‘It’s Time to Start Worrying’: Trans People Are Questioning Their Futures in the US

Earlier this year, Kasja Malin, a 22-year-old trangender student living in Florida, had her access to trans-specific healthcare restricted—even though she is over 18. 

“I was working with my therapist and they had to drop me, and then my doctor, we were about to get things going a month ago or so, and then 254 [a bill that bans care for minors, allows the state to take over custody of children receiving gender-affirming care, and even restricts trans healthcare access for adults] was passed, and she had to just be like, ‘Wait, no, I can't actually prescribe you anything,’” Malin said.  

Florida is one of the most politically hostile states towards LGBTQ people in the country: A number of anti-trans policies and bills have been introduced in the state this year that restrict gender affirming care and criminalize healthcare providers who provide it, threaten gender affirming parental custody, and ban the use of public funds for gender-affirming care for people of all ages. Now, only doctors can prescribe hormone therapy, something nurse practitioners could previously do as well. 

According to reports, many healthcare workers in states with gender-affirming care bans like Florida are avoiding prescribing hormone replacement therapy altogether because they’re worried about repercussions, including criminal charges. The ambiguity of many of the anti-trans bills makes matters worse. Kajsa said that her doctor luckily referred her to an alternative source for Hormone Replacement Therapy (HRT)—something some doctors haven’t done for their patients, she said.

VICE News spoke with trans people about how the current climate is affecting them and their futures in the U.S., and found that many are worried about how bad things could get in the U.S., and how the 2024 presidential election could make things even worse. 

While people have different contingency plans—some want to leave the U.S. and others don’t or can’t—it all boils down to the same thing: trans people in the U.S. are worried that things will get worse for trans people before they get better. 

They’re not worried unnecessarily: Mainstream hate targeting trans people has been on the rise, and more than 500 anti-trans bills have been introduced in state legislatures in 2023 alone. Nineteen states have passed gender-affirming care bans for minors—16 of those states passed bans this year alone. Some states are going after trans adults, too: states like Texas and Florida have falsely equated gender-affirming care, which is endorsed by major U.S. medical organisations as safe and effective, to child abuse. Politicians at all levels of government across the country have repeatedly tried to restrict what bathrooms trans people can use and what sports teams they can join. Last year, GOP politicians spent upwards of $50 million on anti-trans campaign material during the midterm elections. 

Far-right pundits have also zeroed-in on trans people, spreading harmful myths and disinformation. The Daily Wire’s Matt Walsh, disgraced former Fox News anchor Tucker Carlson, and LibsofTikTok founder Chaya Raichik have all falsely accused trans and other LGBTQ people or their families and healthcare providers of “mutilating children” and of being “groomers.” Walsh’s Daily Wire colleague Michael Knowles called for the eradication of “transgenderism.” The rise in hate has also turned physical: viral videos show conservatives defacing pride paraphernalia in stores like Target while hate groups have targeted drag events all over the country.   

Ultimately, Malin wants to leave Florida and is considering leaving the U.S. eventually for Norway, where she has some friends. Malin is not the only one. VICE News previously spoke with people who are also trying to flee the U.S., including one person who already left and is currently seeking asylum in Germany. 

“Everybody has a lot of anxiety about not knowing what's going to happen next,” JJ, a trans man who lives in Texas, told VICE News. JJ asked to only use initials so that he wouldn’t be outed. “It's just a lot of anxiety, really. Everybody is kind of scrambling just to prepare for the absolute worst.”

JJ is currently in pre-med, and doesn’t plan to make any major life changes until he’s finished school. But, he said, “if things get worse here, the plan is to move out of Texas and ultimately look a little bit farther outside of that if things continue to get worse nationwide. Then, the plan is to leave the United States.” 

When she first heard that other transgender people were leaving the U.S. due to anti-trans fervor, Petra Centrella thought it was "a bit over the top." But now, a few months later, she's just as worried—and contemplating possible next steps.

