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How I was locked out of healthcare as a trans immigrant

When the US health system froze me out of transgender care, friends, family and strangers stepped up

How I was locked out of healthcare as a trans immigrant
Julián Cancino: Campaigns for trans people and immigrants.

When I was 13 years old, my family settled in California. Like most teenagers, I was quick to assert my gender identity: A shy Mexican girl who rejected her quinceanera and French tip manicures, I proudly wore my older brother’s hand-me-downs. In a secretly trained, deep bass voice I would whisper to myself, ‘boy’.

I am a female-to-male transgender man. Growing up I experienced gender dysphoria – the condition of experiencing a gender different from the one assigned at birth. I knew I would never experience my teenage years as a young man unless I had access to gender-affirming medical care such as hormone replacement therapy and surgery.

To get transition-related care, you need health coverage. But my family was unable to receive health coverage, because we were undocumented, or unauthorized, immigrants.

Like many undocumented transgender people, I was locked out – unable to get the care transgender people like me need to live happy, healthy lives.

The lack of access extended to all aspects of my health care. For 15 years, I was denied doctor-recommended cervical cancer screenings, blood pressure tests, chlamydia tests, cholesterol tests, and more. I was denied access to the diagnosis and treatment of preventable diseases.

When my mother, a cancer survivor, was first diagnosed with the disease, she had to give up her weekends to work additional hours as a housekeeper so she could afford the out-of-pocket fees.

My personal struggles echo those of hundreds of thousands of Californians. 1.4 million people are excluded from access to health coverage due to their immigration status. A study by the DREAM Resource Center, a program of UCLA Center for Labor Research and Education, found that 96% of the uninsured immigrant youth who delay medical care do so due to cost or lack of insurance.

In the words of Covered California: ‘It doesn’t make sense to take the gamble of going without health insurance.’ I agree. Transgender people who are undocumented shouldn’t be denied access to gender-affirming care due to their immigration status. Undocumented Californians shouldn’t be denied access to health coverage.

I was 26 years old when, for the first time, I saw my reflection in the mirror. I had just undergone gender-affirming surgery. My body matched my mind: I saw the reflection of a man in his late 20s.

But the funds required for examination fees, the hospital fees, and other surgery-related costs were not covered by a health insurance plan. It was all paid out-of-pocket with the support of strangers, friends, and family.

Today I’m happy with my body and with my choice to medically transition from female to male, and I’m a healthier person as a result. But, as is the case with any person, my health needs go far beyond a single diagnosis or treatment. I need access to affordable and adequate preventive care.

California needs to give all Californians a fair chance at buying their own health insurance plans, including undocumented Californians.

The State of Massachusetts, where I now reside, understands that expanding health care access to uninsured undocumented immigrants is the only reasonable solution to this public health problem. I’m proud to be a resident of Massachusetts, a state where undocumented immigrants may be eligible for health coverage under certain state programs.

Our health care system works best when everyone participates. We must stand in solidarity with transgender and all other LGBTI immigrants by supporting access to health care for all.

Julián Cancino is the co-founder of FAMILIA: Trans Queer Liberation Movement, the leading national LGBT Latino organization. His projects include developing family acceptance training ​and ​ending the immigration detention of trans people. A first generation student, he is a UC Berkeley graduate. You can find FAMILIA on Facebook here and on Twitter here.


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