Transgender Rights and Issues

TRANSGENDER RIGHTS AND ISSUES

EDITED BY ROSE GILROY, MEREDITH JOHNSON, RACHEL KEIRSTEAD,

KELLEY KLING, ELIZABETH MCGUIRE, SHEA O’MEARA, FULTON WALD,

KATIE WIESE, RICKY YEAGER, AND MELISSA ZUBIZARRETA

I. INTRODUCTION ........................................ 418

II. WORKPLACE DISCRIMINATION BASED ON GENDER IDENTITY...... 420

A. FEDERAL LAW ON EMPLOYMENT DISCRIMINATION AND THE

UNITED STATES MILITARY ........................... 420

1. Federal Laws on Employment Discrimination Against

Transgender People. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421

2. Discrimination Against Transgender People in the United

States Military. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 426

B. STATE LAWS ON EMPLOYMENT DISCRIMINATION AGAINST

TRANSGENDER PEOPLE .............................. 432

III. ACCESS TO GENDER-AFFIRMING HEALTH CARE ............... 435

A. FEDERAL LAW: THE PATIENT PROTECTION AND AFFORDABLE

CARE ACT ....................................... 439

1. HHS Interpretations of Nondiscrimination in the ACA . . 439

2. Legal Interpretations of “Sex” as Implemented in the

ACA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 441

3. Constitutional Challenges to the ACA . . . . . . . . . . . . . . . 442

B. STATE LAWS ON GENDER-AFFIRMING HEALTH CARE . . . . . . . 443

1. States Which Prohibit Transgender Exclusions in Health

Insurance Coverage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443

2. States Which Exclude Gender-Aff‌irming Services from

State Employee Benef‌its Plans . . . . . . . . . . . . . . . . . . . . 444

C. RELIGIOUS EXEMPTIONS AND GENDER-AFFIRMING

HEALTHCARE ..................................... 444

1. Federal Religious Exemptions and Gender-Aff‌irming

Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 444

2. Religious Exemptions in the Trump Administration and

Resulting Legal Challenges . . . . . . . . . . . . . . . . . . . . . . . 445

3. State Religious Exemptions Laws . . . . . . . . . . . . . . . . . . 448

IV. VIOLENCE AGAINST TRANSGENDER INDIVIDUALS .............. 449

A. DOMESTIC VIOLENCE ............................... 449

B. HATE CRIMES ..................................... 451

1. Federal Legislation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 452

2. State Legislation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 453

C. GAY AND TRANS PANIC DEFENSES ..................... 455

417

D. POLICE MISTREATMENT OF TRANSGENDER INDIVIDUALS AND

VIOLENCE IN PRISON ............................... 457

1. Police Mistreatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . 457

2. Violence in Prison. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 458

V. PUBLIC ACCOMMODATIONS & HOUSING ..................... 462

A. PUBLIC ACCOMMODATIONS ........................... 462

1. Anti-Discrimination Laws . . . . . . . . . . . . . . . . . . . . . . . . 463

2. Discriminatory Laws. . . . . . . . . . . . . . . . . . . . . . . . . . . . 465

3. Discrimination in Schools . . . . . . . . . . . . . . . . . . . . . . . . 468

B. HOUSING ........................................ 472

1. Federal Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 474

2. State Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 477

VI. IDENTITY DOCUMENTS .................................. 477

A. FEDERAL RULES ................................... 478

B. STATE RULES ..................................... 480

1. Drivers’ Licenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 480

2. Birth Certif‌icates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 482

VII. CONCLUSION ......................................... 485

I. INTRODUCTION

2020 was a monumental year for the transgender rights movement, which

presents unique legal issues within the broader struggle for LGBTQþequality.

While trans individuals continue to face disproportionate discrimination and vio-

lence, in Bostock v. Clayton County, the Supreme Court monumentally held that

Title VII explicitly protects trans employees.

1

Furthermore, high-prof‌ile trans

individuals, such as Sarah McBride, who recently became the United States’ f‌irst

trans state senator, are bringing heightened visibility and support to the struggle

for transgender rights and social acceptance.

2

In recent years, trans individuals

have competed in the U.S. Open, graced the cover of TIME and Vanity Fair, pre-

sided over courtrooms as judges, and served with distinction in the military.

3

The

struggle for trans equality has also been fought on the political and legal fronts.

The f‌irst transgender lobbying day took place in 1995 in Washington, D.C.

4

Thirteen years later, the f‌irst transgender mayor of a U.S city, Stu Rasmussen,

was elected.

