Accessing healthcare as a trans teen: Dorian’s story

Accessing healthcare as a trans teen: Dorian’s story

April 21, 2023
Category: Perspectives
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A trans flag with a medical plus symbol on top. At the bottom, there is a drawing of five people standing, looking up

Healthcare is a basic necessity in life, no matter who you are or how you identify.

However, the way that the American healthcare system is built makes it incredibly difficult for LGBTQ+ people, especially transgender and gender non-comforting individuals, to receive the care that they need.

Through the difficulties with funding, the overall inaccessibility of care, the lack of representation, and the stigmas attached to receiving gender-affirming care, our healthcare system is often unfriendly – and sometimes downright hostile – to LGBTQ+ people. This is especially true for transgender people.

Here is the story of a student we’ll call “Dorian”. (To protect their privacy and safety, we are not using their real name.)

Dorian is an Anytown alum and a transgender teenager living and attending school here in our Piedmont Triad community.

In Dorian’s own words, these are their experiences navigating the healthcare system as a trans teen:

“I can personally speak to the issue of the American trans healthcare system being very difficult to work with. I have been seeking transition-related care since October of 2021, and have been met with roadblocks at almost every turn. Before you start any kind of transition-related care, nearly every doctor wants a letter from a therapist or psychiatrist. I had to do three months of therapy before I could even see a specialist to begin hormone therapy. Hormone replacement therapy, or HRT, is a very common process for transgender people to go through. It involves taking medicinal hormones to more closely align your body with how you identify. I’ve been seeing an endocrinologist for HRT since January 2022, and it’s been a profoundly difficult process. There’s very little standardization of care for trans patients, which means that every doctor will tell you something different about how hormones work, what dosage you need, how they should be administered, (pill, patch, gel, shot), and what levels are correct. This has been especially frustrating when trying to adjust my treatment plan over time to fit my needs, because my doctor is convinced her way is correct, even when there is much peer-reviewed evidence to contradict her.  


I’m speaking from the position of being financially stable with good health insurance, which is not everybody’s case. Finances are a huge barrier to trans care. Specialist appointments, the medicine themselves, psychiatric care, and prices for surgery that are often not covered by insurance can all stop people from being able to medically transition. That’s just unjust. There have been legal battles here in NC to make trans care coverage by NC insurance providers mandatory, but those rulings face challenges from transphobic legislators and may not go through.  


That’s not to mention the frustratingly long time span that medical transition takes. Of course hormones need time to work, but their efficacy is slowed down by doctors that don’t know what they’re doing. Even getting in with a specialist endocrinologist can take months, and getting surgical consults for gender affirming procedures is also an incredibly lengthy process, spanning months or even years. I would certainly say that after a year of medical transitioning, I have been severely prohibited by the process.  It’s inaccessible from a financial standpoint for anyone that doesn’t have that support or good insurance, and even someone who does will find that providers are often not knowledgeable, hard to work with, and have waiting lists that are incredibly discouraging.  


The most important change that we can make to this system is to make it more financially accessible. We need people who are willing to go to bat in courts and legislators who support trans people in order to make state health plans cover ALL transition-related procedures. We need providers who are willing to listen to us, and adjust treatment methods when their patients feel like something isn’t working for them. We need therapists who are willing to expedite the process of referring patients to a specialist, and we need trans care not to be stigmatized.” 


Now that you have heard Dorian’s story about their experiences with the healthcare system, here are some questions to reflect on: 

  • What if you needed care and couldn’t get access to it?  
  • What would happen if you couldn’t afford crucial care? 
  • How would you feel if your doctor didn’t listen to you when you were vulnerable with them? 
  • How do you think trans people who don’t have access to medical transition feel? Many trans people feel that they must transition medically and not just socially for the sake of their mental health. 
  • What if you had to drive hours to a specialist for the care that you needed? 
  • What if you had to wait months or years for a life-altering surgery? 
  • How would you feel if legislators actively fought against your right to equity in healthcare? 


This video shares other LGBTQ+ individuals’ experiences within the American healthcare system: