By Nico Lang

Sarah McBride knows how difficult it can be to get quality, affordable healthcare in the United States. When her partner, Andy Cray, needed an emergency operation in 2014 to drain fluid that was accumulating in his lungs, the couple had no choice but to say yes. Cray was quickly losing the capacity to breathe, and without undergoing the critical procedure, he could soon die.

While McBride says Cray had “good, comprehensive health insurance,” the doctor he needed to see didn’t take insurance. They were forced to pay for the cost of his treatment, which was nearly $3,000, out of pocket. The couple then had to submit an insurance claim and essentially “roll the dice” on whether they would ever be compensated for Cray’s treatment. It took several months before the reimbursement went through, according to McBride, which was difficult but — at a time in which an estimated 41 million people are underinsured in the U.S. — it was also lucky.

“That is an experience no one should have to face, but it’s frankly the reality for far too many people,” McBride tells MTV News.

McBride, a longtime activist for transgender rights and press secretary for the LGBTQ+ advocacy group Human Rights Campaign, says it’s this experience that encouraged her to launch her historic bid for the Delaware State Senate. If elected, the 28-year-old would be just the fourth trans person elected to a state legislature and the first to be seated in a state Senate. In addition, McBride’s home state has never elected an openly LGBTQ+ candidate to statewide office.

Her candidacy is part of a recent wave of landmark victories for trans candidates across the country. In 2017, Virginia’s Danica Roem, who campaigned on repairing a dilapidated road in her home town, became the first transgender woman elected to a state legislature. Colorado’s Brianna Titone and New Hampshire’s Gerri Cannon were elected the following year.

McBride says she isn’t running to make history, though. Instead, she wants to make sure that no person in her state has to make the choice she did: between a thousand-dollar medical bill they can’t afford and the lives of people they love.

“I do recognize that anytime a barrier is broken, it can help to empower others and potentially save lives,” she says. “But at the end of the day, this can't be about making headlines. It’s got to be about making a difference in our community. That’s what Andy was about. That’s how I try to live my life every single day.”

McBride is campaigning for the Delaware’s First Senate District because she believes the legislature is where she can effect the greatest amount of change. Earlier this year, she lobbied with the advocacy group Moms Demand Action to advocate for a trio of comprehensive gun reform bills in the Delaware General Assembly, including bans on high-capacity magazines and semiautomatic weapons.

Those proposals stalled in committee, leaving Delaware with few statewide regulations on licensing or registering firearms. While the Giffords Law Center to Prevent Gun Violence gives the state an overall “B” grade on gun policy, there’s still room for the state to grow. For instance, Delaware does not impose a waiting period on gun purchases, limit the number of weapons an individual can buy at one time, or require that residents be licensed before owning a gun. If she’s elected, she’ll be in a position to helps close these loopholes.

While coverage of her campaign has, thus far, focused on her gender identity, McBride believes Roem’s victory in Virginia shows trans candidates can win when they run on the issues. She plans to campaign on what “keeps voters up at night,” including paid family leave and criminal justice reform. Earlier this year, lawmakers in Dover introduced 19 bills to address prison overcrowding and recidivism.

“Voters don't care about gender,” she says. “They care about the issues that are impacting their lives, whether that's infrastructure, whether that's family inclusive workplace policies, or being able to access a job that pays a livable wage.”

The issues important to Delawareans are also critical for members of the trans community. A 2015 survey from the National Center for Transgender Equality (NCTE) found that the top two priorities for transgender voters were decreasing violence and expanding access to health care. In an October 2018 poll conducted by the University of Delaware, 60 percent of state residents stated their support for Medicare for All, while 68 percent are in favor of universal health care.

McBride did not specify the details of her plans, having only announced her candidacy two weeks ago. Nonetheless, she believes Delaware has the potential to be a progressive standard bearer for the rest of the country. Her campaign kickoff video, filmed in a park down the street from her childhood home in Wilmington, emphasizes her belief that her home state is a “state of neighbors.”

