Transgender people should have access to quality health care and should not be denied coverage due to pre-existing conditions, including gender dysphoria. However, transgender people continue to encounter barriers despite recent legal changes including the passage of the Affordable Care Act (ACA). Transgender people face significant job loss and job fragility and, therefore, a higher rate of uninsurance. A majority of public and private insurance plans still have discriminatory exclusions for transgender-related care, but some states (see map) and health plans are changing the rules, recognizing that these exclusions should no longer stand and are a barrier to care. Due to the lack of research data about transgender people, there is still little funding for transgender specific health care that often precludes effective public health services. NCTE works with federal, state and local agencies and health advocacy groups to ensure that regulations, policies and laws are passed and implemented, which ensure that transgender people have access to quality health care without exclusions.
Suicidality is one of the most serious elevated health risks facing transgender people. While the causes of suicide are complex, growing evidence links high rates of suicidality among transgender youth and adults in part to stigma and discrimination. Suicide prevention efforts should be transgender-competent.
Transgender people in the US face high risk for HIV infection. Unfortunately, data is often lacking on how many transgender people are infected with HIV at a national level, but local health departments and researchers studying transgender people and HIV have shown high levels of infection and racial disparities. Areas of challenge include: understudy of transgender men and HIV infection; police interactions with transgender people conflicting with public health initiatives; discrimination and social stigma for transgender HIV people; health care provider insensitivity; co-occurring mental health and substance abuse conditions. NCTE is committed to working with HIV health experts and policymakers to ensure transgender inclusion, sensitivity, access to care, as well as ensuring once a cure is identified that it is accessible to transgender communities, especially those that are low-income or communities of color.