A boon is underway at medical institutions from coast to coast, aimed at helping transgender Americans who suffer gender dysphoria because of the mismatch between their bodies and their gender identity.
Gender-transition services and surgeries are becoming more widely available across the nation, and more insurance companies are adding coverage to help the more than one million Americans who identify as transgender.
"Access to these treatments is lifesaving for many transgender people," said Kate Kendell, executive director at the National Center for Lesbian Rights, one of the nation's strongest legal advocates for LGBTQ Americans. "The recent sea change among insurers and state Medicaid programs is long overdue, and we must be vigilant about protecting and expanding these protections."
"Half of the respondents to the 2011 National Transgender Discrimination Survey said they had to educate their health care providers on how to treat them appropriately," Mara Keisling, executive director of the National Center for Transgender Equality (NCTE), told NBC OUT. "Too few providers are sufficiently trained in how to treat transgender patients, and even fewer have the expertise to offer critical transition-related services. It is heartening that an increasing number of medical institutions and providers are learning about the importance of competency around transgender issues and transition-related procedures."
The Cleveland Clinic, Boston Medical Center, Oregon Health and Science University in Portland and Mount Sinai Hospital in New York City are among the latest medical centers to provide gender-affirming procedures.
"At Mount Sinai, we are offering the full array of services for transgender people regardless of whether they have already accomplished their transition," Zil Goldstein, a nurse practitioner and program director at Mount Sinai's Center for Transgender Medicine and Surgery, told NBC OUT. "We want people to know that these treatments are available, and also that our staff are prepared to serve and care for the transgender community with sensitivity."
This month an institution with a controversial history regarding transgender health care added its name to the list: Johns Hopkins Medicine. Johns Hopkins made history in 1965 as the first academic institution to offer gender-affirming surgeries, but it stopped in 1979 and never resumed. However, in a letter posted earlier this month, it reaffirmed its "commitment to the LGBT community" and announced it will resume gender-reassignment surgeries in 2017.
"We have committed to and will soon begin providing gender-affirming surgery as another important element of our overall care program, reflecting careful consideration over the past year of best practices and the appropriate provision of care for transgender individuals," the letter stated.
Even though not every transgender individual seeks or qualifies for surgery -- because of personal reasons, their health or insurance coverage -- demand is high. The increase in services has ramped-up since 2014, when the U.S. government's Centers for Medicare and Medicaid Services started covering transgender-related procedures, which have been indelicately called "sex change operations." A more common name is sex reassignment surgery, or SRS, and a more popular name within the trans community is gender confirmation surgery, or GCS.
"Despite the recent improvements in institutions offering these lifesaving transgender health services, there is still an unmet need for compassionate and comprehensive care," Goldstein told NBC News.
"This is life-affirming and, in many cases, lifesaving treatment that is recognized as medically necessary by the medical profession," Jillian Weiss, executive director of the Transgender Legal Defense and Education Fund, said. "It is crucial that we have a cadre of medical professionals across the county and around the world who have the training and experience to provide health care to the millions of transgender people who require it."
Right now, 12 states and the District of Columbia offer Medicaid programs covering transition-related care, according to the NCTE. But that leaves 38 states with none.
"No one should be denied medically necessary care because of who they are, and yet, that has been the reality for most transgender people for decades," Kendell of NCLR told NBC OUT. "These positive changes are long overdue, and they are already under attack by anti-LGBT groups. We must be vigilant about defending and protecting them."
Dawn Ennis is an award-winning journalist who was the first to transition in a network TV newsroom. She is now a freelance writer, producer and editor, as well as a widow, a single parent of three children, and the subject of an award-winning documentary, Before Dawn/After Don. Ennis is also on YouTube, on Twitter and blogging at lifeafterdawn.com