JERSEY CITY, NJ - Until Obamacare came along, Clara (not her real name) of Jersey City didn’t have a lot of options when it came to paying for necessary medical services for transgenders. Although employed in Hoboken for years, she rarely made enough to afford the often-expensive treatments.

Obamacare was for her, and for many others like her, a godsend.

But last week, President Donald Trump said he intended to eliminate treatment for transgenders from Obamacare healthcare. The fact that he made the announcement in Gay Pride Month only serves to show how little sympathy the President of the United States has for the issue.

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“This is horrible what he is doing,” said Jersey City Mayor Steven Fulop, who has been on the forefront of providing medical insurance for transgender city employees in Jersey City.

The change in the national program could halt or interrupt treatment for Clara, and many others who have been going through the litany of procedures necessary to maintain, and to eventually reach surgery.

Clara said the lack of health insurance for transgender people is a huge problem, partly because many face other health issues, and partly because many need guidance from a trained physician to get through the complicated regimen of hormones and other drugs. Lack of doctors trained to deal with the transgender population is nearly as problematic. 

Estrogen treatments, testosterone reduction, and other drugs can have dangerous side effects unless administered by a doctor.  Until recently, most doctors were not trained in transgender medicine.

In the past, Clara went to a number of primary doctors none of which then knew anything about the issue.  “I went to primary doctors and they looked at me like I had three heads,” she said. 

Often transgender people have to pick and choose services. For Clara, estrogen treatment poses yet another risk. “My grandmother had breast cancer. This increases my chances of getting breast cancer. I have to be monitored, something that does not happen with self-treatment.” 

Clara didn’t have personal health insurance until after the federal Affordable Care Act (Obamacare) began to offer it. “I was one of the first to sign up for it,” Clara said. “I used to live paycheck to paycheck. But I’m very conscious about my credit.” Having insurance benefited her and allowed her to help get her mother a loan to start a business.

“It is life changing to have insurance,” she said.

Now in her mid-30s, Clara said stress over health issues can be overwhelming, and transgender people have significant medical and financial issues that the extended insurance coverage would help resolve.

“I handle stress well, but many do not,” she said.

Since Fulop instituted the plan for city employees, access to medical services focused on gender issues has increased and so the impact of Trump’s move may be felt less significantly in Jersey City than in other parts of the country.

“It hasn't had a direct effect on me,” Clara said. “I'm lucky. I live in Jersey City. Bigots here are few and far between, but when I think of my trans brothers and sisters from less progressive places not able to access healthcare during a pandemic it makes me very upset.”

“Trans people could die from this. It really sucks that we are being put on the sacrificial altar so an unpopular leader can try to get support from the far right. It's depressing.”

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