A MidWestern transgender woman trying to survive in the real life.

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OPM Ends Gender-Affirming Care in 2026

The recent announcement from the Office of Personnel Management (OPM) that gender-affirming health care will be excluded from the Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) programs beginning in 2026 represents a profound step backward in civil rights and health equity. Under this directive, chemical and surgical interventions for gender transition will no longer be covered, though counseling for gender dysphoria must remain available. Insurance carriers are required to develop exceptions processes for individuals currently undergoing such care, yet the parameters of those processes remain undefined. Providers of gender-affirming care are also barred from being listed in plan directories, effectively discouraging access (Office of Personnel Management, 2025; Moss, 2025).

To understand the gravity of this reversal, it is necessary to recall how hard-fought the gains for transgender health care under FEHB were. In 2014, OPM lifted the longstanding blanket exclusion of gender-affirming procedures, and by 2016 carriers were instructed not to categorically deny such care. This change aligned federal benefits with emerging medical consensus that gender-affirming treatments are not elective but medically necessary. The World Professional Association for Transgender Health (WPATH) and the Endocrine Society have long affirmed that access to hormone therapy and surgeries significantly reduces psychological distress, improves quality of life, and prevents serious health complications (Hembree et al., 2017; Coleman et al., 2022). For nearly a decade, transgender federal employees and retirees could rely on this coverage as a matter of equity and recognition of their humanity.

As a transgender woman who has been receiving gender-affirming health care for more than eleven years, this policy shift strikes me not just as a bureaucratic adjustment but as a direct threat to my life and well-being. Having undergone an orchiectomy, I rely on estradiol not simply as an affirming treatment, but as essential hormone replacement. Without it, my bones, cardiovascular health, cognition, and emotional stability would be at severe risk. Estradiol for me is no different than thyroid medication for someone with hypothyroidism—it is medically necessary, lifelong care. To see it lumped under a politically charged category of “optional” transition services is both scientifically inaccurate and deeply insulting.

What unsettles me most is the uncertainty this policy creates. OPM’s promise of an “exceptions process” offers little clarity. Will it protect those of us with medical histories spanning over a decade of consistent care? Or will it force us into endless appeals and denials, treating every prescription refill as a battle? This ambiguity is destabilizing, and I cannot help but feel that it is intentional—designed to make care harder to access and to discourage providers from stepping forward.

As a federal retiree, I gave years of service under the assumption that the benefits I earned would protect me equitably. Now, I feel as though my identity has made me a target within the very system I trusted. The estimated 14,000 transgender federal employees and retirees who will be affected are not faceless statistics; we are people who dedicated our careers to serving this country, only to be told that our health care needs are unworthy of recognition (Lambda Legal, 2025; them.us, 2025). The exclusion also signals a dangerous precedent: that essential medical care can be stripped away not because of evidence or cost, but because of politics.

This change must be understood in its broader social context. Over the past decade, transgender Americans have seen both progress and backlash. The Affordable Care Act’s Section 1557 extended nondiscrimination protections in health care, and the Supreme Court’s ruling in Bostock v. Clayton County (2020) affirmed that gender identity is protected under Title VII. Yet, simultaneously, states across the country have passed laws restricting access to gender-affirming care, particularly for youth, framing these measures as cultural wedge issues. The OPM directive extends that wave of exclusion into the federal system, embedding discrimination into the nation’s largest employer-based insurance program.

For me personally, this is not an abstract policy debate. It is about whether I will be able to continue accessing the medication that keeps me healthy and alive. It is about whether the years of progress we celebrated were only temporary reprieves. And it is about what message this sends to younger transgender people entering federal service today: that their health and dignity can be used as bargaining chips in political battles.

I cannot help but feel anxious about what the future holds, but I also feel resolved. This rollback will not go unchallenged. Advocacy groups such as Lambda Legal, the National Center for Transgender Equality, and others have already condemned it as unlawful and are preparing legal strategies (Lambda Legal, 2025). As a transgender woman and a retiree, I plan to add my voice to that chorus, because silence is what allows discrimination to endure. We have fought too hard, and for too long, to let the ground be taken out from under us without resistance.

