Accessing Gender-Affirming Medical Care in Small Town Juneau, Alaska Proves to be Difficult 

Accessing Gender-Affirming Medical Care in Small Town Juneau, Alaska Proves to be Difficult 

TW: mentions of suicide

An under-the-radar people in Juneau, the transgender community, face few and scarce options to receive medical treatment. 

By: Chatham Moser


In Juneau, Alaska, the transgender community now faces an additional obstacle—having limited options for obtaining medical gender-confirmation treatment. Compared to most capital cities in the US, Juneau is uniquely surrounded by forests, glaciers, and is teeming with wildlife, and is one of only two capitals with no roads out of the town. But for the transgender community, daily life is more unique than others in town.


Although many great strides have been made in LGBTQIA+ rights in the last few years, the transgender community still faces higher levels of intolerance in various ways. A study done by the HRC found that 62 percent of the US population support trans rights, one in ten trans people have been physically assaulted, 29 percent of trans adults live in poverty, 27 percent have been fired, not hired, or not received a promotion due to their gender identity, 22 percent have no health care, and 29 percent have been refused health care by a doctor or provider because of their gender identity. These statistics make daily life more daunting, and in Juneau, the lack of health care is noticeable. 


Margie Thompson, the Koru Counseling owner, has been Juneau’s only gender-affirming-focused therapist for years, as well as a transgender activist. Thompson explains how she knows, firsthand, the lack of health care offered to trans people in Juneau, especially those receiving gender-affirming hormone therapy (GAHT). “Finding a medical professional that will be willing (to provide GAHT) and, more importantly, respectful is hard. I am usually able to recommend two or three professionals that I am confident with,” Thompson says. “A couple of reliable healthcare providers is not adequate or sufficient in a community of 33,000 people.” 


With the suicide and self-harm rate high in transgender people, medical treatment can mean life or death. According to American Psychological Association, 40 percent of transgender people have attempted suicide, and transgender youth rates are even higher at 50 percent. Suicide and self-harm could also be prevented by supporting trans people through their social and medical transition processes. 


A study in 2018 by the National Institutes of Health found that gender-affirming hormone therapy reduces symptoms of anxiety and depression, lowers perceived and social distress, and improves the quality of life and self-esteem in transgender individuals. Thompson adds, “I often see patients whose mood and entire life view shift drastically within the first few weeks of GAHT. But getting to that stage has been difficult for many of my patients because of the lack of medical resources. That is what is so worrisome.” 


With an ever-growing public presence, more transgender people are demanding that their medical needs should be as easily accessible as cisgender people’s are. Eden, who is using their first name for privacy, is a student at the local University of Alaska Southeast. They explain how being a transgender woman feels in a town where resources are limited. “When I began my transition, my options [for medical care] were small.” They said that, of Juneau’s doctors, “one was even a good friend’s mom, the other was a family friend, which made me feel uncomfortable. It took me months to finally find someone who I could see. It feels unfair I have to research and put so much effort into receiving medical care that I need.” 


Eden is not alone; a push for more people in the medical field to receive proper training has been a nationwide conversation. A study done by the National Center for Transgender Equality found that 33 percent of those who saw a healthcare provider reported at least one negative experience related to being transgender, such as being verbally harassed or refused treatment because of their gender identity. Twenty-three percent of those surveyed said they did not seek the healthcare they needed in the past year, because of fear of being mistreated as transgender people. 


Stories like Eden’s are often overlooked, which allows for Juneau’s inadequate transgender healthcare resources to continue. Eden adds, “It feels like my job a lot of the time to educate others on trans issues; I even have to with my own doctor. I always think how much sooner I could’ve started my transition had I had the right resources.”

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