This Pride, instead of celebrating the history of LGBTQ+ liberation, reveling in community support, or feeling joy at having found the courage, language, or visibility to embrace oneself, transgender Floridians are crowdfunding their moves out of state, staying home to avoid having to use a public restroom, and desperately attempting to arrange for continued healthcare amid a national debate on the validity of our existence. 

This year’s legislative assault on trans lives and futures is unprecedented in both volume and vitriol. More than 450 anti-LGBTQ+ bills were filed nationwide, with anti-trans initiatives seeking to ban access to healthcare, restrooms, sports, legal protections, identity documents, and even basic recognition while criminalizing supportive loved ones and healthcare professionals; over 70 of these bills have since been signed into law. 

In Florida, speech and education in schools have been censored or prohibited, including social affirmations like using a student’s correct name and pronouns, regardless of their parents’ wishes. Gender-affirming care for youth is banned, and the 80% of trans adults who previously received their care from nurse practitioners must now find new providers. Next month, a bathroom ban levying criminal consequences will go into effect. Taking stock, it’s difficult to avoid the conclusion that  the political endgame is persecution and erasure.

The ramifications are already dire. State and national advocacy organizations have issued travel advisories urging LGBTQ+ folks to avoid Florida at all costs—even during connecting flights—against the backdrop of a declared national emergency. Since January, trans Floridians have raised over $200,000 on GoFundMe to facilitate moves to safer states. A June Data for Progress survey found 8% of trans Americans have already moved from their home state because of new anti-LGBTQ+ laws, with an additional 43% strongly considering it—a potential for hundreds of thousands of domestic refugees. 

Our bodies and senses of self have become battlegrounds for political gain and community division. Self-righteously equipped with falsehoods, ardent hypocrisy, and the hollow determination to uphold the power structures they benefit from, politicians, pundits, and the droves they incite through fear-mongering, hate, and bigotry now feel an entitlement to arbitrate human nature and what should constitute an individual’s being and medical care. Religion and morality are being manipulated to serve prejudicial, unconstitutional ends. And despite the endorsement of every major medical association nationwide on the lifesaving benefits of gender-affirming care for youth, settled medical opinion is construed as experimental. 

In response to these nationwide attacks, the American Medical Association strengthened its commitment to protecting gender-affirming care, 13 states have passed transgender sanctuary laws, and court cases challenging anti-trans healthcare legislation have so far succeeded each time. 

In a landmark victory secured by the ACLU of Arkansas just this week, the state’s ban on gender-affirming care for adolescents was permanently blocked. The court  ruled that the Arkansas law violates the constitutional rights of trans youth, their parents, and their medical providers. Critically, in his decision, US District Judge James Moody Jr. made over 300 factual findings about the reality of trans care, debunking the unfounded narratives that have proliferated nationwide, concluding what we already know to be true: gender-affirming care is lifesaving, necessary medical intervention.

Notable court victories have also been secured in an initial West Virginia SCOTUS decision and lower court rulings in Indiana, Tennessee, and Florida. 

Deciding to medically transition requires surviving a most personal journey. The overt social risks are eclipsed by the determination to do right by oneself in this short and precious life. Accessing care is expensive; even when it is attainable, the path is riddled with hurdles.

While we have seen the rights to bodily autonomy and privacy whittled away in this post-Trump, post-Roe era, bans on gender-affirming care have already been struck down by federal courts as unconstitutional sex discrimination, in violation of the 14th Amendment’s Equal Protection Clause. So too with drag bans, which have been held to violate the First Amendment right to free expression. 

In his federal ruling last week that temporarily blocks enforcement of Indiana’s ban on gender-affirming care for youth, Trump-appointed Judge Patrick Hanlon was unequivocal: preventing trans folks from accessing the affirming care they need results in “irreparable harm.”

And just two days ago, in a federal ruling that struck down Florida’s ban on Medicare coverage for gender-affirming care as unconstitutional, US District Judge Robert L. Hinkle declared, “the statute and the rule were an exercise in politics, not good medicine.” 

