The Buzz This Week
June is Pride month, a time each year to honor and celebrate the LGBTQIA+ community. Access to healthcare is a fundamental human right, and as Andrea Palm, Deputy Secretary of the U.S. Department of Health and Human Services noted, “Pride is a reminder that until everyone enjoys the full promise of equity, dignity, protection, and freedom, our work is not finished.”
Earlier this month for the first time in more than 40 years, the Human Rights Campaign, the largest LGBTQIA+ rights organization in the country, declared a state of emergency for LGBTQIA+ people. The declaration comes in response to the more than 70 anti-LGBTQIA+ bills signed into law and more than 500 introduced in state legislatures in the last year, double the number from the previous year. Prior to 2020, no states had introduced bans to gender-affirming care. This year, nearly half of the anti-LGBTQIA+ bills aim to ban gender-affirming care.
With the passage of these bills and the end of the COVID-19 public health emergency, many trans people have lost or risk losing access to lifesaving gender-affirming care. Many people who were on Medicaid will lose coverage through Medicaid re-enrollment, and changing telehealth practices limit the ability to be easily seen by a trusted provider. Even when trans people can access in-person care, they are often met with discriminatory treatment. According to a poll from Washington Post and Kaiser Family Foundation, nearly 20% of trans patients have been refused hormone treatments, and only 10% say providers “know a lot about caring for trans people.”
Why It Matters
Without providers having proper medical training, trans individuals have to spend a significant portion of their visit time educating providers on their healthcare needs. For the more than 1.6 million trans individuals aged 13 and above who live in rural communities, time spent seeking appropriate care can take even longer. Trans residents of rural areas are 3 times more likely to need to travel more than 25 miles for care.
Trans youth are another group significantly impacted by these bans and limited access to providers. One of the largest studies of its kind, released this year, followed more than 300 trans youth for more than 2 years after beginning hormone treatment. The study found significant reduction in depression and anxiety in participants—nearly 70% of those with severe depression saw it reduced to minimal or moderate, and almost 40% of those with anxiety saw a reduction to the nonclinical range.
Diana Tordoff, a researcher at Stanford who has performed studies on gender-affirming care, notes, “Access to gender-affirming care is fundamentally a human rights issue. Trans people and their families deserve high-quality science and research with which to make their own personal medical decisions and to inform evidence-based clinical guidelines—not just for access to gender-affirming care, but also for preventive care, screening, and treatment for a wide range of health issues that impact all people.”
Editorial advisor: Roger Ray, MD, Chief Physician Executive.