How One Organization Is Working to Combat the Uptick in Anti-Trans Legislation

people protesting anti-trans health care legislation

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Key Takeaways

  • To date, 82 anti-transgender bills have been introduced in the 2021 legislative sessions, making it the year with the highest number of anti-trans bills. 
  • The National Center for Transgender Equality is mobilizing supporters to pass the Equality Act, federal legislation that would prohibit discrimination on the basis of sex, sexual orientation, and gender identity. 
  • Under Section 1557 of the Affordable Care Act, it is illegal to discriminate against people on the basis of sexual orientation or gender identity.

2021 is a record-breaking year for anti-trans legislation. So far, more than 110 anti-transgender bills have been introduced in the 2021 state legislative sessions, surpassing the 79 bills introduced just last year. Why are there so many proposals? We asked health policy experts to explain this year’s uptick and the impact that this legislation has on the transgender community. 

Jess Waggoner, PhD, assistant professor of Gender, Women, and Sexuality Studies at the University of Wisconsin Madison tells Verywell that the uptick in anti-trans legislation is a build up of previous policy level battles including the bathroom bill debate in 2016 and marriage equality in 2015.

“These healthcare and sports bills are the newest tactic in erasing and justifying violence against trans people,” Waggoner says. 

Impact of Legislation on Transgender Health 

Waggoner points to statistics from a 2020 national survey conducted by The Trevor Project. Forty-eight percent of LGBTQ youth reported engaging in self-harm in the past twelve months. Among transgender and non-binary youth, the figure was 60%. And 86% of LGBTQ youth also reported that recent politics had negatively impacted their well-being.

Recent legislation includes House Bill 1570—legislation banning access to gender-affirming care for transgender minors—which became law in Arkansas.

A flurry of bills regarding transgender people’s participation in sports was also introduced and passed in 2021. For example, on April 23, 2021, Alabama passed HB 391, a law that excludes transgender youth from athletics.

“These sports bans are introduced under the guise of 'fairness,' specifically in women’s sports,” Waggoner says. “There is no acknowledgment that bodies in sports are already diverse and have wide-ranging capabilities and that trans people have been active in sports for years—elected officials who are advancing these hateful agendas cannot actually provide evidence of any unfairness or competitive advantage.” 

The U.S. was riding off of anti-trans legislation and efforts posed under the Trump Administration. Some of these efforts include:

  • July 23, 2020: The Department of Housing and Urban Development formally announced the rollback of a previous rule that protected transgender people from discrimination by homeless shelters and other housing services receiving federal funds. 
  • March 23, 2018: The Trump Administration announced an implementation plan for a ban on transgender military service members. 
  • May 2, 2017: The Department of Health and Human Services (HHS) announced a plan to roll back regulations interpreting the Affordable Care Act’s nondiscrimination provisions to protect transgender people. 
  • March 28, 2017: The Census Bureau retracted a proposal to collect demographic information on LGBT people in the 2020 Census. 

“This uptick is directly linked to anti-trans legislation that invalidates young trans people, as well as youth being trapped in unsafe and unsupportive living situations during the COVID-19 pandemic,” Waggoner explains. 

The National Center for Transgender Equality Is Stepping In

D. Ojeda, PhD, healthcare policy advocate at the National Center for Transgender Equality (NCTE), tells Verywell that the NCTE—an organization with a mission to change policies and societal culture to increase understanding and acceptance of transgender people—has been focused on combating anti-trans legislation through the passage of the Equality Act. They say that the act would codify and amend protections against discrimination based on gender identity and sexual orientation with the Civil Rights Act of 1964.

“We have been mobilizing our supporters and working with Senate offices to call their senators to pass this critical legislation vital in combating these terrible bills on the state level,” Ojeda says.

Currently, Ojeda is partnering with GLMA—an organization of health professionals working to advance LGBTQ equality—to draft a national and ongoing letter against the anti-trans medical bans against trans youth and healthcare providers.

“Over two thousand providers have already signed this,” they say. “I welcome more providers to sign on.” 

Know Your Rights 

Coupled with NCTE’s advocacy efforts, the organization also runs Know Your Rights page on the NCTE website.

“The Know Your Rights page is our guide to help trans people understand what kind of plans are available to them, which plans would work, mainly when covering gender-affirming healthcare services and educating our community and our rights to health care,” Ojeda explains. 

Federal and state laws prohibit most public and private health plans from discriminating against transgender people. Illegal discrimination includes:

  • Health plans having automatic or categorical exclusions of transition-related care
  • Health plans having categorical exclusion of a specific transition-related procedure
  • An insurance company placing limitations on coverage for transition-related care 
  • An insurance company refusing to enroll you in a plan, cancelling coverage, or charging higher rates because of your transgender status 
  • An insurance plan denying coverage associated with one gender

“The most crucial information for trans people to know about their coverage and healthcare rights is that your insurance should cover gender-affirming health care,” Ojeda says. They add that if a trans person were to be denied coverage or if there is an exclusion in the healthcare plan, it would be illegal to exclude medically necessary procedures. 

What’s Being Done Today

Last month, the Biden Administration reinstated Section 1557 under the Affordable Care Act, making it illegal for healthcare providers to discriminate against transgender people.

“The update was made in response to the U.S. Supreme Court’s decision in Bostock v. Clayton County and subsequent court decisions—which explicitly states that sex discrimination includes discrimination on the basis of sexual orientation and gender identity,” Ojeda says. 

“A lot still needs to be done, and there is a lot more on the structural and local level, but to get at these changes, we must also look at the pressure on a national level,” Ojeda says. “We must pass the Equality Act to ensure that people will not be discriminated against due to gender identity nationwide.”

What This Means For You

If you are experiencing discrimination while seeking healthcare services, a complaint can be filed at

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Human Rights Campaign. Breaking: 2021 becomes record year for anti-transgender legislation.

  2. The TREVOR Project. National survey on LGBTQ youth mental health 2020.

  3. ACLU of Alabama. HB 391 - anti-trans participation in sports.

  4. National Center for Transgender Equality. Trump’s record of action against transgender people.

  5. National Center for Transgender Equality. Know your rights: health care.

  6. Washington State Hospital Association. Update to Section 1557 nondiscrimination final rule.

By Kayla Hui, MPH
Kayla Hui, MPH is the health and wellness ecommerce writer at Verywell Health.She earned her master's degree in public health from the Boston University School of Public Health and BA from the University of Wisconsin-Madison.