Access to gender affirming healthcare varies wildly across the United States from one state to the next. For people in some states, there is unrestricted access to this kind of care – while it is banned (or will soon be banned) in other places. While it’s great that some states have stood up for the rights of these individuals, that decision has led to an unintended consequence that wound up stressing the system beyond what may have been expected.The issue is that people who have been denied care in their home state are visiting the states that don’t have bans to get the services they require. Although these states are welcoming to the patients, the healthcare systems in those states are not necessarily ready to accommodate such a swelling demand.A growing list of states are becoming established as places for transgender people to seek refuge and get the gender affirming care they need. Included on this list are California, Connecticut, Colorado, Illinois, Massachusetts, Maryland, Minnesota, New Jersey, New Mexico, New York, Washington, Vermont, and D.C.

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The attraction of these states for transgender individuals is obvious and it goes beyond just access to healthcare. Coming to a state that doesn’t have a ban on treatments for transgender people feels like the right thing to do for many of them, as they’ll be coming to a place that isn’t trying to actively restrict or take away their rights.In the states that permit this type of care, the requests for appointments are growing rapidly – at a rate of 50% a year or more. For example, a hospital in Minnesota was recording around 100 requests per month, and that number has now climbed to around 150. These calls are coming from people in various locations around the country from those in states where a ban has been put into effect or will be soon.The inevitable result of this climbing demand is extended wait times for people to get help. It can be many months – or even more than a year – before an appointment is available.Supporting the protection of transgender people in search of inclusive gender affirming healthcare requires not only that the laws allow for them to be treated, but also that the infrastructure is in place to make sure care is available in a timely manner. It’s likely that these so-called refuge states will start working on initiatives to boost funding and take other measures to make as many appointments and treatments available as possible.In an ideal world, the bans that put restrictions on transgender people getting the care they need will gradually disappear over time, and traveling to other states to get treatment will become a thing of the past. Until that day, however, it seems likely that this trend is only going to grow in strength, and it is yet to be seen how the states that permit this type of care will be able to successfully adapt to the demand to serve everyone as effectively as possible.

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States that protect transgender health care now try to absorb demandHEALTHCARE LAWS AND POLICIES