The hurdles and hardships of being trans in America

By Theresa Diffendal

            Imagine if you needed a letter from your therapist signing off on your mental stability before you could receive a prescription.

For about one in every 300 people in United States, that scenario is a reality.

Trans individuals are those who do not identify with the gender they were assigned at birth. Often times trans individuals will take hormones, a process called Hormone Replacement Therapy (HRT), or undergo surgery to help their bodies physically present as the gender with which they identify.

However, trans people often have to jump through a myriad of hoops before they can begin receiving these treatments, treatments which Mazzoni Center Senior Communications Manger Elisabeth Flynn said help to counteract “things like depression, anxiety, rejection by family and society…[which] stem from the difficulty of being trans or gender nonconforming in a society where being different in any way can be hard.”

Emmet Binkowski, a 22-year-old senior at Bryn Mawr College, has been taking testosterone since October 2014. Binkowski goes to the Mazzoni Center to receive health care. The Mazzoni Center is non-profit health care center located in the heart of Philadelphia, the city of brotherly love. It is unique in that in specializes in healthcare for members of the LGBT+ community – lesbians, gays, bisexuals, trans, and other gender identity and sexual orientation minorities.

Emmet Binkowski & Friend

To be given a prescription for hormones, trans individuals often have to get cleared by a therapist before they can begin HRT or undergo gender reassignment surgery.

“You have to go and talk to a social worker basically,” Binkowski explained. “Some places just a regular endocrinologist will prescribe you hormones if you have a letter from a therapist that you’ve been seeing and talking to about your transition. There’s gatekeeping that goes on where you have to have this official letter.”

That’s one visit. “Then you also have to get bloodwork done to make sure there’s nothing physiological that would make it harmful for you to start hormones,” Binkowski said. For example, testosterone can make already high blood pressure worse.

“Then they show you how to do the injection. Then you can just do them yourself every week. They teach you to do it in the fat instead of the muscle because it hurts less,” he added. “Sometimes it feels like nothing at all, sometimes it stings, but it’s no big deal after you’ve done it every week for a year.”

But just getting to a health care center can be a struggle. The time period between coming out as trans and starting HRT was extended “because it was just difficult to get into the city and go all the way to Mazzoni and come back. It takes hours by the time you go there, do whatever you need to do, and come back. Continue reading →