CAPITOLA — When Ash began receiving services and care that aligned with his gender identity, it changed his life.
“I have made tremendous strides with my mental health,” Ash said, speaking before an audience of approximately 50 people Friday inside the Capitola Branch Public Library. “I think a lot of that would probably not stand up without gender-affirming care because gender-affirming care has made me feel like I have a life worth living.”
That care has included doses of testosterone for almost a year, but Ash, 17, emphasized that a more expansive definition of “gender-affirming care” was essential to appropriately capturing all that contributed to the positive transformation.
“Gender-affirming care is so much more than hormones and surgery,” Ash, who hopes to one day become a pediatric nurse, continued. “Gender-affirming care is getting a haircut, people using your (correct) pronouns; stuff like that.”
Ash was one of four panelists assembled by the Queer Youth Task Force of Santa Cruz County for a discussion on the topic summarized simply by the event’s thematic title: “Why you should care about gender-affirming care.”
The nearly two-hour convening featured testimony from legal experts, health care professionals and local youth and young adults, all there to explain their experiences and relationships to gender-affirming care while demonstrating how an attack on the rights of the LGBTQ+ community is an attack on the rights of all.
It was emceed by Adam Spickler, a Cabrillo College trustee and the first openly transgender man elected to public office in California’s history, who was also joined in the audience by Supervisor Monica Martinez, the first openly LGBTQ+ person ever elected to the Santa Cruz County Board of Supervisors. Martinez’s colleague on the board, Supervisor Kim De Serpa, was also in the room, alongside staff and representatives from Cabrillo College, Santa Cruz City Schools, the county Office of Education and the county Public Health Division.
A.D. Sean Lewis, a senior attorney with Lambda Legal where he specializes in transgender rights cases, explained that the traditional definition of gender-affirming care refers to a range of social, legal and medical interventions or treatments that affirm an individual’s gender. Though often used in the context of those undergoing a gender transition, Lewis said that he appreciates a broader definition of gender-affirming care that applies just as appropriately to cisgender people — or someone whose internal sense of gender corresponds with the sex that person was identified as having at birth — as anyone else.
“It’s an individualized approach to care that’s based on who people are, how people understand themselves and then what interventions are going to support that understanding,” said Lewis, a transgender man.
Dr. Jen Hastings, another panelist and expert who established the transgender health program at Planned Parenthood Mar Monte in early 2003, said the positive results of this approach to care has been reliably reflected in scientific studies and data.
“We have a gradually increasing body of scientific research and evidence that has been showing that trans and gender expansive people do better when they get the gender-affirming care that they deem that they want personally,” said Hastings. “We have research that anxiety, depression and suicidality dramatically decrease when there’s access to care that is appropriate for you.”
While panelists made efforts to educate the attending audience about the experiences and needs of transgender people, they all felt it was just as important to express their profound concerns about the current political climate. During the 2024 presidential campaign, then-candidate Donald Trump spent millions of dollars on campaign ads attacking opponent Kamala Harris’ support for LGBTQ+ rights using demeaning rhetoric that continued to escalate after he was sworn into office for a second time.
But the verbal bludgeoning has been met with aggressive policy shifts as well, including a flood of executive orders targeting transgender people along with regulatory actions aimed at blocking youth from gender-affirming care. In response to the Trump administration’s actions, the county Board of Supervisors adopted a resolution in support of LGBTQ+ residents last February, along with a commitment of $100,000 a month later that went to supportive services.
In December, the U.S. Department of Health and Human Services announced proposed rule changes that seek to remove hospitals that provide gender-affirming care — referred to as “sex-rejecting procedures” in the agency’s release — from Medicare and Medicaid programs.
The move would equate to massive financial losses for hospitals across the country that, combined with the billions of dollars of cuts to these same programs contained in the federal spending bill passed by Congress last summer, puts hospitals and other health care providers in an impossible position, said Lewis.
“It positions trans kids as the fulcrum through which all social health care is going to get funded,” he said. “What they’re really trying to do is gut health care in this country and they’re using trans kids as the Trojan horse through which to do it.”
Conversely, Health and Human Services Secretary Robert F. Kennedy Jr. maintains that the shift is meant to “stop unsafe, irreversible practices that put our children at risk.”
Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz added that, “Children deserve our protection, not experimental interventions performed on them, that carry life-altering risks with no reliable evidence of benefit.”
By Hastings’ estimation, there are about 200 transgender youth seeking care in Santa Cruz County. Less than 1% of transgender youth overall end up detransitioning, according to Hastings.
Both members of the youth panel at Friday’s event were clear about the positive impact gender-affirming care has had on their lives. They asked for local youth that speak up about their own gender identities to be met with listening, respect and an environment of acceptance.
Taylor Wade, a 23-year-old psychology student at UC Santa Cruz and transgender woman, said her personalized care helped relieve confusing and depressive emotions.
While California has policies that are designed to protect transgender youth from federal actions, Wade and other featured speakers explained that if gender-affirming service options are ultimately curtailed, it will only cause transgender people to turn to off-market products and other potentially unsafe avenues to get their needs met.
“At least for the vast majority of people, they’re going to make the decision to just continue pursuing hormone replacement therapy without all of the safety and all of the other things that can be provided by these health care institutions,” said Wade. “It just really would harm people.”
Additional information about gender-affirming care is online at qytf.org/gender-affirming-care.