5

The following year, President Barack Obama nominated the f‌irst

1. Bostock v. Clayton Cty., 140 S. Ct. 1731 (2020).

2. Veronica Stracqualursi, Delaware Democrat Sarah McBride to Become Nation’s First-Ever

Transgender State Senator, CNN (Nov. 4, 2020, 10:19 AM), https://www.cnn.com/2020/11/04/politics/

sarah-mcbride-delaware-state-senate/index.html.

3. Milestones in the American Transgender Movement, Opinion, N.Y. TIMES (Aug. 28, 2015), https://

www.nytimes.com/interactive/2015/05/15/opinion/editorial-transgender-timeline.html.

4. Id.

5. Id.

418 THE GEORGETOWN JOURNAL OF GENDER AND THE LAW [Vol. XXII:417

openly transgender federal appointees to serve in his administration, later hiring

the White House’s f‌irst openly transgender staff member.

6

In 2021, newly elected

President Joe Biden nominated Rachel Levine to serve as the Assistant Secretary

of Health. Levine will be the f‌irst openly transgender federal off‌icial conf‌irmed

by the U.S. Senate.

7

While trans visibility in popular culture and media is increasing, and efforts are

being made to center trans people in social movements, such as #BlackLivesMatter,

trans people are still subject to stigma, discrimination, and violence at disproportionate

levels.

8

Federal Bureau of Investigation data shows that incidents of hate crimes moti-

vated by gender identity rose from 33 in 2013 to 118 in 2015 and have remained in

the triple-digits in the years since.

9

Lack of uniform documentation procedures, failure

to properly identify and distinguish gender identity from sexual orientation, and ques-

tionable reporting rates cast doubts on the accuracy of current data, suggesting that

hate crimes motivated by gender identity are more common than statistics indicate.

10

The transgender rights movement is also largely fought on the state level.

Research by the Movement Advancement Project summarizes legal rights and

protections afforded to transgender individuals in each state and considers laws

that both negatively and positively affect trans rights. Fifteen states and the

District of Columbia have high gender identity equality status; nine states are me-

dium equality states; twelve states are low equality states; and fourteen states are

negative equality states.

11

Notably, legal protections explicitly covering gender

identity lag signif‌icantly behind those covering sexual orientation.

12

This Article uses the terms “transgender” or “trans” to refer to a person whose

gender identity is different from the sex assigned to them at birth. Gender identity

is distinct from sexual orientation. Gender identity refers “to each person’s deeply

felt internal and individual experience of gender—which may or may not corre-

spond with the sex assigned at birth—including the personal sense of the body

6. Id.

7. Samantha Schmidt et al., Biden Selects Transgender Doctor Rachel Levine as Assistant Health

Secretary, WASH. POST (Jan. 19, 2021, 6:20 PM), https://www.washingtonpost.com/health/2021/01/19/

rachel-levine-transgender-biden-hhs-pick/.

8. Kiara Brantley-Jones et al., Black Trans Lives Matter: Activists Call for Inclusion in Racial Justice

Movement, ABC NEWS (Oct. 20, 2020, 4:53 PM), https://abcnews.go.com/US/black-trans-lives-matter-

activists-call-inclusion-racial/story?id=73571954.

9. See FED. BUREAU OF INVESTIGATION, HATE CRIME STATISTICS 2015, 4 (2016), https://ucr.fbi.gov/

hate-crime/2015/topic-pages/incidentsandoffenses_f‌inal.pdf; FED. BUREAU OF INVESTIGATION, HATE

CRIME STATISTICS 2013, 4 (2014), https://ucr.fbi.gov/hate-crime/2013/topic-pages/incidents-and-

offenses/incidentsandoffenses_f‌inal.pdf; see, e.g., FED. BUREAU OF INVESTIGATION, HATE CRIME

STATISTICS 2017, 4 (2018), https://ucr.fbi.gov/hate-crime/2017/topic-pages/incidents-and-offenses.pdf.

10. See Daniel Engber, The FBI Says Hate Crimes Are Soaring. It Actually Has No Idea, SLATE

(Nov. 14, 2018, 3:54 PM), https://slate.com/technology/2018/11/hate-crimes-fbi-data-insuff‌icient.html.

11. Snapshot: LGBT Equality by State, Gender Identity, MOVEMENT ADVANCEMENT PROJECT, http://

www.lgbtmap.org/equality-maps (last visited Feb. 7, 2021).

12. See id. (classifying fourteen states as negative equality regarding gender identity and two states

as negative equality regarding sexual orientation).

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