For Many Transgender Youth, Leaving Is Not an Option

The demand for equity across healthcare disparities increases as transgender youth continue to fight for equal rights.

Published: Dec 14, 2023  |  

Health policy and communications professional

Refugees. Migrants. Displaced families. Leaders at this year’s United Nations Climate Change conference are using these words to discuss the climate crisis and its devastating impact on global communities. These words could just as easily describe transgender youth and their families who are currently fleeing hostile states to access the healthcare they need.

After a year of unprecedented anti-trans legislation, 22 states now have laws banning necessary healthcare for transgender youth. Many families have been forced to seek refuge in safe-haven states, such as Illinois and Massachusetts, which passed laws to preserve accessible healthcare and protect doctors and families from prosecution by state legislatures.

This workaround leaves countless families at risk. What happens to youth in banned states who cannot afford to leave or families who choose to stay? Mainstream narratives of families with privilege who have the means and resources to move across state lines critically miss the realities for many transgender young people.

For many of us, community support doesn’t just feel good but is also essential to our health. Social support and connectedness, particularly for transgender people, significantly decrease symptoms of depression and anxiety. For transgender youth in particular, having even one space where their chosen name is used is associated with a 29% decrease in suicidal ideation and a 56% decrease in suicidal behavior. Transgender young people may find these affirming spaces online, at home, or at community events. More than 50% of transgender and nonbinary young people report feeling affirmed at school.

Although you may be happy in a place where you feel safe and have friends who understand you, you also need access to medical care to help your body feel aligned with your gender and improve your quality of life. Similarly, while you could feel connected to your hometown because of ancestral or familial ties, you also want to access healthcare that alleviates symptoms of depression and anxiety, which often come from living in a transphobic world. When state legislatures ban necessary medical care, transgender youth and their families are forced to weigh options like this and are left with an impossible decision to make.

Some families may ultimately decide they’re willing to pack up and move or even drive hours across state lines to access healthcare, but the reality is most families simply cannot afford it—especially families of color. Recent Census Bureau data show that Black and Indigenous peoples experience poverty at a rate more than twice that of white people. Wage gaps also persist, with Black and Hispanic households earning only half of what white households make. These financial disparities mean that transgender youth of color are disproportionately impacted by anti-transgender policies with no options to access necessary medical care in their state. Nevertheless, some families will continue to share GoFundMe pages to raise money while others will reach out to organizations like the Campaign for Southern Equality, which provides rapid response support to families of transgender youth impacted by the healthcare bans.

Traversing state lines cannot be our long-term solution. Nor can GoFundMe campaigns, especially with data showing racial inequalities in medical crowdfunding. People of color account for less than 20% of medical GoFundMe pages, and even those who do raise money receive significantly fewer and smaller donations compared to white people.

Reality necessitates that we approach our resistance to anti-transgender healthcare bans from the intersectional lenses of race and gender identity. Equity is not watching the most marginalized people escape the destruction of their homes and communities, but rather doing everything in our power to stop those communities from being destroyed in the first place. We must all call for legislation that stops our states and communities from becoming unsafe places trans youth need to escape from. We cannot, nor should we, expect that families with a transgender young person will leave their homes for healthcare. Transgender people are not going away. There is no second planet Earth, and there is no humane option other than full access to essential healthcare for all transgender people.

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