Denial of an opportunity to make a living is the single most damaging and pervasive form of discrimination against trans people. Since changing gender is so readily apparent, trans people often lose their jobs, are denied employment, or become under-employed regardless of their experience or education. Trans people are frequently denied housing or even evicted from their rented homes, and many more have been denied service at restaurants, stores or other public facilities. In schools, trans youth often must deal with harassment from other students with little protection from transphobic teachers and school administrators, who often react with dismay, disrespect, or disbelief.
Many health care providers refuse to treat trans people who seek modification of their bodies through endocrinology or cosmetic surgeries, and there are only a small number of surgeons in North America who perform sex reassignment surgeries. Moreover, most medical procedures related to sex reassignment are routinely excluded from nearly all health insurance plans, and thus the costs must be borne directly by the patient, with the surgeries ranging from $5,000 to $150,000.
Sadly, many AIDS service organizations have not regarded trans people as part of their service community, even though transgendered sex workers are at very great risk for HIV/AIDS and other sexually-transmitted diseases (STDs). Many trans persons will not seek health care due to the ridicule they must face when dealing with insensitive health care providers. There also have been cases where even emergency medical care has been withheld from transgendered persons.
Legal Protection for Trans People
In existing case law, the courts have found that transgendered people are not covered under anti-discrimination laws protecting persons on the basis of sexual orientation or sex. Trans people were specifically excluded in the Americans with Disabilities Act of 1991, and they also are not covered under the disability laws of nearly all the states that have them. Both state and federal courts have almost uniformly held that transgendered people are outside the legal definitions and protections of existing anti‑discrimination laws.
Only a few jurisdictions, including the states of Minnesota (by statute), Oregon (by administrative decision) and a small but growing list of cities and counties, offer trans people protection from discrimination. Thus most transgendered activists have viewed inclusion of protection based on gender identity in the federal Employment Non-Discrimination Act (ENDA) as absolutely critical.
Trans people are frequently subjected to verbal taunts and threats, hate mail, harassing telephone calls, vandalism, and acts of physical and sexual violence committed by the same persons who target lesbian, gay, and bisexual people. Transgendered people are frequently perceived to be homosexual simply because of their appearance, which is often that of a masculine woman or a feminine man. Because this perception is so pervasive, trans people are particularly subject to targeting by people who are homophobic. But due to police refusal to investigate, the victim's shame, and the lack of any legal requirement to report such attacks as hate crimes, acts of violence against trans people often go unreported.
Obtaining legal identification for their new names and genders is often difficult for trans people. While legal name changes may be obtained in almost all states either through the courts or by common law, the rules for changing gender on identity documents vary greatly from state to state. Most states do not officially permit pre-operative or non-operative transsexuals to obtain change of sex designations on their new driver's licenses. While most states will recognize a new sex status and correct birth certificates after sex reassignment surgery, a few states refuse to amend birth certificates for any reason.
School transcripts, employment records and credit histories also can be difficult to change. Instead of statutes, often there are only unwritten "policies", which are followed inconsistently, and thus trans people are sometimes left to the mercy of transphobic administrators.
A New Day is Dawning
In spite of all these complex difficulties, many more trans people are coming out, transitioning or finding new ways to live meaningful lives. More parents are learning to accept and embrace them for who they are, and to be justly proud of their exceptional honesty and courage. While many couples part when one spouse comes out, an increasing number are staying married, resulting in legal same sex marriages. Some trans parents are raising their children, continuing their careers or finding new ones, and organizing to build a safer, saner society. The medical and counseling professions are slowly becoming more informed, more flexible and more willing to provide the necessary, specialized services. Support groups for trans persons and their families are forming in increasing numbers, and even the media is carrying many positive stories.