The Hardships of a Transgender Person in Texas

  • Will they accept me as a person?
  • As I go through the list in Texas, I realize each and every clinic in Texas will not accept insurance for these procedures.
  • Texas should mandate that clinics accept insurance for these necessary procedures.

While the potential threat of violence in Texas against a transgender woman is significant, there are many other concerns for transgenders in the state of Texas that they inevitably face every day. I will explain some of these, and if you will bear with me. I would like the public to comprehend the hardships that the LGBT community, especially Transgenders face every day.

I will start with the most pressing issue of an LGBT or transgender person’s pain: acceptance.

When an LGBT individual (whether he/she be gay, lesbian, bi, or transgender) figures out that they are this way, they sit and ponder, “what will happen if I inform my friends, my family? Will they accept me as a person? Or will they do as I see every day in everyday life, on the news, will they shun me because of what I am?”

Hormone replacement therapy (HRT), also known as menopausal hormone therapy (MHT) or postmenopausal hormone therapy (PHT, PMHT), is a form of hormone therapy used to treat symptoms associated with female menopause. These symptoms can include hot flashes, vaginal atrophy, accelerated skin aging, vaginal dryness, decreased muscle mass, sexual dysfunction, and bone loss. They are in large part related to the diminished levels of sex hormones that occur during menopause.

They debate this and finally gain the courage to inform a friend, then maybe all friends. Some will accept them for whom they are, others will look down upon them because of their choice that they are selecting.

At that point they confront the ultimate challenge, telling their family, their parents, their siblings, and their spouse and kids if they are mature enough and married. They start with the siblings, because hey, they are close in age. Will my brother or sister accept me, will they detest me? Some will accept their sibling for whatever they are because they love them. Some will lose their siblings over their choice.

At that moment they go to the parents. “Do I start with mom or dad? Do I inform them both at the same time?” Maybe the person decides, “I am not retelling this story and answering questions multiple times. I will sit them both down and tell them at the same time.” All the while, trembling with fear and the hope of acceptance, they tell their story of why they prefer this life. Some parents will love their children with unconditional love, and accept, and may indeed support their child with the hardships that he or she is facing. While other parents will disown their child, because “no son or daughter of mine is going being that way.”

OK, they at present think to themselves, the hard part is over. As they think, I may have lost some friends, family or loved ones because of me telling them who I am choosing to be. But at least it’s not a secret anymore and I don’t have to hide it, I can finally be myself.

So they have told their family and friends. Now time to go out in public and face the people. In the streets, in restaurants, and at school or work. This can’t be that hard, the hard part is over, right? So they go do whatever it is they plan to do, then they notice. The people staring, the people pointing and giggling at them, the harsh looks from strangers, the evil eye of some people. They feel the hatred coming from total strangers, as they walk through life.

This part is primarily focused on the transgender individual. So as the story continues…

A transgender person then considers and chooses to get hormone replacement therapy, but “how do I go about this?” they wonder. They do weeks, even months of research, and with no help from the public, they finally get the answers on how to start. They must see a psychologist or a counselor first to even initiate the process. So they spend hours on the phone trying to call the therapist to get an appointment. Many will answer and say “we don’t deal with transgender patients.” So the search continues, and they finally find one that does transgender issues, but wait, do they take my insurance? They ask this question, and they find out, no they don’t, but we take cash. But I cannot afford to pay cash for every appointment. So the search continues, and they finally find someone that deals with transgender issues and that takes the patient’s insurance, Yay, I found one, now the process can start.

But at the first appointment, they find out that they have to see a counselor a few times before they will refer them for hormone replacement therapy. So, after a few sessions, the counselor finally says its time; I will refer you for HRT. Yay, the long wait is finally over, I can start my transition. So they get the referral from the counselor and go to the doctor or clinic they were referred to, only to find out that they don’t take their insurance, but you can pay x amount for each visit. So they call their therapist to get them to find another doctor that will accept their insurance. A few days later, sometimes weeks, they get a call saying, “Well, I sent the referral to Dr so and so. Call them and set an appointment.”

So they call this doctor and are relieved when they confirm they take their insurance, but due to the popularity of this clinic, we can’t see you until September. But it is July they tell the receptionist. We understand, we can aid you to find another doctor, or we can schedule you an appointment for September 23rd at 8:15. Would you like for us to schedule the appointment? They tell the receptionist, yes, go ahead, I’m out of options.

