“The single most extreme anti-trans law to ever pass through a state legislature,” in the words of the ACLU, was signed into law in Arkansas this month. Overriding the governor’s veto, the Arkansas legislature passed House Bill 1570, banning healthcare professionals from providing gender affirming care to trans youth. Banning the services that trans people need for gender transition doesn’t stop people from being trans - it steals the resources they need in order to stay alive. One doctor testifying against the bill told the legislature, “Do you know how many phone calls I’ve had...in the last week of children saying, ‘Dr. Hutchinson, if this bill passes, I will kill myself’? Multiple. I guarantee you, if this bill passes, children will die.”
The struggle to access gender-affirming care sees barriers at every turn. At the government level, state legislators in 2021 have filed a record number of bills targeting trans people, with restricting gender affirming care as one of the top priorities. In states not explicitly outlawing transition-related care, the hoops to jump through to access that care can be excessively prohibitive. This, combined with the powerlessness and instability commonly shaping trans lives, makes the opportunities for necessary healthcare slim. Trans people are fighting tooth and nail for things at the bottom of Maslow’s hierarchy of needs.
Maryland is a state of “hoops” for gender affirming care. For gender affirming surgical procedures, for example, you can expect to need as many as 3 letters from different medical and behavioral health providers stating that you do in fact need surgery if you want any insurance coverage. Unless your providers are part of the handful of professionals versed in trans care, you likely will find yourself asking therapists and doctors with little to no competence in trans issues to speak as the master of your fate on surgeries you have known you need long before you came to their door. These letters have meticulous guidelines set out by WPATH, expire after 12 months, and can only be used for any one procedure - so if you don’t raise enough money in time or you need another surgery, you have to start the process all over again. Imagine how that feels for our clients.
As social workers, we play a crucial role in securing trans people’s access to care by writing letters of support for gender-affirming surgeries. Denying our clients access to care through our incompetence on the matter is unethical and dangerous. It is our urgent duty to get the training we need in order to write these letters.
That’s why the Queer Community Alliance has partnered with the Intercultural Center to make training in writing letters of support for gender affirming surgeries a permanent part of the curriculum, both in the School of Social Work and the School of Medicine. We will be keeping trans people alive by supporting their transition goals. Anyone interested in helping can email the Intercultural Center at ILE@umaryland.edu.
So, are we in Arkansas? No, but we don’t need an outright ban on gender affirming healthcare reproduce patterns of oppression in our trans clients’ lives. Trans people’s healthcare needs are a matter of life or death, and social workers maintain the barriers to trans people’s survival needs by remaining ignorant of what we need to do in order to serve trans clients. We need this training in our curriculum. We need to be in the business of saving trans people’s lives.
With love and pride,
The Queer Community Alliance
Edgar Fields, co-chair, he/him and they/them pronouns
Jennifer Blue, co-chair, she/her pronouns
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