Cassandra Beckham is worried about casting her first vote as an openly transgender woman.

“I have run into several road blocks down here just trying to get my birth certificate amended so I can get an updated driver’s license picture,” the 22-year-old Houston, Texas, resident told Rewire in a phone interview. She described placing calls to the Department of Motor Vehicles, the Department of Human Services, the Harris County Clerk’s Office, and eventually, the Texas Secretary of State’s office, all in a protracted effort to determine what identification she’d need at the polls.

Texas is one of 14 states that received an “F” from the National Center for Transgender Equality (NCTE) for having the nation’s least trans-friendly driver’s license policies for changing gender markers.

All 14 states that earned a failing grade require trans people to produce a court order, an amended birth certificate, or proof of surgery—even though the latter has no bearing on a person’s gender identity and may not be an option for personal, medical, or financial reasons. Proof of surgery also runs counter to the American Medical Association’s (AMA) call for modernizing birth certificate policies.

“State laws must acknowledge that the correct course of treatment for any given individual is a decision that rests with the patient and the treating physicians,” said then-AMA President Ardis Dee Hoven in a 2014 statement.

For Beckham, the stakes in this presidential election are personal. Her “biggest fear,” she said, is that a victory for Republican presidential nominee Donald Trump could propel his running mate, Mike Pence, the stridently anti-LGBTQ governor of Indiana, to the White House. And that’s why she is more eager than ever to vote.

By law, gender identity and presentation are not required to match the name, photo, or gender marker on government-issued identification, according to NCTE. In practice, that’s not always the determination that poll workers and election officials make when voters arrive at the ballot box.

A September 2016 report from the University of California-Los Angeles School of Law’s Williams Institute found that strict photo ID laws could disenfranchise as many as 34,000 transgender voters in Alabama, Georgia, Indiana, Kansas, Mississippi, Tennessee, Virginia, and Wisconsin.

Voter Suppression Efforts Escalate 

Trans voters represent just one marginalized group that may face barriers to exercising their constitutional right to vote amid the rancor leading up to Election Day. Trump repeated voting falsehoods around this summer’s anniversary of the Voting Rights Act of 1965, a law designed to stop states from passing legislation preventing Black voters from accessing the ballot box.

A senior campaign official last week touted Trump’s “major voter suppression operations” against Black people and young women. Trump continues to use his platform to claim that the presidential election is “rigged” against him, perpetuating the myth of voter fraud and riling up white nationalists who openly plan to monitor urban polling areas in an attempt to thwart Black voters.

Trump’s alleged voter-intimidation efforts prompted a federal judge to order the Republican National Committee to disclose any details about “ballot security” agreements with the campaign.

Compounding the fraught state of affairs: November 8 will mark the first presidential election since the U.S. Supreme Court in 2013 gutted key sections of the Voting Rights Act. Several states rushed to enact voter ID laws within hours of the ruling. Other laws followed in the intervening years, along with corresponding legal challenges. Following the death of conservative Supreme Court Justice Antonin Scalia, a deadlocked Supreme Court blocked North Carolina from enforcing the state’s photo ID requirement and other voting rights restrictions ahead of Election Day.

“Voting While Trans” Responds

The absence of Voting Rights Act protections prompted NCTE to update its guide to “Voting While Trans,” including a checklist of actions that trans voters should consider before and during Election Day. NCTE advises trans voters to first check their voter registration status or register to vote, ensure their name and address is up to date, and determine what, if any, identification their state requires.

“We want to make sure that our voters are privy to the information they need to walk into the polls,” Arli Christian, NCTE’s state policy council, told Rewire in a phone interview.

“Keep in mind that these strict voter ID laws, none of them say, ‘transgender people cannot vote,’” she said. “The impact on transgender people is heavier … because it is harder to get an updated ID. Photo ID requirements are burdensome for everybody, and they are particularly burdensome for transgender [people].”

Some of the states with the most restrictive voter ID laws, she continued, make a bad situation worse by maintaining a burdensome process to update gender markers on driver’s licenses and other forms of state government-issued identification.

For example, Georgia, Mississippi, and Tennessee, which have strict photo ID laws according to the National Conference of State Legislatures’ standards, earned grades of “D” or “F” from NCTE for lacking trans-friendly driver’s license policies.

“Georgia, Mississippi, and Tennessee all require voters to show photo identification to cast their ballot,” Christian said in an email. “And yet they have some of the most burdensome policies (or no policy at all) for updating the gender marker on state-issued photo identification, leaving trans voters in those states with few options for showing up at the polls with accurate identification.”

Trans Voting Concerns Remain

Texas’ “F” grade from NCTE did not stop the state from pursuing onerous restrictions, petitioning the Supreme Court in September to reinstate its broader voter ID law. A federal court previously found that the law disproportionately burdens Black and Latinx voters and violates the Voting Rights Act.

Beckham said she’s “anticipating discrimination” when she votes in Texas.

“Luckily, I am very passable. Most people don’t know [I’m transgender] unless I tell them. And they really don’t know until they see my driver’s license, and that’s when everything starts,” she said. “My main concern is having to show my driver’s license and then looking completely different than the person on the license.”

Despite similar concerns, discrimination at the polls did not materialize for Jessica Soukup during early voting last week . The 50-year-old transgender woman credited her positive voting experience, her first while openly presenting as a woman, to Texas’ weakened voter ID restrictions.

“I really think that that made a difference for me,” Soukup told Rewire in a phone interview.

Where she voted also helped, she said. Soukup cast her ballot at Texas State University in San Marcos, where she works as a systems analyst, rather than in her conservative suburban community.

For NCTE, stories like Beckham’s and Soukup’s underscore what policies need to change for trans voters.

“We think that restrictive voter ID laws should be removed. We should make it easier for all folks to get to vote,” NCTE’s Christian said. “At the same time, we also want to remove burdens to updating gender marker[s] on IDs, so that everyone can have access to accurate identification.”