OK, September 23rd slowly creeps up and the day is here for them to see the doctor and get started on HRT. They go to their appointment, go through all the necessary steps, get the prescriptions and get their hormones. Life as the opposite gender can now officially begin.

They start their transition, go through life living the opposite gender, and then they go in public, they go to the movies, the grocery store. People laughing at them, staring at them, pulling their kids away as they walk by, whispering, or even worse hollering slurs at this person. Multiple counseling sessions later to get over the hatred of the people they encounter. They finally start living a normal life.

Then hey, it’s time to change my gender and name, wonder how I do that? They research and find out how to go about it. They file the paperwork, wait on a court date, which could be months in the future. They go to the hearing, tell the judge why they want the name and gender change, and many get it, while some may not. Then the process of changing the ID, the name on the social security card, and birth certificate.

So now, the story continues, the parts involving me personally. Being a transgender female.

OK, it’s great. All has been finally changed. Now I want surgery to finish the transition. So I look at my insurance and find out that GRS (Gender reassignment surgery) is covered. I breath easier now because I can get it. I talk to my counselor and my doctor. I get letters for the surgery as the insurance requires. Let’s go down the list, let’s see:

  • A letter from a Ph.D. Psychologist – Check.
  • A letter from a second psychologist – Nope, have to get that.
  • A letter from the doctor who prescribes the hormones – Check.
  • 1 year of continuous hormone treatment – Check.
  • 1 year of living as the opposite gender that they are going to – Check.
Sex reassignment surgery (SRS), also known as gender reassignment surgery (GRS) and several other names, is a surgical procedure (or procedures) by which a transgender person’s physical appearance and function of their existing sexual characteristics are altered to resemble that socially associated with their identified gender. It is part of a treatment for gender dysphoria in transgender people.

OK, so all they need is the 2nd letter from a counselor using an evaluative process. I go and get this, and now I have everything that I need to get the surgery completed. So I start calling all the clinics, doctors, or specialist that preform the GCS (gender-confirming surgery). As I go through the list in Texas, I realize each and every clinic in Texas will not accept insurance for these procedures. They accept cash, or I can get a loan through Care Credit. None of these is an option, so I continue searching. As the months go by, I finally find one that takes insurance, but it is not the insurance that I have. So I check on the insurance and will purchase a policy that they will accept. But when I apply for this insurance, I am told they don’t cover the area that I live in. Therefore now I am out of options. The only option I have is paying cash for the procedure. Which will be years, as I find out the surgery is in excess of $24,000.00.

So I do some research and find I can get an orchiectomy. At least this will stop the testosterone and will cut down on the number of pills I will have to take for the HRT. I talk with the doctor and counselors, get letters for this surgery. I call clinics that perform orchiectomies, but I am told they only do these for testicular cancer patients, and they will not perform them on transgenders. So the only place that will do it is the same places that will not accept the insurance that I carry. I call them because I know they want cash for the surgery, and ask how much this orchiectomy costs. Well, to my surprise, this is still expensive $7-10K, just for an orchiectomy.

I research insurance and clinics and find Texas is amongst the very few states that their Medicaid or private insurance covers gender reassignment. But no mandates are in place making the clinics accept it. So while the insurance includes these procedures, it is impossible in the State of Texas to get these procedures done with insurance. Remember some of these are necessary surgeries due to health complications due to the T-blockers being taken. If these individuals get the surgery, they can stop taking the t-blocker all together, minimizing the damage to their kidneys.

The only option that countless Texans and I have is the following:

  • Pay an extravagant price with cash for said procedure; or
  • Move to one of the many states that the clinics accept insurance for these procedures.

How can Texas allow this to happen? Why can’t the state mandate that clinics have to accept the insurance if the insurance will include the procedure? Maybe not all clinics, but at least one in the state? This needs to be attended to quickly and justly. Transgenders need representation in Texas, and they need to be able to receive the procedures that they require.

The sole question that remains is, Why does Texas insurance cover these procedures if Texas clinics won’t accept it?

That’s Texas for y’all. Transgenders and LGBT individuals get less support in Texas than any other state.

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Addison Perry-Franks

Addison Perry-Franks is a proud Texan and Scurry County resident, active in her community. She has built a thriving small business that has successfully delivered IT solutions to national retail chains since 2008. She came out as transgender in May 2018 and has been happily married to her wife, Lacey for 11 years.  They have five children. 

Addison is also running in 2020 for Texas House of Representatives, District 83.

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