July 26 2017

Gender dysphoria is a condition of significant distress and discomfort with one’s sex assigned at birth not aligning with the gender that one identifies with, a condition that many transgender and gender nonconforming individuals experience.

Gender dysphoria and lack of access to gender transition related medical services to help align transgender and gender nonconforming people’s identities and bodies is a leading cause of distress, depression and suicide among transgender populations. This is because in society people make assumptions about how to refer to someone, what they identify as, and how they should be treated based off appearances.

When you have a high voice people automatically assume you are a woman, unless you visibly appear otherwise. If you have facial hair, people will assume that you are a man, even if this isn’t the case.

While not all people who misgender someone do it intentionally or wish to harm that person, the impact does often still make transgender or gender nonconforming people feel disrespected, uncomfortable, and feel inadequate about “passing” as the gender they identify as.

While one instance of misgendering may not seem like a big deal, when it happens repeatedly the impact is multiplied. Repeated misgendering, intentional or not, can cause severe psychological stress for the person being misgendered. Furthermore, this type of behavior reinforces the cultural norm that there is a certain way people of different genders should look, and this notion contributes to the violence that is exerted against gender non-conforming populations for not fitting into those norms.

As a transgender man, I know firsthand how life saving these medical services can be. I began to transition when I turned fifteen but was not able to access hormone replacement therapy treatment until I turned eighteen. Not being able to access medical care that is essential for my wellbeing exacerbated the depression that I was experiencing to a dangerous level and I often coped with the stress of being misgendered and misidentified by others based on my appearance with unhealthy behaviors.

Imagine that every time you look into the mirror you see yourself in the body of a gender different than your own.

For transgender and gender nonconforming people this is the reality. Transgender and gender nonconforming people know that it’s not just uncomfortable but it can literally be life threatening, both from self-destructive behaviors and from violence from people who feel hostility towards those who bend gender rules.

I consider myself to be one of the lucky ones as I have the only health insurance provider that offers accessible transgender competent therapists, doctors, endocrinologists here in Kern County. While all health insurance companies must cover these services, finding providers who offer these services within Kern County has been difficult.

In fact, the only known providers offering hormone replacement therapy for low-income patients with Medi-Cal or without healthcare insurance in Kern County have left those provider networks, or are not currently practicing. That doesn’t mean that there aren’t doctors who would serve Kern’s transgender population. It just means that Kern County’s transgender population is not able to find them and therefore has been undergoing a crisis for the lack of medical services for at least the last seven years from when I became involved with the community.

California law designates that transition related health services, such as hormone replacement therapy, are medically necessary treatments for gender dysphoria and requires health insurance companies to cover these services to ensure the health of transgender patients. Furthermore, transgender patients in Kern County often have to file appeal claims to Medi-Cal when their transition related coverage or gender specific services, such as gynecology or prostate exams, are denied. These services are medically necessary and patients shouldn’t have to jump through bureaucratic red tape every time they need to see a doctor.

That is why, through the Dolores Huerta Foundation, I am leading a transgender health care coalition with Bakersfield LGBTQ, the Gay and Lesbian Center of Bakersfield, and transgender community members to help increase access to transition-related medical services.

We are gathering data about transgender people’s access to healthcare in Kern County, compiling a trans-inclusive medical providers list who accept various public health insurances, and writing letters asking agencies known for providing healthcare to low income populations and transgender populations to expand their hormone replacement programs and bring providers to Bakersfield.

We are appealing to doctors, endocrinologists, and other medical service providers to please step forward and let the LGBT community know if they offer services such as hormone replacement therapy, are willing to get trained if they are unaware of how to administer treatment to transgender patients, and to please step up and offer these services in our County so that the transgender population does not have to travel to places like Fresno and Los Angeles just to receive much needed medical care.

This piece originally appeared in the South Kern Sol. South Kern Sol is supported by a grant from The California Endowment.