Transgender Americans received a surprising mini-victory amid the Republican passage of President Donald Trump’s “One Big, Beautiful Bill” when an attempt to restrict gender-affirming care died in the legislative process.
The bill had included language that would have banned Medicaid from covering gender-affirming care for transgender minors. But in a final deal made to appeal to conservatives, the legislation struck the term “for minors.”
Republicans passed the legislation via the process of budget reconciliation, which allowed them to avoid a Democratic filibuster. But that meant the legislation had to relate to federal spending and the Senate Parliamentarian, who determines whether legislative language complies with the so-called “Byrd Rule” criteria found it was not germane.
Initially, the Senate version included similar language. But the parliamentarian found that it did not comply with the Byrd Rule after Democratic staff argued for it.
Still, Republicans included it in the language of the text they hoped to put on the floor. That would have required Democrats to raise a point of order on the legislation, which would mean the amendment would need 60 votes and the 53 Republican senators would need to pick off seven Democrats.
Rep. Dan Crenshaw (R-Texas) said he thought that would be an easy fight.
“It’s a good bet to take,” he said on X.
“For one thing, nothing to lose so why not try? But second, I believe the Democrats won’t want to pick this battle. This is a very very popular provision. I think the Democrats know they’ve lost the battle. The science isn’t on their side and neither is the public.”
But transgender people had a powerful ally in Sen. Ron Wyden, one of the remaining lawmakers who opposed the 1996 Defense of Marriage Act, the law that made the federal government recognize marriage as one man and one woman. Wyden said at the time that he would raise a point of order if needed.
“I was first senators come out and support marriage equality and I said if you don’t like gay marriage, don’t get one,” the Oregon Democrat told The Independent.
“This is the same thing. This is a private choice for adults should be blankship belong to them.”
According to the Williams Institute at UCLA School of Law, about 276,000 transgender adults use Medicaid. But Republicans have focused heavily on anti-trans rhetoric and policy, with numerous state legislatures enacting bans on gender-affirming care for youth with gender dysphoria.
In addition, late last year, House Republicans included a provision in the National Defense Authorization Act that banned TRICARE, the health care program for active-duty military servicemembers, from covering “certain medical procedures for children that could result in sterilization.”
In 2024, the Trump campaign ran an advertisement criticizing his Democratic opponent Kamala Harris for allowing taxpayer-funded gender-affirming surgeries for undocumented immigrants in prison, famously using the tagline: “Kamala is for They/Them” while “President Trump is for you.”
In the end, the final agreement that led to the legislation being passed in the Senate excluded the language on gender-affirming care without the Democrats having to raise a point of order.
Rep. Mark Takano of California, the chairman of the Congressional Equality Caucus, heralded the win for transgender people, saying that the four big fights for them are access to medical care, freedom from bullying and harassment at school, freedom from harassment at the workplace and the ability to participate in sports.
“The fact that this was achieved in the Senate, rather painlessly, was a was a pretty remarkable time of events,” Takano told The Independent.
Initially, it looked like Republicans would want to include amendments to the Senate version. Rep. Marjorie Taylor Greene proposed an amendment to restore the ban. But Republicans opted to pass the legislation without amendments, meaning the language was not included in the final bill.
Before the final House bill’s passage, Rep. Sarah McBride of Delaware praised the fact the language died.
“I think there are a lot of people who are rightfully relieved,” she said.
