“Trans” is a wide-ranging umbrella term that applies to numerous identities: transgender, gender non-conforming/variant/creative, non-binary, genderqueer, intersex and others. It’s a wide spectrum enriched every day as we learn more about human gender and sexuality. If you identify as the gender you were assigned at birth, you are cisgender. It can also be defined as a gender role society considers “appropriate” for your sex.
“I do a lot of parent education,” says Logan England, peer counselor at Thundermist’s Trans Health Action Team. “We have a fair number of parents who are concerned because our world isn’t as open and accepting of transgender people as it needs to be.” The team is a group of medical, behavioral health and allied service professionals who work to improve healthcare outcomes and social culture across the state. It encompasses a wide and expansive range of services that includes primary care, group therapy and transitional surgery. They offer trainings about what it means to be trans and the difference between gender expression and sexuality. “I would say 75% of the time when parents are resistant, it’s not that they are resistant to the concept of their kid’s self identity, it’s because they’re fearful of how their kid is going to be treated,” said England.
England works as a peer navigator. It’s a job that involves intensive case management, taking a peer role in the community. “We’re trans as well,” said England, “so we have lived experiences in the problems our clients work with.” Peer navigators assist clients with issues that can arise in the workplace, from coming out to communication skills, and act as overall physical and moral support. One of the more common issues a trans person can face is just navigating the morass of bureaucracy involved with changing their name, gender market and sometimes insurance. If a person forgets to ask the right question when finding out information, or even go through the steps in the wrong order, their name or gender marker won’t get changed. FAFSA, for example, can be a struggle if you’ve changed your names and everything doesn’t match. And that’s on a good day.
Peer navigators like England advocate on behalf of their clients to insurance companies. As time goes by, this gets easier. Generally, most plans will have some coverage for top and bottom surgery. Some others, like face feminizing operations or some that require delicate laser hair removal, are considered elective in some cases. There is less gatekeeping as time goes on from insurance companies. There are less unreasonable hoops to jump through to prove coverage for transgender procedures.
“If you type trans and Rhode Island into Google, you’ll find us,” said Ethan Huckel, executive director of TGI Network, a statewide organization dedicated to providing support and advocacy for Rhode Island’s transgender, gender diverse and intersex communities. They provide different outreach than the folks at Thundermist. TGI Network is really known for its support groups that have existed in one form or another for many years. For many, it’s their first introduction to the organization.
TGI Network plays a big part in the RI Trans Health Conference, particularly in its community track. The conference is made up of members of the transgender community, as well as medical providers who want to be able to better serve trans patients. TGI Network also does fun events, aimed at people who don’t need the peer support groups, but still want to feel part of a community. They do social events like dance parties, an annual picnic and educational events like long-term financial planning.
“One of the biggest issues is our lack of emergency housing for trans people,” said Huckel. Homelessness, especially during the winter months, is a chronic problem for Rhode Island’s trans population. Shelters don’t guarantee beds for trans populations, and shelters aren’t always safe places for them. Discrimination can be an issue when finding housing and sometimes employment. It’s illegal, but also hard to prove in court. Huckel gave the example of someone he knows who wasn’t fired from their job, but was switched to only working overnight shifts. Trans youth especially is an underserved demographic in state. “There’s no real safety net for trans youth,” said Huckel.
Mental health is a big component of trans health services. Over at Butler Hospital, they’ve started two intensive outpatient groups (IOPs for short). Their True Self IOP is aimed at serving the psychological needs of the LGTBQ+ community, much of it surrounding issues such as identity and social stigma. A standard outpatient program typically includes seeing a therapist once a week. The True Self program is more intensive. It meets Monday through Thursday for three hours for a period of four to six weeks. Each therapy plan is customized and based on the patient’s needs.
Frequently, people in the True Self program have issues such as social stigma and identity. They have no social support system, and learn through the program how to make a good support system. This IOP is mostly centered on youth, ranging in age from 18-26. The second leading cause of death in that age range is suicide, making mental health resources vital. Butler also has an IOP centered around college students that started around the same time. There are plans for expansion in 2019, including starting to advertise, and in True Self making support staff 100% affirming, which means they will be trained in affirming their LGBTQ+ patients by being responsive to their needs. Using the correct pronouns is a good example.
President Trump may have tried to legally define trans people out of existence last year. But locally we have people working very hard to keep them healthy, safe and connected. Our last election cycle saw two prominent trans women running for office: Nika Lamazzo ran for the General Assembly and Justice Gaines ran for PVD City Council in Ward 1. Our trans community isn’t going anywhere.