Most mainstream attention to transgender people, when it happens at all, frames us as deeply unknowable. Communicating with us involves abstract discussion of pronouns and grammar rules that some people insist are too complicated. Being allowed to use public restrooms without fear of arrest or harassment becomes a question of whether a facility has specialized “transgender bathrooms.” Our political demands are seen as exotic, specific to our small community, leaving plenty of room for the right wing to ask why a small fraction of the population should be allowed to demand anything at all.
Increasingly, Democrats take pains to acknowledge our struggles — though it often feels like they’re less making a particular effort to win our votes and more signaling to a mostly cisgender audience that they care. It’s an improvement over being a political punching bag, but also leads to baffling outcomes like Warren’s recent promise to let a single unnamed young trans person vet her secretary of education. This vaguely othering exceptionalism creeps into policy proposals as well, where candidates sometimes find room for a niche platform plank targeting us specifically, but rarely discuss how their more sweeping reform plans would affect our lives.
Bernie Sanders’s campaign comes as a breath of fresh air. Bernie has a long history of supporting trans rights. His platform includes a number of excellent policies to fix unique hassles of trans life, such as ensuring nonbinary people can receive proper identity documents. But he also takes pains to include us fully in the sweeping universal programs that are his hallmark. It’s those big ideas that have the most potential to improve our lives, because policy tweaks won’t change much for trans people — or anyone else — without inviolable rights to education, health care, jobs, and housing.
Two of Bernie’s signature proposals, tuition-free college and the elimination of student debt, show how universal programs help vulnerable groups in particular. The ever-rising cost of higher education is a society-wide burden, but for trans students it’s often weaponized by controlling, anti-trans parents. The current means-tested assistance programs require the parents of any student under twenty-four to provide financial information to apply for loans and scholarships — so by withholding their consent, parents can punish their adult children by denying them a college education.
There are workarounds, but they are needlessly cruel. If students can prove to their school’s financial aid office that they are estranged from their parents, the school can issue a “dependency override,” allowing them to apply for aid on their own. But schools are under pressure to protect this system from overuse, and only 0.5 percent of students receive aid this way. As a result, trans students — already in pain due to the emotional and financial retaliation of their family — must stand before a suspicious authority figure and recount the details of their rejection.
This is what means testing looks like on the ground: forcing people in their most vulnerable moments to recount the hardships and traumas of their lives, on pain of losing their lifeline to stability. Free college for everyone avoids this entire situation and takes a powerful weapon out of the hands of transphobic parents.
In her essay, “I’m Gay and I Want Medicare for All,” Meagan Day lays out two ways of thinking about LGBT health care needs: firstly, as people with bodies, we suffer the full array of human maladies, and like all people deserve to be treated competently and compassionately. Secondly, there are particular treatments we are more likely to need for reasons tied to our identities, and truly meeting our medical needs requires providing that care.
You might reasonably expect that providing compassionate general medicine to trans people could be done with a few sensitivity seminars or the threat of malpractice lawsuits hanging over bigoted practitioners. Not with for-profit insurance hanging around.
In 1981, transphobic activists successfully lobbied to have transition care, up to then covered by Medicare, reclassified as “experimental” and “cosmetic,” and therefore outside the realm of procedures covered by Medicare (even as the same medications and surgeries remained available to cisgender patients — for instance, covering prescription estrogen for menopausal women). Private insurers, who use Medicare as the national standard for what is medically necessary and are loath to pay any bill they can avoid, quickly followed suit.
Insurers then went a step further, using this policy to deny all kinds of medical care to trans people by claiming that any and all things wrong with our bodies were a manifestation of our gender identities (and therefore not covered), a phenomenon called “trans broken arm syndrome.” Pre–Affordable Care Act (ACA), a diagnosis of transsexualism could count as one of those dreaded preexisting conditions insurers could use to refuse to take us on as clients, making us uninsurable.
Although a federal appeal in 2014 restored transition coverage to Medicare, discrimination in private coverage remains common. Adding insult to injury, the endless, odious paperwork required by the ACA, which is already a nontrivial burden for anyone, becomes for trans people a nightmare of confusion and contradiction, causing many to experience delays in care or drop out of the system entirely.
Think of the worst fight you’ve ever had with your health insurance. Now imagine navigating it while your birth certificate, Social Security card, driver’s license, and medical records all had slightly different information, and your coverage depended on proving you were slightly different versions of yourself from bill to bill. One of the authors once found it was simplest to pretend to be his own husband on the phone.
Medicare for All is the gold standard of US mainstream health policy, wiping away the entire for-profit insurance industry and the very possibility of being uninsured. But what about that second type of care, the suite of hormones and surgeries we might need as part of gender transition?
The ACA attempted to slip us in under Fox News’ radar by keeping the law vague and backfilling it with policy clarifications, which were promptly overturned in court by bigots with deep pockets. Bernie’s bill explicitly includes transition-related procedures, along with HIV prevention, birth control, and abortion, betting that our best chance to win coverage of stigmatized care is with solidarity.
And finally, Bernie’s bill eliminates whole swaths of insufferable paperwork — paperwork anyone who has transitioned is very familiar with. As he stated in the December debate: “If I am president, no more forms.”
Ending At-Will Employment
Current federal antidiscrimination protections for trans people rest on a somewhat tortured reading of the Civil Rights Act which argues a trans woman is actually a man violating sex stereotypes in protected ways, leaving us at the mercy of increasingly conservative federal courts. Bernie signing the Equality Act, which establishes sexuality and gender identity as protected categories under the Civil Rights Act, would secure our formal rights. But very few employers are dumb enough to tell employees they’re discriminating against them; decades of experience covering for their racist and sexist discrimination have taught bosses to make up vague issues with performance, team-player-y-ness, or other excuses to cover their asses.
Discrimination hits anyone whose physical appearance or personal ID documents mark us as trans while applying for jobs. Nonbinary identity, lack of access to transition care, and inability to pay for expensive court-ordered document changes all can out trans applicants as trans against their will. Those who have a hard time finding work before coming out — for reasons of racism, sexism, poverty, or any other issue — pay the highest price.
Sadly, it is extremely hard to prove discrimination in failure to hire; ending that will require cultural shifts more than legal ones. But even after being hired, many trans people (as well as many lesbian, gay, and bisexual people, and in some cases, religious minorities) face surprise discrimination because our identity may not be apparent to employers. Coming out, or the revelation that we transitioned sometime in the past, can cause a good job to suddenly become unstable. Because of this, many are unwilling to risk coming out at work.
The issue of hiring discrimination will still be an enormous problem. But ending at-will employment, as laid out in Bernie’s Workplace Democracy Plan, would be a sea change, putting the burden of proof on the boss to terminate workers.
All the previous challenges, along with discrimination by landlords, force tragic numbers of trans people into homelessness — 20 percent of trans people in the United States report having been homeless at some point, the same percentage that report discrimination by landlords. The rate of homelessness is highest among those who are pushed to the margins in other ways, through racism, extreme poverty, criminalization, and more. The Equality Act would amend the Civil Rights Act to forbid housing discrimination based on gender identity and sexual orientation.
But being legally entitled to rent is not especially useful if we are priced out of all available units. This is why Bernie’s Housing for All program is critical. It is the only policy on offer that tackles the scale of the housing and homelessness crisis, ensuring that the approval of a hiring manager and a private landlord will not be a prerequisite for living indoors.
Transgender and gender-nonconforming people need education, health care, job security, and housing, just like cisgender people. The capitalist class, which controls access to these things, threatens to deny them to us as their primary weapon of oppression of the entire working class. Those weapons are brought to bear against transgender people in often maddening and brutal ways — and still more so against those who also face racism, transmisogyny, and other compounding forces.
The most effective way to stop this oppression is to take away the weapons of capital altogether. Bernie’s policies won’t take us to the end of capitalism, but they would allow us all to secure the necessities of life while we keep up the fight.