Transgender Emergency Evac Plan

Let's discuss the myth that “you can’t change your biology”. While it is true that some aspects of your biology cannot be changed (such as chromosomes) intentionally, the aspects of your body that people see and you interact with every day can indeed be adapted and even permanently altered.

Medication has come a long way, and while the science and application of these medications isn’t perfect, drugs are tested thoroughly before being permitted for use and prescriptions, meaning that unless you are actively in a trial to test the effects of a drug, you’re not likely to be surprised by the side effects since most if not all of them have been discovered already.

Which brings us to gender affirming healthcare. GAC is insanely expensive without (and even with) insurance. Some insurance companies refuse to cover it at all, some only after jumping through several hoops and age requirements (some of which go beyond being the age of majority), some only after certain types of doctors sign off of it, and even then many are still denied, or are approved and then have that decision revoked. This causes a large gap in access, even for adults, who can receive this type of care. Most transgender adults who want surgery never receive it at all due to costs. Even amongst those who do receive surgery, it’s usually only one type. With that in mind, let’s look at gender affirming healthcare.

Puberty Blockers: Puberty Blockers are temporary medications given to children who are going through an early puberty, also known as precocious puberty (before age 8 for girls and before age 9 for boys). For transgender and gender-diverse youth, they can also be used to delay or completely stop the progression of puberty until the child determines their intent to transition, or they decide they no longer want to. Stopping puberty blockers will allow puberty to develop as anticipated. Many people consider puberty blockers for trans youth to be a compromise, an option to satisfy those who think transgender children are too young to know who they are. Others feel they are absolutely necessary to allow youth who suspect they are trans the chance to explore their gender further before deciding on medical transition that can have permanent effects.

Hormones: Estrogen and testosterone are the hormones that influence sex and sex characteristics. A gross over-simplification is that higher estrogen results in female characteristics and higher testosterone results in male characteristics.

Trans women taking estrogen can expect breast development/growth, body fat redistribution, changes in muscle mass and potentially a decrease in strength (averaging to what women of a similar workout experience). Skin produces less oils, pores become smaller, and skin changes texture, and a decreased amount of erections. There are other changes. Changes, risks, symptoms, and side effects are influenced by personal and family history. Trans men taking testosterone can expect a deepening of the voice, extra hair growth across the body, increase in oils on the skin, thinning hair especially around the temples (potentially a receding hairline), increase in muscle density, bottom-growth (increased size of clitoris), fat redistribution, lessening or complete cessation of menstruation. There are other changes. Changes, risks, symptoms, and side effects are influenced by personal and family history. Both can expect changes in skin as well as body and urine odor. Increased appetite is also common in both parties since the body is producing changes that take energy to do. Children who have not yet reached the age of puberty will not be prescribed hormones for gender transition, even in places where gender affirming care is legal for minors (with parental approval). A prepubescent child is not going to be given testosterone or estrogen to assist in medical transition. Even some children who have reached puberty (which can start as young as 8 or 9) may still be expected to wait until they are older to access hormones. If hormones are prescribed to a child, they will be carefully monitored to ensure they are developing at a similar rate to their peers. The typical recommendation for starting hormone replacement therapy (HRT) is 13-14 for trans girls seeking estrogen and 14-15 for trans boys seeking testosterone.

Surgeries:

Top Surgeries: These surgeries change the chest of an individual. For trans men, this is the removal of breast tissue and, if desired, changing the placement of the nipples. For trans women, top surgery usually entails enlarging the breasts via implants or other methods.

Bottom Surgery: These surgeries reconstruct genitalia and, in some people’s definitions, can include hysterectomies and orchiectomies (or orchidectomies). Many, though not all, of these procedures result in no ability to conceive or impregnate, sterilization.

For trans men this can include phalloplasty which takes a skin graft from the body and uses it to create a penis, and metoidioplasty which is the lengthening of the clitoris. Accompanying procedures may include vaginectomy which is the removal and closure of the vaginal canal, and scrotoplasty which reshapes labia tissue to form a scrotum (often with testicular implants). The specifics of each procedure should be discussed with a surgeon if you are interested in them.

