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Families with Transgender Kids Face Increasing Challenges Accessing Essential Care

by Ethan Kim
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transgender healthcare

In recent times, families with transgender children are encountering difficulties as they are compelled to travel out of state to seek the necessary care. One such family, Flower Nichols and her mother, embarked on a journey from Indianapolis to Chicago, turning it into an adventurous outing while acknowledging the primary purpose of their trip.

Their destination was the University of Chicago, where they would consult with a doctor to determine whether Flower, an 11-year-old, could continue receiving puberty blockers. This quest for medical providers outside of Indiana arose due to a law signed by Republican Governor Eric Holcomb on April 5. The legislation prohibited transgender minors from accessing puberty blockers and other hormone therapies, disregarding parental consent and medical advice.

Approximately 20 states have implemented laws that limit or ban gender-affirming care for transgender minors, although legal challenges are underway in some cases. Prior to this wave of legislation, these treatments were widely available to children and adolescents across the United States and were endorsed by major medical associations.

Opponents of gender-affirming care argue that there is insufficient evidence of its claimed benefits, relying on discredited research, and assert that children should not make life-altering decisions they may later regret. Conversely, advocates and affected families argue that such care is crucial for the well-being of transgender children.

While a federal judge blocked portions of Indiana’s law from taking effect on July 1, many patients still faced challenges in continuing their treatment.

During their trip to Chicago, Jennilyn Nichols, Flower’s mother, aimed to create positive memories rather than allowing the law’s intrusiveness to dominate their experience. They enjoyed exploring the Museum of Science and Industry and made a delightful stop at a beloved candy store, striving to maintain a sense of normalcy and acceptance—a testament to the resilience and determination of families in similar situations.

In Indiana, Mississippi, and other states, families are grappling with new laws that imply, and sometimes directly accuse, them of child abuse for supporting their children in accessing healthcare. Transgender children and teenagers often perceive the recent bans on gender-affirming care in Republican-led states as a signal that they are unwelcome and unable to express their true selves in their home states.

For parents, guiding their children through the typical challenges of growing up is already a complex task. Now, they face the added pressure of locating medical care outside their state that enables their children to thrive.

In the Nichols family’s case, support came in various forms as they journeyed to Chicago—Flower’s grandmother stepped in to care for her 7-year-old brother while their father worked, and a community of parents with transgender children donated funds to make the trip more comfortable. These families recognize that what transgender and gender-expansive youth need is no different from what all young people need: love, support, unconditional respect, and a sense of inclusion within their families.

According to Krisztina Inskeep, founder of the support group GEKCO in Indiana, families have sought solace in the organization as legislative debates, strained familial relationships, and tireless efforts to find proper care have surged following bills targeting transgender youth. Inskeep highlights that most parents grapple with the complexities of their child’s gender identity, falling within a gray area of understanding and acceptance.

Flower and Jennilyn embarked on their journey to Chicago on June 13, filled with hope but also uncertainty. Armed with a care plan from Indiana University’s Riley Children’s Hospital, they pondered whether the Chicago providers could accommodate their needs if Indiana’s ban was temporarily halted. They also considered the logistics of making the three-month drive, as Flower’s treatment required regular administration of puberty blockers.

The decision to initiate puberty blockers two years prior was not taken lightly by the family. Initially, Jennilyn questioned the permanence of her daughter’s gender expression, reflecting on potential failures as a parent during pregnancy. However, they rejected unscientific theories and listened to Flower, who vividly recalled the joy of wearing princess dresses from an early age and felt a strong sense of identity.

Conversations between Flower and her mother are characterized by open and honest dialogue. Jennilyn recalls expressing fear about how the world would accept Flower, assuming that the process of understanding one’s gender identity was reserved for adults. However, she now recognizes Flower’s unwavering sense of self and focuses on more typical concerns such as school, relationships, and personal growth. Flower appreciates her mother’s trust and involvement in medical decisions, but acknowledges the importance of practical considerations and their joint decision-making process.

Meanwhile, in Mississippi, a ban on gender-affirming care was enacted on February 28. As a result, a father and his transgender son made plans to relocate to Virginia by the end of July. There, the son could continue receiving healthcare and regular visits to doctors.

Ray Walker, the 17-year-old son, resides in a suburb of Jackson with his mother, Katie Rives. Walker is an honors student with interests in theater and cooking, supported by a close-knit group of friends. When the ban on hormone therapy for individuals under 18 was signed by Mississippi Republican Governor Tate Reeves, he accused “radical activists” of promoting an ideology that convinced children they were in the wrong body.

Prior to the ban, the largest hospital in Mississippi had already ceased hormone treatments for transgender minors and subsequently closed its LGBTQ+ clinic. Walker and other teenagers managed to receive treatment at a smaller facility in another city, but access was terminated once the ban took effect.

With dwindling access to gender-affirming care and the subsequent legal prohibition, Walker’s father accepted a job in Virginia to ensure his son could continue receiving healthcare. Walker plans to move in with his father, leaving Rives in Mississippi with her other two children.

Walker vividly remembers the distress he experienced during the onset of puberty at the age of 12. He felt his body was unable to handle the changes, and subsequent evaluation, puberty blockers, and hormone injections played a vital role in improving his self-image. However, the sweeping efforts to restrict gender-affirming care in conservative states eventually reached Mississippi, narrowing the path to stability that Walker and his family had forged and leaving them with no choice but to relocate.

Walker emphasizes that he was born the way he is and cannot deny his identity. The abrupt change in plans caused by the law has taken a toll on him and his family, leaving them feeling torn apart by the state they once called home.

