How to Access Gender-Affirming Care in a Hostile State I Be the Transformational Change
- Morgan Messick
- Aug 25
- 5 min read
If you're transgender or non-binary and living in a state where gender-affirming care is restricted or banned, you're not alone - and you're not powerless.
While anti-trans legislation has created real barriers to accessing the healthcare you need, there are still pathways to affirming care, support networks ready to help, and legal protections that remain in place.
This guide will walk you through practical strategies, safety considerations, and resources to help you access gender-affirming care while protecting yourself and your family.
Your identity is valid, your healthcare needs are legitimate, and there are people and organizations working every day to ensure you can access the care you deserve.
Understanding the Legal Landscape
When we talk about "hostile states" for transgender healthcare rights, we're referring to states that have implemented restrictions or outright bans on gender-affirming care - particularly for minors, but increasingly for adults too.
These laws vary dramatically: some states ban certain treatments for youth while allowing adult access, others restrict insurance coverage, and some are attempting to criminalize providing or receiving care.
The legal landscape changes rapidly, with new bills introduced monthly and court challenges constantly reshaping what's enforceable.
To navigate this safely, you need current, accurate information about your specific state's laws. The ACLU's LGBTQ+ rights tracker, Transgender Law Center's legal database, and Movement Advancement Project's policy maps provide regularly updated state-by-state breakdowns. Don't rely on social media or news headlines alone - legal nuances matter when it comes to your safety and access to care.
Privacy & Safety First
Before pursuing any care, understand your privacy rights and limitations. HIPAA protects your medical information from being shared without consent, but it doesn't prevent healthcare providers from reporting information if state law requires it.
Some states have enacted laws requiring providers to disclose gender-affirming treatments to parents or state agencies, while others are considering criminalizing the provision of care itself.
Protect yourself by using your preferred name and pronouns when possible during healthcare interactions, even if it's not legally changed yet. Consider using secure communication methods like Signal for sensitive conversations, and research whether using a VPN might add an extra layer of digital privacy.
Avoid sharing detailed medical plans on unsecured platforms or social media. If you're planning to travel for care, keep details private until after you've returned safely home. Remember: being cautious isn't paranoia - it's practical safety in an uncertain legal environment.
Options for Accessing Care
Telehealth Services for Gender-Affirming Care
Top telehealth platforms for trans healthcare:
Plume - A virtual gender-affirming care clinic exclusively for trans and gender non-conforming folks
Folx Health - LGBTQIA+ focused telehealth services
QMed - Queer and trans-affirming virtual care
These platforms offer informed consent hormone therapy through telehealth consultations. While they can't operate in every state due to local restrictions, many can still prescribe hormones that you pick up at local pharmacies or receive through mail-order services.
Use the resources above to research whether your state allows telehealth hormone prescription and whether your insurance covers these services.
Travel to Safe States for Trans Healthcare
Before traveling for gender-affirming care:
Research informed consent clinics in nearby states with better access
Confirm out-of-state patient policies before booking appointments
Gather required documentation (ID, insurance cards, medical history)
Plan for follow-up care and extended prescription refills
Budget for travel, lodging, and medical costs
Planned Parenthood locations often provide hormone therapy with minimal wait times and sliding scale fees. Some providers offer extended prescription refills for patients who travel long distances.
Local LGBTQ+ Clinics and Planned Parenthood
Find local gender-affirming care providers:
LGBTQ+ health centers - Search the LGBTQ+ Healthcare Directory
Feminist healthcare clinics - Often provide inclusive, affirming care
Planned Parenthood locations - Many offer informed consent hormone therapy
University health centers - Some provide trans-inclusive services
Community health centers - Federally qualified health centers with sliding scale fees
These organizations often operate on sliding scale fees and prioritize patient privacy and safety.
Temporary Relocation Considerations
For some people, temporarily relocating to access initial care or escape immediate legal threats becomes necessary. If you're considering this option, research safe states for gender-affirming care, understand residency requirements for establishing care, and connect with mutual aid networks in your destination area who can help with housing and navigation.
More more information on relocating, read: Finding Home Again: A Relocation Guide for Transgender Individuals in 2025
Financial & Travel Assistance for Trans Healthcare
Accessing gender-affirming care often requires significant financial resources, especially when traveling or paying out-of-pocket. Fortunately, mutual aid networks and national organizations offer grants, travel stipends, and fundraising support specifically for transgender healthcare access.
National organizations providing financial assistance include:
Trans Lifeline for emergency support
Point of Pride for treatment grants
Folx Care Fund for hormone therapy funding
Many local LGBTQ+ organizations also maintain emergency funds for community members needing to travel for care, while grassroots transgender mutual aid groups on social media platforms regularly crowdfund for individuals' healthcare needs.
When seeking financial assistance, be specific about your needs and how funds will be used. Provide clear, honest information about your situation, follow application guidelines carefully, and remember to pay it forward by supporting others when you're able. Many mutual aid efforts rely on community members supporting each other through both giving and receiving help.
Advocacy & Community Support
Navigating hostile legal environments is exhausting and isolating, but you don't have to do it alone. Connecting with local LGBTQ+ groups provides both practical support and emotional community during difficult times. Local organizations often have the most current information about provider networks, legal developments, and emergency resources in your area.
National advocacy organizations like the Transgender Law Center, Lambda Legal, and GLAAD are fighting these restrictive laws in courts while providing legal resources and know-your-rights information. Many offer legal helplines if you're facing discrimination or need guidance about your rights. Plugging into these advocacy efforts - whether through donations, volunteering, or simply staying informed - helps build the collective power necessary to change these hostile environments long-term.
Remember that solidarity and community care are acts of resistance. Supporting other transgender and non-binary people, sharing resources, and building networks of mutual aid creates resilience that extends far beyond individual healthcare access.
Your Healthcare Matters - And It's Possible
No matter what your state's laws say, your identity is valid and your healthcare needs are legitimate. While accessing gender-affirming care in hostile states requires extra planning, caution, and resources, it remains possible through telehealth services, travel, community support, and advocacy organizations working to protect trans rights.
Take the next step today: reach out to at least one resource mentioned in this guide, whether it's checking the legal landscape in your state, researching telehealth options, or connecting with a local LGBTQ+ organization. You deserve affirming care, and there are people ready to help you access it safely.
For more helpful guides, mutual aid resources, and community support, visit bethetransformationalchange.org and join our movement for lasting change in LGBTQIA+ healthcare access.
This guide is for informational purposes and doesn't constitute legal or medical advice. Laws change frequently - always verify current information for your specific situation and consult qualified professionals when making healthcare decisions.
