Determined to make every aspect of life for transgender people even more difficult, the Trump administration has recently unveiled plans to change a rule in the Affordable Care Act so that it would allow insurers to discriminate against trans people. The proposed change would narrow the definition of sex discrimination, a reversal of an Obama-era decision to stop insurance carriers from refusing to insure trans people.
While the Trump administration is not looking to help trans people get the care they need, Planned Parenthood has been offering trans-specific health care since 2016. In fact, according to Jacquelyn Marrero, the director of media relations for Planned Parenthood of New York City, Planned Parenthood sees everyone regardless of their ability to pay. Patients who lack insurance can work with a financial counselor to either find funding or another form of insurance for their care. If they are ineligible, Planned Parenthood can see them at low or no cost, depending on their ability to pay for services.
"Our motto has always been care no matter what," Stacey De-Lin, M.D., a physician at Planned Parenthood, said in an interview. That ethos has led them to offer care to trans people who identify with the many gender identities under the trans umbrella.
"We've always wanted to be a sanctuary for people who want access to compassionate and nonjudgmental care," De-Lin said. That care includes services that Planned Parenthood is known for, like reproductive care and sexual health care, as well as hormone therapy.
Data shows that transgender women are disproportionately at risk for getting HIV -- and data about HIV often exclude trans men. But, according to De-Lin, Planned Parenthood offers an array of sexually transmitted infections testing and examinations, birth control, pre- and post-exposure prophylaxis, and abortions regardless of a patient's gender identity.
According to De-Lin, Planned Parenthood's intake process involves asking patients how they like to be addressed and what name they prefer, especially because documents like insurance cards and government IDs don't always match up with the name a person uses. That, according to De-Lin, means that Planned Parenthood and the Trump administration are currently at odds.
"They see gender as fixed at birth, and we see things differently," she said.
According to De-Lin, Trump's proposed health care change could severely limit a provider's ability to discuss reproductive and sexual health care choices with a client frankly.
Of course, offering services to transgender people and offering services that trans people can actually utilize are two different things. According to De-Lin, all of Planned Parenthood staff undergoes regular training with trans people to understand how best to offer people the care they deserve.
"Each time we have those trainings, I learn so much and grow," she said. "Everyone who works here, we're all dedicated to giving that care and making our patients comfortable."
Planned Parenthood showed this week that it was willing to put its money where its mouth is and withdraw from Title X federal funding because of a new rule that requires organizations that receive Title X money to stop referring women to abortion providers.
Acting president and CEO of the Planned Parenthood Federation of America Alexis McGill Johnson called the new Title X requirement an "unethical and dangerous gag rule" and said that Planned Parenthood refuses to be "bullied" into stopping patients from getting the services they need.
"Our patients come to us because they expect the best information and health care available," Johnson said. "And we have a commitment to provide that to them. But the gag rule would make it impossible for us to uphold that commitment."