Women's Day 2024: How Can Trans Women Be Free?

As attacks against trans women continue to escalate in the United States, Healthnews spoke to a trans journalist and advocate about what safety for trans women (and all gender-diverse individuals) would look like in light of International Women’s Day.

Only 0.5% of the U.S. adult population identifies as transgender, and yet, last year, over 220 bills were introduced across the country that specifically targeted the trans community.

These bills attempt to limit access to school sports, restrooms, and locker rooms for trans youth; remove books and all references to LGBTQ+ identities and experiences from school classrooms; and ban access to safe, effective, gender-affirming medical care.

Despite the fact that every single major medical association supports health care for trans people and the majority of trans people say transitioning significantly improved their quality of life, trans individuals are seeing their access to health care disappear left and right.

The American Civil Liberties Union (ACLU) is currently tracking 474 anti-LGBTQ+ bills introduced in 2024, many of which directly target trans people. And in 2023, for the first time in its more than 40-year history, the Human Rights Campaign declared a National State of Emergency for LGBTQ+ Americans in response to the hundreds of anti-LGBTQ+ bills introduced into statehouses across the country.

Real-world impacts

“These state actions not only directly impact people’s lives, health, and welfare of transgender and non-binary people, but they also shape our vision of ourselves as a society and a larger community,” reads an article on improving “life chances” for trans people, published in the Journal of Law, Medicine & Ethics.

The article argues that these laws shape the contexts within which trans and non-binary people receive services and engage with their communities, while also creating an overarching social landscape in which anti-trans sentiment and rhetoric cultivate misunderstanding of, hostility towards, and violence against trans folks.

Online rhetoric, coupled with incessant anti-trans legislation, does inevitably translate into real-world suffering and violence, and trans women specifically often bear the brunt of these effects.

Almost 500 gender identity-motivated hate crimes were recorded in 2022, with the number of hate crimes based on gender identity increasing by over 32% from 2021 to 2022.

Between January 2013 and November 2023, 335 transgender and gender non-conforming individuals were identified as victims of fatal violence in the U.S. — 83% of which were trans women. And in 2023 alone, there were 35 homicides of transgender or gender-expansive people, with Black trans women facing the bulk of this violence.

Much of the hysteria surrounding this community stems from extremists on social media, according to Erin Reed, an independent trans journalist and advocate who closely covers anti-trans legislation. Online, she says, extreme anti-trans influencers and groups stoke fear among their followers and direct hatred at the LGBTQ+ community as well as anyone who supports them. Their sizable platforms allow them to influence politicians, ultimately leading to many of the bills that end up introduced in state legislatures.

This week, for example, anti-trans groups released the "WPATH" files in an attempt to discredit the medical profession’s support of gender-affirming care and create a scandal. Reed fact-checked the document and found 216 instances of factual errors, misrepresentations, and distortions of "leaked" materials.

Healthnews spoke with Reed about the current reality for trans women (as well as all gender-diverse individuals) in the U.S. and what it would take for their health and safety to be guaranteed.

Q: What is the greatest threat to the health and safety of trans women in the U.S. right now?

A: Growing extremism in the United States over transgender and LGBTQ+ people remains the greatest threat. This threat persists across state lines, existing in both states traditionally considered safe and also those considered more restrictive for transgender rights. Hate accounts and influencers appear capable of shutting down hospitals, schools, and driving harassment with little time to prepare.

These influencers also wield tremendous power over the Republican party and are capable of focusing large mobs onto any moderate Republican legislator that shows an ounce of support for LGBTQ+ people. The bills that are then passed restrict transgender people in all areas of life.

Q: How are restrictions on gender-affirming care harming trans people?

A: The impact of gender affirming care bans is intensely damaging to transgender youth, as well as trans adults that are also seeing restrictions on care. These bans target our best-practice medical care, force people to medically detransition, and inflict severe psychological harm.

In a recent report, 86% of transgender and nonbinary youth say recent debates over anti-trans laws, such as healthcare bans, have negatively impacted their mental health. Many people have been driven out of their home states in search of care. These bans will negatively impact some families for the rest of their lives.

Q: What would it take for trans women (and all trans people) to experience true safety, health, and wellbeing?

A: The temperature over transgender issues needs to turn down. Our major social media platforms need to enforce anti-hate provisions that were once common but have since been stripped away. Targeted identity-based harassment must be vigorously combatted, and hate content should not be monetized and given viral reach.

Q: What would a society in which all trans people are respected, safe, healthy, and free look like?

A: A society in which transgender people are respected and free looks like a world where transgender people can walk about freely without being concerned about the legal circumstances around every action they take and can experience the full depth of life with joy.

Transgender people do not seek any greater rights than anyone else, only the ability to engage in our basic functions of living, make our private healthcare decisions, have documents that grant us dignity and reflect who we are, and freedom to learn about our history and engage with one another without fear of prosecution.