For trans women this can include vaginoplasty which reconstructs the penis and scrotum into a clitoris, labia, and vaginal canal, vulvoplasty which is like vaginoplasty but without the creation of the vaginal canal, and an orchiectomy which is the surgical removal of testicles.

Before diving into some more specific gender identities, today I wanted to take a moment to explain some other important information, specifically the difference between sex, gender identity, gender expression, gender rolls, and so on. First off: What’s The Difference? Sex: Sex is the biological characteristics that define how your body develops and maintains itself, specific to reproductive processes. Things such as chromosomes, hormones, sex organs, and genitalia allow doctors to determine the sex of a person before or after they are born. While sex is typically explained as a binary of male or female, the reality is that sex is a spectrum. Yes, there are intersex people (people whose primary and or secondary sex characteristics fall outside of the ‘typical’ bounds of male and female) the reality is that genetics also play a role in perceived sex alignment. Body curvature, bone structure/density, body type and builds, all have a socially defined ‘typical’ expression concerning male and female, but none of this is absolute. Many of these ‘defining differences between men and women’ aren’t actually related to sex, at least not in their entirety, and are entirely manufactured by social ideas of gender. While it is true that many factors relating to biological sex cannot be changed, it is equally true that you can change aspects of your biology and maintain said changes to better align with your gender identity, a subject that will be discussed another day.

Gender: An internal sense of identity that determines the perception of yourself in relation to gender expression, gender rolls, expectations, and sex. While it is expected that a child can identify their gender around the age of 3, and firmly assert this gender by 4, this is not always seen in transgender people for a variety of reasons. The language to describe our experiences is not available or taught to us, neurological differences (such as autism) may affect how gender is perceived or thought about, lack of acceptance and even punishment from deviation, and many more reasons can contribute to a child not being able to or not being allowed to assert their gender identity by this age. Other folk simply don’t recognize their gender is different until later in life such as when puberty brings about permanent changes, or the dangers of being openly trans have subsided enough to allow that self reflection and understanding.

Gender Expression: Gender expression is how a person outwardly presents their gender, and does not have to align wholly or at all with their gender identity. Gender expression can be displayed through clothing, hairstyles, social mannerisms, walking styles, verbal tones and fluctuations, and more. While many of these may be subconscious (such as walking or speech patterns) other physical displays such as clothing, hair, and accessories are often deliberate. As said before, this presentation does not have to align with the person’s gender identity. For example, a cisgender man may wear a skirt or a dress, clothing typically associated with women. This cis man may not feel his gender is feminine at all, but enjoy wearing skirts and dresses anyway. Although gender expression is not tied to gender identity, many trans people are still ridiculed for not ‘performing’ or presenting their gender in a strictly binary way. For example: a trans man may get flack for wearing makeup or having long hair, even if done in a masculine way. Gender Roles: Gender roles are socially constructed expectations of mannerisms, dress, attitudes, expressions, and cultural roles in society. Many consider gender roles to be oppressive as they limit or restrict the socially acceptable ways to experience and express their gender or other aspects of their identity. For example, men are often expected to hold in their feelings and not outwardly cry, to remain stoic. Women are often seen as more emotional and nurturing, expected to be caregivers and not seen as capable of hard work. These stereotypes make it difficult for anyone, but especially gender-expansive people to navigate society without being ostracized. Gender roles are pushed onto people from a young age, such as the social lessons taught to girls and boys differing, often resulting in one being punished for things the other is allowed or even expected to do. This is only reinforced as children age as adults and peers reinforce the expectations over and over. Gender roles make it difficult to deviate without fear of ridicule or punishment.

