When We Cannot Access Care

Creative Ways to Affirm, Celebrate, Protect, and Defend Your Gender

Part 1 of 3

Gender-affirming care for trans people, especially young people, is under attack. Many U.S. states have banned or restricted access to gender-affirming care for people younger than 18 or 19. The Trump administration is trying to shut down access even in states where it is still legal. It’s a scary and heartbreaking situation, because we know that gender-affirming care is critical, life-saving healthcare.

At the same time, lack of access to gender-affirming care is not a death sentence. Almost every trans person I’ve ever met has had times when they couldn’t access the care they wanted and needed. We have lots of experience as a community about how to care for ourselves and each other when the world tries to tell us we can’t be who we are.

These are strategies that have worked for me. They’ve gotten me through times when I couldn’t get gender-affirming care, or was in a challenging environment.

Everything on this list is something that you can do whether or not you have access to the healthcare you need. While not all of them are right for every person, I hope there are at least a few things on this list that will fit whatever your situation is.

Whether we survive and thrive out of love for ourselves or to piss off the people who try to erase us (or both!), we have the power to make it through everything we are facing.

1. Play with your clothes!

For a lot of folks, clothing is one of the first ways they experiment with gender. Sometimes playful dress-up starts earlier than any conscious awareness of being trans. Whether in front of the mirror or in front of other people, clothing can help us start to bring our internal sense of who we are to the surface. Experimenting with clothing and style is also a way to remind ourselves that we have power over our own bodies and how people see us.

I have clothes that help me address pain points in my relationship with my body, and that emphasize things I feel good about. I have heavy lace-up boots that I wear on days when I need to feel connected to my power and strength, and big, soft hoodies for days when I wish I didn’t have to get out of bed. I have clothes for blending in, and clothes for celebrating when it’s safe enough to stand out.

I do most of my clothes shopping at thrift stores, both because it’s affordable, and because it lowers the stakes. If my shirt cost $5, I feel a little more able to buy something I’m not sure about, experiment, and change my mind when I need to.

Sometimes people who love us want to help us find our style and “look good.” If it’s fun for you to shop for clothes or swap fashion ideas with other people, that’s awesome! Just remember that there are no right or wrong answers to how you should dress. If someone tries to “fix” your look, I suggest finding a trans content creator online who dresses like Ms. Frizzle and telling people you are now only accepting fashion advice from them.

You do not have to go out in public for this to work. Sometimes wearing something awesome while alone, behind a locked door, is the best self-care we can do.

2. Cultivate fiercely loving community.

In my early twenties, I lived as a housemate with a queer couple and their kids. One day, after dealing with a lot of anti-trans bullshit and mispronouncing, I posted something on social media about wishing I could lock myself in an echo chamber of my accurate pronouns. I came home that evening to find my bedroom covered in post-it notes that said “he,” “him,” and “his.” I still remember the moment I walked into that room, the warmth and relief of knowing that whatever happened in the world outside, I was seen and loved by the people I shared home with.

Maybe you have those people in your life already. If you do, you know what a blessing it is. If the people in your life are hostile or even just lackluster in their support of your whole incredible self, I hope you can find the community you deserve. Some places to look are LGBTQIA+ community centers, organizations, and support groups, school-based Gender and Sexuality Alliances, affirming faith communities¹, and groups organizing for justice and inclusion.

3. Get adopted.

I cannot tell you what my life would have been like without older queer folks. They have taken me out for meals, hosted me in their homes, donated toward my dreams and projects, shared their life experiences, and taught me that you can age without becoming stuck in old habits or shaking your fist at the metaphorical kids on your lawn.

I’ve also had the opportunity as I get older to support a lot of younger queer and trans folks. In my experience, there is no greater honor than getting to offer support to people walking the path you’ve just been on.

I can almost guarantee you that there are older queer and trans folks, as well as fierce allies, in your community who would be excited to offer you listening, care, and other support.

4. Find good mental health support.

The double-punch of gender dysphoria and discrimination has resulted in trans folks having very high rates of depression, anxiety, and other mental health issues. This is especially true when our access to gender-affirming care is restricted.

Even if you don’t experience any particular mental health challenges, the weight of existing as a trans person in the world today is enough to make access to support really important. “Good mental health support” can mean having an awesome, trans-affirming therapist (highly recommend this if it’s an option for you). It can also mean having a good friend with whom you take a walk and talk about your feelings every couple of weeks, or having a trans-affirming crisis hotline number taped to your fridge, just in case.

Some communities have peer mental health support programs, where you can talk confidentially to someone who isn’t a clinical provider. There’s also no shame in going to the hospital for emergency mental health care, if you need that, or getting yourself into an outpatient program that provides a little more support than once a week therapy. All of these “count,” as long as they are meeting your needs.

In addition, I recommend making sure you have a primary care provider who will take you seriously if you tell them something is wrong, whether or not it’s physical.

If you are struggling emotionally or need help accessing mental health resources, I recommend a call or text to Trans Lifeline.

5. Invent an imaginary twin.

It took me a really, really long time to get my name legally changed. Like, 15 years. The ADHD is strong with me.

That means that there were many years of my life when I received mail, carried an ID card, and occasionally had to answer to a name that I had actually never used (I went by a nickname as a child– think “Beth” vs “Elizabeth”). My legal name didn’t feel like me, but we obviously had some kind of relationship, because her stuff was all over my house! So I started jokingly referring to this other person with my legal name as my twin sister. Like, “Oh gosh, someone is sending me Elizabeth’s mail again! Gotta talk to her about that.” Your mileage may vary, but this actually really helped me. It bypassed my dysphoria, because why would I feel dysphoric when talking about someone else?

It was also funny to watch people who had known me for a long time try to figure out if I really had a secret twin they didn’t know about.

6. Curate youself some rad trans media.

I don’t mind feeling different from other people, most of the time. I think my gender is awesome partly because it’s unique, and I like having a life experience as a trans person that is different than a lot of other people’s. But the relentless stereotypes and hostility, along with a lack of positive trans representation in a lot of mainstream media, eventually gets so freaking exhausting. That’s why I seek out media by and about trans folks– for a little respite from feeling like an alien whose ship went home without them.

We are normal. We are beautiful. We are awesome. We are real. It’s just hard to remember those things when the world as a whole is constantly telling us the opposite.

So I read trans authors. I follow trans creators. I watch trans tv and movies. I subscribe to trans journalists. It helps me remember that my gender is what I say it is, and being trans is normal and beautiful, and trans people are hotter and more awesome than everyone else.

(Just kidding, cis people. Kind of.)

This is the first post of a three-part series. If you’d like to share a strategy that has worked for you, email me at transyouthcoaching@gmail. Let me know how you’d like to be identified (or not) if I include your suggestion later in the series!

1. Here are a few places to start on finding LGBTQIA+ affirming religious groups within Jewish, Pagan, Christian, Muslim, and Buddhist traditions. Quakerism has been a good spiritual home for me. ↩︎