Gender-Affirming Health Care Saved My Life. Everyone Should Have Access to It.

I have been awakened almost every day of 2021 to reports of gratuitous attacks on transbodies. From the slew of anti-trans bills that dominated state legislatures, to almost daily reports of how each year outpaces the last in reported murders of trans people, to J.K. Rowling’s latest hurtful ruminations on the existence of trans people — every day there are reminders of how we are situated precariously both discursively and materially. Too often, our joy and our pain are weaponized. Increasingly, the public debates are leading to the institutionalization dangerous anti-trans policy.

A common topic of public debate among those who don’t know us but hate us is whether or not our health care system is legitimate. The care that has saved so many lives has become increasingly difficult to access and contested.

Gender-affirming care can save lives, even though it is considered experimental and dangerous.

In August 2009, I flew to San Francisco from Boston to receive life-saving surgery. I was 26 years of age, in law school, and wanted to make a career as a trans advocate. However, I was overcome with shame and disgust at the time.

My entire life was disembodied, fragmented, and I felt lost. In 2008, I was finally trans and began to integrate all the parts of me. This was years before LaverneCox would grace its cover. TIME Magazine, and my main public reference of trans existence had been the scripted version of Brandon Teena’s life and death in Boys Don’t Cry. Trans-ness was often a joke in popular culture or a death sentence. It was liberation for me.

Top surgery was not covered under insurance at the time. Also, there were very few surgeons willing and able to perform the surgery. The trans community had developed resources to share information. We took care of one another when society or government wouldn’t. I was supported by my community and took out additional student loans. Priceline-d a hotel and I began the journey that would allow for me to live the life I have lived for the past 12 year.

One of the most memorable and joyous moments in my life was waking up from top surgery to see my body differently. There were many other moments that followed: the first time I wore a T-shirt and not a bib, the first time I went to the beach and the first time I looked in the mirror. Embodiment is the opposite of hiding. It is nourishing and exhilarating to live a life that is not your own. It is survival.

I pledged to spend my entire life working to create legal, political, social and other conditions so that others can have the same opportunities that I had.

Now, 12 years later, as a lawyer and deputy director for trans justice at the American Civil Liberties Union’s LGBTQ & HIV Project, I am litigating cases to ensure that others have the ability to access the very care that saved my life. At the very least one state, Arkansas, has already passedA law banning all gender-affirming treatment (including hormones, top surgery, and puberty-delaying medications) for minors. We succeeded! blockedThis law was not in court. However, the case is currently on appeal and new laws similar to it are being developed.

A well-funded, growing movement claims that gender-affirming healthcare is experimental, harmful and should be banned. Every day in state legislatures, on social media, in public discourse, we are told that we have been “mutilated” and “irreversibly damaged.” What we know to be true about ourselves is called a “delusion” from which we need saving. Protesters gather outside hospitals and clinics with photos of our bodies in order to call our liberation damnation.

This care can save lives, and my personal experience is supported by decades of data. Trans people will be able to access the gender-affirming healthcare they need. mental health improves dramatically. Science, medicineThis care is safe and effective, as evidenced by the testimony of thousands of transgender people over many decades.

The ban on transgender youth being cared for has been a major focus of much of the current debate about care for trans people. This is because the discourse is based on fear and misinformation rather that the actual reality of how the care works. Transgender minors cannot access care without the consent of their parents, and with the support of their mental and medical health providers.

Minors receive a majority of their care non-surgically. No medical care is given to minors before puberty. It is sometimes necessary to provide care, such as medication to delay puberty and gender-affirming hormones to induce puberty consistent to gender identity.

It is not true that parents or doctors push children to become transgender. A young person will often have gone through years and years of struggle within their family before they are prescribed care. Finding affirming doctors is difficult — and sometimes, impossible — in many places, and in many other places there are long waiting lists before care is available. Families often cannot afford the care and insurance does not cover it. We have a crisis of systemic discrimination facing our youth — not a crisis of lax facilitation of unnecessary treatment.

Every morning I feel at home in the body. I would give anything to feel more at home within my body. I cannot imagine the pain and agony that I and so others would have gone through if we had access to treatment like puberty blocksers when we were younger.

As a litigator against bans on transgender care, I am constantly immersed in claims that transgender people are inherently harmful and that we should stop our youth pursuing miserable futures. Transgender people are not inherently harmful and there is no way to stop them from being who they are. Proponents of banning our care, who mock and debate our existence are trying to ensure we will continue to struggle against a world that hates. They look at our joy and liberation, and it represents something terrifying — the idea that our bodies, our souls, our lives are more nuanced and complex than the binary narratives we have been sold. They can continue trying to take away our rights and our health care, but they will continue to exist, to support one another and to thrive. We all carry the emotional and physical scars of our journeys. But, when we are on the path to self-determination, all those scars are liberating.

Gender-affirming care saved my life, so I will never stop fighting for it.