A new report from the Campaign for Southern Equality (CSE) and the Southern Equality Research & Policy Center reveals that due to state laws banning gender-affirming care for minors, U.S. families now have to travel longer distances and face higher travel costs to access care for their transgender children.
The report, titled The Extreme Travel Burden of Bans on Medically Necessary Care for Transgender Youth, using mapping software, estimated the distances families in states with anti-trans healthcare bans would need to drive to reach clinics. It also gathered information from over 500 parents of trans children through CSE’s Southern Trans Youth Emergency Project (STYEP), which assists families in accessing care in states with gender-affirming care bans.
Before the recent wave of anti-trans laws, families in most parts of the contiguous U.S. were within a one- to four-hour drive from a clinic where their kids could receive care, as stated in the report.
In the deep south and rural areas, it now takes over eight hours of driving time for families of trans youth to reach clinics providing gender-affirming care. This type of care has been endorsed as safe, evidence-based, and often necessary for treating gender dysphoria in young people by major American medical associations.
The report includes an example of how, prior to Republican Gov. Greg Abbott signing a state ban into law last June, families in Houston, Texas, could access gender affirming care for their kids within the city limits. Now, they must drive over 18 hours roundtrip to reach a clinic.
Even in states like Arkansas, where bans have not gone into effect, some providers have stopped seeing patients, forcing families to travel for care. In other states, like North Carolina and Georgia, trans kids who were receiving gender-affirming care prior to the passage of those states’ bans can still receive care in-state, while new patients must travel elsewhere. It’s even more complicated in Georgia, where minors can receive puberty blockers, but must travel to access hormone therapy.
The report also examines the costs and other challenges associated with travel for care, including gas and vehicle costs, airfare, overnight expenses, meal costs, and time off from work and school.
CSE reports that about 90% of families in states with bans that are also surrounded by other states with bans choose to fly rather than drive to states where they can access care. While this can reduce travel time, it also increases the cost for families, with the average cost of a single roundtrip domestic flight being around $276. Other factors, such as childcare for other children, ground transportation, and hotel accommodations, further increase the costs for families of transgender youth. Additionally, these trips are usually not one-time occurrences. Families that cannot or do not choose to permanently move are compelled to travel regularly, sometimes every three to four months, for appointments, according to the report.
A parent in Texas told CSE that the state’s ban on transgender healthcare and another in Louisiana, which is next to Texas, had caused chaos for their family. After healthcare providers in both states could no longer offer gender-affirming care, they had to travel to see a provider in Albuquerque, New Mexico. Although a STYEP grant paid for their flight, they also had to pay for hotel stay, rental car, and their daughter’s medication.
Another parent in Oklahoma talked about the toll that traveling to another state had on their daughter.
“She said on the drive that having to go to another state — one that is even more conservative than our own — was humiliating and scary,” the parent said of their child. “It was incredibly stressful to have to stop at gas stations and rest stops not knowing if anyone would comment on what bathrooms we were using.”
