In honor of Trans Awareness Week, we wanted to learn more about gender-affirming care, so we talked with Ivy Hill (they/them), community health director for the LGBTQ+ org Campaign for Southern Equality. When asked what comes to mind about the topic, Ivy says, “Often when people ask about gender-affirming care, they are really just expressing a curiosity about trans people’s genitals and private parts. But the reality is that being trans is just a small part of people’s identities and it is frustrating for us to constantly be spoken about as bodies.”

“Trans people are your neighbors, your friends, your family members—we are so much more than how we’re so often painted in the media or in statehouses. We need to stop attacking trans people’s access to healthcare and we need to call those attacks what they are: Attempts to render us invisible and hold us back from being able to thrive.”

Keep reading to learn more about gender-affirming care and the realities of accessing it.

What is gender-affirming care?
It’s everything from being treated with respect when you have to go to the doctor for a common cold to mental healthcare to reproductive healthcare to access to hormone replacement therapy to any other care you desire or require in your transition journey (such as facial feminization surgery, electrolysis, etc.). People often think immediately of gender-affirmation surgery when they hear “trans-related healthcare”—but that is merely a fraction of it. That’s why LGBTQ+ advocacy organizations are so focused on ensuring that providers and their staff have all the resources they need to be not just trans-competent but trans-inclusive and trans-affirming.

How much do gender-affirming procedures usually cost?
Because of the broad spectrum of types of care people receive, it can be hard to estimate the specific costs of procedures, treatments, or therapies. But we do know that any type of healthcare is expensive at baseline. We also know that trans people have less access to quality insurance, stable housing and transportation, and employment which can negatively impact their access to healthcare. On top of that, it can be really challenging to find affirming providers at all—even if someone has health insurance that covers trans-affirming care, there aren’t often enough providers, especially in Southern states and rural communities. We believe that medical insurance should cover trans-affirming care as it would any other necessary healthcare service because it’s life-saving, fundamental to trans lives, and not “optional.”

How can people who can’t afford paying upfront access gender-affirming care?
We know that evaluating the expenses involved in trans-affirming care can feel really overwhelming, especially since trans people—and especially trans Southerners—face disproportionately high rates of under- and unemployment. We’ve seen folks run personal fundraisers for their care or crowdsource funds from other community members. Many LGBTQ+ organizations have emergency assistance grants or funds specifically to support this work. But again, the reality is that this care can be expensive and there are way too many barriers to accessing it; no one should have to crowdfund for necessary medical care—because healthcare is a human right.