References

Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., … Winter, S. (2022). Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal of Transgender Health, 23(sup1), S1–S259. https://doi.org/10.1080/26895269.2022.2100644

Hembree, W. C., Cohen-Kettenis, P. T., Gooren, L., Hannema, S. E., Meyer, W. J., Murad, M. H., … T’Sjoen, G. G. (2017). Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, 102(11), 3869–3903. https://doi.org/10.1210/jc.2017-01658

Lambda Legal. (2025, August 19). Lambda Legal condemns Trump administration’s illegal exclusion of gender-affirming care from employee health benefits. Retrieved August 22, 2025, from https://lambdalegal.org/newsroom

Moss, K. (2025, August 20). Coverage for gender-affirming care will be eliminated from FEHB plans in 2026. Government Executive. Retrieved August 22, 2025, from https://www.govexec.com

Office of Personnel Management. (2025). Carrier Letter 2025-01b: Chemical and surgical sex-trait modification exclusion. Retrieved August 22, 2025, from https://opm.gov

them.us. (2025, August 20). Trump Admin to end coverage of gender-affirming care for federal workers. them. Retrieved August 22, 2025, from https://www.them

From Liberation to Sanitation: How Corporate Pride Stripped the Parade of Its Sexual Soul

Participants march in the 53rd annual Chicago Pride Parade on June 30, 2024, in Chicago, Illinois. (Photo by KAMIL KRZACZYNSKI / AFP) (Photo by KAMIL KRZACZYNSKI/AFP via Getty Images)

The Chicago Pride Parade has undergone a dramatic transformation since its early days, shifting from a jubilant, sexually expressive act of defiance into a carefully curated and often sanitized celebration. What was once a radical protest against heteronormativity and state control has become, in many ways, a corporatized festival designed for comfort rather than confrontation. I witnessed this difference firsthand. In 1996, I marched in the Chicago Pride Parade representing Northern Illinois University’s LGBTQ student group. We carried signs demanding queer liberation, chanted with raised fists, and celebrated our bodies and desires publicly, unapologetically. That experience was one of joy, solidarity, and sexual freedom—a moment when Pride was still very much about disrupting societal norms, not being absorbed into them.

Back then, Pride was deeply rooted in the spirit of the Stonewall Riots, which were themselves an uprising against police brutality and sexual repression. The early parades were messy, loud, and intentionally provocative. The presence of leather dykes, drag queens, trans sex workers, and bare-chested men wasn’t seen as a liability to be managed but as a central part of the protest. The parade was a place where queer people could publicly celebrate their sexualities, assert their right to pleasure, and reject the shame imposed by religious institutions, the state, and the medical establishment. As Gayle Rubin (1984) argues in Thinking Sex, sexuality is a frequent site of oppression, and its liberation is integral to broader social justice.

In recent decades, however, the increasing influence of corporate sponsorship and political interests has dulled the parade’s revolutionary edge. Corporate logos now dominate floats where once activists had marched. Politicians use the parade for photo opportunities rather than advocacy. In 2017, members of Black Lives Matter were briefly detained for disrupting the Chicago parade to protest police presence—an incident that underscores how the parade now often serves authority rather than challenges it (Bridges, 2017). These developments reflect a broader trend in which the politics of Pride have been defanged in order to be palatable to mainstream audiences.

As corporate sponsors and city officials pushed to make Pride “family-friendly,” explicit expressions of sexuality became increasingly discouraged. Kink communities, once a visible part of the parade, have been pressured to tone down their presence. Nude or partially clothed participants are often now treated as potential public relations liabilities rather than as rightful members of the LGBTQ spectrum. This retreat from sexual expression is not benign. It represents a fundamental misunderstanding of what queerness means and why visibility matters. As Sarah Schulman (2012) notes in The Gentrification of the Mind, the loss of sexual politics from queer spaces is not accidental but a consequence of neoliberal attempts to assimilate LGBTQ people into systems that continue to marginalize them.

