Gender-affirming care in Kentucky: What’s available and where to find it
It comes as no surprise to say that the Kentucky LGBTQ+ community has been under a series of relentless attacks lately. Gender affirming care is no longer available to trans and gender diverse youth in the state. Medicaid cannot be used for gender affirming care. And Trump’s just-passed Big Beautiful Bill further cuts Medicaid and healthcare funding for millions of people. It’s no exaggeration to say that these laws and rulings have a catastrophic effect on our community.
It’s more important than ever to equip LGBTQ+ Kentuckians with the knowledge of what healthcare is available to them, and how they can access that healthcare. This is especially pertinent for our queer and trans siblings in rural Kentucky. Outside of urban areas, LGBTQ-friendly healthcare can often be scarce.
Popular opinion may lead you to believe that queer and gender diverse people exist only in places like Louisville or Lexington. But there are significant swaths of LGBTQ+ folk in the vast bluegrass between our populous cities and towns. It’s imperative that healthcare be accessible for all LGBTQ+ Kentuckians, regardless of where they live.
Paying for healthcare costs
Earlier this year Kentucky lawmakers voted to rescind Medicaid funding for gender affirming care, and the Trump administration is restricting Medicaid even further. This is a devastating blow to those living in rural areas, where many people rely on Medicaid to pay for their healthcare. Because so many rural Kentuckians are dependent on Medicaid, the hospitals that serve these rural areas may soon be at risk of closure if the vital pipeline of Medicaid funding runs dry. Many LGBTQ+ Americans rely on Medicaid, including 21% of trans people and 40% of people living with HIV. Medicaid is the single largest funder for HIV healthcare in the country.
In light of these setbacks, organizations have cropped up to help support LGBTQ+ Kentuckians in continuing to access healthcare. The Kentucky Health Justice Network provides financial assistance to trans and non-binary Kentuckians for gender affirming care and gender affirming items. They also offer advice and assistance for navigating the confusing and heternormative world of healthcare insurance.
Southern Equality helps families with grants so trans and gender diverse youth can travel to access gender affirming care out-of-state. Southern Equality also assists with navigating the ins-and-outs of insurance, and provides connections with community support groups and providers in your area.
Finding an LGBTQ-affirming doctor
Not all healthcare practitioners are created equal. Many of us know through experience that not all providers have the knowledge and sensitivity to tend to the needs of the LGBTQ+ community. Finding someone that you’re comfortable with and who has LGBTQ-know-how can feel like an uphill battle. This search can be especially tiresome in rural areas where healthcare resources can already be in short supply.
It may feel confusing to know where to start. It’s important to think about your goals. What are you looking for: A therapist? A general practitioner? Hormones? Surgery? HIV care? Do you need to find someone who takes your insurance, or can you afford to pay out of pocket? OutCare can help you navigate the practitioners that are available to you based on your location and your insurance. The best part is, everyone listed on the site is qualified to care for LGBTQ+ patients.
If you are trans or non-binary, it can help to look for clinicians who use a model of informed consent. Providers that operate with a model of informed consent inform patients about the potential risks of gender affirming care, and allow them to access care if the patient decides that they are comfortable with the risks. Clinicians who do not operate with a model of informed consent require letters from mental health specialists before allowing patients access to gender affirming care. Operating on a model of informed consent lessens barriers and makes care more accessible and less stressful to attain.
A user on reddit compiled a map of every informed consent clinic in the country. Unfortunately, all of the in-person Kentucky providers are in cities, and would require travel for trans and non-binary Kentuckians based in rural areas. Many virtual healthcare providers that offer gender affirming care also operate with a model of informed consent.
In-person care
LGBTQ+ healthcare outside of urban areas may be sparse, but it’s not a total fantasy. The Phyllis D Corbitt Community Health Center is located in Wilmore and has a nurse practitioner that provides LGBTQ+ care one day a week. This clinic helps with primary care, surgery referrals, mental health referrals, hormone therapy for adults, PrEP, and general care/referrals for children and adolescents.
HIV care
There are a multitude of Ryan White Part B services available to people living with HIV in Kentucky. Every area of the state is serviced by a care organization and each clinic provides comprehensive care for people living with HIV. While many people in rural areas live far away from the HIV services that they need, these outpatient organizations can often provide transportation for clients if the care they are traveling for is HIV related.
