Since New Mexico Governor Michelle Lujan Grisham signed into law House Bill 7 last year, advocates say New Mexico has become a refuge for those seeking gender-affirming care who come from states where such care is restricted or prohibited.
But while many people associate gender-affirming care with surgery, as Equality New Mexico’s executive director Marshall Martinez makes clear, it encompasses a wide spectrum of care.
“Gender-affirming care can be something as simple as having conversations with a counselor or therapist about discovering one's identity, or about how to live in this particular world and society as a transgender or non-binary person,” he said. “Gender affirming care can often include medical care, and so that can look like prescriptions, puberty blockers, hormone replacement therapy, etc. And in some cases, gender affirming care can include surgical care as well--what we now refer to as surgical gender affirming care, but was previously known as ‘sex reassignment surgery’”.
Zed Serna is the secretary on the PFLAG Las Cruces board, as well as the Program Supervisor for the House of Kahlo at Families and Youth Innovations Plus (FYI+) in Las Cruces, a resource hub for LGBTQ+ youth and their families . He is also transgender.
“Well, I felt different when I was four, but I didn't know what ‘trans’ even meant, and I didn't even hear about what ‘trans’ meant until I was in high school. So finding that out--and I think it was 18 years old, was when I found out--when I was leaving high school, when I found out what, what trans even really meant. And it was just digging through libraries and stuff like that is really what I found out, and to figure out who I was.”
While gender-affirming care is legal in New Mexico, finding and keeping a provider remains a challenge, an issue that Serna was facing last month.
“Because every doctor, they're doing their first year, their second year, their third year. And then after that, they go on to different states, and they go on to bigger states,” he says. “There's more resources or more money for them, so then I lose out on a doctor. I recently just lost my doctor. So I have about a month to find a doctor to be able to help me that will accept my insurance, that's accepting in the community.”
Dr. Molly McClain is an associate professor in family medicine at the University of New Mexico who also works with gender-expansive individuals and communities within Albuquerque. She says that Zed Serna’s experience with keeping a gender-affirming care provider is an issue with primary care in general. She also cites the troublingly low rate of applications to study family medicine.
“The rates of application to family medicine this year went down by 19.2%,” she says. “And so this, to me, is not because our residencies aren't doing their best, and that we aren't doing our best in terms of recruitment and retention. To me, it's very intelligent people looking at a system that's completely undervalued and under-resourced, and not choosing to work so hard to become a doctor, pay a half-million dollars in debt to become a doctor, and then go into a system that doesn't value the hard, hard work that we do.”
Regarding any pushback or safety concerns from those who opposed gender-affirming care, Dr. McClain feels that she has received plenty of support from her community in Albuquerque and within UNM. But traveling out of state, the situation can be different.
“When I go out of UNM and give talks--and I actually last year, I was able to be an expert witness for some of the legislation for HB7 that passed--that was a different environment where a lot of interesting critiques, and a lot of very clearly not educated critiques came forward. And I think it's really helpful for me to hear those kinds of critiques, because then I can kind of learn what people are worried about.”
Some organizations, like ACLU New Mexico, stress that while New Mexico state laws and policies help protect access to gender-affirming care, those interested in traveling to New Mexico for that care, should contact organizations in your home state to ask them logistical questions and how to stay safe.
Marshall Martinez said that Equality New Mexico doesn’t collect data of how many people are coming from which states to New Mexico for care, out of an abundance of caution, in case someone tries to compel them to hand over that information.
“That said, what those of us who work in LGBTQ communities, and sort of adjacent in reproductive healthcare access, what we know anecdotally is that last year in the spring, about three weeks after New Mexico had passed our protections for gender affirming care, is when Texas passed their prohibition on gender affirming care for young folks,” Martinez said. “And so we've started to see a lot more families traveling from Texas to New Mexico to access that care.”
Following up with Zed Serna recently, he said that he had to take some days off from work to do so, but he was able to find a doctor in Las Cruces. But Serna is still concerned that the challenge that he faced to find a local gender-care provider remains for other people he knows.
“There's some programs that I work closely with, and they come to me asking, like, do you have any resources? Or do you have any doctors? Do you have any therapists? Do you have all of this stuff? And to be the person, that's like, I have a certain therapist, but when it comes to doctors, I don't have very much…it just feels like I should be the one that could be able to be that…that person that can give that for our youth and stuff, because a lot of our youth are asking about it. And if I don't have the answers, it's just like, you know, it's hard, it's hard. It's hard sometimes.”
If he hadn’t been able to finally find a new doctor in Las Cruces recently, Serna said he would have had to travel from Las Cruces to Albuquerque to receive care, which because of the distance, would have been especially difficult for him or anyone lacking the means to travel there all the time.
