The recent directive disallowing exclusions in California healthcare plans for care related to gender transition is significant progress! I continue to be excited by what this may mean for transgender CA residents with health insurance. The next obstacle to overcome? The absolute dearth of trans-friendly/trans-competent resources in many parts of the country.
I get emails from people from all over the US, seeking gender transition and not living near any well-known resources in order to be assisted therapeutically or medically. I often go immediately to Google after receiving such an email, for which I always chide myself. My peeps know how to Google, and Google well. Do I really think I can Google resources in their area, and something is magically going to appear for me that did not for them? No. If a resource was available on the internet, it would have been found. “Did you try Laura’s Playground?”. Yes, they have usually looked for resources on Laura’s Playground. Then I’m stumped. I start reaching out to people who may happen to know of something that is not easily accessed on the web.
(A special shout out to Zander Keig, an incredible advocate for the trans* community and someone who is always willing to help me look for resources when I hit a brick wall.)
It would be one thing if this were just about logistics; it’s not. These are not just emails looking for resources; they are pleas for help. Pleas for help peppered with “I don’t know how much longer I can do this” and “I can’t remember the last time I was happy.” There’s an urgency inherent in these emails that cannot be ignored, and makes finding no resources in their area all the more frustrating.
I may not be able to see them in person, but I can still picture the look in their eyes, and on their faces. It’s a look I’ve seen countless times before in many of the clients I’ve had the honor of meeting with face-to-face. It’s a look that tells me the internal obstacles they’ve overcome were overwhelming enough; obstacles to resources are sometimes more than they can bear.
There needs to be MORE gender therapists, gender clinics, and endocrinologists/doctors willing to treat this population. Every major medical center and hospital should have doctors employed who are knowledgeable and equipped to medically prescribe hormones to the transgender citizens of this country. I think back to my first transgender client; I knew next to nothing about the therapeutic and medical needs of this community. This first client gave me a chance and the rest, as they say, is history.
If you are a transgender person or a loved one, seek resources where you think there are none. Talk to therapists and doctors to see if they are willing to get educated and begin working with this population. There are excellent sources of information to guide professionals new to this arena, such as the World Professional Association for Transgender Health (WPATH) Standards of Care and the Center for Excellence Primary Care Protocol. Somehow we’ve got to make this circle bigger so that care is readily available to ALL.
Gender Blog by Darlene Tando, LCSW 
Can we somehow find a way to educate other therapists on this topic? Is it just a lack of funds, lack of exposure, or ignorance on the therapists’ part? I know these client & families are out there. I wish there was a way for you to “Skype” your clinical sessions and still get paid the same amount. Sometimes I feel like that may be the only way to get the folks in rural areas the help they need…like you have time to do that?! 🙂 This just makes me sad for those people…On another note, a huge hug and thank you to your first trans client for sparking your interest on this topic. xo
Hillary, thank you for such a great comment. There definitely needs to be a way to “recruit” more therapists. I hope the exposure in education sparks some interest in future therapists! I know we are gaining numbers, as evidenced by how big gender conferences are getting, sometimes I just wish it would happen a little faster. 🙂 I can Skype for sessions, but because I am licensed in the state of California, I am unable to provide therapy for people residing in other states. Otherwise I would for all these people who contact me! The other thing is that many of these people need medical transition even more so than they need “gender therapy”. Stay tuned for my next post, “Calling All Doctors”!