As Walker’s moving date approaches, Rives cherishes the time they have together as a family and prepares herself for the physical distance that will soon separate them. Her younger children will lose the daily presence of their older brother. Rives acknowledges the privilege they have in being able to relocate to another state for healthcare, recognizing that most people in Mississippi do not have such options.

Flower, initially disheartened by the legislative debates in Indiana, found renewed hope after attending her first Pride march in Indianapolis. Adorned with a transgender pride flag and surrounded by rainbow heart-shaped stickers, she held a sign that declared, “She belongs.” Her favorite activities, like being a Girl Scout and playing Pokémon with her brother, are largely unaffected by politics. Prior to their trip, she joyfully rode a pink scooter in an Indianapolis park, her hair tousled by the wind.

Before entering Chicago’s Museum of Science and Industry, Flower confidently used the women’s restroom. At a local diner, she ordered a mint chocolate chip milkshake and a vegan grilled cheese sandwich. Jennilyn meticulously planned their itinerary to ensure a joyful and stress-free experience.

First and foremost, they would enjoy a relaxing morning at the hotel. Then, they planned to have fun at a nearby park and even had a backup plan in case of any complications. And, of course, they were excited about visiting a candy store.

The doctor’s appointment the following day, although initially daunting, brought a reason for celebration. If Indiana couldn’t provide the necessary care, they could rely on Chicago.

Jennilyn firmly stated, “Indiana could do whatever they’re going to do, and we can just come here.”


This shift in legislation and the resulting challenges have profoundly affected families in Mississippi as well. On February 28, a ban on gender-affirming care became law, prompting a father and his transgender son to leave the state for Virginia at the end of July. In Virginia, the son could continue receiving necessary healthcare and seeing doctors.

Ray Walker, a 17-year-old, resides with his mother, Katie Rives, in a suburb of Jackson, the state capital. Walker, an honors student with interests in theater and cooking, has a supportive group of friends. When the ban on hormone therapy for individuals under 18 was signed into law, the governor accused “radical activists” of promoting an ideology that convinces children they are in the wrong body.

Prior to the ban, Mississippi’s largest hospital had already discontinued hormone treatments for transgender minors and subsequently closed its LGBTQ+ clinic. Walker and other teenagers received treatment at a smaller facility in another city, but access ended when the ban took effect.

As access to gender-affirming care became increasingly restricted and eventually outlawed, Walker’s father made the decision to accept a job in Virginia to ensure his son could continue receiving healthcare. Walker plans to move in with his father this month, while Rives will remain in Mississippi with her other two children.

Walker vividly remembers the anguish he felt during the onset of puberty at age 12. He describes his body as unable to handle the changes. However, with a years-long process of evaluation, followed by puberty blockers and hormone injections, Walker experienced an improvement in his self-image.

Then, the sweeping efforts in conservative states to restrict gender-affirming care reached Mississippi, narrowing the path to stability that Walker and his family had forged and leaving them no choice but to relocate.

Walker emphasizes that he was born this way and cannot deny his identity. The sudden change caused by the law has torn their lives apart, as Mississippi sends a message that they are not wanted in their own home.

As Walker’s moving date approaches, Rives cherishes the moments they share as a family and braces herself for the physical distance that will soon separate them. Her younger children will lose the presence of their older brother in their daily lives. She acknowledges the privilege they have in being able to move to another state for healthcare, recognizing that most people in Mississippi do not have such options.


Flower, initially disheartened by the debates at the Indiana Statehouse, found solace and optimism after attending her first Pride march in Indianapolis. With a transgender pride flag draped around her shoulders and her pink shirt adorned with rainbow heart-shaped stickers, she proudly held a sign proclaiming, “She belongs.” Her favorite activities are often free from political influence, such as being a Girl Scout and playing Pokémon with her brother. Prior to their trip, she joyfully rode a pink scooter through an Indianapolis park, her hair tousled by the wind.

Before entering Chicago’s Museum of Science and Industry, Flower confidently used the women’s restroom. At a local diner, she ordered a mint chocolate chip milkshake and a vegan grilled cheese sandwich. Jennilyn meticulously planned their itinerary to ensure a joyful and stress-free experience.

Frequently Asked Questions (FAQs) about transgender healthcare

Q: Why are families with transgender kids forced to travel out of state for care?

A: Families with transgender kids often have to travel out of state for care due to restrictive laws in their home states that ban or limit gender-affirming treatments. These families seek the necessary care elsewhere to ensure their children can receive the support they need.

Q: How many states have enacted laws restricting gender-affirming care for trans minors?

A: At least 20 states have enacted laws that restrict or ban gender-affirming care for transgender minors. However, legal challenges are underway in several of these states.

Q: What do opponents of gender-affirming care argue?

A: Opponents of gender-affirming care argue that there is insufficient evidence to support the benefits of such treatments. They often rely on discredited research and express concerns about children making irreversible decisions. However, medical associations have endorsed gender-affirming care as vital for the well-being of transgender kids.

Q: How are families coping with these challenges?

A: Families are facing these challenges by seeking support from advocacy groups and community networks. They are traveling out of state for medical care, relying on donations and financial assistance from others, and navigating strained relationships and emotional struggles while supporting their transgender children.

Q: What impact does this have on transgender kids and their families?

A: These laws and challenges send a message to transgender kids that they are unwelcome and unable to be themselves in their home states. Families face emotional and logistical burdens as they navigate the search for healthcare, often feeling alienated and unsupported. The impact on the well-being and mental health of transgender kids and their families is significant.

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