Last week was a bizarre time to be queer on social media: Many cishet people voiced enthusiastic support for Luigi Mangione, the man accused of shooting and killing UnitedHealthcare CEO Brian Thompson, arguing that the health insurer’s denial of claims led to so many deaths that the murder was justified as retaliation. Meanwhile, Congress was passing a bill that would require an insurer (Tricare) to deny claims, and it was hard to get anyone to even pay attention to that.
President-elect Donald Trump made denying people health care central to his campaign, spending over $200 million on ads criticizing Kamala Harris for ensuring that trans inmates in California could get health care. Meanwhile, Harris repeatedly attacked Trump for his previous attempts to cut Medicare and kept on bringing up how he only had “concepts of a plan” for what would replace the Affordable Care Act (ACA), a law that provides healthcare coverage to over 45 million people. Trump repeatedly tried to repeal the ACA during his first term.
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Health care was on the ballot, and Americans clearly voted against it, giving the “banning denials for preexisting conditions is communism” party control of the House, Senate, and White House.
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The most generous interpretation of these facts is that Americans would rather deny health care to a tiny minority – just how many undocumented transgender inmates are there who need gender-affirming surgery? – than provide it for everyone, a stance that spells doom for universal health care. In a country of over 330 million people, there will always be a reviled person getting access to health care somewhere or people making health care decisions that other people disagree with.
In fact, one person I was talking with last week dryly noted, possibly joking, that she’s against single-payer health care in the U.S. since Republicans would use it to end access to gender-affirming care for trans people.
In the past two weeks, the House and Senate passed the 2025 National Defense Authorization Act, the bill that funds the military, with an amendment that bans Tricare (which provides healthcare coverage to servicemembers and their families) from reimbursing some forms of gender-affirming care for transgender minors.
This is literally about denying people’s health care claims. People in the military and their families are among those for whom the United States federal government currently provides health care coverage. But the demonization of youth transitioning over the last few years has led majorities in both the House and the Senate to tell military servicemembers that they’ll have to pay out of pocket in order to provide health care to their trans kids.
That is, the circle of people getting government health care coverage will get smaller next year, should the NDAA be signed into law in its current form. And the people who’ll be denied care are children, and one of the reasons people want to deny them health care is literally because they are children and therefore should “wait” before they can have access to health care.
This happened as people on social media were posting memes supportive of Mangione, memes that portrayed him as a Robin Hood-type character whose actions would either bring down the U.S. health insurance system or at least were justified because of how terrible it is for people’s legitimate health care claims to be denied.
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But I didn’t see anyone posting memes like this acknowledging what Congress was working to pass.
Part of the issue is probably that a lot of people don’t see gender-affirming health care as real health care, despite how all major medical associations in the U.S. support it as a safe and effective treatment for gender dysphoria. It’s been shown to save lives, and cisgender people can access the same treatments for similar reasons. In fact, cisgender boys get gender-affirming surgeries more often than trans minors.
Still, people think about trans health care as siloed off as a separate issue from health care coverage, even though many of the battles around trans access to health care are about insurance companies’ and government insurance programs’ refusal to cover it.
This may be why universal healthcare initiatives will be doomed in the U.S., at least in the foreseeable future. We just saw the GOP use the health care needs of a very small minority — undocumented transgender inmates — to gain political power, power that they will use to deny health care coverage to the wider population.
Until people accept that others are going to make decisions for their own bodies that they wouldn’t personally make for themselves – and that’s ok – building support for universal health care is going to be an uphill battle.
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