One hundred and twenty five miles. That’s how far many of the trans people who we work with at Gender Benders in Upstate, South Carolina have to drive to find a medical provider who will treat them with dignity and respect. For these folks who live in places like Cowpens, South Carolina a simple trip to the doctors office often means driving to Augusta, Georgia to the Equality Clinic or Charlotte to see someone in the Charlotte Transgender Healthcare Group. This trip takes about four and a half hours in the car round trip, and costs a someone a whole day of work and around $25 in gas just to get to their appointment.
Simultaneously to all of this we know there are affirming doctors who want to treat trans patients in nearly every small town across the South. So, why don’t they? Why do we see this enormous gap in services for Southern rural trans folks? It’s not typically because these providers have malice or ill intent towards trans folks. Contrary to that many providers deeply care about LGBTQ people, but they still aren’t providing Hormone Replacement Therapy, or meeting the basic needs of trans patients. This is rooted in the belief that trans folks need to see specialists in order receive care.
The truth is that treating a trans patient isn’t all that different from treating any other patient. I mean, sure, we’re cuter than a lot of non-transgender folks - but, if a medical provider is providing hormone therapy for Polycystic Ovary Syndrome or Low Testosterone for anyone they should also be able to provide Hormone Replacement Therapy for trans folks.
We also know that trans folks see unemployment rates that are three times higher than the national average with black trans folks facing rates that are four times higher according to the 2015 U.S. Transgender Survey conducted by National Center for Transgender Equality. According to the Williams Institute an estimated 1.4 million adults in the US identify as transgender, and more trans people live in Southern states than any other region of the U.S. When we add all this up it’s easy to see that the current state of healthcare for trans folks in the rural South is inaccessible at best.
This is why the Gender Benders have been offering trainings to medical providers, and working with places like the Greenville Health System, Carolina Center for Behavioral Health, and Spartanburg Regional Hospital around trans issues.
Gender Benders is a grassroots organization for transgender, gender non-conforming folks, and our friends and families. We developed a three pronged approach to serving our people. The first leg of what we do is connecting people to the resources they need to lead full and healthy lives. The second leg of what we do is engage in activism and education to create safer communities for our people. And the third leg of what we do is hold intentional space for people to develop relationships with other trans and gender non-conforming folks.
We collaborate with doctors who do specialize in working with trans folks to create resources like this insurance fact sheet that outlines helpful information about alternative coding for trans healthcare. The sad reality for many trans people is that we have to provide this information to our healthcare professionals in order to get our care coded in a way that insurance will help offset the cost. Keep in mind, this is for those of us who are fortunate enough to even have insurance.
Another piece of this work for us is connecting people with resources like Trans in the South: A guide to Resources and Services, which I maintain in my role with Campaign for Southern Equality. The resource guide lists trans-friendly primary care providers, mental health professionals, HIV/AIDS care organizations, legal resources and more. This helps connect people to the care they need, but it’s still not enough.
Almost 25 percent of trans people who took the U.S. Transgender Survey reported not seeking out a medical professional when they needed to see one for fear of mistreatment. A 2014 study on suicidality in the trans community by the Williams Institute found that 60 percent of trans people who aren’t able to find a doctor attempt suicide. Knowing this - and aware that the Trump administration is working to legalize trans health care discrimination - we cannot afford to turn a blind eye to this deprivation of resources the trans community faces when it comes to nearly every sphere of life, but in healthcare particularly.
Transgender health care is primary care. We have the ability to bridge this gap, and make adequate healthcare available for trans folks who live in the rural South. We must dispel this myth that trans care is specialty care. We must empower medical providers with resources for treating trans folks. We must make healthcare accessible for trans people.
Access to healthcare is among the most basic of human rights. Every person should have access to at least one primary care physician in their town that will treat them with dignity and respect.
Note: this piece was published first in The Advocate.