The Campaign for Southern Equality (CSE) has released the “How Far?” report in partnership with the Southern Equality Research & Policy Center, providing an in-depth look into the impact statewide healthcare bans on trans youth. The report looked at how bans on gender-affirming care have disproportionately impacted trans youth across the American South, especially those kids and teens in rural, lower income communities.
Since 2021, 24 states across the country passed legislation limiting or barring gender-affirming treatments and surgeries for trans and gender-nonconforming people under 18, including North Carolina. House Bill 808 (HB 808) was put into law last August by the General Assembly, and since then, it’s faced criticism from LGBTQ+ advocates and allies. Some of the treatments barred because of HB 808 include puberty blockers, hormone therapy and surgical care.
The law punishes doctors who continue to provide gender-affirming care by revoking the individual’s license. In addition, state funds for North Carolina Medicaid participants can’t be used to pay for gender-affirming medical care to minors.
According to data documented by the Southern Equality Research & Policy Center, at least 105,200 trans youth have experienced a direct impact from the healthcare bans across the South. However, the report acknowledges that estimate is conservative, meaning the actual number is probably higher. These bans have resulted in many families having to travel with their children to receive what they and pro-LGBTQ+ folks say is essential healthcare.
Prior to the gender-affirming care bans, most families were within a couple of hours roundtrip from medical providers. Data analysts for the research center were able to use GIS software to calculate how many miles one would have to drive and how long it would take to get to a clinic serving trans youth. It takes a two-hour one way trip (four hours total) and over 100 miles to reach the closest clinic from Greensboro, where providers were previously available within a matter of minutes.
The report also looked at how much it would cost for a parent and child to travel together to receive gender-affirming services. According to estimates using the IRS’ baseline of $0.67 per mile, it would cost someone $201 just in gas and mileage to drive from Durham to Richmond and back. That doesn’t include food or lodgings, which could likely add two hundred dollars or more to the total. And that’s not even including the actual treatment.
Some parents spoke to the CSE for the report under guarantee of anonymity, sharing their experiences since healthcare bans went into effect in their prospective states. One parent from Oklahoma shared that their daughter was deeply affected since their state passed its ban on care for trans minors. Because of this, the family was forced to travel elsewhere to receive healthcare for their loved one.
“She said on the drive that having to go to another state — one that is even more conservative than our own — was humiliating and scary,” the parent explained. “The whole trip was fairly miserable, because of how all these things built up, even though we were relieved to know we could continue her care.”