Gender-affirming healthcare has come a long way in Michigan. Just this past March, Gov. Whitmer signed legislation to amend the Elliott-Larsen Civil Rights Act (ELCRA) to include LGBTQ+ people, which will ensure transgender Michiganders won’t suffer discrimination when seeking gender-affirming care, which is oftentimes lifesaving. Not only that, Medicaid in Michigan covers hormone replacement therapy (HRT) and gender-confirmation surgery, something not true for every state. Pride Source examined other ways Michigan is meeting the healthcare needs of its trans citizens — and how the state can do better.
Kalamazoo County is taking the lead when it comes to gender-affirming healthcare. YWCA Kalamazoo recently asked the county commission to allocate $100,000 for its Reproductive Health Fund. This fund covers things like childcare services and travel expenses for clients needing HRT, abortion care, PEP, doula services and the like.
“The Reproductive Health Fund was an idea that kind of launched a little over two years ago,” said Daniel Hamilton, director of public policy for YWCA Kalamazoo. “We really kind of wanted to survey the gaps of women and reproductive folks who were experiencing gaps in accessing reproductive health care in Kalamazoo.” One in three of those surveyed said they were impacted.
“I think that that particular service that the YWCA has with the reproductive fund is so important,” said Tracy Hall, a Kalamazoo County commissioner from 2017 to 2022 and current executive director of OutFront Kalamazoo. “I know it’s gonna be a challenge, but OutFront and other community organizations have directly benefited. Part of it is gender-affirming products, and the demand — it’s incredible.” She said items like chest binders, shavers and deodorant are in such high demand that there is a waiting list.
The reproductive health fund does not use public county dollars to pay for direct abortion care. However, the fund does pay for abortion and gender-affirming care —both direct and practical support care — from alternative funding sources. Still, some believe the commission is being forced to take a position on controversial issues. Hall has no problem with that.
“I think the county should declare its support for abortion. It should declare its support for gender-affirming products. We are talking about medical procedures that are lifesaving for not just queer youth, but anyone who has the capacity of having a child. There are consequences and risks, and we should declare our choice and our freedom to our own bodily autonomy.”
Hamilton added that of all the reproductive health services YWCA Kalamazoo provides, they’ve seen the greatest increase in demand for gender-affirming care. He called it “really just a powerful resource that is helping families understand, again, the support that they have for folks [to] live their most authentic lives.”
Just as Hall, Hamilton and others in Kalamazoo County are proclaiming that trans healthcare is healthcare, so too are Democratic lawmakers in Lansing. There, first nonbinary state legislator Rep. Emily Dievendorf (D-Lansing) is at work collaborating with community leaders to craft legislation that would, among other things, designate Michigan as a sanctuary state for transgender individuals and families fleeing states that have passed transphobic public policy.
According to the Trans Legislation Tracker, of 540 anti-trans bills introduced in 49 states so far this year, 66 have passed and 376 are active — only Delaware is unaffected. Last year, California became the first state to pass refuge state legislation; another half dozen or so are now taking steps to explicitly protect access to healthcare for their trans and nonbinary citizens.
“We are in the midst of working on several policies to try to ensure that Michigan can be one of the safest places in the country for our trans and nonbinary communities,” Dievendorf said. “Some of this is in great part because we have really strong elders like Grace Bacon, who continue to advocate really strongly for the trans community.”
Dievendorf said that trans, nonbinary and gender non-conforming folks “need to know that there are places that they can go where they are safe and where they and their healthcare can be guaranteed. So, we are planning to introduce trans sanctuary legislation as soon as June, so that we can now catch up with all of those wonderful states that are already leading on this. And I say that with great joy.”
Grace Bacon, a longtime transgender activist and pioneering organizer originally from Flint, agrees.
“I do believe that Michigan should become a safe haven state for families who need to escape from the states who are enacting some of the most draconian laws ever seen in this country,” Bacon said. “Most of those laws target the most vulnerable part of our community: our children. These families are uprooting their whole lives.”
Michigan’s sanctuary state legislation is being modeled after California and Minnesota’s protections for the trans community, Dievendorf said. In Minnesota, a bill was passed that would prevent state courts or officials from complying with child removal requests, extraditions, arrests or subpoenas related to gender-affirming healthcare that a person receives in Minnesota. It has since been signed into law by Gov. Tim Waltz.
“Minnesota,” Dievendorf said, “their legislation affirms that healthcare can include a number of social or medical interventions that affirm gender identity, including puberty blockers, cross sex hormones, permanent hair removal, voice therapy and surgical interventions.”
But Dievendorf expects pushback. Last year, Dievendorf’s Republican colleagues in Michigan introduced a bill that would classify gender-affirming care for minors as felony child abuse. To be sure, the governor’s signing pen will never come near that kind of negative legislation.
Bacon believes that the state of Michigan should go beyond merely guaranteeing safe space for trans individuals of all ages to carry out decisions made regarding their own healthcare. “These displaced people will need temporary housing and some unemployment compensation,” Bacon said. “FEMA has temporary housing units and the federal government should ante up some unemployment funding. This is an emergency that may be too big for states to handle by themselves. I feel that Gov. Whitmer should directly contact President Biden for help.”
Dievendorf is also looking at evidenced-based medicine for intersex youth. “Corrective” surgeries are often non-consensual and medically unnecessary, according to the American Academy of Pediatrics and many global organizations like Human Rights Watch. In addition, Dievendorf said she and Bacon are considering ways to protect homeless youth who are trans to ensure they receive the care they need despite lacking the support of their biological families.
“For gender-affirming healthcare, there are some things that need to be done,” Bacon said. “But for the most part, Michigan has done a pretty good job of staying out of the way, which is the way it should be. I feel that an adult has a right to transition and to use gender-affirming healthcare. WPATH [World Professional Association for Transgender Health] standards should be the only gatekeeper, and the state of Michigan should have no interest in the matter. Care for minors should also fall under WPATH standards with the permission of one parent or legal guardian.”
For their part, Dievendorf is hopeful.
“Within the Democratic Party, we are not allowing trans folks to be used as a bargaining chip or as a way to divide us,” Dievendorf said. “There is unification when it comes to the fact that trans folks need to be considered with humanity and should not be discriminated against. And considering the fact that we have a Democratic trifecta in Michigan, I do think it is recognized that we need to move forward with equal rights and equity and humanity for trans folks and nonbinary folks in Michigan at this time.”