Although New York state offers protections for gender-affirming medical care, resources for transgender Binghamton University students and local community members are somewhat limited.
Gender-affirming medical care encompasses a variety of medications, surgical interventions and other treatments like puberty blockers, hormone replacement therapy, top surgery, bottom surgery, facial surgery and vocal surgery. There are also social elements to transitioning, like name and personal pronoun changes, haircuts and clothing choices. While some people use medical intervention in their transition, others do not.
Aiden Braun, a coordinator at the Q Center, described the challenges local transgender people face, including proximity barriers to clinics that offer gender-affirming care.
“Much of upstate New York, including Broome County and the Southern Tier, is conservative, so trans and gender diverse people may face challenges finding healthcare, receiving treatment, and being treated equitably depending on the area,” Braun wrote.
Despite efforts by the Trump administration to challenge transgender rights, including an executive order that declares sex as unchanging, New York state prohibits health care providers from discriminating based on sexual orientation or gender identity when providing care or insurance coverage.
Clinics providing gender-affirming medical care, specifically hormone replacement therapy, typically use one of two models: a diagnostic approach or the informed consent model. Clinics utilizing the diagnostic approach require patients to have a gender dysphoria diagnosis, which can be time-consuming and expensive.
“One of the major barriers to HRT access was that most providers required a therapist’s letter — some even required two,” said Tarett Blusk, a senior majoring in English. “I could not justify spending months going to therapy for something I already knew about myself, plus the money it would demand.”
Other clinics use an informed consent model, where physicians disclose the risks and benefits of hormone replacement therapy to the patient, and their parents if they are under 18, allowing them space to make an informed decision.
The Oneonta-based Gender Wellness Center or the Planned Parenthoods in Ithaca and Syracuse are the closest options for Binghamton residents seeking hormone replacement therapy from a clinic employing the informed consent model.
“I would go to Planned Parenthood every three months for labs as was required; 4 labs per year,” Blusk wrote. “However this presented challenges — transportation being one of the biggest. Without a car, it was extremely difficult to make my appointments, and with a single parent who works full time, it was hard to arrange times that worked for both of us. It came with a lot of careful planning, a lot of inconvenience, and a lot of stress.”
While Blusk said traveling for medical care was expensive and interfered with schoolwork and his parent’s work schedule, he recommended the Planned Parenthood in Syracuse “for anyone who is low on options.”
“When I went, they were kind, queer-friendly, and didn’t make me jump through hurdles,” Blusk said. “That being said, Planned Parenthood’s HRT services do not operate with endocrinologists who specialize in gender affirming care.”
Individuals on hormones may be able to fill their prescriptions at United Health Services. Braun said UHS practitioners certified by the World Professional Association for Transgender Health can provide hormone replacement therapy, adding that Decker Student Health Services can provide referrals to UHS Primary Care or the Gender Wellness Center.
Blusk shared that when he tried using UHS for hormone replacement therapy, he was “immediately faced with healthcare insurance jargon, overwhelming costs, and a lot of unknown factors.” He said that “getting gender affirming care just isn’t feasible” in Binghamton, adding that he wanted to see more from the University “than just a webpage with a list of resources.” The University did not return Pipe Dream’s request for comment.
Bee Huh, a co-director of Transcend, a “peer-led social group for transgender and gender expansive students,” and a senior majoring in English, receives estrogen online through Planned Parenthood, previously having used Folx, an online clinic specializing in queer health care. They said that access to gender-affirming medical care in Binghamton is “lacking.”
“We believe that campus health services should be better equipped to help trans students obtain gender affirming care,” Huh said. “It’s telling that most trans students need to travel to Ithaca to get the care they need.”