Native Tribal Groups Declare Sovereignty Amid Federal Crackdown on Gender-Affirming Healthcare

In June, at the Two Spirit Conference held in Elko, Nevada, Native American communities gathered to support LGBTQ+ rights and oppose recent federal and state actions that threaten transgender protections and access to gender-affirming healthcare. Organizer Myk Mendez, a trans and two-spirit individual from the Fort Hall Shoshone-Bannock Tribes in Idaho, expressed concern over the rising challenges, stating, "I want people to love their lives and tell their stories without fear of discrimination or harm." The term "two-spirit" refers to a culturally and spiritually distinct gender identity recognized uniquely within Native American Nations, not just a sexual orientation. These communities are witnessing firsthand how political shifts, including President Donald Trump’s actions, are impacting access to essential health services. In March, the National Indian Health Board adopted a resolution emphasizing tribal sovereignty over health issues affecting Native LGBTQ+ populations, advocating for the preservation and expansion of support programs. This move aims to counter federal policies that have limited protections; notably, Trump’s administration signed executive orders restricting recognition of gender diversity and dismantling diversity and inclusion initiatives across federal agencies. Additionally, a website created by the Indian Health Service describing two-spirit people was removed earlier this year but was later reinstated after a court intervention. The current disclaimer states that information promoting gender ideology is disconnected from biological reality, asserting only two sexes—male and female. Leaders and community members emphasize that two-spirit identity is rooted in longstanding cultural traditions predating colonization, representing a spiritually and culturally distinct gender. Across reservations, access to gender-affirming treatments like hormone therapy has become increasingly difficult. Some community members report delays or denial of hormone-related medications, even where laws permit such treatments for adults. This has created a "chilling effect," prompting concerns about safety and identity preservation among Native LGBTQ+ youth. Tribal advocates like Lenny Hayes and Itai Jeffries highlight that policies recently enacted threaten healthcare access and exacerbate health disparities, including higher rates of depression, self-harm, and suicide among two-spirit young people. The National Congress of American Indians and the Indian Health Board have championed policies to safeguard and enhance healthcare services for these populations, recognizing that homophobia and transphobia contribute to disproportionate health risks. Despite legal protections, barriers persist, and many Native LGBTQ+ individuals feel vulnerable, with some considering leaving their communities for safer environments. There's also concern about federal budget cuts affecting efforts to combat HIV and other health issues prevalent in Native communities. The CDC reports that HIV diagnoses among Native American gay and bisexual men increased by 11% from 2018 to 2022, with limited access to testing outside healthcare settings. Tribal leaders remain committed to resisting federal attempts to erase indigenous identities and are focused on providing resources and support to preserve cultural resilience and health equity for two-spirit and LGBTQ+ Native Americans.