I started physically transitioning in the 1980s, decades before trans folks had health care protections under the Affordable Care Act (ACA). Back then, I bought hormones off the street, or from doctors who performed back-alley injections without follow up. Formal education on hormone replacement therapy didn’t exist, so I relied on anecdotal stories from other trans women. My friends and I bought birth control pills from Vietnam or purchased unregulated hormones on the black market. The risk of taking altered substances was worth it to affirm our identities.

Before I was associate director of St. John’s Well Child & Family Center Transgender Health Program, I was a patient, first walking through their doors in 2015. I’d never experienced trans-affirming, competent health care, so this opened my eyes to a world of possibilities. My gender identity and journey were not only affirmed by my doctors — I felt that my health and well-being were important.

Everyone deserves to feel validated when they access the health care system. I can say firsthand that the protections and accessibility to trans competent health care provided by the ACA saves countless trans lives every day. In fact, St. John’s Transgender Health Services, a pioneering program that serves over 2,100 people was able to grow rapidly largely due to funding and policies provided by the ACA. Now, this could all change because the ACA is under attack.  […]