For anti-trans antagonists, the clock is ticking.

Today marks a historic moment in the lives of our nation’s pregnant workers: after more than a decade of advocacy on Capitol Hill, the Pregnant Workers Fairness Act (PWFA), signed by President Biden in December 2022, goes into effect. PWFA mandates “reasonable accommodations” for pregnant workers unless providing them would impose an “undue hardship” on their employer. For millions of U.S. workers, the new law promises to assure they no longer will have to choose between their paycheck and a healthy pregnancy.

Pregnancy is a normal condition of employment; more than 80 percent of all working women will have at least one child during their lives. But existing legal protections have been glaringly insufficient for workers whose duties may conflict with pregnancy’s physical realities — such as cashiers (prolonged standing), nurses (repetitive heavy lifting), custodians (exposure to chemicals), and firefighters (battling potentially lethal blazes). Under the Pregnancy Discrimination Act (PDA), enacted in 1978, pregnant workers have been entitled to temporary job modifications only if their employer provides them to others “similar in their ability or inability to work.” That language long has been used to deny needed “accommodations” to pregnant workers, on the grounds that favored non-pregnant colleagues are insufficiently “similar.”

Credit: John Mofield

Even after the Supreme Court’s 2015 Young v. United Parcel Service, Inc. ruling clarified that employers must have a compelling reason for denying accommodations to pregnant workers while granting them to others, employers — and judges — continued to withhold them. One study found that more than two-thirds of workers brought PDA failure-to-accommodate claims after Young lost their court cases.

ACLU client Michelle Durham was one of them. In March 2015, Michelle learned that she was pregnant with her first child. Michelle’s doctor told her not to lift anything over 50 pounds; because Michelle’s job duties as an Emergency Medical Technician (EMT) regularly required that she lift patients and stretchers far heavier than that, she asked her employer, Rural/Metro Corporation — a company providing medical care to underserved communities — to temporarily reassign her.

What happened next derailed Michelle’s life, and propelled her into the spotlight as an advocate for pregnant workers’ rights. Rural/Metro gave Michelle an ultimatum: Keep lifting heavy loads in violation of her doctor’s orders or go on an unpaid leave of absence for 90 days — after which she would be fired unless she returned to work. With six months to go until her due date, Michelle was terrified; she desperately needed her paycheck.

As she later put it, testifying in support of PWFA before Congress, “I wouldn’t trade the experience of being [a] mom for anything. But I will never be able to get back those months before and after [my son] was born, when all I could think about was what I was losing by being pregnant — not what I was gaining.” Ultimately, Michelle left Rural/Metro rather than risk her pregnancy. She had to move in with her grandmother, racked up credit card debt, and incurred crushing hospital bills when she delivered her son.

After filing a lawsuit, Michelle ultimately reached a settlement with Rural/Metro that provided some relief for the hardship she had experienced. The bad news is that her legal battle took 7 years, in part due to a federal judge’s ruling that, under the PDA, Michelle was not “similar” to EMTs with occupational injuries. The ACLU won reversal of that decision on appeal, but the same judge reached a similarly erroneous conclusion at a later stage of the case.

As detailed in a new explainer on PWFA’s protections — co-authored by the ACLU and the Center for WorkLife Law — pregnant people needing accommodation no longer must identify “similar” non-pregnant co-workers. Modeled on the Americans with Disabilities Act, employers must grant pregnant workers an accommodation so long as it is “reasonable” and does not impose an “undue hardship” on the employer. Such clarity will aid workers and their employers alike in reaching mutually-agreeable solutions, with less cost and disruption — not to mention delay — than litigation.

As Michelle Durham put it before Congress, “Pregnant workers need to be able to point to the law, in real time, to make their employers do the right thing so that a long-fought lawsuit isn’t necessary.” She added, “My employer could have kept me on the job, but it didn’t — because it didn’t think it had to.” Starting today, Congress has left no doubt that they do.