Countries that have declared havens for transgender people are effectively calling for “get gender-affirming healthcare here without fear of domestic prosecution.”
Now that bans on such care for minors are being enforced across the country, Texas could be the next state, depending on the outcome of this week’s court hearing, but patients and their families are putting their clinics’ capacity to work. I am trying. Despite already long and growing waiting lists, there are a limited number of providers offering gender-affirming care and a limited number of patients that can be seen each day.
These refugee states–so far, California, Connecticut, Colorado, Illinois, Massachusetts, Maryland, Minnesota, New Jersey, New Mexico, Washington, Vermont, plus Washington, D.C. — the question is how to act and build an environment beyond the promise of legal protection. A network that serves more patients.
“We are doing our best to ensure that these children are hospitalized so they do not experience any interruptions in care,” said Angela Cade Gepfard, M.D., medical director of the Minnesota Children’s Hospital Gender Health Program. Stated. twin city. “For patients who haven’t yet seen a doctor and will be added to the general waiting list, it can be daunting to think that it will be over a year before someone sees them.”
Orphanages have been flooded with bookings from all over the country, including Florida, Texas and Montana, all of which have been banned. Requests increased from about 100 to 140-150 per month in one year. The program hopes to hire more staff to meet demand, but that will take time, Gepfeld said.
More than 89,000 13- to 17-year-olds live in states with limited access to gender-affirming care, according to a research letter published in the Journal of the American Medical Association in late July. , not everyone chooses or can afford gender-affirming care.
Transmasculine, non-binary 17-year-old Rhys Perez is preparing to move from Houston to Los Angeles this month for college. “I’m going to get out of Texas in the nick of time,” said the teen, who said California’s protection of gender-positive care was one of the main factors in his decision to go to college.
Perez has just started looking for a provider in Southern California, but has already encountered several clinics and has been waiting nine to 14 months for her first visit. They were disappointed to learn that hormone replacement therapy likely wouldn’t start until the sophomore year.
“Hormones and other things weren’t something my family fully understood or supported,” Perez said. “I thought it would be best to wait until I moved for college, but I’m frustrated to find out I have to wait even longer.”
“I wish I could start college my way,” they said.
The original sanctuary laws and executive orders were emergency measures to protect transgender people and their families from the threat of prosecution by more than 20 states that have restricted or banned such medical care, proponents say. . It doesn’t usually include provisions to strengthen the health system, but proponents say it needs to be the next step.
“That’s what we want to build over the next year or two, where we don’t just make a promise to be a shelter for people, but we actually keep that promise and make sure that people who evacuate. “When you come here, you can get care when you need it,” said Kat Roan, executive director of LGBTQ+ advocacy group Outfront Minnesota.
Kellan Baker, executive director of the Whitman-Walker Institute, the policy and education arm of the eponymous clinic in Washington, D.C., said these efforts involve legislators, governors, large employers, Medicaid programs, and medical boards. He said he needed to get involved.
“This will be a comprehensive effort, and everyone at all levels enacting these shield laws will recognize that access needs to be backed by the availability of providers, not just promises of access on paper. I hope so,” Baker said.
Republican Texas Governor Greg Abbott became the first governor to order an investigation into families of minors receiving gender-affirming care, and Congress passed a ban on such care earlier this year.
Whether the law takes effect on Sept. 1 will be decided by an Austin judge who will hear arguments in the lawsuit filed by the family and doctors seeking a temporary injunction on Tuesday and Wednesday. The lawsuit alleges that the bill violates parental rights and discriminates against transgender teens. It’s unclear when the judge will make a decision.
Ginger Chun, education and family engagement manager for the Texas Transgender Education Network, said she reached out to about 15 families with transgender family members last year. Already this year she has spoken to about 250 families, who have asked them about everything from explaining the law to finding ways to access care. People seeking care outside of Texas face waiting lists.
A study published in JAMA found that the average travel time for Texas youth to get to clinics for gender-positive treatment increased from just under an hour to more than seven and a half hours.
“Finding out where people can get care is kind of an ever-changing process every day,” Chung said.
Minnesota Democratic Rep. Lee Finke, who proposed a bill to protect gender-positive care, predicts that “thousands” of people will come to the state for care within two years. He’s also looking for solutions to the provider shortage, which he plans to look into further at the next Congress, which starts in February.
Finke, a transgender woman who represents part of the Twin Cities area, said, “I don’t know what Congress can do to increase the number of people who have access to some kind of medical care.” “As a policy maker, I don’t see the mechanism by which you can say that given that there are specific providers, she needs one specific provider. It would certainly be interesting to see.” Masu.”
There are a limited number of providers nationwide, and for many, it’s not a full-time job. For example, Minnesota has 91 health care providers, according to a search on the World Association of Transgender Health Professionals website. According to the Williams Institute, an LGBTQ+ think tank at UCLA Law School, the state has 29,500 transgender people aged 13 and older.
Dr. Katie Miller, medical director of adolescent health care for the Minnesota Department of Children’s Affairs, estimates that “probably at least a few hundred families” are migrating to the Twin Cities seeking gender-affirming care.
“People are trying to do things that are kind of insane, like kicking kids out of school and moving,” Miller said.
In many ways, the quest for gender-affirming care is similar to access to abortion, for which people cross state lines and sometimes face the threat of prosecution. A key difference from gender-affirming care is that permanent access is key, as treatment is generally continued for the rest of one’s life.
Some parents, like Minnesota activist Kelsey Waits, anticipated long wait times and proactively sought out gender-affirming caregivers for their children. Her 10-year-old transgender child, Kit, eventually joined a hospital system that could provide inhibitors and hormones so that she would not have to go through puberty without medical assistance.
“A lot happens in a year during puberty,” says Waits. “Just the stress it puts on the family, on the kids, and on the parents trying to find care for their kids, is horrendous.”
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