Pronouns: Pronouns are words used in place of proper nouns (such as a persons name, etc). They are usually used to refer to living beings, but are occasionally used for other things (such as transportation vehicles like boats, planes, cars, etc). Pronouns consist of words like he, she, they, often denoting gender and how many people are present. He/Him/His is the typically male or masculine. She/Her/Hers is the typically female or feminine. They/Them/Theirs is a gender neutral set, used for people who are neither men nor women, when the gender of a person is unknown, or when multiple people are being referred to at once. Using they/them to refer to a singular person is grammatically correct. It/Its is a set of pronouns usually reserved for inanimate objects (such as a vase, table, sink, etc). People have been referred to using It/Its pronouns as a way to dehumanize them, however, some people have adopted these pronouns to refer to themselves. As long as the person expresses a desire for them to be used, it is okay to refer to someone with It/Its pronouns. While these sets are considered standard or at least common in English, new pronoun sets, known as neopronouns, are being created by people who feel none of those options suit them. Some examples of neopronouns are: Xe/Xem/Xyr (same grammatical rules as They/Them) Ne/Nem/Nes/ (same grammatical rules as He/Him) There are also noun-self pronouns, or pronouns where a name or noun is used instead of pronouns. [Noun]/[Noun]’s/[Noun]self

Finally, there are people who don’t have pronouns and only want to be referred to using their name, which will require restructuring of your sentences to accommodate.

To celebrate pride month this year, let's look at the broad spectrum of gender identities! Let's start with something simple: What is gender?

Gender is defined by the American Psychological Association (APA) as "the socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate for different genders... [G]ender implies the psychological, behavioral, social, cultural aspects of gender..."

Gender, and specifically gender identity, is a deeply personal sense of self. An identity that many people, cis or trans, explore deeply for years of their life, maybe up until they pass. Others may never give it a passing thought, and neither experience is inherently better than another.

There's a theory that I personally believe: There are as many genders as there are people.

This doesn't mean there are unique labels for every single person on Earth (though what would be the harm if there was). This just means that the way two people experience even the same gender is still different. Two women, two men, two nonbinary folk, will never experience gender the exact same way as someone who uses the same label as them.

Much like humans, animals, plants, and so on are defined by broad, common experiences in their classifications, so too do people experience the same gender widely differently. One woman may see her gender best expressed through form fitting clothes and sequence dresses while another feels her gender is best represented by loose t-shirts and baggy pants. They may both see themselves as women, but their gender, how they experience it, how they express it, how they describe it, differs, and there's absolutely nothing wrong with that!

Still, humans tend to enjoy defining experiences via labels to better create community around those who experience similar things to them, and that's why the list of gender identities and labels is ever evolving, to encompase those broad or niche expereinces.

So for the first day of Pride Month, let's look at some broad terms to get ourselves aquatinted with some different experiences relating to gender identity.

Cisgender: It is not a gender identity in itself, but rather an adjective (descriptor word) used to describe the state of ones gender aligning with their sex at birth (example: a person born male identifying as a man). It is considered an umbrella term, holding other identities under it.

Transgender: It is not a gender identity in itself, but rather an adjective (descriptor word) used to describe the state of ones gender not aligning with their sex at birth (example: a person born male identifying as a woman). It is considered an umbrella term, holding other identities under it.

Nonbinary: A gender identity that is not wholly bound under the concepts of man and woman. While it is a gender identity, it is also an umbrella term used to describe more specific experiences of gender that do not fully align under man and woman. Nonbinary as a term and identity is considered part of the transgender community and held under the transgender umbrella.

Two-Spirit: An umbrella term specific to indigenous communities, and one that cannot be claimed by non-indiginous people. Doing so is a form of cultural appropriation. The label encompasses a wide variety of identities and cultural roles within Native tribes, the definitions and experiences of which differ from region to region and even tribe to tribe. It is an umbrella term used to describe the specific experiences of indigenous gender identities, but does not replace the specific terms and labels thereof.*

Intersex: Intersex is not a gender identity but rather an umbrella term to describe people whose bodies have mixes of male and female specific sex characteristics. These mixed characteristics may involve chromosomes, hormones, genitalia, and or reproductive organs. There is no one set "intersex" type, and the medical and social challenges of intersex people differ based on what characteristics they possess or are perceived. Intersex people are often considered to be part of the trans community because their experiences and struggles are similar to transgender people's (gendered expectations, perception, healthcare access, etc). While some intersex people are transgender, not all intersex people are.

