Why some people are choosing to move to states that protect gender-affirming health care.


KFF health news

Hal Dempsey wanted to “Escape Missouri.” “Florida is on the run,” Arlo Dennis said. Tillison Family “Can’t Stay in Texas”

They are part of a new migration of Americans who are uprooting their lives in response to A. Legal framework Restricting health care for transgender people across the country.

Missouri, Florida and Texas are at least one. Limited to 20 states Components of gender-affirming health care for trans youth. The three regions include the following States that protect Medicaid – Public health insurance for low-income people – from paying for key aspects of such care for patients of all ages.

More than a quarter of trans adults are KFF and the Washington Post At the end of last year, they said they moved to another neighborhood, city or state to find more acceptance. New restrictions on health care now and the possibility of getting more in the future provide additional motivation.

Many are heading to places that are passing laws to support care for trans people, which those states are appealing to sanctuaries. California, for example, passed legislation last fall. Protecting those who receive or provide gender-affirming care from prosecution. And now, California providers are getting more calls from people who want to move there to avoid disruptions in care, said Scott Nass, a family physician and transgender care expert based in the state.

But the influx of patients is a challenge, Nas said, “because the existing system can’t handle all the refugees that might be there.”

Arlo Dennis, 35, a target of trans people and health care in Florida, convinced his family it was time to uproot their Orlando area, where they had lived for more than a decade. They plan to move to Maryland.

Dennis, who uses pronouns, stopped getting hormone replacement therapy after Florida’s Medicaid program stopped covering transition-related care in late August, saying the treatments were experimental and lacked proof of effectiveness. Dennis said they ran out of medicine in January.

“It definitely made my mental health struggle and my physical health struggle,” Dennis said.

Bruce E. Stidham for KFF Health News

After the state’s attorney general announced a crackdown on gender-affirming medical care for transgender people, Hal Demsey, who uses the pronouns they/them, raised nearly $3,000 on GoFundMe to “escape” Missouri. Dempsey and his two trans partners moved to Illinois in late May.

Moving to Maryland would take away the wealth Dennis says his family doesn’t have. They started GoFundMe campaign in April and raised more than $5,600, mostly from strangers, Dennis said. The family, which now includes three adults and two children, plans to leave Florida in July. Dennis said the decision wasn’t easy, but they felt they had no choice.

“I’m fine if my neighbor doesn’t agree with how I’m living my life,” Dennis said. But this is literally preventing my existence and preventing me from getting health care.

Mitch and Tiffany Tillison decided to leave Texas after the state’s Republicans made anti-trans youth policies the centerpiece of their legislative agenda. Their 12-year-old son came out as trans two years ago. Fearing for her safety over threats of violence against trans people, they asked that only her middle name, Rebecca, be published.

This year the Texas Legislature He made a law Limiting gender-affirming health care to youth under the age of 18. It specifically bans physical care, but local LGBTQ+ advocates say recent crackdowns have made a positive difference in access to mental health care for trans people.

Mitch Tillison

Rebecca, a 12-year-old from Texas, came out as transgender two years ago.

The Tillisons declined to say what kind of treatment their daughter is receiving, but they say they have a right as parents to give their daughter the care she needs — and Texas has taken away that right. That, plus the growing threats of violence in their communities, especially online May 6 mass shooting A neo-Nazi attack at Allen’s Premium Outlets, 20 miles from their home in suburban Dallas, led the family to decide to move to Washington state.

“I kept her safe,” Tiffany Tillison said, and she often thinks about her son coming to her, on the long, late drive home from a soccer game during the day. “It’s my job to keep her safe. My love is infinite, unconditional.

For her part, Rebecca said she was practical about the proposed move in July: “It’s sad, but it’s what we have to do.”

Calls to lose key medical care in Missouri have prompted some trans people to reconsider living there. In April, Missouri Attorney General Andrew Bailey He issued a state of emergency. Seeking to limit access to transition-related surgery and cross-sex hormones for all ages, and to restrict access to birth control pills, which delay puberty but do not change sexual behavior. The next day, 24-year-old Dempsey, who uses pronouns, a GoFundMe fundraiser for themselves and their two partners to leave Springfield, Missouri.

“We are three trans individuals who are all dependent on hormone replacement therapy and gender-affirming recently banned care,” Dempsey wrote in the fundraising appeal.

Dempsey also said he had a three-month prescription for hormone therapy from his doctor in Springfield to help him through the move.

Bailey resigned after the state legislature in May Limited new access Minors are susceptible to such treatments, but not adults like Dempsey and their colleagues. Still, Dempsey said their future in Missouri doesn’t look promising.

Neighboring Illinois was an obvious place to move; The legislature there He passed a law in January It would require a government-regulated insurance plan to cover gender-affirming health care at no additional cost. Where exactly was the big question. Chicago and the surrounding area seem very expensive. The partners wanted a progressive community similar in size and cost of living to the city they were leaving. They were looking for Springfield in Illinois.

Bruce E. Stidham for KFF Health News

Gwen Schwarz is working her way out of her hometown of Springfield, Missouri. She says she no longer feels safe there because anti-trans laws threaten her access to hormone therapy and other treatments.

“But it’s not Springfield, Illinois,” Dempsey said.

Gwendolyn Schwarz, 23, had hoped to stay in her hometown of Springfield, Missouri, where she recently graduated from Missouri State University with a degree in film and media studies. She planned to continue her education in a graduate program at the university and had to undergo a transition-related surgery next year, which would take a few months of recovery.

But her plans changed as Bailey’s rule inspired fear and confusion.

“I don’t want to be stuck in a situation where he can’t see my body and be temporarily disabled,” Schwarz said.

She and a group of friends are planning to move west to Nevada, where state lawmakers have passed that measure. He needs Medicaid to cover it Gender Affirmation Therapy for Trans Patients.

Schwarz hopes that moving from Missouri to Nevada’s capital, Carson City, will allow her to move on with her life without fear and finally get the surgery she needs.

Dempsey and his partners settled in Moline, Illinois. All three had to quit their jobs to relocate, but they raised $3,000 on GoFundMe, more than enough to put a deposit on an apartment.

On May 31, the partners packed up their unsold goods and made the 400-mile journey to their new home.

Since then, Dempsey has been able to see a medical provider at a clinic in Moline that caters to the LGBTQ+ community — and received a new prescription for hormone therapy.

KFF health newsFormerly known as Kaiser Health News (KHN), it is a national news division that produces in-depth journalism on health issues and is one of its core operating programs. KFF – An independent source for health policy research, polling and journalism.


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