“Those things won’t happen here,” they said. “Crazies don’t win elections. We don’t legislate discrimination anymore in this country.”
My liberal coworkers and I were sitting down to lunch at my favorite Indian restaurant, and I’d just made the unpopular argument that Donald Trump could still win. As a trans woman in the trans-hostile state of Missouri, stakes were high for me. I told them that even though Kansas City, where I lived, has some nondiscrimination protections, anti-trans legislation was just going to get worse. I was tired of being a political football. I wanted the opportunity to have a better future. I declared at that lunch that if Trump became president, I might have to move somewhere else.
Many of my friends and family members rolled their eyes in skepticism that I’d make such a dramatic change. In fact, I had started seriously thinking about moving during a different argument with one of these friends. I was listing off the mess of new legislation coming down the pipelines in both my home state of Kansas and its neighbor, Missouri, that targeted transgender people, imposed bathroom restrictions, and made it harder to sue your employer for discrimination. In the heat of the moment, my friend threw down a challenge: If there are better places for transgender people out there, then why don’t you just go?
It was a good question, one that caught me off guard. At first, I had financial objections—picking up your life and moving across the country to start over is expensive. I couldn’t afford it.
But fate is not without a daring sense of humor. Last December, I lost my job, and with the closing of that professional chapter came a severance package. I even got to keep my medical benefits for three months and, with the money, I decided to take the leap of faith. After Trump won, almost exactly a year ago, I officially decided to abandon Kansas City, Missouri for Denver, Colorado.
Merriam-Webster defines “refugee” as “one that flees,” especially “a person who flees to a foreign country or power to escape danger or persecution.” I’m a white person with a college degree, but my gender made me a target. I started to wonder: Is this our nation’s long-term political future? Will the politically marginalized be forced to become domestic refugees, fleeing oppressive places across the country to find “sanctuary” cities and states?
In the face of a Trump presidency, Colorado was that sanctuary.
I knew I couldn’t afford a moving truck all the way to the coast, and I didn’t have enough time to sell all my possessions. So if I couldn’t make it to the trans-friendly states of California, New York, or Oregon, I figured Colorado and its beautiful mountain ranges were second best.
The state had been on my radar since 2003, when Dr. Marci Bowers, a well-known champion of gender confirmation surgery and a transgender woman herself, started her practice in Colorado, rendering the state a surprisingly accepting hotbed for people like me. Tech development seemed to be exploding there; my professional credentials as a social media analyst meant getting a job in tech-adjacent fields would be manageable. But beyond a welcoming culture, there were tangible, legal reasons why Colorado made sense.
In 2007, Governor Bill Ritter signed Senate Bill 25, the Employment Nondiscrimination Act, to extend statewide employment anti-discrimination protection to LGBTQ Coloradans. A year later, the state passed the Colorado Anti-Discrimination Act that also protected LGBTQ Coloradans in cases of public accommodation and housing. These laws would give me legal protection from bigoted landlords and supervisors or customers who disagree with who I am as a person.
Then there was Bulletin B-4.49, which could mean the difference between perpetual discomfort and profound relief. Issued in 2013, it affords me regulatory guidance for insurance without gender-related surgical or psychological interventions being considered cosmetic or elective, without my gender identity classified as a pre-existing condition, regardless of what happens with national healthcare. I still need to have insurance in order to access these benefits, either through my employer or by purchasing it myself. But at least the mountainous struggle of finishing my transition finally feels plausible.
Not all transgender people pursue surgical intervention, or even agree on a single term to describe it. (I call it gender confirmation surgery.) But for those of us who find it to be the right medical decision for them, it’s almost never for cosmetic or otherwise elective reasons.
Like me, many of us who seek out surgery do it because we’re plagued by gender dysphoria, a mismatch between the internal neural mapping of our bodies and the physiological tissue with which we were born. I’ve taken hormones, but never had the resources to have surgery. I can best describe the way I feel as wearing an itchy full-body sweater without anything on underneath, and you can only find the relief your body craves if you have a series of expensive surgical operations.
There are all kinds of reasons cis people ask trans people about their transitions, and much of the time, their intentions aren’t pure. Their questions are usually rooted in bad jokes in movies and TV. But some people are curious because they’re trying to find a personal way to connect with my journey. Virtually all Americans can feel some level of sympathy about bad doctors and insurance problems, given the state of the country’s medical system. So in that spirit, I’m going to break my own rules and talk publicly about my surgical dreams.
Back in high school, I started to feel this sagging weight across my chest. It was like a phantom limb in reverse—in the middle of puberty, body parts I’d never had were responding to stimuli that shouldn’t exist. I was consumed with jealousy that my best female friends’ breasts were growing. I still envy simple things cis women take for granted, like wearing their yoga pants in public without incriminating bulges.
Thanks to time and the internet, I have been able to understand these feelings and accept myself. But I still would do almost anything to take off that itchy sweater.
My dream surgery would include vaginoplasty and labiaplasty, breast augmentation, and maybe some work on my nose to make it cuter and rounder and fix that time I tripped over a chair in second grade. My booty could use some work to widen the hips of my frame and a tuck to regain its former pop. Dr. Christine McGinn, another transgender surgeon in Pennsylvania, even partners with a local tattoo artist to disguise post-surgical scars, which I’d definitely opt for, too.
