The Windy Sanctuary: Trans Care in Chicago under Threat

Following the "transgender tipping point" in the mid 2010s many Americans believed that transgender rights were on the way to being fully secured in the United States within the decade. However, the election of Donald Trump and the following proliferation of anti-trans legislation have placed tremendous doubt on the security of trans civil rights and access to transition related healthcare in the United States. In response to increasing hostility, several liberal states have implemented shield laws to protect targeted healthcare. Whether these policies have actually provided security for trans people accessing care has not been thoroughly investigated. This qualitative study seeks to understand what everyday access to trans healthcare looks like in Chicago, a city with both shield laws and a wide variety of options for care. Over the course of 2025 care in the city began to face restrictions that disrupted residents' confidence in shield policies. Additionally, informants reported numerous barriers to accessing care in the city, particularly clinical diagnosis which provided the largest obstacle timewise and was the most vulnerable to exploitation by medical gatekeepers. In this paper, I discuss the vulnerabilities present in Chicago's trans healthcare system and the ways in which they reveal failures of the liberal state in providing security for marginalized healthcare.