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  • Jess Barrows

Barriers in Trans+ Healthcare & How To Overcome Them



First and foremost, let’s clarify what Trans+ healthcare is and how it differs from general healthcare.


Trans+ people have the same basic health needs as cisgender people: regular physical exams, preventative care, sick care. Trans+ people may also have health care needs related to their transition, or gender identity, that require a different type of care. This care could include care related to a physical transition, including (but not limited to) hormone replacement therapy, gender affirming surgery, or other gender affirming procedures, as well as affirming mental health care.


Accessing this type of affirming care can be a challenge for trans+ people. Many providers lack necessary education, and subsequently lack the understanding and empathy related to trans+ people and their specific needs. To be a medical or mental health provider comes with the responsibility to provide affirming care for all, and so it is our duty to educate ourselves to do so. Today, we have ample resources to be educated, and we should consider it our responsibility to do so. Not doing so allows transphobia in healthcare to continue.


What are the barriers that exist?

Some of the barriers that exist in trans+ healthcare are:

  • Overall lack of access to care due to lack of providers who are sufficiently knowledgeable

  • Financial (insurance, income)

  • Discrimination

  • Socioeconomic barriers (transportation, housing, mental health)

  • Encountering providers who are ignorant, or incompetent, in trans+ needs

  • Providers that require extra steps, or create additional barriers, for trans+ people (Referred to as gatekeeping)

  • Comfortability disclosing your gender identity to a provider

Many of these barriers exist among other minority groups, and they are especially magnified for trans+ people.


So, what do we do?

Local resources and services for various trans+ serving organizations exist to serve the population in various ways. These services include gender-affirmation specific services, however also services with providers or staff that have been identified as LGBTQIA+, and therefore deemed as “safe spaces.” For organizations that are identifying resources, services for those with insurance, self-pay, no or low cost should be noted, as trans+ clients may have various financial accessibility needs.


If you are a trans+ person seeking care (healthcare, mental health care, etc) I recommend you be diligent: read reviews about the care and/or services provided, and explore various resource-based websites to identify specific resources that have already been vetted. Additionally, resources exist to help trans+ people struggling with other barriers to care (see below for some local NJ options).


If you have an existing mental health provider, I recommend you request assistance from them to help link you to services and provide resources. As mental health providers, we should provide supportive services and linkage to resources to decrease the burden on our trans+ clients. Trans+ clients have likely experienced gatekeeping, barriers, and stressors accessing mental health care, so there exists a duty for us to attempt to decrease this moving forward.


Ultimately, real change can only come about through an overhaul of the system. The end goal must be this: Trans+ healthcare must be accessible. Without total affirming care, trans+ people risk continued oppression in the health and mental health cares systems. Affirming care is associated with an overall better quality of life. Access to gender affirming care is proven to be associated with decreased mental health symptoms. According to The Trevor Project’s most recent youth (13-24) study, LGBTQ+ individuals who reported access to spaces that affirmed sexual orientation and/or gender identity had lower rates of attempting suicide.


When trans+ healthcare is unaccessbile or minimally existant, it shows. According to the same study, over 50% of trans+ youth have seriously considered suicide.


We must first identify the causes of the lack of access. We must assess and understand why those causes exist, and identify long-term solutions to them.


Trans+ people are everywhere, this is not specialty care. Trans+ healthcare needs to be incorporated as a part of general medicine / general healthcare. Providers often believe they need specialty knowledge to provide gender affirming care; It is simply a lack of basic knowledge and understanding that should be taught to all.


Check out these resources to create a more affirming practice, environment, classroom, etc:

https://www.ndsu.edu/fileadmin/hdfs/documents/misc/Affirmative_therapy_handout.pdf

https://www.glsen.org/sites/default/files/2019-11/GLSEN_LGBTQ_Inclusive_Curriculum_Resource_2019_0.pdf

https://pflag.org/inclusionanddiversity


If you or a person you love is struggling with accessing affirming providers, do not know how to access support, don't know where to start in navigating the barriers to accessing appropriate care and services for trans+ individuals, or are seeking therapy as you navigate the process, reach out to our knowledgable and compassionate staff at NJ Recovery & Wellness. Wellness is within reach!


Here are some additional resources for LGBTQ+ resources and services in New Jersey


Trans Resource & Information Project (TRIP NJ)

www.TRIPNJ.org

Founded by NJRAW clinician Jess Barrows, the project called TRIP NJ (Trans Resource & Information Project) is designed to streamline the transition process for people in the trans+ community in New Jersey. The goal is to increase accessibility by way of information and resources, and to be able to overcome any barriers that currently exist in trans+ healthcare.


EDGE

www.EDGENJ.org

"The mission of EDGE New Jersey is to respond compassionately and responsibly to those living with HIV, those at risk, and the LGBTQ+ communities by providing supportive services, housing opportunities, prevention strategies, and education to enhance the community it serves. The vision of EDGE is to empower those we serve to achieve a healthy, safe and self-sufficient life, therefore gaining the resources to positively influence their community."


Out Montclair

www.OUTMONTCLAIR.org

"Out Montclair is a nonprofit organization created to raise awareness and provide support and solidarity for the LGBTQIA+ community of Montclair. We offer educational and charitable activities and events to promote inclusivity and equality for lesbian, gay, bisexual, transgender, queer, non-binary and gender-fluid youth and adults. Additionally, we are a safe space where our community and our allies can come together and celebrate who we are."


The Pride Center of NJ

www.PRIDECENTER.org

"The Pride Center of New Jersey, Inc. is an all-volunteer 501(c)(3) nonprofit organization dedicated to the health and well-being of all individuals in the LGBTQ community. The Center is a safe space to gather together, and so much more. Here, we celebrate who we are as individuals and as a community. Here we find comfort in unity. In this place, we accept who we are and how far we have come in the fight for equal rights. Here we continue to fight for equality.


Everyone in the LGBTQ community and their allies are welcome at The Center. We have a wide range of programming to meet the needs of those who seek us out. We encourage anyone interested in learning about The Center to check out our calendar and stop by and attend a group or meeting.


As a non-profit organization, we operate solely on membership funds, donations from the public and supportive organizations. All contributions go directly to benefit LGBTQ youth and other programs, and are tax-deductible."