“On June 21, the Virginia Department of Health released a list of transgender resources and referrals within the commonwealth. While Richmond has 42 services that offer legal, medical or mental health support, only two provide hormone replacement therapy.
“Most [patient care providers] aren’t comfortable initiating transitioning for someone,” says Melissa-Irene Jackson, program manager at Virginia League of Planned Parenthood. “It doesn’t need to be such a specialized service.”
This was one of many issues discussed Thursday at the Fierce Urgency of Now: Virginia’s First LGBTQ+ Health Equity Symposium. The event, put on by the Health Department and LGBT support organization Side by Side at Virginia Commonwealth University’s James Branch Cabell Library, featured keynotes on health inequities beyond HIV/AIDS within the transgender community and how they affect LGBTQ people of color.
Jackson, who spoke on the panel about transgender health care, recalled meeting trans patients at Planned Parenthood. Due to negative experiences with medical professionals, they never had blood drawn prior to visiting the clinic. A survey done in 2015 by the National LGBT Health Education Center found that fear and discomfort accounted for 31 percent of trans people’s main reasons for delaying medical care in the past year.
“Folks don’t know what they need to know,” Jackson says of health care providers. “We need to be way more thoughtful about this and meet people where they are.”
While services catering to the specific needs of the trans community, such as hormone replacement therapy, are available, trans health care should extend beyond these services, panelists said. They stressed the importance of properly educating doctors to create inclusive, LGBTQ-affirming environments for all patients, so that patients don’t have to explain basic knowledge of their bodies.
As for insurance coverage in Virginia, most health plans exclude necessary medical procedures for LGBTQ people, such as pap smears and prostate exams or mental health services that help treat gender dysphoria and the effect hormone replacement has on mental health.
Austin Higgs, a program manager at the university’s Office of Continuing and Professional Education, spoke about her search for quality health care as a trans woman of color. Since she encompasses a variety of identities, Higgs says it’s challenging to find a therapist or medical provider offering proper care.
“When I check all the boxes in my medical provider website, literally it said no one in my area,” Higgs says at the panel on people of color in the LGBTQ community. “So that’s harmful for me because I feel like I’m not going to be able to trust the person if they don’t check all those boxes.”
Delegate Danica Roem, who made history in 2017 as the first openly transgender person elected to the Virginia General Assembly, gave the closing presentation of the afternoon. Reflecting on the journey to taking office, she said she’s determined to “flip the script to do something positive,” especially when trans-inclusive policies get struck down.
“I’m listening to health insurance people, to other folks who are professionals in the health care industry, debate my health care without any of them having to actually have the lived experience about what it means to be a trans person pursuing health care,” Roem says. “A lot of people who have no idea what it’s like to be me are deciding my fate right now.”
Gov. Ralph Northam spoke briefly, acknowledging the steps being taken to make state employment applications more inclusive with the Employment Equity Initiative.
As of July 1, the application no longer includes salary history, age or school name while offering space to put a preferred pronoun.
"Virginia will be inclusive,” Northam says. “Doors open, lights on.”