More than 500,000 transgender people live in the South, according to the Williams Institute at the UCLA School of Law. National data show that nearly a quarter of trans people do not get any kind of healthcare because of a fear of discrimination. A new report from the Campaign for Southern Equality and Western NC Community Health Services examines the specific barriers faced by transgender people who live in the South.
“The Report of the 2018 Southern Trans Health Focus Group Project” shares the findings of in-depth interviews with trans people from six states including North Carolina. Austin Johnson is the principal investigator for the Southern Trans Health Focus Group Project. He joins host Frank Stasio to share report details and his own struggles accessing healthcare as a trans man in the South. Johnson is also an assistant professor of sociology at Kenyon College.
Dr. Jennifer Abbott also joins the conversation. She is a family physician at Western NC Community Health Services who provides care for trans patients. And Kalya Gore shares information from the latest Trans in the South guide, a resource from the Campaign for Southern Equality that lists trans-friendly businesses, from attorney’s offices to healthcare providers, and details resources related to medical transition funding and insurance coverage. Gore is a project adviser at Southern LGBTQ Health Initiative. She also shares her experience as an advocate and as a trans woman in the South.
Johnson on the lengths some trans patients have to go through to get healthcare:
We had some of our participants [who] were traveling two or three hours to places like Atlanta or Asheville to receive care. And a lot of these people who were traveling were not financially in a situation where that was easy for them. And then on top of having to travel to get the care, they were paying out of pocket for that care. So it became an additional burden to be in the South in a rural area … Some of our participants who were under resourced couldn't access more resources, but local organizations like churches were providing resources … [But] they couldn't have access to those things because they weren't welcome in those spaces. So in the face of a widespread socioeconomic disparity in the South, trans people are even further marginalized because they don't have access to the charities that are there to provide care.
Johnson on the importance of using correct pronouns and names for trans patients:
This is one of the easiest things that providers and health care practices can change in terms of creating a welcoming environment for their patients. A lot of folks think that they have to invest in expensive continuing education or a wholesale reform of their practice, but that's not really true. It's something as small as respecting the name, the pronoun and the interaction style of trans people can go a long way in terms of creating a welcoming environment so that trans people feel comfortable accessing care [and] feel comfortable seeking care.
Dr. Abbott on what materials are available for healthcare providers:
I think one of the biggest resources available is the is WPATH — World Professional Association for Transgender Health …That's an international organization, and they have standards of care available online. They also have a symposium every other year where healthcare providers from all over the world can educate themselves and share research. And in the last decade there has been a lot of strides in research and evidence in terms of the safety of gender-affirming hormones. There's a wonderful guideline that came out a couple years ago from the UCSF Center of Excellence and Transgender Health that's available to anyone online. So I think now, new providers who are interested in learning have many, many resources compared to what there were a decade ago.
Gore on what happens when a doctor refuses to prescribe hormones for a trans patient:
A lot of people in the South — specifically trans women of color — we're faced with that. We're having providers tell us: No. And for us, no is not an option when it comes to our transition, because our transition is what makes us thrive and what makes us live our beautiful lives. So we're going to do it by any means necessary, which is why I'm an advocate now because I don't want people to have to go through that route.