“If there was a correction for diabetes, would you not correct it? This is real. The pain is real.”
Rebecca Mills is one of the thousands of transgender Coloradans caught in a crossfire. While President Trump works to roll back Obama-era healthcare gains, Colorado is at work becoming a regional base for sex-affirming medical care.
Mills said she will be among the first transgender women to undergo vaginoplasty at Denver Health, a “bottom” surgery the hospital began offering in May. She can afford it because Obamacare requires Medicaid to cover doctor-recommended medical transitions.
Right now, the Trump administration is working to change that.
If you’re one of the people questioning whether genital reconstruction surgery should be covered by Medicaid, consider this. Forty percent of transgender adults report attempting suicide at least once in their lifetime. That’s nearly half of the entire community. It’s nine times higher than the general population.
The figures are mind boggling. And they speak volumes about the need for a supportive community.
The surgery, Mills said, will finally put all the pieces of her long and difficult struggle together. “All my life I tried to run from this.” She said she tried to run by becoming competitive. She thought if she excelled in traditionally masculine areas, no one would know who she really was.
At 17 years old, the Colorado native got her pilot’s license. She became a flight trainer in college, and was a Lear Jet captain by the time she was 23. Mills will turn 42 in July. She hopes to celebrate her birthday fully transitioned.
“I circled the globe seven times and I was just miserable,” she said. “Now I’m happier than I’ve ever been in my life… I will finally have that last little piece that makes me feel whole.”
Like most transgender individuals, her road to happiness was not easy. In deciding to transition, she lost her job and not one, but two, families. She said when she came out, her birth mother no longer wanted anything to do with her. Her adoptive family then rejected her, too.
“They prayed for four years for a blue-eyed, blonde-haired boy. I could only be two-thirds of that,” Mills’ voice cracked as she explained how good her family was to her growing up. Then everything changed. “My father told me specifically ‘not in this house.’ I love them. I miss them greatly.”
Now, with Medicaid benefits in place, she is ready to step into her future.
Last month, Denver Health became the first hospital in Colorado to offer vaginoplasty surgeries.
“Denver Health has a number of surgeons working to improve access to gender confirmation surgeries for our transgender and non-binary patients,” said Kari Kuka, the administrative director of their new LGBT Center of Excellence.
Dr. Marci Bowers took over the nation’s first genital reconstruction clinic in Trinidad, Colorado between 2003 and 2010, before moving to Los Angeles. She came back to Colorado to train surgeons in the male-to-female “bottom” surgery procedure.
“Denver Health will be the only hospital in Colorado and surrounding states offering these services,” Kuka said.
When Sable Schultz began her medical transition in 2015, there were no laws requiring insurance companies to pay for sex-affirming medical care.
“Insurance didn’t cover hormones. It didn’t cover anything. At that time people often had to leave the state, or even the country, to get care,” she said.
Determined not to see the clock turned back, Schultz is now the transgender program manager at Denver’s GLBT Center. “Trump is saying we can treat people differently because of their gender. I don’t think that’s a value Americans have pushed for,” she said.
For now, Colorado does have some protections in place. Any insurance company that works with the Colorado Health Exchange must cover most transgender medical care. But, Shultz points out, “there’s still concerns about private employers based outside of Colorado.”
She is also worried about Trump’s push to institute new “religious freedom” guidelines that would allow any doctor to refuse care to transgender patients based on religious beliefs.
“In the past,” Schultz said, “transgender people have been denied basic medical care, even for colds or flues.”
One Colorado is about to embark on an updated, comprehensive look at healthcare disparity. Their last review found transgender people experienced discrimination in healthcare more than any other arena—including housing and employment.
Further research into figures from the Centers for Disease Control found that fear of discrimination led to some serious delays in seeking healthcare—even for minor health issues. People reported being afraid to tell their doctors they were transgender.
Programs in Colorado are working overtime to ensure people feel welcome and receive the care they need. Schultz said people from the region are coming to Denver for medical care they can’t get in Kansas, Oklahoma, Montana, or Wyoming.
“Providing a full range [of healthcare] helps transgender individuals have more productive lives and lowers the cost of healthcare long-term,” she said.
Schultz also pointed out surgery is often necessary to update legal documents. But, more importantly, she emphasized the need to provide life-affirming medical care.
“Every person deserves to be recognized for the complex, amazing human beings they are.”