Post-surgery, I want any of my future partners to be able to peel off my panties without a second thought. I’ve had sex, even though it’s hard for me to deal with psychologically, and I like it. But I’ve also wondered what it would be like to fuck in my real body.
I imagine that visiting a doctor like Bowers for a simple consultation would feel like Charlie visiting Willy Wonka’s factory, with every amazing thing I’d ever dreamed of, all in one place, accessible through a magical golden-ticket surgical lottery. The Willy Wonka analogy feels extra-appropriate because of how ridiculously expensive these procedures can be without trans-friendly insurance: up to $30,000 or more for genital surgery alone, according to Teen Vogue’s Elle Bradford, who painstakingly detailed what it costs to be trans in America.
For me, Colorado meant a chance to live my life like any other woman, and the first step is living in a place with reliable, affordable access to doctors competent with trans issues. The National Transgender Discrimination Survey notes that a quarter of transgender people report having to teach their medical professionals about trans healthcare. Fifteen percent report being asked invasive questions about their gender identity unrelated to the reason for their visit. You can also be denied care altogether (I was: “We don’t treat people like you”). You can be mocked for your identity by medical professionals (I have been: “You need a therapist, not a doctor”).
Imagine this itchy sweater making it hard to do the rest of the things in your life that matter—eat, sleep, interact with others in public, seek medical care—because you’re afraid of people reacting badly to something you didn’t want or choose for yourself in the first place. Imagine having difficulty finding or keeping a job, even getting an apartment, just because of who you are.
Then imagine you hear the news that you could avoid this miserable series of forced choices, escape this life altogether and maybe even start over fresh, if only you lived somewhere else in the country. Wouldn’t you go?
Since I started writing this piece in June, I’ve only felt more vindicated by my decision. The Department of Education withdrew its finding that an Ohio school district discriminated against a transgender girl. In July, the Department of Justice filed a legal brief arguing that the Civil Rights Act of 1964 does not prohibit discrimination on the basis of gender identity, a reversal of longstanding Justice Department policy. That stance was finalized in October with the release of the Department of Justice memo to the same effect.
This administration has also backtracked on plans to include transgender people in the 2020 census, tried to ban us from the military, and rolled back nondiscrimination protections around transition-related healthcare included in the Affordable Care Act.
Colorado’s legal protections will shield me from some of this trouble, but I acknowledge that simply fleeing a transphobic state isn’t a viable solution for every transgender person. There’s a level of privilege and accessibility that comes with the ability to just pick up and move to start over the way I did. And even when it’s possible, there are still endless hoops to jump through.
So far, Colorado hasn’t exactly been Willy Wonka’s factory. When I arrived in Denver, I contacted the Gender Identity Center, which informed me that there weren’t enough practitioners here for everybody and resources were tight. Denver Health offers informed consent hormone therapy now, which means I could theoretically take care of my most basic needs on my own if I could afford the medication. But I can’t afford it right now. I haven’t had consistent access to hormones since January, after swallowing them religiously for more than two years. To say that my mental state has deteriorated since is a generous way of putting it. There are days where even I am surprised my boyfriend has stayed by my side.
I’m in a much better place, politically speaking, but I still lack the financial ability to access those benefits. In my haste to move before the 2017 legislative session, I didn’t secure a full-time job in my field ahead of time, which would have allowed me secure a new prescription for my hormones, too. The cost of living here is higher, with my rent costing almost 50 percent more than it used to in Kansas City. Right now, I’m attempting to make ends meet by working overnights at a grocery store while searching for a writing gig or one that works directly with the LGBTQ community. Job-searching is nearly impossible without existing connections.
The result has been serious financial hardship. I’ve had to swallow my pride and learn how to ask people outside my immediate family and friends for help. I have used GoFundMe to raise money from people I know. Recently, I had to ask a supervisor to loan me some cash so I could buy some staple groceries. He kindly gave me what he could, no questions asked.
If I won a million dollars tomorrow, there’d still be hurdles to getting the surgery I want. The standing requirements of many surgical offices, even Dr. Bowers and Dr. McGinn, require letters from two psychological professionals recommending the treatment and certifying that I am stable enough to undergo the procedure. And, there are wait lists for surgery even after that. Because of how few practitioners are trusted to do excellent work in this field, we’re all clamoring for the same few people. Last time I checked in with both Bowers and McGinn, for example, there’s at least another eight-month wait before I could have the procedure. I have heard of wait lists as long as two years.
Through the internet, I have been able to stay somewhat connected to support back in Missouri and Kansas, but starting over is inherently lonely. The only real friend I have here still is my boyfriend. Only my mom still talks to me as it is—the rest of my family are unaccepting Baptists. I found out through the grapevine that my sister had a baby boy, though she didn’t call or text me herself to tell me.
Despite all this, I don’t regret my decision. It feels like there’s a light at the end of the tunnel again. But this latest of phase of my long journey has made one thing clear: Without an enforceable federal standard, navigating this constantly-shifting patchwork of policies and politics is a reality for any American trans person, no matter where they are. Even the lucky ones like me.