23-05-2025
‘He Is Working to Erase Us': A Trans Activist on the Real Reason Trump's Budget Bans Trans Care
Ash Lazarus Orr (he/they) has served as the press relations manager at Advocates for Trans Equality for two and a half years. He has been an organizer in West Virginia for over a decade, focusing on the intersectionalities of gender-affirming care and abortion access. They're also an abortion storyteller for We Testify and Planned Parenthood.
Transgender rights are once again on the chopping block for Republicans' political gain. The House's proposed budget in the so-called 'big, beautiful bill' includes measures that would deny life-saving, medically necessary, and evidence-based transition-related health care to trans people of all ages — banning it from Medicaid (where an estimated 152,000 trans Americans are enrolled) and no longer requiring Obamacare plans to cover it. This bill intentionally puts trans people's lives at risk, and is just the latest in a series of calculated attempts to divide and distract the American people, while dehumanizing some of the country's most vulnerable citizens.
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The bill is being sold to the public as a set of historic tax cuts. But in reality, it's not about fiscal responsibility: It's a cruel strategy by anti-trans, extremist politicians to push trans, nonbinary, and intersex people out of public life. From our workplaces and schools to our health care, housing, and basic freedoms, the Trump administration and its allies are working to erase us. They are trying to make it harder just to exist, let alone thrive.
Let me be perfectly clear: transition-related health care — which includes everything form hormones and puberty blockers to voice therapy, mental health support, and gender-affirming primary care — is health care. It is safe and essential, backed by decades of medical research, and supported by every major medical and mental health association in the United States. It's recognized as being safe and effective, and essential. These proposed cuts are flying in the face of medical consensus.
Stripping away health care for anybody is un-American. Denying trans people access to medically necessary care goes against the most basic values that this country was founded on: freedom, dignity, and the right to pursue life and liberty. Health care is a human right for everyone — including trans people.
Along the same lines, bodily autonomy is a core American value. Like all Americans, trans people and their families should be able to go to their medical providers and not have politicians interfering in these deeply personal medical decisions. We must be free to pursue, alongside our doctors, the medical care that lets us survive and flourish. This proposed ban undermines our fundamental right to privacy and self determination.
Unfortunately, this bill is only the beginning. It's part of a broader political agenda and calculated strategy to fuel fear, blame marginalized communities, and distract the public away from the real causes of economic hardship — corporate greed, failing infrastructure, and chronic under-investment in public services. Instead of tackling these problems, Republicans are continuing to fuel manufactured outrage to score political points, because this administration wants people pointing fingers at their neighbors instead of holding the powerful accountable.
In practice, this ban on transition-related health care would do nothing but disrupt an already overwhelmed health care system. The very people who are already most vulnerable to systemic discrimination and economic instability are now being potentially stripped of access to life-saving care, and it's all for political show.
If passed, this bill is going to affect every single person that is utilizing Medicaid. It will disproportionately impact folks who live in low-income, rural, or spread-out regions. We are going to see so many folks who are already residing in health care deserts — which are continuing to grow year by year — lose access. People will suffer because of this.
Though we have been singled out in this bill, trans people are just like everyone else you know. We are your friends, your neighbors, your colleagues. Like every other person in this country, we deserve access to health care.
This is a moment to choose to be on the right side of history. Lawmakers must reject bigotry and show leadership by defending access to trans health care — not take it away from vulnerable communities. Again, this is not just about trans people: laws like this one, if passed, will impact every single person using programs like Medicaid, and those who get their health insurance through the Affordable Care Act. I strongly encourage folks to reach out to their senators and demand that they vote no on this bill. Because trans people deserve equal rights, and to live our lives fully and authentically.
As told to Elizabeth Yuko
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