“It’s a state where everyone knows each other,” McBride says, a nod to Delaware’s petite population of just 900,000 people. “Because of that, Delaware is a state that has the capacity for adopting the kind of policies and laws that leave no one behind.”

McBride knows that Delaware can be a “laboratory of big ideas and bold solutions” because she has witnessed its promise up close. As a young trans activist, her advocacy was widely credited with the passage of Senate Bill 97 in 2013, an LGBTQ+ civil rights ordinance that barred discrimination on the basis of gender identity and sexual orientation in housing, employment, and public accommodations throughout the state.

Although both houses of the Delaware General Assembly were controlled by Democrats, pushing the legislation through was a tough battle. McBride fought to pass SB 97 the same year that Delaware passed a marriage equality bill, and no state had ever enacted same-sex marriage and a nondiscrimination ordinance at the same time.

“Fortunately we understood that politics isn't the art of the possible,” she says. “It's the art of transforming impossibility into possibility.”

The nondiscrimination ordinance fight offered McBride a glimpse into the unique risks associated with being a trans woman in public life. She testified in front of the Delaware General Assembly on at least three occasions, tending to fears about whether the bill’s page would lead to women and children being targeted in public restrooms, a widely debunked myth. A woman approached McBride after one of her testimonies and threatened to “chop it right off” if she ever saw her in the women’s bathroom.

“Was I surprised that someone threatened me?” she wrote of the encounter in her 2018 memoir, Tomorrow Will Be Different. “No. But the fact that it wasn’t surprising should be an outrage. It further underscored the need for the bill and, in particular, for protections from discrimination and harassment in bathrooms.”

Although she had been out for less than a year at the time, McBride didn’t back down; she knew how much was at stake. When she first began the work of lobbying for SB 97, it was with the hope that she and Cray, a fellow trans activist, could move back home one day and start a family, without worrying that they could be fired from their jobs or evicted from their homes. Even today, LGBTQ+ people can legally be denied housing and employment solely because of their identities in 29 states.

McBride’s determination paid off. In June 2013, former Delaware Gov. Jack Markell mentioned her by name as he signed the bill into law, crediting her “tireless” efforts for making “a real difference for all transgender people in Delaware.”

In the six years since the ordinance’s passage, McBride has never stopped pushing for equality. During the 2016 Democratic National Convention, she made history as the first out trans person to ever be invited to speak onstage at the event. After the audience rose to its feet, McBride told the thunderous crowd that her experiences in advocacy have shown her that “change is possible.”

However, Cray would not be there to celebrate the milestone with her. In August 2014, he died of oral cancer at the age of 28. The couple was married in a small ceremony on the roof of their Washington, D.C. apartment just days before he passed away.

“One of the most difficult conversations I had with Andy was in the last few weeks of his life, crying about not just his fear over death, but also his sadness over the fact that he wouldn't be able to be there for those he loved,” she says. “I'll never forget his blue eyes through the tears and him saying, ‘I’m sorry, Bean, that I won't be able to be there to tell you I love you and that I’m proud of you.’”

Should she be elected a member of the Delaware General Assembly in 2020, McBride hopes to keep making her late husband proud by working for the values he believed in: kindness and fairness for everyone. As a researcher for the public policy organization Center for American Progress, his pioneering work laid the foundation for trans inclusions in the Affordable Care Act (ACA). Those protections, known as Article 1557, have since been challenged by the Trump administration.

To date, McBride is the only candidate to have declared in the race for Delaware’s District 1, where the Democratic primary is scheduled for September 2020. It’s unclear if she will face challengers in the race.

If McBride is elected to the state legislature next year, she knows the victory will be a testament to the “kind, funny, brilliant” man who continues to inspire her work every day. When she wakes up in the morning, the first thing she does is ask herself: “What would Andy do?”

“For Andy, the work was never about prestige,” McBride says. “It was always about doing good. He is someone who lived every day fighting to make change, regardless of whether he got praised. I try to carry on that legacy.”