This story was first published 19th.
This year, states are trying to ban transgender people from using public restrooms and renewing identification documents such as driver's licenses. Lawmakers in several states are trying to rewrite state laws to define gender based on reproductive ability and exclude gender identity from discrimination protections.
So far, these bills, which aim to weaken civil rights protections for transgender people and ban them from public facilities, have not made much progress. According to the ACLU, only five anti-LGBTQ+ bills have been passed this year, and several states notorious for pushing such bills, including Florida, Utah, and West Virginia, have adjourned this year's legislative session.
Still, these efforts can have a disastrous impact on the lives of trans adults, with medical health experts saying that ongoing political efforts to limit LGBTQ+ rights are having a negative impact on their physical and mental health. They are concerned about the long-term effects. Additionally, many of the bills currently in place would create disparities in health care for transgender people at a time of heightened anxiety.
Right now, Ashton Colby feels like he's in a state of chronic stress. A 31-year-old white transgender man living near Columbus, Ohio, he felt severe whiplash as the state's policies regarding gender-affirming care changed unexpectedly in recent months.
“In many ways, I feel eviscerated, dehumanized, and unable to accept who I am because my fundamental, basic humanity is out in the open and up for debate.” “I feel completely misunderstood,” he said.
Colby has been vocal about anti-trans policies in recent years. But she never thought that transgender adults could be forced to live without medical care. In Ohio, that almost happened. Republican Gov. Mike DeWine proposed restricting gender-affirming care for adults instead of supporting a statewide ban on care for minors. But after public outcry, the state health department announced it would no longer enforce those restrictions for adults.
Colby initially thought she would lose her health care provider of eight years. He considered moving to Denver. She also worries that her ability to access necessary documents and her rights as a transgender person could be at risk if Republicans win the White House and Congress this year.
This is something that Dr. Carl Streed, president of the United States Professional Association for Transgender Health (USPATH), thinks about all the time. It's the negative health effects of transgender people not feeling safe in society. He believes anti-trans policies will increase isolation in what the surgeon general has called an epidemic of isolation and loneliness in the United States.
“These policies that restrict people's public lives actually harm people directly, both in terms of mental health, community connections, and access to care in emergency situations, both in terms of pressing issues. But in the long term, global health will deteriorate even further, “probably over the next five or 10 years, if not sooner,'' he said.
What does poor health look like? Increased isolation and inability to participate in public life and direct contact with the community can lead to poor cardiovascular health, high cholesterol and high blood pressure. It is more likely that As a result, your risk of heart attack and stroke increases. Isolation is also associated with poorer cognitive function and memory, Streed said.
“They're definitely creating quite a checkerboard of restricted public spaces,” said Streed, a primary care physician at Boston Medical Center. “But the thing is, these are national discussions. What's happening in Florida is the conversations we have with patients in the doctor's office.”
Transgender people living in states with unrestricted access to health care and public spaces are understandably concerned about such policies in other states, he said. Restrictions may also be affected while visiting friends and family.
So far this year, the ACLU has tracked about 200 anti-LGBTQ+ bills continuing to move through state legislatures. That means these bills are valid. Although many other bills have been defeated, fear and terror in many in the transgender community, and the larger LGBTQ+ community, remains extremely high.
Simone Criss, an attorney with the Southern Florida Legislature and director of the group's transgender rights initiative, said at a February press conference that Florida's often confusing array of anti-LGBTQ+ policies incite fear. He said it was aimed at.
“The purpose is to create fear, to mislead us from understanding what our rights are. Ambiguity and ambiguity are key,” she said. She was speaking to advocates, local residents and members of the media gathered at an impromptu “town hall” to break down the legal implications and dispel misconceptions of Florida's new driver's license policy. Ta.
Angelique Godwin, an Afro-Latinx transgender woman and advocate for Equality Florida, spoke on Monday about how transgender Floridians are supporting each other amid increased restrictions on daily life. Godwin lost her access to health care last spring when Gov. Ron DeSantis signed a law banning patients from receiving gender-affirming care from nurses. Subsequently, she was unable to refill her prescription for estradiol valerate as part of her gender-affirming care, and other TransFloridians are experiencing similar experiences as pharmacies refused service to patients in the confusion after the law was passed. Did.
“Thankfully, I had a stash and a little extra medication for myself. But there are people close to me who didn’t have access and were affected by it. I did,” she said. “It was a sudden thing for them.”
Godwin then found a facility in Tampa with doctors working on a sliding scale payment system, where he was able to continue his treatment. It also helped that she obtained insurance through the federal health insurance marketplace. And under the new law, she was able to keep mental health appointments with her family doctor.
Many more care gaps are being filled by mutual aid grants and organizations like Folx Health, an LGBTQ+ telehealth provider. Folx requires an in-person visit with a doctor, and patients review and sign a consent form to receive treatment under state law.
“A lot of people struggled for the first three months from June to August. Most of the people I know here in Florida since then are still here,” she said. .
According to the ACLU, approximately 30 bills are still moving through state legislatures that would limit how transgender youth and adults can access health care. These bills would ban gender-affirming care (meaning puberty blockers and hormone therapy) for transgender youth, block insurance and Medicaid coverage of gender-affirming care, and prevent such care from incarcerated transgender people. It restricts access to.
Even if states do not pass restrictions on gender-affirming care, it is already difficult for transgender people to access it in large parts of the country. And for many transgender people, accessing medical services essential to their health already requires traveling across state lines.
Dr. Angela Rodriguez is a San Francisco-based plastic surgeon who specializes in transgender care and often works with patients who travel to California. And it's not just because they can't find trans-affirming care. Her transgender patients come to her from Alabama, where good dentists and primary care physicians are difficult to find.
She's heard similar things from out-of-state patients over the past few years. “Who will take care of them in the long run?”
“Some patients fly all the way back from the East Coast because they don't feel comfortable talking to a local doctor,” she says. She works with patients traveling from out of state to make sure they have a support system, loved ones and friends in California to take care of them after surgery.
Dr. Johanna Olson-Kennedy, incoming president of USPATH, who treats adolescent and young adult patients at Children's Hospital Los Angeles, said states' bans on gender-affirming care for minors have worsened the mental health of young trans patients. He said he was doing it. Her patients also worry about simply being in public and whether they can safely use public restrooms in some states. Florida and Utah have extreme bans on public restrooms, and eight other states prohibit transgender people from using restrooms that match their gender identity at school.
“I don't think people really think about the mental health burden of the pandemic, but having this on top of that is really an extraordinary uplifting thing for young people,” she said. . Most of her patients go to college or graduate school, and many plan to avoid higher education in states with anti-trans laws.
Olson-Kennedy herself doesn't feel safe on social media. For someone who provides gender-affirming care, it's often a hostile environment, as her job is politicized by Republican lawmakers, lobbyists, and far-right media figures.
“We can only manage a certain amount of hearing, so you have to get an injection when you leave the clinic,” she said. “It's not something that's taught in medical school. … This is not something that children's hospitals or pediatricians have dealt with in the past.”
Olson-Kennedy said more people need to understand what gender-affirming care means. This care is provided to minors over a long period of time, with the involvement of their parents or guardians, and is intended to treat the severe despair caused by gender dysphoria that many transgender people feel. Yes, she said.
“I wish people would put aside their own discomfort and lack of understanding and really realize that this care is medically necessary. ,” she said.
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