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SRLP’s Response to the Trump Administration’s Erasure of TGNC People’s Healthcare Needs from Section 1557 of the Affordable Care Act

This week, we remembered and mourned the death of Layleen Polanco, an afro latinx trans woman, who died in NYC Department of Corrections custody last June. Nearly a year after her passing, our city announced that it would not hold anyone accountable for the negligence that led to her preventable death in solitary confinement. 

As hundreds of thousands of people across the country take to the streets in support of Black lives to call for accountability to our communities and call for the abolition of police and prisons, we are reminded that these violent systems do not protect nor serve us–they merely perpetuate anti-Black racism and transmisogyny. 

This morning, our grief swelled when we learned of the deaths of our Black trans sisters Dominique “Rem’mie” Fells of Philadelphia, PA and Riah Milton of Liberty Township, Ohio. The overwhelming violence against Black trans women must end. The police violence against black trans people and trans people of color like Tony McDade must end. We are grieving. We are scared. We are angry.

Then, this afternoon, the Trump Administration dropped the final rule for its interpretation of Section 1557 of the Affordable Care Act. Historically, Section 1557 protected transgender and gender non-conforming (TGNC) people’s right to access health care, albeit within a transphobic and racist healthcare system. Now, the Administration has changed the meaning of the law, sending a violent message to TGNC people across the country, and enforcing the transphobic view that reduces us to made-up notions of “biological sex.” The Trump Administration baselessly claims that this new rule will save Americans $2.9 billion over the next five years. As abolitionists in New York City, we note the irony that this is under half the budget of the NYPD for just one year. Assigning dollar amounts to trans lives fuels the racist transmisogyny that has claimed the lives of so many of our Black and brown siblings. We see this decision as yet another symptom of white-supremacist capitalism. We will continue to fight to dismantle this system, and build a better world for TGNC people of color, and especially for Black and Brown trans women. 

We recognize that TGNC individuals already face unrelenting discrimination and harassment when accessing medical care, even in a city as “progressive” as New York and despite formal legal protections. Yet, due to the commitment of the Sylvia Rivera Law Project, the tireless organizing of our Movement Building Team and Direct Services Team for more than a decade, and the ongoing leadership of our communities, TGNC New Yorkers’ have a right to gender-affirming healthcare because of cases like Cruz v. Zucker. Thus, this rule change will do little to affect the daily lives of TGNC New Yorkers. However, the Trump administration’s message is loud and clear–this is yet another state-sponsored attack on our communities, which we know will have a dire impact on trans communities in other states. This is why now, more than ever, we say: DEFUND, ABOLISH, and REINVEST that money into TGNC communities of color that already know how to keep each other safe

Discrimination on the basis of gender identity and expression is still illegal in NYC and across New York State. If you or someone you know has experienced difficulties in accessing gender-affirming medical care, please contact Stefanie Rivera, Director of Client Services, at or Hannah Walker, Director of the Survival and Self-Determination Project, at to schedule an intake with us. 

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