What's health care have to do with coming out?

13 days ago
Noah Lewis, Executive Director of Transcend Legal, makes the connection between coming out as trans and needing health care. https://transcendlegal.org.

English subtitle

Hi, I’m Noah Lewis, founder and Executive
Director of Transcend Legal.
Happy National Coming Out Day!
I came out as transgender in 2004.
I had been slowly realizing it for months,
and in March of that year, I called up my
parents and said, “I think I’m a boy.”
They asked me some questions, and they were
very calm about it.
My mom asked if I was going to physically
transition, and I was like, “no, I don’t
have any plans to do that!”
They were far ahead of me on that one.
We hung up, and I thought, “That went well!”
But, it turned out that they were just in
shock; this fundamental thing they thought
they knew about me was turned upside-down.
So the next time we spoke, they were pretty
freaked out and angry.
They are, as I like to say, Fox News watching
Republicans who voted for Donald Trump.
Not exactly the people you might expect to
be psyched to have a trans kid.
In 2004, Chaz Bono hadn’t come out yet.
There were no well-known trans people out
in the public eye.
So my parents had no one to look to as a model.
They were embarrassed to tell their friends.
Now, for some parents, it’s a little bit
cool to have a trans kid, but 13 years ago
it was a different story.
So for the next two years, it was hard with
They were constantly pushing back and questioning,
“why are you doing this, why are you doing
Meanwhile, I was in the middle of law school.
That summer I had a job lined up working on
animal law, which is why I went to law school
in the first place.
I worked that job for about 2 weeks, but I
was depressed, I was isolated, and I couldn’t
take any more.
So, I quit that job, and when I went back
to law school in the fall for my third and
final year, I went back as Noah.
Some of my more knowledgeable friends asked
what pronouns I wanted to use.
But I was still shy at that time about using
“he” because it takes a lot of courage
to use a different pronoun - it means making
a public statement about who you are.
This idea came to me that I should legally
change my name on my birthday in January.
At the time that schedule seemed a bit rash,
but at the same time, I knew that I never
liked my old name.
So on my 28th birthday, I officially became
But it was still hard to focus on law school.
I remember one time it was finals, I was in
the library, and instead of studying, I was
on Yahoo!
Groups researching top surgery.
And I was dealing with trying to get coverage
through my school’s health plan, and coming
to realize it wasn’t going to happen while
I was still a student there.
It also became apparent that I wasn’t going
to be able to study for the bar exam that
summer because I was not functional.
But I did manage to graduate.
And I became the first openly trans person
to graduate from Harvard Law School.
I was the only person I knew to graduate without
having a job lined up, which was made was
worse since I couldn’t take the bar exam
- it’s hard to get a job as a lawyer if
you are not licensed to practice law.
So I moved back to Pittsburgh where I’m
I couldn’t bring myself to do much of anything
because I was so depressed.
I worked on getting top surgery scheduled,
which I had in January of 2006, paying out
of pocket.
I had top surgery before starting testosterone
because I knew I didn’t want breasts.
I had never wanted them.
But I was nervous about testosterone and it
being able to change your brain or change
your personality, and all these fears that
you have.
But I started testosterone in April, and it’s
no coincidence that I got a job a few weeks
later, and moved to Connecticut.
But then what happened was that one weekend
I noticed I felt terrible.
I had no idea why.
And then it was maybe two weeks later and
I felt completely awful again.
But then I had this lightbulb moment.
Oh, the testosterone wore off.
You take the shot every two weeks, and the
levels had gone down at the end such that
it wasn’t working any more, and I was actually
feeling like I used to feel all the time.
And it’s sad to think about.
I lived so much of my life in a state that
was so completely abnormal - only I didn’t
know it.
It’s hard when you’re in that state to
know that you can ever feel any differently.
But thankfully, I did.
And I have no explanation.
There weren’t any real physical changes
at that point.
It wasn’t about the physical changes of
It was about brain chemistry.
My brain works when it’s getting testosterone,
and it doesn’t work when it’s not.
So for me, the time period after coming out
and before accessing trans health care, that
was the worst period of my life: I was no
longer in denial about being transgender,
but I was dealing with the dysphoria - the
mismatch between my body and my brain.
It wasn’t suppressed in my subconscious
It was screaming at me all the time!
I couldn’t do simple things like read because
I’d look down and see breasts that my brain
didn’t expect to be there.
I was miserable.
Dysphoria isn’t just disorienting; it’s
completely consuming.
So on this National Coming Out Day, I don’t
want any trans person to feel that have to
live as someone who they’re not.
If a trans person comes out, but then doesn’t
have the ability to get health care, it’s
a recipe for disaster.
You may know the statistics about depression
and suicide and poverty among trans people
— well, a lot of that could be remedied
by health care.
I was unemployed for a year.
I had enough privilege that I didn’t end
up homeless or worse.
But not everyone is that lucky.
Trans women who are visibly transgender and
can’t access facial gender reassignment
surgery face rampant employment discrimination
and street harassment on top of the dysphoria
they experience from not recognizing themselves
in the mirror.
And trans men who come out and start testosterone
but can’t get top surgery can have terrible
dysphoria and face safety issues.
Having facial hair and a deep voice but still
having breasts can set a person up for verbal
or physical harassment.
So if you want to support trans people on
National Coming Out Day, using the right name
and pronoun is a great start.
We also need to knock down all the barriers
that trans people face to getting health care.
The difference between getting trans health
care and not getting it is the difference
between living happily and living in real
pain, and sometimes, the difference between
life and death.
There are people struggling with debilitating
dysphoria every single day, just like I was
before I got health care.
Transcend Legal is small start-up organization
operating on a shoestring budget.
We’re focused on health care for trans people.
We’re providing lots of free and low-cost
services and advocacy.
We’re doing a lot with a little - and we’d
like to do a lot more with a little more.
We’ve had some great successes, and we’re
looking to have more.
Our aim now is to hire a few more attorneys.
There’s no shortage of attorneys - trans
or not - who want to do this work.
They send me unsolicited resumes, but I can’t
afford to hire them.
My staff and I are not trained in the law,
not fundraising.
So please help in any way you can.
Share this video with your friends.
Sign up for our email list and stay up to
date with what we’re doing.
Check out our videos series on how to get
trans care covered under insurance.
If you want to volunteer, we may have a need
for you.
And finally, please donate if you can, whether
it’s one time or every month.
Together we can ensure that next year on National
Coming Out Day, more trans people will be
able to come out with the knowledge that they
can get the health care that they need to
be who they are.