Note from the editor: GenderNexus provides request letters for gender-affirming care, not direct medical referrals.
When Kirin, the 11-year-old daughter of Beth Clawson, began taking puberty blockers next time, her doctors implanted a small add in her quadriceps about the length of an essential.
An implantation, the doctors reasoned, may provide sex-accepting treatment for up to 12 months without the need for refills. If Kirin’s ability to receive treatment in Indiana was withdrawn, Kirin would be able to safely maintain receiving treatment.
They were preparing for a cause. Next April, Gov. Anyone under the age of 18 must be able to receive gender-affirming hormone care, including puberty blockers and hormone replacement therapy (HRT), under the authority of Indiana Governor Eric Holcomb.
Puberty blockers are a removable form of testosterone therapy that is frequently prescribed to children with gender dysphoria, which stops the production of sex hormone in toddlers beginning puberty around the ages of 10 or 11. According to studies by the New England Journal of Medicine, trans children taking puberty blockers and HRT reported decreased symptoms of anxiety and despair and improved happiness with their lifestyle and presence. However, puberty blockers do not completely stop the body from producing sex hormones.
However, critics claim that puberty blockers may weaken bone density, but these effects are not permanent, and that this is very serious of a skilled change for minors to get deciding for themselves.
An order was granted against Indiana’s children gender-affirming treatment restrictions next June, a month before it was set to take effect, but providers like Clawson’s were still on guard. The order has been lifted. The legislation could still be revived.
Eliza Housman (center) and others protest outside the Indiana Senate Chamber last February while the Senate Health and Provider Services Committee heard Senate Bill 480. The bill banned gender-affirming medical or surgical treatment for minors.
On Feb. 28, it was, the U.S. Seventh Circuit Court of Appeals in Chicago issued a sit on the order, allowing the law to take effect quickly.
Overnight, babies on puberty blockers and HRT lost treatment exposure. Hot flashes, cramps, and mood swings may result from sudden departure from hormone and progesterone.
These are children who needed medical attention the day after the lawsuit was lifted, according to Beth Clawson. So individuals were trying to find a lot of places for a lot of kids.
The recently implemented ban prohibited doctors from making referrals to out-of-state providers, leaving transgender children and their families on their own to get and proceed care in different states, in addition to gutting youngsters gender-affirming services in Indiana.
People are traveling out of position to discover care for their children, comparable to those who seek abortions in states where the procedure has been prohibited.
This map shows state laws on gender-affirming therapy for minors. Almost half of all states have banned youth gender-affirming therapy, while 14 states and the District of Columbia passed shield laws enshrining the practice.
It’s not simple. Ohio, Kentucky, and 21 different states even banned youth gender-affirming therapy, resulting in clinics in the few surrounding states that do provide care, including Illinois and Michigan, having more than yearly waitlists.
Yet, since the law took effect, trans activist groups across the state have also seen a rise in interest and attendance. They have evolved into informal hubs for connecting people with doctors, transportation, and travel expenses for those who travel across state lines to seek medical care.
“Everything just stopped,” he said.
Emma Vosicky, executive director of the Indianapolis-based organization GenderNexus, received 17 messages from parents of transgender children within 36 hours of the Seventh Circuit Court’s decision to uphold the injunction on youth gender-affirming therapy.
“They were terrified about what was going to occur, and what it meant for their child”, Vosicky said. They all hit a brick wall, they said. Everything just stopped if they had a prescription that needed to be filled, if they needed a new prescription.
GenderNexus offers both care coordination services and support groups, such as supportive referral letters for gender-affirming care and gender and name changes in the legal system. However, since the ban, according to Vosicky, GenderNexus has effectively evolved into a “triage” resource for families, making it easier for them to comprehend what the law requires and providing information on medical sources that Indiana doctors are not permitted to mention.
“Even if a physician knows that there’s medical care out there that can help their patient, they can’t say that under our law”, Vosicky said. “It smacks of ‘The Handmaid’s Tale,’ that people have to travel to states where they can actually get medical support”.
