As Republican-led attacks on transgender Americans intensify across statehouses and within the Trump administration, Vermont U.S. Rep. Becca Balint, a Democrat, has introduced legislation that aims to meet the moment — not with fear, but with care.
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On Monday, to mark Trans Day of Visibility, Balint unveiled the Transgender Health Care Access Act, a federalbill designed to expand access to lifesaving, evidence-based gender-affirming care across the country. The legislation addresses a national crisis unfolding in real-time: as of today, 27 states have enacted laws restricting gender-affirming care for trans youth, while six executive orders signed by President Donald Trump target trans people across sectors — from military service to public education and health care access. Federal judges have blocked most of his anti-trans measures.
“This has been a really horrible time for the trans community,” Balint told The Advocate in an interview Monday morning. “You’ve got a president who has signed six executive orders specifically targeting trans Americans. And you’ve got Republicans in Congress who are very publicly demonizing Americans for their own political gain.”
The bill, which Balint said she was proud to introduce on Trans Day of Visibility, would fund provider training, improve medical curricula, bolster community health centers, and prioritize rural access to care. It also includes an explicit prohibition on conversion therapy.
In a public statement, Balint was even more direct: “Republicans are obsessed with attacking trans people. It’s dangerous,” she said. “Over and over again, they use messages designed to get Americans to fear one another and to divide us. As Republicans use their power to take away health care and continue to attack and dehumanize trans folks, I’m not standing down.”
A blueprint for access
The bill offers a concrete federal framework to address persistent gaps in transgender health care.
It would allocate $10 million annually to improve gender-affirming care curricula in medical schools and licensing programs. These funds would be used to create, evaluate, and implement model curricula, including medical instruction and cultural competency training focused on treating transgender patients. The bill directs the Secretary of Health and Human Services to ensure that new training models reach academic and clinical environments — including those in rural or underserved areas.
Another $15 million per year would fund a demonstration program to train medical residents, nurse practitioners, physician assistants, counselors, psychologists, and other health professionals in delivering gender-affirming care. The bill specifically encourages training in culturally competent practices and allows for grants to support clinical experiences, research, and faculty development.
Under the bill, community health centers—often lifelines for underserved populations—would receive $15 million annually to build capacity for gender-affirming care. That includes professional development, nondiscrimination training, updates to health records systems, and the creation of local review boards.
Finally, the bill authorizes $5 million annually to establish collaborative networks that connect rural providers to peer education and telehealth-based training in gender-affirming care. Balint said the goal is to bridge the isolation many rural providers face and ensure that trans people living outside urban areas can still access safe, informed care close to home.
“These investments aren’t just theoretical,” she told The Advocate. “They’re about making sure that trans people in small towns — people who may not be out to anyone — can walk into a clinic and get care from someone who understands what they need.”
A coalition of support
The bill is endorsed by a broad coalition of civil rights and LGBTQ+ advocacy organizations, including the Human Rights Campaign, American Civil Liberties Union, Equality California, Center for American Progress, the Congressional Equality Caucus, Advocates for Trans Equality, and the National Center for Lesbian Rights.
“Everyone — no matter their zip code or who they are — deserves access to the care they need,” said David Stacy, HRC’s vice president of government affairs. “This legislation would play a critical role in building a strong, sustainable framework that supports the transgender community in accessing health care.”
Rodrigo Heng-Lehtinen, executive director of Advocates for Trans Equality, called the bill a powerful counter to the campaign to erase trans people. “Access to transition-related care is medically necessary for transgender patients, a position that is overwhelmingly supported by doctors, scientists, and the medical literature. It is safe, effective, and lifesaving,” he said.
Beyond policy
Balint emphasized that gender-affirming care is not limited to urban enclaves, pushing back on what she described as a damaging and false narrative. “There’s this misconception that transgender people only exist in liberal cities, that this is some kind of phenomenon that only exists among liberals,” she said. “But in the same way that members of the lesbian community and gay male community are everywhere, trans people are everywhere. They just may not feel comfortable being out to you as trans.”
“They are your neighbors, your friends — maybe your cousins,” she added. “It isn’t just in urban and suburban areas. It’s in rural places like Vermont, Kentucky, and Tennessee and in the middle of nowhere, Illinois.”
She warned that Republican efforts to gut Medicaid would further devastate rural health care systems and disproportionately harm transgender people living in those areas. “This is not some kind of liberal plot,” Balint said. “This is just people, again, trying to live their lives.”
For Balint, the bill is also a message to those watching who may feel alone.
“You don’t have to understand everything about trans people or the health care they need,” she said. “But at a basic level, you can still acknowledge that every American should be entitled to health care and dignity and respect.”
Balint’s bill also arrives during a pivotal moment in the courts. In December, the U.S. Supreme Court heard oral arguments in U.S. v. Skrmetti, a case that will determine the future of gender-affirming care for minors and could reshape equal protection law for transgender Americans.
At issue is Tennessee’s SB 1 law banning puberty blockers and hormone therapy for trans youth — while allowing those same treatments for other medical conditions. During arguments, conservative justices expressed skepticism about striking down the ban.
Asked what she would say directly to trans people on this Trans Day of Visibility, Balint made it clear they are not alone.
“Every time they see me speaking out … I want them to imagine hundreds of people standing behind me, shoulder to shoulder. I am not the only one in this fight,” she said. “We will prevail. We will get through this horrible time. We have to.”
