Groups help youth find hormone care
Indiana families seek care elsewhere after ban
BLOOMINGTON, Ind. – When Beth Clawson’s 11-year-old daughter Kirin began taking puberty blockers last year, her doctors gave her an arm implant, a small insert in her tricep about the length of a key. The implant, the doctors reasoned, would provide gender-affirming therapy for up to 12 months without the need for refills. It would allow Kirin to safely continue treatment if her ability to get care in Indiana was withdrawn.
They were preparing for a reason. In April 2023, Indiana Gov. Eric Holcomb signed a bill banning Indiana doctors from administering gender-affirming hormone care, including puberty blockers and hormone replacement therapy, to anyone under the age of 18.
Puberty blockers are a reversible form of hormone therapy often prescribed to children with gender dysphoria that pause the production of sex hormones in children beginning at puberty, around age 10 or 11. Puberty blockers do not permanently stop the body from producing sex hormones, and research by the New England Journal of Medicine found transgender youth on puberty blockers and HRT reported decreased symptoms of anxiety and depression and improved satisfaction with their life and appearance.
Critics say hormone therapy is too severe of a medical transition for minors to be deciding for themselves – hormone therapy for minors requires parental consent – and that puberty blockers can weaken bone density, though these effects are also not permanent.
An injunction was granted against Indiana’s youth gender-affirming therapy ban last June, a month before it was set to take effect, but the injunction could be lifted. The law could still be revived.
On Feb. 28, it was. The 7th U.S. Circuit Court of Appeals issued a stay on the injunction, allowing the law to take effect immediately.
Overnight, children on puberty blockers and HRT lost medication access. Sudden withdrawal from testosterone and estrogen can cause side effects including hot flashes, headaches and mood swings.
“And these are kids who needed appointments the day after the injunction was lifted,” Beth Clawson said. “So people were scrambling to find very few spaces for quite a few kids.”
In addition to gutting youth genderaffirming services in Indiana, the newly enforced ban barred doctors from making referrals to out-of-state providers, leaving transgender kids and their families on their own to find and continue care in other states.
In the wake of the ban, families are turning out-of-state to find care for their children.
It’s not easy. Ohio, Kentucky, and 21 other states also banned youth genderaffirming therapy, resulting in clinics in the few neighboring states that do offer care, including Illinois and Michigan, having more than yearlong waiting lists.
Yet, since the law took effect, trans activist groups across the state have also seen a rise in interest and attendance. They have become informal resource hubs for connecting people with doctors, transportation and travel expenses for those crossing state lines to find care.
Within 36 hours of the 7th Circuit Court staying the injunction on youth gender-affirming therapy, Emma Vosicky, executive director of the Indianapolis-based group GenderNexus, received 17 messages from parents of transgender kids.
“They were terrified about what was going to occur, and what it meant for their child,” Vosicky said. “All of them hit a brick wall.”
GenderNexus provides both support groups and care coordination services, like supportive referral letters for gender-affirming care and gender and name changes in the legal system. But since the ban, Vosicky said, GenderNexus has effectively become a “triage” resource for families, helping them understand exactly what the law says and providing information regarding medical resources doctors in Indiana aren’t allowed to mention.
“Even if a physician knows that there’s medical care out there that can help their patient, they can’t say that under our law,” Vosicky said.
Anti-LGBTQ+ legislation has been on the rise in state legislatures across the country in recent years, with 2023 seeing a record number of anti-LGBTQ+ legislation being introduced, according to the American Civil Liberties Union. Critics note these bills are largely peddled by influential Christian conservative groups like the Alliance Defending Freedom, which the Southern Poverty Law Center defines as a hate group. Groups like the ADF have also promoted bills that seek to ban transgender girls from female sports teams and require teachers to inform parents if their child comes out as gay or transgender.
Even before the gender-affirming therapy ban, Clawson had been getting involved with Protect Our People, an LGBTQ+ advocacy group.
“It reached a point a few years ago where we couldn’t just observe anymore,” Clawson said.
But since February, POP has become part of a statewide network that connects transgender youth with genderaffirming care across state lines, providing referrals, hotel costs and even transportation through a volunteer network of drivers.
“We’re working on donations to be able to afford gas cards, money for hotels, money for food and travel, and we have a network of people who volunteer their time and their cars to take people to the care,” Clawson said.
Melanie Davis, a founding member of POP, said even as these groups work to provide access to care access, she worries about the psychological damage to transgender youth seeing discriminatory laws and hate speech levied against them.
“It’s open season on queer kids,” Davis said. “That’s what that says.”
Clawson says the political environment in Indiana has made her and her family consider moving out of state. But as she works with POP and other advocacy groups to connect transgender children to health care, she feels it’s vital to continue the fight here.
“We worked hard to find a place that we love and create this community,” Clawson said. “And we don’t want them to take that away from us.”