Moreover, this sanitization undermines the very people whose liberation Pride was supposed to champion. Trans people, sex workers, people living with HIV, and those engaged in non-normative sexual practices have seen their visibility diminish just as the broader LGBTQ movement claims “inclusion.” According to Ritchie and Mogul (2007), this erasure aligns with a carceral and assimilationist approach to queer politics—one that values respectability over radicalism and marginalizes those who don’t conform. What was once a space to celebrate and politicize sex has been repackaged into a space where sexuality must be discreet, marketable, and inoffensive.

The shift is especially devastating for younger queer people, who now encounter a version of Pride that often leaves out the sexual energy that was once central to our movement. In Gay Shame, Halperin and Traub (2009) explore how the repression of queer sexuality under the guise of “progress” leads not to freedom, but to a new form of policing—this time from within the community. When Pride becomes merely a parade of sanitized slogans and rainbow logos, we lose not only our history but our future.

The LGBTQ movement was born from sexual deviance, rebellion, and refusal to conform. Sanitizing that history does not protect us—it disarms us. If we allow Pride to become sexually lifeless, we are not making it more inclusive; we are making it less honest. Pride must be reclaimed as a space where queer and trans people can express their desires and bodies with the same unapologetic defiance that launched the movement. Otherwise, it risks becoming a museum piece: brightly colored, well-funded, and utterly devoid of power.

 

References

Bridges, T. (2017, June 25). Activists protesting police presence at Chicago Pride Parade briefly detained. Chicago Tribune.

Halperin, D. M., & Traub, V. (Eds.). (2009). Gay shame. University of Chicago Press.

Ritchie, A. J., & Mogul, J. L. (2007). In Queer communities, police presence isn’t about safety. ColorLines. https://www.colorlines.com

Rubin, G. (1984). Thinking sex: Notes for a radical theory of the politics of sexuality. In C. Vance (Ed.), Pleasure and danger: Exploring female sexuality (pp. 267–319). Routledge.

Schulman, S. (2012). The gentrification of the mind: Witness to a lost imagination. University of California Press.

Unapologetically Sexual

I was let go from my student teaching position because of some tweets. In these posts, I said, among other things, “I like to suck dick.” It wasn’t part of a curriculum. It wasn’t aimed at students. It was a personal expression—raw, queer, unapologetic. And for that, I was deemed “unfit.”

But I am not ashamed. Because when I say something as simple and carnal as “I like to suck dick,” I’m not being obscene—I’m declaring war on the suffocating norms that define who gets to express desire and how.

Let’s be clear: this isn’t just about sex. It’s about power.

The phrase “I like sex” is broadly acceptable when said by a cis, straight man. Even when women say it, it must be delivered with just the right balance of flirtation and modesty, wrapped in acceptable femininity. But when a transgender woman like me speaks directly and honestly about her sexuality—without euphemism, without apology—it’s treated as taboo. It becomes scandalous, political, dangerous.

And that’s exactly why I say it.

Heteronormativity doesn’t just regulate bodies—it polices desire. It dictates what kind of sex is real, what kind of sex is dirty, and which voices are allowed to claim desire at all. Trans women are often reduced to caricatures: hypersexual porn tropes or sexless tokens of pity. To say, plainly and proudly, that I love sucking dick is to reject all of that. It’s to assert my autonomy, my pleasure, and my humanity.

Yes, I am a transgender woman. Yes, I am sexual. And yes, I will speak about it.

My words weren’t unprofessional. They were inconvenient—to a system that still finds trans joy threatening and trans pleasure unspeakable. I lost a role in education for telling the truth about myself. But I gained something else: clarity. I know now that empowerment doesn’t come from fitting in. It comes from taking up space. From naming what you’re told to hide. From loving your body and your voice enough to say what they told you you shouldn’t even feel.

So I will continue to speak freely. Not because I want to provoke—but because I refuse to be erased. I want other trans women to know that they can be intelligent, nurturing, sexual, kinky, loud, soft, and bold—all at once. I want us all to know that our worth doesn’t shrink because someone else is uncomfortable with our truths.

When I say “I like to suck dick,” I’m not just being honest.

I’m being powerful.

And in a world built to silence women like me, that is revolutionary.

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