Mental health care for trans Kentuckians: Open Doors Counseling Center's entry table with a rainbow "All Welcome" board.

The entryway at Open Doors Counseling Center. Photo by Corabelle Bundy Jolie.

Trans Kentuckians Are Staying Home. The Data Says Community Is What Helps.

October 15, 2026/in Health, Mental Health/by Jules Crawley

Mental health trends in transgender and nonbinary Kentuckians have displayed shifts during recent policy debates.

A 2025 Queer Kentucky survey showed that 34.5% of respondents reported that these recent policy debates have very negatively impacted their mental health.

Some gender expansive Kentuckians told Queer Kentucky that policy debates have led to them feeling like they are at the focal point of society right now, making the simple act of going into public feel daunting.
Hayes Farris, a nonbinary Kentuckian, said when they step out in public, it feels like transgender people are what sit at the forefront of people’s minds.

Farris said part of it is not knowing what people are thinking.

“Is that person looking at me because they are seething inside and hate that I exist? Are they curious? That’s just a heavy mental load to carry around,” they said.

Delgonna Cole, a transgender woman, said she is constantly thinking about what might make her easy to “clock” as transgender in public.

“I’ve had people come up to me at Kroger saying, ‘Hey, I have a question. Are you trans?’” she said. In reference to policy debates about the rights of transgender people, Cole said, “If it wasn’t pushed so intensely, I think I wouldn’t be so constantly afraid of going outside.”

Even healthcare providers for transgender and nonbinary Kentuckians reported seeing changes or responses from their patients reflecting these negative effects.

Dr. Keisa Fallin-Bennett’s practice has included transgender people for around 10 years, and for most of her career, she has been providing her services in Kentucky.

Fallin-Bennett said the impact varies from person to person, but she has heard from several patients that the impacts of recent policy debates have been devastating.

She said there has been a lot of policy debate prior to 2023, but that is where it all really took off.

“People start in a difficult state because of the world and having to accept that the institutions are kind of actively working against them,” Fallin-Bennett said.

Policy changes have led to decreased federal funding for her place of employment, and these changes have altered what is allowed to be provided to transgender patients, according to Fallin-Bennett.

According to the survey, when transgender women are denied healthcare in any aspect, they are more likely to avoid all healthcare. Some of this avoidance may be due to shaken trust in the healthcare system.

Fallin-Bennett discussed the issues that a 2023 Kentucky law stated that neither hormones nor surgery could be provided to transgender patients under 18, but an executive order to cut federal funding for institutions that treat individuals under 19 was signed in 2025 under President Donald Trump.

Under the threat of losing federal funding, Fallin-Bennett’s practice could no longer treat people under 19 years old, and people under that age limit who were already on hormones had to be weaned off.

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“Frustrations are really building, and it really erodes the trust that people have in us,” Fallin-Bennett said.

For Cole, after struggling to get endocrinologists to properly prescribe her gender-affirming hormones, she took matters into her own hands.

“They wanted to stop my HRT dose because it got too high… but the levels were lower than a cis teenager’s,” she said. “So I just stopped seeing them, and I started doing DIY.”

Cole said she buys everything online, did extensive research, and measures her blood levels all on her own.

Transgender women report provider refusal at rates of 38.5%, far above the 12.6% statewide average for queer people, according to the QKY survey.

Another factor that gender expansive Kentuckians must think about when it comes to healthcare is finding understanding in their providers.

“I don’t think it’s ever been a question of safety, but more comfortability. I haven’t had any issues where I have felt unsafe, but even then, my therapist doesn’t know what questions to ask,” Jordan Gaither, a nonbinary Kentuckian, said.

Transgender and nonbinary Kentuckians are finding it difficult to cope with the world as it is right now, whether they are coping with self-medication, isolation, therapy or something else.

Gaither said they have had to figure out what they need on their own and come to their therapist with it, rather than being provided the necessary tools to cope.

This points to a potential lack of LGBTQ+ education for mental healthcare providers in Kentucky, but organizations like Open Doors Counseling Center are centered around providing care to queer people and have a queer staff.

Tanya Stephens, who uses no pronouns, only a name, says Open Doors is a great place for finding care as a queer person in Kentucky.

“They do a lot of good things to try to help. I did find a safe feeling place there,” Stephens, a local nurse practitioner, said.

Open Doors Counseling Center is part of a nonprofit organization called Caritas Care Solutions. The center provides identity counseling, trauma and grief counseling, financial therapy and more, and focuses on creating a safe space for LGBTQ+ people.

Finding mental health resources can be difficult in Kentucky. Eve “Sylvie” Derrington, who is nonbinary, said monetary restrictions can be part of the struggle.

“If there were more programs where you pay what you can based on your income, especially oriented to specific communities, that kind of thing would be helpful,” they said.

Derrington said coping is complicated, but it can help: “Trying to find community is a big coping mechanism. We’re not very good at it, but when we do have it, it’s beneficial.”

The Queer Kentucky survey showed that those with a lack of community reported significantly more severe outcomes in every policy impact measure.

Fallin-Bennett echoes that finding. She said that while it might seem easier to isolate right now, community is a crucial coping skill for queer people.

“People have been hit by this issue, and it makes everybody want to stay home. I think it’s the exact time that people need to be gathering with other people as much as their mental health allows,” she said. “We need to be outside of our houses for our mental health and have interaction with other humans… hopefully humans that are in the same boat.”

For Farris, policy debates have had an impact on them and their friends, but the conflict has helped them pull each other closer.

“I think it’s almost made us closer, and we know that community is everything right now,” they said. “I wish more people knew that it’s not a burden to lean on people you love.”

If you or someone you know is in crisis, the 988 Suicide and Crisis Lifeline is available 24/7 by call or text at 988, and restored its specialized “Press 3” service for LGBTQ+ youth on September 30, 2026, after a 14-month shutdown. Trans Lifeline’s peer support hotline is at (877) 565-8860, staffed Monday through Friday, 1 p.m. to 9 p.m. Eastern. The Trevor Project’s counselors are available 24/7 for LGBTQ+ young people at 1-866-488-7386, or by texting START to 678-678.