Health Care Assistance Program
A Rainbow Youth Project USA, Inc. Special Initiative
Access to gender-affirming healthcare can be lifesaving for transgender, gender diverse, and nonbinary people.
Gender-affirming healthcare is care that focuses on transgender people’s physical, mental, and social health needs and well-being while confirming their gender identity. It aims to validate transgender as an identity, rather than a disorder.
Transgender may be used as an umbrella term that describes people whose internal sense of gender is different than that which they were assigned at birth or who surpass traditional expectations of gender identity or expression.
Transgender people often experience considerable health disparities stemming from discrimination, ignorance, and systemic biases on top of less access to healthcare.
Until recently, little gender-affirming healthcare existed. But research strongly suggests that limiting gender-affirming medical care for people can have wide-ranging negative effects on their health.
The Rainbow Youth Project USA, Inc. is pleased to offer assistance in obtaining non-surgical gender affirming health care to those transgender individuals negatively impacted by Medicaid or state-level prohibitions against necessary care. The program can assist with scheduling appointments with physicians for initial consultation or continuation of care.
In a majority of instances, these health care appointments can often be completed via telehealth and the attending physician will have the patient undergo lab work locally with the results being submitted for review.
Barriers to Health Care
Some transgender people may not consult health care services because they have had negative experiences with doctors in the past. For that reason, organizations such as the World Professional Association for Transgender Health (WPATH) have created resources to help transgender people find knowledgeable, supportive, caring and compassionate providers in their communities.
For the best care possible, people should feel empowered to take an active role in their health by:
Voicing concerns if something doesn’t seem right.
Asking questions if they are unsure about any information.
Being forthcoming about any medications and past surgeries, as these may affect treatment plans and preventive care options.
Gender-affirming healthcare is patient-centered and works to align a transgender individual’s outward, physical traits with their gender identity. It may include a combination of medical, surgical, mental health, and other services.
As of 2022, this type of healthcare is coded in the 11th edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-11) under the term, or diagnostic category, “gender incongruence” in the chapter “conditions related to sexual health.”
It’s now clearer that gender incongruence isn’t a mental disorder, but with a substantial need for gender-affirming healthcare, the World Health Organization decided there are needs that can best be met if gender incongruence remains coded under the ICD-11.
Gender Dysphoria Diagnosis
Procedures related to gender affirmation are provided at different stages, typically starting with a diagnosis of gender dysphoria from a mental health professional. Gender dysphoria is not the same as being transgender, nor is it felt by all transgender individuals. Gender dysphoria is a medical condition where patients suffer psychological distress that is caused by conflicts between the assigned gender at birth not matching the patient’s mental and psychological gender identity or conflicts between societal interaction not reflecting the patient’s true preferred gender.
Social affirmation includes aligning clothing, hairstyles, names, pronouns, and use of facilities, such as restrooms, with a person’s gender identity.
For many transgender or nonbinary people, pronouns are a way to affirm an aspect of their gender that’s often not aligned with other people’s assumptions. Pronouns can help affirm a transgender person’s existence.
When an incorrect pronoun or gendered word is used to refer to someone, it’s called misgendering. These pronouns may be gender-specific or gender-neutral. Examples include:
For prepubescent young people, listening and respecting a youth's identity, including using the name and pronouns the young person identifies with, is the only care they can receive before they’re eligible for medical and surgical interventions.
Hormone therapy (Endocrinology)
Hormone therapy involves using testosterone hormones for adults who were assigned female at birth and both estrogen hormones and testosterone blockers for adults who were assigned male at birth. It’s prescribed to help a person gain the outward characteristics that match their gender identity.
For young people who haven’t gone through puberty, this involves using certain types of hormones to temporarily pause puberty. Puberty blockers allow more time to explore gender identity before the physical changes associated with puberty onset.
During this time, individuals can decide whether they want to eventually pursue less reversible gender-affirming medical interventions, such as hormone therapy or surgery.
If puberty is allowed to continue, more surgeries might be necessary to reverse the development of secondary sexual features such as breasts, facial hair, and body hair.
There are also nonsurgical options for aligning certain physical aspects of gender identity, such as:
name and gender marker/sex marker changes
exercise (to create more masculine or feminine frames)
hair and makeup
speech therapy to help match vocal characteristics with gender identity
hair removal through laser treatment, electrolysis, or waxing
padding of the hips or buttocks