On What to Expect

October 20, 2026/in Health/by Kaiden Jacques

This story first appeared in Queer Cincinnati: Beyond the Binary, published Oct. 23, 2026.

When I moved to Ohio nearly 5 years ago, I had absolutely no idea what I was doing. Behind my own medical transition was an individual navigating healthcare decisions, personal identity, and a lot of uncertainty. While the thought of medically transitioning was extremely daunting at first, I found community in my trans friends, trans support groups, and queer healthcare systems that specialize in affirming care. When I was dropped off in Cincinnati at 17 to begin my new city life, I realized I had a lot to figure out. It was late fall, 2017. I had just realized transitioning was even an option for myself. I came stumbling out of the closet, taking my first few steps with a new name and look. The first few months were horrifying. Thankfully, I quickly found that people were much more accepting than what I had braced myself for. I found myself being introduced to a whole community of others who I identified with. We were all in the same queer boat, and it was a rocky one.

By the time I turned 19, I felt it was time for me to start medically transitioning, and I wasn’t alone. When talking to some of my other trans friends (especially those pre-transition), the question of whether it was too soon or too late often came up as a concern. While I believe it’s never too soon or too late, certain restrictions in Ohio make age one of the main factors in considering who can, and cannot, transition. For example, House Bill 68, enacted in 2024, sets 18 as the legal age for accessing gender affirming care. While the process itself may look different, and you may have different experiences than others, age has nothing to do with who can begin their transition. I still felt too young, admittedly, but also too old when I started. My whole life I watched the world shame kids and teenagers who were happy in their body as kids that would come to “regret it” later in their life. It felt like trying to find my way while walking in the dark when it came to what my insurance covered. I didn’t know where to go, who to talk to, or what I was supposed to know. Ohio is one of the many states that score negatively in gender care according to the Movement Advancement Project (MAP) as of 2025. While city protections and ordinances protect Ohioans from discrimination surrounding things like applying for employment and housing, that same protection doesn’t follow you once you leave city lines. Even still, I’ve been rejected from countless jobs as my identity was just “too confusing” for them to understand and accept. This is something I would have liked to know before I moved here.

While I can’t speak for the collective experience of hormone therapy, the initial steps are incredibly daunting. I’m grateful that I had friends in similar situations who guided me to Equitas Health, a service dedicated to the queer community. They stand as a federally designated Community Health Center specializing in inclusive care. To get started, you’ll likely have to be diagnosed with gender dysphoria for some time, and have a physical with plenty of bloodwork, as HRT can absolutely affect your cardiovascular health. Patience was the hardest thing to learn throughout the process. It won’t happen overnight, not even in the first few months. You’ll probably beat yourself up over it, wondering when it’ll happen and if it was even worth it. But my advice would be to give it time, and you’ll forget why you were so worried in the first place.

This story exists because of readers like you. Give $5 a month to keep Queer Kentucky free.

After my first few doses of HRT, I had to fight my insurance to keep it. My options were already limited, and I became allergic to what was covered. I ended up losing my insurance before we could begin discussing alternatives. HRT without insurance appeared to be one issue after another. Out of pocket, prices can be anywhere from $50 to $500 per month, depending on what you’re taking. From experience, it’s not uncommon for people to put a “pause” on their transition simply because the costs are too much. While I’m glad I was able to get on Medicaid, the constant changing of predatory laws can’t guarantee it remains an option.

There’s a lot to expect, and a lot more that will catch you off guard. Transitioning will change the way you see yourself, the way others see you, and your relationship with the world around you. So where should you start? Start by talking to as many people you know, then keep talking to even more people. As infinite as the internet is in knowledge, the actual in-person experiences of those I talked to gave me much more insight. Support groups and queer events are everywhere when you know where to look. Talk to friends and family about who and what they know. If the option is there, talk to your doctor, therapist, and your psychiatrist. They will know more about how to get the ball rolling on their end. If you can’t talk offline, start talking online too. Start by getting out there, and don’t stop once you do. You’ll be surprised by how much your community has to offer.