The LGBTQIA2S+ community is under constant attack. Celebrating your queerness and living authentically is becoming increasingly difficult. Especially when it comes to embracing and loving your body authentically. One of the many ways to support and affirm your gender identity is through gender-affirming care. Gender-affirming care is a hot-button issue right now as it's viewed by some lawmakers as medically unsafe and, in some states, a form of child abuse. Anti-trans legislation is running rampant throughout the United States, and gender-affirming care is becoming unavailable in more and more states. For every person and lawmaker claiming that gender-affirming care is harmful or unsafe, do you know what gender-affirming care is? Let's get into it!

Gender-affirming care encompasses a range of social, psychological, behavioral, and medical means meant to support and affirm an individual's gender identity. Some of the most well-known methods of gender-affirming care are hormone therapy, wearing binders, and any form of cosmetic surgery. Gender-affirming care is meant to combat gender dysphoria and affirm your gender identity. Gender dysphoria is the psychological distress resulting from the conflict between one's sex assigned at birth and one's gender identity. Gender-affirming care actively saves lives, and a lack thereof can have some incredibly harmful effects. 

A survey by the Trevor Project in 2022 on LGBTQ Youth Mental Health found that 93% of trans and nonbinary youth are worried about being denied access to gender-affirming medical care due to local or state laws. Also that less than 1 in 3 trans and nonbinary youth found their home gender-affirming. According to the Human Rights Campaign and a study by The Williams Institute, 30.5% of transgender youth between the ages of 13-17 live in states that have passed bans on gender-affirming care. Gender-affirming care is age-appropriate care necessary for the well-being of many trans and nonbinary people who experience symptoms of gender dysphoria or distress from having their gender identity not match their assigned sex at birth. 

Types of Care

Gender-affirming care isn't only medical or surgical transitions. Rather, it also encompasses social, behavioral, and psychological care. Some types of gender-affirming care are counseling, speech therapy, hair removal, chest binding, genital tucking, or stuffing. Chest binding is the practice of minimizing the appearance of one's chest using sports bras, skin-safe tape, or binders. Genital tucking is tucking back the penis and testicles using skin-safe tape, tight underwear, or pantyhose. Tucking can help to get a smoother look for more form-fitting clothes. Stuffing or packing is putting a fabric or specifically designed packer in the underwear to give the appearance of fullness. A simple but very effective form of gender-affirming care is makeup. Makeup can help you achieve any look, from transformative to subtle. It's the dealer's choice.  

Medical or surgical forms of gender-affirming care are puberty blockers, hormone therapy, or cosmetic surgery. Puberty blockers are a medication that suppresses the release of sex hormones, including testosterone and estrogen. Puberty blockers are taken by youths before they've begun or finished puberty. For those assigned male at birth, puberty blockers can decrease the growth of body and facial hair, prevent voice deepening, and limit the growth of genitalia. For those assigned female at birth, puberty blockers can limit or stop breast development and stop menstruation. Hormone therapy is for those who've already experienced puberty to increase estrogen or testosterone levels to develop secondary sex characteristics associated with their gender identity. Secondary sex characteristics are developed through puberty and characteristics associated with gender, such as facial hair, body hair, voice changes, and breast tissue growth. 

Forms of gender-affirming cosmetic surgery are facial feminization, tom surgery, or bottom surgery. Facial feminization surgery, or FFS, is a series of plastic surgery procedures to create a more feminine appearance. The procedure can reshape the Adam's apple's forehead, eyebrows, nose, cheeks, jaw, or shape. It can also include nonsurgical treatments such as cosmetic fillers, fat grafting, or liposuction. Top surgery can create a more masculine or feminine appearance by removing or reshaping breast tissue and repositioning the nipples. Bottom surgery is reconstructing genitalia to affirm one's gender identity. Bottom surgery can be female-to-male (FTM) or male-to-female (MTF). FTM involves a hysterectomy to remove the uterus and undergo genital reconstruction, either metoidioplasty or phalloplasty. MTF consists of the removal of the penis, scrotum, and testicles. Another procedure of MTF is vaginoplasty to create a mons pubis, labia, and clitoris with a feminine appearance and sensations. But that's not all! All forms of cosmetic surgery are gender-affirming as they can help you feel more embodied or empowered in your gender identity. Whether fixing a receding hairline, breast implants, or lip fillers, if it helps you to feel comfortable with your body, go for it!

With these various forms of cosmetic surgery as gender-affirming care, it's essential to know that surgery isn't necessary to be considered a "man" or "woman." Forcing the trans community to have gender-affirming surgery discredits the trans experience. It does an extreme disservice to the trans community. 

Going Through Changes

If you choose to go through medical forms of gender-affirming care such as hormone therapy, your body will go through many changes, almost like a second puberty. One example of this is bottom growth. Bottom growth is when the clitoris, labia, or vulva grow in size caused by testosterone from hormone therapy. With bottom growth, the clitoris can grow in length and circumference, with the average person seeing 1 to 4 cm of growth. The labia can become longer, more prominent, and darken in color, which is also typical with taking testosterone. Going through bottom growth can increase one's libido, making the clitoris larger or more sensitive with increased blood flow, causing it to look a deep red or pink/ It can even affect the way you orgasm, making it feel more intense or abrupt. Taking estrogen as hormone therapy can cause physical changes such as dry skin, smaller pores, and less oil production. It can cause breast development, fat redistribution, and erectile dysfunction, but an orgasm can still be reached if desired or shrinking testicles. ‍

Access to Care

As access to gender-affirming is changing daily and under relentless attack, knowing where to find the proper care for you is essential. First things first, always consult a medical professional before taking any medical or surgical gender-affirming care. An excellent place to start to find a medical professional that supports the LGBTQIA2S+ community and gender-affirming care is the World Professional Association for Transgender Health, a non-profit that provides resources and high-quality care for transgender youth. You can also call your insurance provider to see if they have a list of gender-affirming doctors or look for virtual care. A virtual gender-affirming healthcare provider is Plume. For access to binders or transtape try GC2B or TomboyX. Gender-affirming care is a tool to help you resonate with your gender identity. It's completely optional and meant to help you live authentically. Whether or not you choose to receive gender-affirming care shouldn't be considered the standard of transness or queerness. Protecting gender-affirming care is necessary and helps to protect the futures of trans and non-binary youth. 

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