There are many more umbrella terms that could be gone over, but for now this should suffice to get our foot through the door on this topic. Follow along for the rest of the month to learn more about specific identities and learn more about the vast experiences of gender!

On top of general maintenance, a video has been linked on the site to give you a brief overview of how to make an E.E.P., linking to the new Youtube channel and it's first video! The video provides a brief overview on how to make your own E.E.P. More detailed information is available on the website.

If you are the parent of a transgender child, I urge you to look for a new state to live in. The safety of your child may depends on it, even if they are not seeking gender affirming care or have no plans to. Resources are available at the Transgender Emergency Evacuation Plan website to help you determine where is safest for your family to move to and find services to help with the cost of moving.

Erin Reed, a transgender journalist, has listed Texas as one of three "Do Not Travel" states for trans people in her February Trans Risk Assessment Map (alongside Kansas and Florida). The Movement Advancement project has given Texas a score of -8/26 for Gender Identity and -6.75 overall on their Equality Map of the United States.

Regardless of if the government will force trans youth to attend such 'clinics' (a theory unconfirmed with no solid evidence thus far), this 'clinic' being forcefully opened paired with the ban on gender affirming care for minors, including affirming mental health services, is more than enough justification for you to move to a safer state. There are other reasons of course such as Ken Paxton (Governor of Texas) creating a list of transgender people seeking gender marker updates and bathroom bills like in Odessa, Texas that encourage 'tattling' on presumed transgender people for using the 'wrong' bathroom.

In short, Texas is one of the most unsafe places within the United States for a trans person, especially trans children, to live. I strongly urge you to use the linked resources to begin planning for a move out of the state. It is not impossible to reach. There our services here to help you, services and organizations that I am actively seeking to add to the Trans Evac. Plan website's resource page everyday.

Amongst other heinous and false classifications, Donald Trump has declared that his "Counter Terrorism Priorities" lie against those who are pro-transgender and against fascism (antifa), two classifications that on their own are not made up of inherently dangerous people.

It is alarming but unsurprising. These types of threats are part of why I made the Transgender Emergency Evacuation Plan in the first place. I know that moving to a safer area, even in an overall unsafe country, can bring peace of mind. The knowledge that your neighbors would be willing to protect you instead of throw you under the bus makes you feel better and more confident, less fearful, and overall improves your quality of life.

The Trans E.E.P. aims to aid in providing resource information for trans folk across the United States. Resources for moving, legal aid, healthcare, and more is already available on the website, but the work isn't done until every trans person is safe. I urge you to share this resource to those you trust and those who need it.

If you know of or run an organization aiming to help transgender folk in any capacity, please use the contact form on the website to let me know about it so I may look into it and potentially add it to the site.

Follow a similar course of action if you notice any inaccurate or outdated information on the site. I am only one man and am bound to make mistakes, but I do my best to correct them as soon as possible.

Finally: If you can, I ask that you support my endeavors via my Ko-Fi. The money is first and foremost used for the website including hosting and domain costs, which is what allows the site to remain up for use. Other funds go towards myself for medication, bills, and other expenses so I may continue working on this resource for all of you.

If you don't feel comfortable donating to me, consider giving that money to the ACLU of your state instead.

Although only up and running for a short while, the Trans Emergency Evacuation Plan website has seen over 2 thousand visits!

As time goes on, its compiled resources and guide to leaving unsafe states will only become more important to the well-being of trans people across the United States. Which is why I humbly request donating to my Kofi in honor of trans visibility day!