“It's like, ‘maybe now it's time to start worrying—like actually worrying,’” said Centrella, a Tulsa, Oklahoma, resident. “Unfortunately, I'm not in a position to leave the country. I hope it doesn't get too bad.”

Even trans people living in blue states that are still considered safe for LGBTQ people are worried about their futures. “I think regardless of what happens, I don't feel at home in the United States anymore. When I first came out, I was kind of hopeful,” said Lilith, who lives in California. But, she said, “my intent is to no longer live in the United States.” (Lilith asked to only include her first name because she isn’t out everywhere.)

Rei, a trans woman in New Jersey, whose first name is only being used for privacy reasons, said she hasn’t even started transitioning as much as she’d like because of the current climate. “I would like to start doing that and all these other things,” Rei said of medical transitioning. “It's just there's so much uncertainty right now. It's very frustrating and it feels like I'm out, but I'm not out.”

Rei remembers how the first time she dressed in women’s clothing, she cried. “It was like, I'm actually happy. It wasn't just having fun. I was actually genuinely happy inside,” Rei said, adding she didn’t want to take the makeup and clothing off. Today, Rei said, she’s careful about when she goes out presenting the way she’d like—and she doesn’t like going out alone. 

“The other day, my mom went with me. There's a gay club and they did a drag queen visibility day,” Rei said. “So I went and did my makeup and stuff… you know, the reason I went is because somebody went with me, like she went with me.”

Rei said she felt safe inside the venue, but outside of it, less so. 

“How Florida's going, if that spreads throughout other states that’s the beginning stages of a genocide,” Rei said, adding that leaving the U.S. isn’t an option for Rei; she has a big family and many pets. 

“It just really sucks, to be blunt, to live like that: Not to be who I am because of fear and what can happen,” Rei said. 

Aly lives in Seattle, Washington, which is also known for its progressive bent. The 34-year-old trans woman, whose last name is withheld for safety reasons, started taking estrogen for the first time a little more than two years ago. She said she felt euphoric when she started treatment: “HRT is producing the most wonderful changes to not just my physical body but to my mental and emotional state, beyond what I could have fathomed. Without a doubt, this is enabling me to live my best life, and I’m just getting started,” Aly said.

But now, even though she lives in a progressive pocket of the country, Aly is worried she’ll soon be unable to access HRT.

“I had to confront the question of like, what if I can't get hormones?” Aly said. “We’re such a big vibrant community. I fear that it would affect us all. I have to question what is my future physiologically?”

Aly feels relatively safe day-to-day, but even in such an LGBTQ-friendly corner of the U.S., she’s noticed an uptick in anti-trans sentiment.  

Aly has restricted her travel in the U.S. to trans-friendly states. During one trip, Aly discovered stickers that said, “a trans person peed here and no one got hurt,” in reference to the onslaught of bathroom bills introduced across the U.S. and the harmful myth that trans people assault cis gender people if they’re allowed in washrooms. Aly made similar stickers and posted them locally, in the Capitol Hill neighborhood of Seattle. But she said that she’s since seen the stickers defaced as well as anti-trans graffiti.

“That is in the middle of Capitol Hill, which is super trans-friendly, and all of a sudden you have this transphobic graffiti taking place amid all of the pro-trans stuff,” Aly said, adding that she isn’t planning on leaving the U.S. and hopes others are able to stay and advocate for trans rights. 

There have been, however, moments of  hope for the LGBTQ community: During the 2022 midterm elections, a record-breaking number of LGBTQ candidates won seats across the U.S. in what was dubbed the “rainbow wave.” There are also many groups working to support trans healthcare, including community-led shuttles that drive trans youth living in states with gender-affirming care bans to blue states. States like California, Minnesota, and New Mexico have publicly voiced support for trans people and their families.

“I am not some demon that is infiltrating the things that you hold dear. I am not a threat to people,” Aly said. “I just want to live my life. And the reality is I can do that at no consequence to anybody else.”