#TransHealthcareNow: Why now is the time for the most vital form of trans inclusion

“New York needs trans healthcare now.” The May 15 protest that told a healthcare conference that 16 years of discrimination is, indeed, intolerable and that, yes, trans lives do matter. (Photo Credit: Erica Chain).

Conferences tend to be rather staid affairs that are rigidly structured by lovelessly adumbrated agendas. Pre-planned panels and speeches dominate those agendas. Thus, when someone goes off-script somehow, the results are bound to be fascinating.

Last Thursday the Sylvia Rivera Law Project (SRLP) in New York City provided a happy off-ramp from the script of HX Refactored, a healthcare conference taking place in Manhattan, when they participated in a direct action on stage to advocate for trans-inclusive Medicaid coverage in New York. A banner was proudly unfurled, speeches were made, and everything flew off script—to the applause of many in the audience, no less, a hopeful sign if ever there was one. The state’s new health commissioner, Howard Zucker, bore witness to the unveiling of a hashtag that demanded #transhealthcarenow.

Reina Gossett, SRLP’s director of membership, explained why this protest took place at this specific conference. “We went to the conference to confront Howard Zucker who has the power to repeal this 16-year-old regulation that excludes trans people from healthcare coverage in New York State,” she told me. “We knew it was important to stop business as usual for the Department of Health, because business as usual for the Department of Health has meant 16 years of transgender exclusion from medically necessary healthcare and that’s outrageously far too long!” 

Too long, indeed. The exclusion she references is a 1998 bill passed by the New York State legislature that specifically forbids the use of Medicaid funds to cover transgender-related healthcare, including hormone replacement therapy, medical aids, or any type of trans surgery.

A number of organizations in New York City, including the Trans Women of Color Collective, The Audre Lorde Project, and Make The Road New York have also taken the lead in challenging this law, building the legal, political, and cultural ferment that underlay SRLP’s recent protest. In the interest of full disclosure, I should note that I am a member of SRLP’s core collective, which acts as its board; but this political moment scarcely belongs to SRLP or any other single organization. It represents a turning point in the political consciousness of many New Yorkers and, particularly, the trans community of color in New York City which is experiencing another great political awakening, not unlike the rise of trans activism that SRLP’s namesake participated in from the 1970s onward.

There is a real and growing sense of trans women of color’s political power, a need to organize that is gripping the younger generation here, and one that is laced through with a powerfully intersectional fire. That lived and embodied intersectionality in my community is one which determines the shape of our political goals; it is why healthcare is at the center of our current political claims.

The wider trans community across the United States is engaged in a number of needful battles, but it is not a coincidence that the ones most urgently engaging trans women of color and poor trans women of all races (to say nothing of the fact that I am speaking of trans women specifically) are battles around healthcare and policing. Healthcare provides us with the baseline of material support for our livelihoods, and the police often constitute an immediate and violent threat to trans women of color—whether it is through harassing women for sex work (whether or not they are actually engaged in it), or through failing to investigate the brutal murders of trans women of color, Islan Nettles being a paramount and tragic example of the latter.

Healthcare remains at the forefront because it is the keystone of the liveable life, a condition made terrifyingly obvious by those least able to afford private healthcare or unable to access it through workplace-provided insurance. For a population that is disproportionately poor, unemployed, and likely to experience discrimination in the workplace, excision from Medicaid—the already perilously thin medical safety net for those with nowhere else to go—is a profound cruelty that makes living nigh-on impossible.

As I wrote not very long ago for RH Reality Check, when Washington D.C. liberalized its transgender healthcare laws:

American society is certainly plagued with health-care problems at all levels—millions remain uninsured, and public health care is under sustained assault—but health care represents a vertex upon which many problems unique to transgender people have converged. Coverage and the education of health-care providers, insurers, and workers would lay a peerless foundation for transgender citizenship.

A right to healthcare access is the guarantee of one of the most basic human rights: the right to live. It is at the very foundation of democratic ideals to suggest that all people, regardless of their station, class, or creed, have an inalienable right to life. It has, thus, been incredibly horrifying to see the resurgence of a pitilessly vengeful ethic that argues some should be left to die, brought to spectacularly public attention during the 2012 Republican presidential candidate debates. But that is not who we are as a people, not truly; it should never be in the realm of debate to decide who should die, or to publicly adjudicate upon who is worthy of life.

Who among us can truly make such weighty decisions?

What trans women of color are now reminding us is that we, as a society, can affirm their right to life, and that this—not hooting and hollering about who should die—is one of our highest callings as citizens.

Katherine Cross never fails to be proud of her sisters.