“We are the most important resource” Care Gaps and Community Responses - Transgender and Gender Variant Healthcare in the South
Data shows that transgender and gender variant people in the south, especially Black trans and gender variant individuals, face far worse issues with physical health, mental health, and access to healthcare than cisgender people, illustrating serious gaps and problems within the medical system. This includes worse physical and mental health, higher rates of abuse and violence and suicidal ideation, less quality care and higher rates of medical mistreatment, increased likelihood of being under- or uninsured, and increased likelihood of not feeling comfortable seeking care (Harless et al., 2019)*. Additional gaps and problems include lack of resources, lack of informed providers, lack of access to care, and outright discrimination. At the same time, transgender individuals rely on each other to fill these gaps. This data physicalization project explores the number of “official” resources that exist for trans people in the south and the important and complex reality of community, peer-to-peer, financial crowdfunding, and online support.
*I will not be listing specific data on these numbers. If you want more information, see the Campaign for Southern Equality's 2019 Southern LGBTQ Health Survey and the Breakout Report on Black Transgender Southerners, and the various reports from the 2015 U.S. Transgender Survey.
Data Set 1: 2015 U.S. Transgender Survey
- 33% of trans people do not seek care due to cost
- 23% do not seek care due to fear of mistreatment
- 33% of those who do seek treatment have a negative experience related to their gender identity
These percentages are wood-burned into the base of the wind chime, represented by rings around the wood.
Data Set 2: Trans in the South Guide
This guide from the Campaign for Southern Equality (CSE) lists different resources and services for transgender and gender variant individuals broken down by state and category. Each strand of the wind chime represents a state: Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Texas, Virginia, West Virginia (shown in order left to right on the image). Each bead represents a different resource in the state.
- Green: mental health providers
- Orange: endocrinologists
- Yellow: primary care
- Dark blue: Planned Parenthood
- Red: HIV care
- Light blue: legal services
Urban and Rural Differences: I used a list of rural counties to delineate if the service is located in an urban or rural county. The resources in an urban county are at the bottom of the string, while the resources in a rural county are towards the top. Many states do not have any resources in rural counties, represented by a single knot in the string.
A note on data limitations: CSE is located in North Carolina, potentially impacting the number of resources found in and around NC compared to other states in the south.
Data Set 3: 2018 Southern Trans Health Focus Group Project, personal stories and experiences
While there are a lack of official resources, especially in rural areas, trans and gender variant individuals fill these gaps with each other through sharing information and resources, organizing support groups, and connecting online.
These connections are vital. They are also difficult to measure since they might be shared in casual conversations, passed through zines or word of mouth, protected, or purposefully kept secret. These connections, these communications, these sounds are both very real and embodied and also somewhat intangible and difficult to predict.