“The Trans Tax”: Addressing Barriers to Gender Affirming Care Through Crowdfunding

• In Event: Medical Sociology Section Roundtables
  In Refereed Roundtable (90 minute): Table 20. Gender Minority Health

Abstract

In accessing transition related healthcare in the United States, individuals face barriers common throughout the US healthcare system, including not having insurance or being underinsured, high co-pays/co-insurance, and confusion regarding state-by-state regulations in our federal system. At the same time, these challenges are exacerbated by unique barriers, including trans specific care exclusions, lack of education among providers, and individual/institutional cissexism in healthcare. In the face of these challenges, some individuals turn to crowdfunding, or the collection of resources from known or unknown others for a specific need or goal, to fund their transition related medical expenses. Based on in-depth interviews with 20 individuals who used crowdfunding to access gender affirming care (GAC), this article highlights how, as social texts, state level legislation, insurance policies, and providers’ guidelines, are negotiated by those seeking care, at times complicating simplistic narratives or what people or communities have “good” or “bad” access to GAC. Additionally, this article discusses how trans specific barriers to care interact with broader inequalities within the healthcare system including ableism and insurance status. Drawing on past research regarding how administrative burden can restrict access to GAC, this article offers the concept of the “trans tax” as a way to conceptualize how mental and financial burdens can become compounded for those accessing GAC, and the limits of crowdfunding and other individualized solutions to adequality address this barrier.

Author

• Hayden James Fulton, Moffitt Cancer Center