These clinics offer a gamut of healthcare services including HIV medical care, medical case management, primary care, labs and testing, nutrition services, oral healthcare, and mental health services. In addition to healthcare needs, they also help people connect to food, housing, transportation, and legal services.
The Kentucky AIDS Drug Assistance Program helps low-income Kentuckians purchase HIV-related, FDA-approved medications. They are delivered through a mail order service. The Kentucky Health Insurance Continuation Program can help eligible individuals pay for their insurance costs if they are at risk of losing their benefits because of an HIV-related disease.
Online healthcare options
If you are queer or trans in rural Kentucky and can’t find a LGBTQ+ affirming provider in your area, you may be able to find one online. The COVID pandemic blew the world of telehealth wide open, and you can now connect with a provider online for primary care concerns, counseling, prescriptions, and a myriad of other healthcare needs. This is a huge boon for rural Kentuckians who can now find an affirming doctor or therapist without the burden of travel.
If you are searching for a LGBTQ+ affirming therapist or counselor, InclusiveTherapists.com is a good place to start. Open Path Collective is another resource that offers affordable online appointments with vetted therapists ranging $40-$70 per session.
Companies like Folx Health and Plume are virtual healthcare platforms that provide a variety of services including hormone replacement therapy, mental health support, sexual health resources, and primary care services. They will mail hormones and supplies directly to you, or a location close to you where you can pick them up. These companies can be more expensive than many in-person providers, but if you live in a rural area that doesn’t have any LGTBQ-friendly practitioners, these virtual providers can be a literal life-saver.
Accessing support through hotlines
It’s easy to see healthcare through merely a physical lens and think of it as care that only applies to our body. But tending to our mental health is an indispensable part of our healthcare too. Supportive LGBTQ+ hotlines can be an uplifting place to turn to if you are struggling with your mental health – whether the topic be gender identity, sexual orientation. or something else entirely. The Trump administration is shutting down the National LGBTQ+ Suicide Lifeline on July 17th, which makes these remaining hotlines all the more crucial.
Catered specifically to the LGBTQ+ community, The Trevor Project is a hotline that offers counseling support for LGBTQ+ youth. Their services are available 24/7 and 365 days a year. You can call to speak with a trained counselor, but you can also text or chat if that feels more comfortable. If you are dealing with issues of identity, coming out, depression, or suicide, please consider reaching out. While this hotline is promoted towards LGBTQ+ youth, it appears that you can still call if you are older. No one will be turned away due to age. It’s important to know that this hotline is a non-consensual active rescue hotline. This means that they will call rescue measures or your local police without your consent if they believe you or someone else may be in danger.
Run by and for trans people, Trans Lifeline is a peer support, suicide prevention hotline. Trans Lifeline encourages you to reach out even if you are not in a crisis, even if you do not identify as trans or non-binary. When you call, your identity is kept anonymous and anything discussed is confidential. This hotline is divested from police and does not engage in non-consensual active rescue. This means that they will not contact the police or an ambulance unless you direct them to do so. When you call there are no intake questions, and they will not ask for any identifying information. They also have a microgrant program (currently paused) that helps redistribute funds to trans and non-binary people. Trans Lifeline’s operating hours are limited. They also have operators who speak Spanish.
Links to resources
Kentucky Health Justice Network
A map of every informed consent clinic
Phyllis D Corbitt Community Health Center
Kentucky Outpatient Healthcare and Support Services
Kentucky AIDS Drug Assistance Program
Kentucky Health Insurance Continuation Program
LGBT National Coming Out Support Hotline
Tbuddy – 24/7 peer support and professional mental health services for transmasculine people
Desi LGBTQ+ Helpline for South Asians
Point of Pride – microgrants for accessing gender affirming care and gender affirming items
Black Trans Travel Fund – offering financial support to Black trans women to safely travel
Elevated Access – a program that pairs private pilots with people who need to travel to access gender affirming care
Open Path Collective – affordable online and in-person psychotherapy appointments with vetted therapists ranging $40-$70 per session
Trans Advocacy & Care Team – peer counseling and support groups
