Margie Thomson sat in her office, holding a heart made of clay in her hands. It’s painted the colors of the transgender pride flag – pink, white and blue. Thomson is a therapist here in Juneau, and she said she’s nervous to speak publicly about the risks to gender-affirming care in Alaska.
But, now, she said, is the time to stand up and use her voice to support her clients, who are overwhelmingly transgender. She said she’s served 350 people in Alaska who identify as gender-expansive, people whose gender identity, expression, or experience doesn’t align with the sex they were assigned at birth.
Alaska’s transgender community is worried that a second Donald Trump presidency might threaten their access to gender-affirming care, or health care that allows people to transition medically — and providers in the state are worried too.
On the day after the election, Thomson had four new requests from patients asking for referrals for gender-affirming care — in case they lose access to it.
“I think a lot of people are worried that that might go away,” she said. “So even though they don’t have the money now and they’re going to go in debt, they want to get the referral.”
Thomson said several providers in Juneau support gender-affirming care services. No one has told her they plan to stop.
“Right now, we have a strong community, and they’re hopefully going to get stronger and pull together,” she said. “Yet the fear is real and the risk is real.”
And Alaska’s two main providers for gender-affirming care say getting a jump on services may be the right move.
President-elect Donald Trump made campaign promises to block gender-affirming care for youth, and to stop federal dollars going towards care, including Medicare and Medicaid.
And he’s done this before. Rose O’Hara Jolley is the Alaska State Director for Planned Parenthood Alliance Advocates. Planned Parenthood is one of the biggest providers of reproductive and gender-affirming care in Alaska.
They said that during Trump’s first term in office, he blocked funding to Planned Parenthood by removing abortion providers from Title X, the more than 50-year-old federal grant program that provides reproductive care across the nation. This made it harder for low-income patients to receive reproductive care from providers like Planned Parenthood.
The Biden administration reversed those changes, but OʼHara-Jolley said itʼs likely Trump will do the same again, which would impact the organizationʼs ability to provide health care, including gender-affirming care.
“But we know that these attacks are coming because they have already started them, and now that they are in positions of power, there’s no reason to believe them that they won’t continue with the promises they’ve made,” OʼHara-Jolley said.
But they said that Planned Parenthood has weathered a Trump administration before, and it doesn’t plan on shutting its doors.
“I want them to know we will continue to provide as much care as we can in all the places, in ways that we can. Unless or until someone forces us to stop. We will not stop providing care,” they said.
Based in Anchorage, Identity Alaska serves nearly 900 transgender patients. Director Tom Pittman said the same funding cuts would apply to them as well, and most of their patients use Medicare and Medicaid.
“It would mean that 70% of our patient revenue would evaporate, which is significant,” he said.
Pittman said that anti-trans rhetoric implies that trans people are a new phenomenon, which isn’t true.
“And this attempt to shift the definitions and histories in order to make a group of people feel this vulnerable, it really is unconscionable,” he said,
Health care for transgender youth has become a hot-button issue for Republican politicians, but the American Academy of Pediatrics, the American Medical Association, and the World Health Organization all support the use of medical gender-affirming care for both adults and youth.
Aidan Key is an educator who trains schools on how to accommodate trans and gender-expansive youth in Alaska. He said the incoming administration will be hard on all trans people, but he’s worried about youth especially.
“We as adults are going to need to find our courage to push back and address the situations that do come up because these children’s lives depend on it,” Key said. “I have no doubt — no doubt — that since the election to today, lives are already ended.”
Data from crisis lines support Key’s theory – one national organization that supports LGBTQ+ youth reported a 700 percent spike in calls and texts immediately after the election.
But he has hope for Alaskaʼs trans community, and he said, in the days ahead, leaning on community is the one thing everyone can do.
If you or a loved one is experiencing a crisis, you can call the National Suicide Prevention Lifeline at 1-800-273-TALK, or contact the Crisis Text Line by texting TALK to 741-741.