The systematic attempt by the Republican Party to eliminate transgender people in America continued last week, with a bill banning medical care for trans youth passed by the Texas legislature. Greg Abbott has already said he will sign it.
The Texas bill is similar to Senate Bill 480, which was passed into Indiana law early last month. Both bills ban gender affirming care such as puberty blockers, hormone replacement therapy and certain surgical procedures for minors. Youths already receiving gender-affirming care in Indiana will be able to do so until the end of the year, but as of July 1, trans people who need care won’t be able to get it here.
Some conservatives would probably object to the characterization that they seek to eliminate all trans people. Many similar bills passed across the country are justified under the guise of protecting children only — once you turn 18, some might say, one is free to transition.
But a closer look reveals such a defense to be disingenuous. For example, in nine states Medicaid policy explicitly excludes transgender-related healthcare for people of any age — never mind that these policies are in direct violation of federal law.
The most depressing part of all this Republican tyranny is that these bills banning or throwing massive obstacles in the way of trans medical care are superfluous to some extent. This is because for many trans people, it’s not just the law that stands in the way of liberation. No, perhaps even more transphobic than the Republicans is the capitalist class.
It can be extremely costly for people to transition in America. Even with insurance, it can cost over $100 thousand to medically transition in the U.S.
For the 14% of trans Americans who are uninsured, gender affirming surgeries such as vaginoplasties can cost over $50 thousand. But such surgeries can be unaffordable even for those who do have insurance. This is because some insurers will argue that certain surgeries are simply “cosmetic” and therefore not medically necessary.
Unsurprisingly, it is greed and nothing more which determines in this country what is and isn’t medically necessary. Never mind that gender affirming care is linked to reduced levels of depression and lowers the very high risk of suicide among trans youth — if the insurance company says a procedure isn’t medically necessary, they must know what they’re talking about!
This is only made worse by the fact that nearly 30% of transgender adults live in poverty. Very high percentages of LGBTQ workers are unemployed and underemployed, which surely has much to do with discrimination. According to a 2020 study by the Center for American Progress, 62% of transgender respondents said they experienced discrimination in the workplace in the past year.
For those of us who are interested in trans liberation, it is not just the reactionaries in government who must be overcome, but also an economic system which makes healthcare inaccessible and hurls trans people into poverty for no other reason than that it’s profitable to do so. Complete trans liberation will necessarily require the end of capitalism.
That may seem like a project too big, too time consuming to help trans people who are desperate now. There are certainly actions we can take short of overthrowing the capitalist system that would help trans people, but we mustn’t shy away of difficult projects.
For example, one thing that could be done is move toward socialized medicine, which would allow trans people to get the care they need for free. Countries like Cuba already do this, and with far less wealth than we have.
There are also smaller gains we can fight for, such as increasing unionization rates, fighting for higher wages and a job guarantee so we can reduce the poverty rates that trans people face. Winning the political battles won’t mean much if the capitalists are allowed to continue their economic war on trans people.
But even these — socialized medicine, a job guarantee, unionization — won’t be easy victories. And so, we mustn’t shrug our shoulders and give up in the face of long odds — we must instead embrace radical visions.
Lenin said the work of socialists is always difficult, “but the thing that makes them different from the liberals is that they do not declare what is difficult to be impossible. The liberal calls difficult work impossible so as to conceal his renunciation of it.”
Let us not confuse the difficult with the impossible. We can and will defeat the enemies of trans people in the public and the private sphere. It’s just a matter of time and will.
Jared Quigg (he/him) is a senior studying journalism and political science.