Connecting individuals who do not have access to state-provided care
Anti-LGBTQ+ legislation has been on the rise in state legislatures across the country in recent years, with 2023 seeing a record number of anti-LGBTQ+ legislation being introduced, according to the American Civil Liberties Union. Criticisms point out that the Alliance Defending Freedom, which the Southern Poverty Law Center qualifies as a hate group, are largely behind these bills. Additionally, organizations like the ADF have supported legislation that would require teachers to be informed if their child admitted to being gay or transgender and that would prohibit transgender athletes from participating in female sports teams.
Another conflict: a bill that forbids the transgender daughter from girls’ sports causes a Bloomington family to fight for her.
Even before the gender-affirming therapy ban, Beth Clawson, Kirin’s mom, had been getting involved with Protect Our People, a Bloomington-based LGBTQ+ advocacy group.
“It reached a point a few years ago where we couldn’t just observe anymore”, Clawson said.
People protest against SB 480, a total ban on affirming care for transgender youth, while the Indiana House public health committee conducts a hearing last year in the Indiana State Capitol.
Protect Our People has joined a statewide network since February that provides referrals, hotel reservations, and even transportation through a network of volunteer drivers who connect transgender youth with gender-affirming care across state lines.
We’re focusing on donations to make it possible to purchase gas cards, hotels, food and travel, and we have a network of people who give their time and cars to provide care for patients, according to Clawson.
Clawson claims that POP has also collaborated with organizations in the state like GenderNexus and Y’all for All, an Indiana nonprofit that provides grant funding to transgender and gender-different individuals seeking medical access.
Challenges to out-of-state care
Accessing care is more straightforward than visiting the following state. Clinics in states that do offer gender-affirming care are often concentrated in distant metro areas, including Chicago, Grand Rapids, Detroit and Minneapolis. Some clinics only administer HRT to those 16 or older, and few offer telehealth options for follow-up appointments.
Endocrinologists in these states are also overworked and underpaid because of the low pay rates in the industry. Laws like Indiana’s have also strained pediatric endocrinology providers as masses of out-of-state clientele from Indiana, Kentucky, Ohio and Missouri seek appointments.
“People are just really scrambling”, Clawson said.
Vosicky points out that the Seventh Circuit Court has only stayed the injunction, which means that future bans could be lifted. However, she worries that transgender children and pediatric endocrinologists and their families will all eventually move away.
“I’ve had to watch some amazing people move out-of-state”, Vosicky said. The state now has this reputation.
“Open season on queer kids”
Advocates stress the value of support groups and solidarity within Indiana, even as these groups focus on providing medical support for transgender kids outside of the state.
Since the injunction was lifted, Kristina Inskeep, a parent of a transgender child and the founder of the Indianapolis-based support organization Gender Expansive Kids and Company (GEKCO), has seen a significant increase in the number of families who are present at group meetings.
“We’ve lost a lot of sleep over this crisis”, Inskeep said. “Families are outraged, and they’re hurting.”
A founding member of POP, Melanie Davis, expressed concern about the psychological harm that transgender youth experience when they are subject to discriminatory laws and hate speech. She mentions the recent passing of Nex Benedict, a non-binary Native American teen from Oklahoma who was taken to the hospital after being physically harassed at school. Benedict’s death was ruled suicide. The district attorney made the announcement that no charges would be brought against Benedict, causing outrage from allies who claimed Benedict’s death was the direct result of a hate crime.
“It’s open season on queer kids”, Davis said. “That’s what that says”.
Inskeep argued that the transitioning of children into adults is a deeply personal and challenging journey for many children and families, and that legislators should not make decisions based on this, especially those without a relevant medical background.
“We parents don’t enter into this lightly, this is not something that happens overnight”, Inskeep said. “We consult with other parents, we read books, we read articles. I find it outrageous that legislators who have no prior experience enact laws that would allow for the children of other people to receive medical care. It’s beyond sad to witness”.
Kirin Clawson jokes around with a friend, Ella Naldi, during a father-daughter dance she attended with her dad, Nathaniel, last year in Bloomington.
Clawson claims that her and her family have been considering moving out of state due to the political climate in Indiana. However, she believes it is crucial to keep fighting this issue because she works with POP and other advocacy groups to link transgender children with healthcare.
“We worked hard to find a place that we love and create this community”, Clawson said. We don’t want them to lose us in return.
Reach Brian Rosenzweig at [email protected].
