Health equity is a myth for too many transgender and gender-nonconforming (TGNC) people in this country. While politicians and corporations parade their support during Pride Month and Transgender Day of Visibility, they do little to protect us when it matters most.

While politicians use trans lives as a talking point to rile up their base, trans people are dying because they cannot access basic medical care. We are not a talking point. We are not a political footnote. We are people who deserve to live and thrive, and our government is failing us at every level.

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The new administration has made it clear that trans lives are expendable, gutting access to lifesaving gender-affirming care and emboldening policies that make healthcare, housing and employment even more inaccessible to TGNC people. The result? More suffering, more discrimination and more preventable deaths.

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These policies create a very real climate of violence for TGNC people. And those in power – elected officials, healthcare leaders and even some mainstream LGBTQ+ organizations – are not doing enough to change this. If we don’t act now, the most vulnerable members of our diverse and expansive LGBTQ+ community will continue to pay the price for this indifference.

Health equity isn’t just a buzzword; it’s a matter of life and death. And yet, the very institutions that claim to serve us continue to leave us behind. If you say you believe in healthcare for all, that has to include us, too. In most cases, our voices are excluded, if not actively ignored. Conversations about LGBTQ+ health and wellness, from both a policy formation and service implementation standpoint, lack trans voices. Consequently, the solutions offered to our community members are broad, uneven and consistently fall short.

Doctors take an oath to do no harm, but too many providers actively contribute to worse health outcomes for trans people, especially Black and brown trans people. Bias, ignorance and outright refusal of care are common. We see it in the alarming number of trans people who avoid medical settings out of fear of mistreatment. We see it in how trans folks are overrepresented in the country’s rates of suicide attempts, untreated chronic conditions and populations lacking basic mental health services. And we see it in our own data at Destination Tomorrow.

In 2024, our team partnered with Tulane University to survey the mental health needs of TGNC individuals and the impact a lack of adequate mental health resources at LGBTQ+ health centers has on the community. Our researchers surveyed 49 TGNC community members over the age of 18 and gathered data from client intake records, demographic information and answers to a comprehensive survey on mental health needs covering depression, anxiety and suicide. What we found validated our gravest concerns; trans people are neglected at every step when accessing healthcare.

Over 80% of TGNC respondents reported that poor mental or physical health has kept them from their daily lives, with over 25% reporting they had been hospitalized in the past for attempting suicide and nearly 75% experiencing homelessness. These numbers don’t lie. This system was never built for us, and it continues to fail us.

We have clients who have been refused treatment, misgendered or denied gender-affirming care because providers simply refuse to see their humanity or fear political retribution. When trans people seek emergency medical services, they are often met with hostility, with their concerns dismissed or pathologized. Trans people are overrepresented in every category of social and economic hardship, so why are we still fighting for scraps when it comes to life-saving care? The data is there. The need is obvious. Yet the silence from those in power remains deafening. Healthcare providers, elected leaders and public health policymakers must do better to engage and treat the country’s TGNC community.

The current administration has doubled down on anti-trans rhetoric and policies that make access to healthcare even more impossible, but it didn’t start there. Over the last two years, over 25 states have banned gender-affirming care for minors. Put simply, trans rights have become nothing more than a political talking point.

From banning gender-affirming care to stripping away protections in healthcare settings, the goal of these policies is clear: to make it harder for trans people to exist authentically. These attacks disproportionately harm Black and brown trans people, who already face systemic racism in healthcare, housing and employment.

Healthcare is a right, not a privilege. The fight for health equity for trans people cannot be limited to a single day of visibility or a once-a-year pledge of support. It requires real, systemic change. We need providers who understand and respect trans patients. We need policies that protect our access to medical care. We need funding for mental health services in every LGBTQ+ center. We need allies who do more than just say they support us.

To those in power: If you truly believe in health equity, prove it. Introduce and pass legislation that protects and expands access to gender-affirming care. Invest in funding for LGBTQ+ health centers to provide onsite, comprehensive medical and mental health services. Mandate cultural competency training for all healthcare providers and hold institutions accountable when they fail trans patients. This is not an abstract political issue; it is life or death.

Editor’s note: This article mentions suicide. If you need to talk to someone now, call the Trans Lifeline at 1-877-565-8860. It’s staffed by trans people, for trans people. The Trevor Project provides a safe, judgement-free place to talk for LGBTQ+ youth at 1-866-488-7386. You can also call the National Suicide Prevention Lifeline at 1-800-273-8255.

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