota have largely attributed the proposals to budget shortfalls stemming from original plans to expand health care to immigrants without legal status. But the moves also occur against the backdrop of broader debate within the Democratic Party over how to handle immigration, an issue that dragged it down in the last election and that President Donald Trump and the GOP have continued to try to capitalize on. The plans, which would scale back health care coverage for undocumented immigrants in the three Democratic-led states just years after it was expanded, have angered progressives and immigrant advocacy groups, who warn the party risks alienating its base — particularly as protests against Trump's deportation plans break out around the country. The latest development came in Minnesota on Tuesday, after both chambers of the Legislature passed a bill to end state-funded health care for undocumented adults. The bipartisan effort advanced through the Republican-controlled House and the Democratic-controlled Senate as part of attempts to balance the state budget. It now goes to Walz, who has said he'll sign it. The bill would end undocumented adults' eligibility for MinnesotaCare — the state-funded health insurance program for low-income residents — effectively reversing one of the signature policy wins Walz secured during a landmark legislative session in 2023, when Democrats were in full control of state government. Undocumented children would remain eligible to enroll in the program under the legislation. In California, Newsom unveiled a budget plan last month that would cut back on health care benefits for undocumented immigrants — a stark reversal from his promises of universal health care for all the state's residents, regardless of their immigration status. Newsom's plan in his 2025-26 budget has called for freezing enrollment for undocumented adults to receive the full scope of the state's Medicaid program, known as Medi-Cal. Newsom's office has said the changes would apply only to new applicants over age 19, that existing enrollees wouldn't be kicked off their plans and that the freeze, which would begin next year, wouldn't apply to people enrolled in limited plans. Newsom's proposed changes also included a new $100 monthly premium for adults 19 and older with 'unsatisfactory immigration status' beginning in 2027. His expansion of Medi-Cal has cost far more than his administration anticipated. Newsom has said the changes will help to balance the state's budget, which has run a multibillion-dollar shortfall that he has blamed on Trump's tariffs, as well as growing costs from higher enrollment in Medi-Cal. Meanwhile, Illinois remains on track by the end of the month to end a program — called Health Benefits for Immigrant Adults — that provides state-funded health care coverage for more than 30,000 low-income adults who are living in the state without documentation. Similarly, the program in Illinois was more expensive than expected when it was created in 2021. Pritzker's latest budget, which the Democratic-led Legislature passed last month, proposed eliminating it by July 1. While the moves would help those states recalibrate their budgets, a sweeping Trump-backed domestic policy bill moving through Congress proposes slashing Medicaid funding for states that provide health care coverage to undocumented immigrants. Trump also signed an executive order this year targeting undocumented immigrants' access to government assistance programs. In response to questions from NBC News, Newsom spokesperson Elana Ross reiterated his statement in his initial announcement of the changes last month that 'instead of rolling back the program — meaning cutting people off for basic care — we're capping it.' Pritzker's office said in an email that 'this year, passing a balanced budget required the difficult decision that reflects the reality of Trump and Republicans tanking our national economy and attempting to strip away healthcare.' A Walz spokesperson didn't respond to questions about Minnesota's plan, which was the result of a compromise after Republican lawmakers had pushed to end the entire MinnesotaCare program. 'No one got everything they wanted,' Walz said last month after he reached a tentative deal with Republicans on the budget, which was finalized in a special session this week. 'There were very difficult conversations about issues that were very dear to each of these caucuses. But at the end of the day, we were able to come to this agreement.' Blowback from the left Immigrant advocacy groups have panned the moves, saying they risk further imperiling the broader health care system, and blasted Democrats for succumbing to Trump's attacks. 'We urge state leaders to build on their progress, rather than placing the health of their residents at risk,' said Tanya Broder, the senior counsel for health and economic justice policy at the National Immigration Law Center. 'Particularly as extremist politicians scapegoat and target immigrants, we are counting on state officials to do the right thing and hold the line. 'As states increasingly have recognized, a community's health and well-being depend on ensuring that everyone has access to health care. Immigrants pay billions of dollars in federal, state and local taxes, yet many are excluded from critical health care programs,' she added. 'Terminating state coverage for immigrants will compromise our collective health, as well as the health care infrastructure that serves all of us.' Some progressives questioned whether the moves were part of a broader strategy by the three governors to move to the right on the broader issue of immigration, which polling has shown still remains one of Trump's strongest issues. They said they could face a backlash from their base by departing from positions on supporting immigrant communities and expanding health care. 'It really feeds into the conservative narrative that undocumented immigrants are a drain on our communities,' said Jennifer Driver, a senior director at the State Innovation Exchange, a progressive legislative policy group. 'This assumption that by moving more to the middle or to the right that you're going to recruit some people back — I think it's a miscalculation. 'The frustration that you're seeing in the Democratic base is due to this kind of this waffling, this kind of idea that 'OK, yes, we are progressive — but only in some moments,'' Driver added. Other strategists suggested it remained too early to gauge whether a broader shift was in play as governors and other lawmakers positioned themselves for potential 2028 White House bids, and they emphasized that the threats blue states face from Trump are serious. 'The Trump administration is squeezing the hell out of states,' said Jeff Blodgett, a Minnesota-based Democratic strategist who was a campaign manager for the late Sen. Paul Wellstone and the state director for both of Barack Obama's presidential campaigns. 'There's just a lot of concern about current and future budgets given what the federal government is doing to states.'