Chris Johnson has a detailed article in the Washington Blade Friday on the devastating effects that “RyanCare” could have on some in the LGBTQ world.
It could jeopardize long term anti-retroviral therapy, which the article maintains has generally worked under Obamacare (but some other reports have said it hasn’t). PrEP medication would not be covered (most likely), increasing the likelihood of more transmissions. We all know what Mike Pence has to say about that.
I actually have much greater concern that the budget could slow down vaccine development that could prevent pandemics in many much more contagious diseases, leading to much more heavy-handed contact tracing and quarantining for novel diseases, and these could affect gay men especially disproportionately in some scenarios.
It is unlikely that medical procedures aiming toward gender change for trans people would be covered, meaning birth certificate chances could not happen in many states.
Time Magazine has a big cover story in the March 27, 2017 issue, “Beyond He or She”, by Katy Steinmetz.
The key concept seems to be gender-fluid, not simply choosing “being” the opposite gender in identity to biological organs. I recall how our French teacher hammered us in ninth grade, “everything is either masculine or feminine, nothing is neuter”. Or in-between. Appearance changes lose their existential eventful nature. The alien assassin character Pie ‘o’ Pah in Clive Barker’s “Imajica” is gender-fluid, as he/she actually changes physically according to desire, a very threatening idea. Gender-fluidity is not the same thing as polarity in the world of Paul Rosenfels, but that's another discussion.
I don’t really see this happening all that much in the clubs and discos, yet at least.