The American Medical Association, the largest association of physicians, says killings of trans women have become an “epidemic,” reports The New York Times.

This year, 18 trans people have been killed in the U.S., and many of them have been Black. 

“We are the most afraid we’ve ever been,” said Mariah Moore, a program associate for the Transgender Law Center, in an interview with the Times. “But we’re also stronger than we’ve ever been.”

“I want us to live in a world where we don’t have to worry about walking out of our front doors and being killed because someone doesn’t understand who we are,” Moore continued. 

Beverly Tillery, the executive director of the Anti-Violence Project in New York, told the Times that people are looking to harm transgender people.

“The increased visibility is a signal for them that they need to double down in fighting back. We’re definitely seeing what we would call a backlash," Tillery stated. 

A large portion of the violence was recorded this summer between the months of May and July, when LGBTQ pride events were in full force, Axios noted. At least 14 LGBTQ people, including seven Black transgender women, were killed during that time, according to a report from the Anti-Violence Project.

In 2018, at least 26 transgender people were killed, according to a Human Rights Campaign report.

“These victims were killed by acquaintances, partners and strangers, some of whom have been arrested and charged, while others have yet to be identified,” the report said. “Some of these cases involve clear anti-transgender bias. In others, the victim’s transgender status may have put them at risk in other ways, such as forcing them into unemployment, poverty, homelessness and/or survival sex work.”

In response, the AMA plans to launch a series of advocacy efforts to combat the epidemic according to a press release. Among the endeavors, they plan to push for the creation of a nationwide database that will properly identify the sex and gender of homicide victims and the establishment of proper police protocol regarding their encounters with trans individuals. 

Members of the transgender community have reportedly faced a wider amount of legal and social attacks in recent years. This includes the Trump Administration’s stance on trans people in the military and their access to health care, reports CNN.

Earlier this week, ABC's Nightline did an in-depth report on the epidemic, titled "Am I Next?" and spoke to several trans people about the grim realities they face on a daily basis.