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Rights Now | FAQs
Q | What policies affect healthcare for trans and gender-expansive adults? How do I keep track of all the changes?
Policies at the institutional, state, and federal level can affect healthcare for trans and gender-expansive adults. One example of an institutional policy is a nondiscrimination statement which protects patients from healthcare discrimination based on characteristics like race and gender. Access to gender-affirming care may be regulated by state and federal laws. In the first few months of 2025, executive orders at the federal level and legislation at the state level have attempted to limit the rights of trans and gender-expansive people. Court cases have been filed to challenge anti-transgender policies. To keep track of policy changes and court cases, check out the following resources:
Q | How do federal immigration policies affect healthcare for undocumented trans adults?
US government policies are increasing detention and deportation of undocumented adults, some of whom are transgender or gender-expansive. Fear of detention by Immigration and Customs Enforcement (ICE) officials during medical appointments has discouraged undocumented people from seeking healthcare. Delays in care can lead to missed diagnoses, lack of access to important medications, and medical emergencies. In general, undocumented trans people have limited access to care due to cost, language barriers, and providers who are unprepared or unwilling to treat them. Based on evidence about the treatment of trans adults in the US healthcare system, it is likely that undocumented trans adults in detention centers have even less access to healthcare and are at higher risk for discriminatory treatment.
Support and resources are available for undocumented trans adults. To start, find immigration resources from:
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Lee JJ, Leyva Vera CA, Ramirez J, et al. 'They already hate us for being immigrants and now for being trans-we have double the fight': A qualitative study of barriers to health access among transgender Latinx immigrants in the United States. J Gay Lesbian Ment Health. 2023;27(3):319-339. doi:10.1080/19359705.2022.2067279
Q | What are the healthcare rights of trans and gender-expansive people who are incarcerated?
Trans and gender-expansive people who are incarcerated are protected against cruel and unusual punishment through the Eighth Amendment of the US Constitution. Although their right to receive gender-affirming medical care may be protected under the Eighth Amendment, access to gender-affirming care for trans people who are incarcerated is often at the discretion of the correctional facility.
An executive order was issued in 2025 mandating that the federal Bureau of Prisons no longer allow transgender women to be housed in a women's prison or other detention center that aligns with their gender identity. The order also attempts to restrict access to gender-affirming care for trans inmates. This order is being challenged in the courts.
Trans people who are incarcerated are more likely to experience abuse from other inmates and from staff while in the prison system, and their access to healthcare may be denied or delayed due to discriminatory treatment.
For more information on healthcare for trans and gender-expansive people who are incarcerated, see the following resources:
Sources
Lee JJ, Leyva Vera CA, Ramirez J, et al. 'They already hate us for being immigrants and now for being trans-we have double the fight': a qualitative study of barriers to health access among transgender Latinx immigrants in the United States. J Gay Lesbian Ment Health. 2023;27(3):319-339. doi:10.1080/19359705.2022.2067279
Resources
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Healthcare for Trans and Gender-Expansive People who are Incarcerated→ from Lambda Legal
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Healthcare for Trans and Gender-Expansive People who are Incarcerated→ from the Transgender Law Center
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Challenging Bias and Discrimination in the Criminal Legal System→ from Lambda Legal
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Prisons and Policing→ from the Transgender Law Center
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Kingdom v. Trump→ from the Transgender Law Center
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Transgender Gender-Variant & Intersex Justice Project (TGIJP)→ [California-based]