You Can’t Stop the Queer South is Them’s series spotlighting LGBTQ+ voices of resistance and resilience in the American South, created with guest editor adrienne maree brown. In the time since producing these stories, Hurricane Helene has devastated areas across North Carolina, South Carolina, Georgia, Florida, Tennessee, and Virginia, with nearly 200 dead, a million without power, and countless homes destroyed or displaced. We ask readers to support on-the-ground relief efforts however possible. See our Hurricane Helene relief resource guide to learn how you can help.
Over the course of the 2024 legislative session, I read headline after headline where journalists and pundits declared victory for LGBTQ+ equality based on the fact that fewer anti-LGBTQ+ bills became law this year than in 2023, when a record number were passed.
Those premature celebrations were hard to read. As a queer Southerner and policy advocate, I have seen the harmful impacts of the 44 anti-LGBTQ+ bills that did become law, including one of the worst anti-transgender healthcare bans to date in South Carolina. Further, it’s impossible to understate the impact of all the legislation passed in previous years that is now in effect. This fight is far from over — and LGBTQ+ people in the South are on the front lines.
Over the past year and a half, I have witnessed how gender-affirming care bans impact trans kids and their families, and how desperately more community support is needed. Through my work as a policy manager with the Campaign for Southern Equality, I’ve partnered with LGBTQ+ organizers across the country to help families of trans youth affected by this legislation – more than 1,000 families, including Mia and her son Rhyan, who were forced to fly to New Mexico for a doctor’s appointment after their home state of Texas banned gender-affirming care for youth.
We’ve done this work through a new program: the Trans Youth Emergency Project, created by the Campaign for Southern Equality after Mississippi passed the first ban on youth gender-affirming care in January 2023. Our goal was to connect families of trans youth in Mississippi to out-of-state gender-affirming care providers, and offset the financial burden of traveling to access care. At the time, my coworkers and I believed that youth gender-affirming care bans would pass in a handful of conservative Southern states. Since then, 27 U.S. states have passed a ban on gender-affirming care for youth, including nearly every state in the South.
As gender-affirming care bans have spread, our program has grown. Just a few months ago, we expanded our project from only states in the South to any state with a ban. We have provided education about gender-affirming care bills and patient navigation to thousands of families. In total, we have given over $600,000 in grants to support their travel across state lines to get care. One parent of a trans son from Tennessee said that the grant was a financial lifesaver – but beyond that, it let them know that they are not alone. Even with support, the burden of traveling for care is exceedingly difficult or even impossible to overcome for some families.
According to research released by our team earlier this year, trans youth living in most parts of the South lived within one to four hours of a gender-affirming care clinic before the bans. But now, trans youth living in the deep South may need to drive upwards of eight hours to reach a clinic. A family in Houston, Texas, would need to travel 600 plus miles one-way to reach the nearest clinic in Albuquerque, New Mexico. Flying from Houston to Albuquerque could cost a parent and child nearly $1,000 per trip, including airfare, hotel, meals, and a rental car. This doesn’t account for the actual cost of healthcare, which often is not covered by insurance. It’s also important to recognize that traveling for gender-affirming care is not a one-time expense. Depending on the type of treatment and the amount of time a child has been receiving care, they may need to see a provider as often as every three months.
Simply put, while it’s important to prevent more anti-LGBTQ+ bills from passing, we need to funnel resources to the people who are currently living under anti-LGBTQ+ bills, like gender-affirming care bans. The financial need of many families seeking care for their children surpasses the $500 grants we provide. Beyond this, there are still many trans adults struggling to access care. Although there are no policies in place right now that outright ban gender-affirming care for adults, policies that regulate when and how adults can receive gender-affirming care, and whether the care is covered by insurance, have a major impact on access. Some of these barriers have been in place for a long time, but the recent conservative political focus on chipping away at access to gender-affirming care is making things worse.
Let’s be clear: For both trans youth and adults, waiting for policy change is not an option. Trans lives depend on having access to gender-affirming care right now.
I do not mean to imply that overturning legislation is not possible – or that working toward that change is not worthwhile. I believe we must do everything in our power to ensure the Supreme Court rules that the bans on lifesaving gender-affirming care for youth are unconstitutional in the upcoming case this term.
But no matter how the Supreme Court rules, the fact remains that these bans have deeply disrupted access to care for youth. They will remain in place for at least the next year, and no ruling will change the fact that gender-affirming care has always been difficult and expensive to access for people of all ages.
Direct support for trans people struggling to access healthcare must be made a priority. Mutual aid is a longstanding practice in the queer and trans community – but it too often involves under-resourced trans communities scraping together funds to support each other’s healthcare through aid networks and GoFundMe pages. This has never been good enough.
Now is the time: As a movement, we must move resources directly to trans people nationwide who are struggling to access gender-affirming healthcare.
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