In September of 2022, Kit Wiedenfeld brought his friends together for a celebratory “T” party.
They were celebrating Wiedenfeld’s first testosterone, or “T,” injection, a treatment that has since become a weekly part of Wiedenfeld’s routine.
These injections are a form of hormone therapy and gender-affirming care, healthcare that helps individuals present outwardly in a way that reflects their gender identities. Gender-affirming care can include hormone treatments, surgeries and mental healthcare.
Wiedenfeld, a second-year studying horticulture, is the president of T-Files, a group for transgender, nonbinary and gender non-conforming students on NC State’s campus. He said receiving hormone therapy and other care opened up the world of physical expression for him.
“I felt like I was falling in love with myself again, which was really nice,” Wiedenfeld said. “I feel like a lot of trans people really appreciate gender expression a lot more because it does feel like you’re finding yourself again, and you’re more comfortable in your own skin. And being able to share that is a really beautiful thing.”
Many medical groups, including the American Medical Association, qualify gender-affirming care as medically necessary, and studies have found that receiving gender-affirming care is associated with mental health benefits and increased quality of life.
Wen Rivero, a recent doctoral graduate from NC State, has received both hormonal and surgical gender-affirming care and said this care helped them identify with the body they saw in the mirror, which in turn motivated them to practice better self-care through actions like going to the dentist.
“Before, I used to think of my body as ‘that person;’ I wasn’t as interested in caring for it,” Rivero said. “Before I was like, ‘Oh, this is a vessel, and it carries me to lab. It carries me through class, and it carries me to my meetings with my advisor, and that’s what it does.’ And now it’s like, ‘Oh, hey! This is my body. I can do things for it.’”
Maya Keele, a fourth-year studying aerospace engineering, has been on hormone replacement therapy for almost eight months now. She said in addition to physical changes, the gender-affirming care she has received has allowed her to be happier.
“I just enjoy life more,” Keele said. “I’m excited to do things instead of feeling obligated to them. … Instead of feeling nervous, or like pressure to fit into a role that doesn’t work for me, it’s like, I actually really look forward to this. … I like living now.”
While some seek gender-affirming care to enhance traditionally masculine or feminine physical traits, everyone has different goals in the care they seek. Wiedenfeld said though he knew he wanted his voice to be deeper, his ultimate goal was to appear as androgynous as possible.
“A lot of times when you do research on gender-affirming care, there’s a very binary aspect to it,” Wiedenfeld said. “Like people assume that if you’re transitioning, you must want to transition to be cis-passing. So for me the resources that I had were like, ‘Oh, so you want to … transition to look like a man,’ and that was like not my transitioning goal. So I had to do a lot of research on what that looked like for me.”
Gender-affirming healthcare is not a new field of medicine, nor is it specific to those who identify as transgender or nonbinary. Hormone therapy for cisgender men and women has long existed for gender affirmation and the treatment of testosterone deficiency and menopause symptoms. And surgical treatment of gynecomastia, which is when breast tissue swells due to a hormone imbalance, in cisgender men has long-been a way to help some feel more comfortable in their bodies.
Despite this precedent and widespread support from medical professionals, gender-affirming care for transgender and nonbinary individuals can be difficult to navigate. Keele said one challenge is accessing reliable information.
“It’s very anecdotal,” Keele said. “So yeah, online communities, especially like Reddit. I don’t use Reddit otherwise, but the trans communities there are really good for finding information on who you can trust and stuff like that. So yeah, it’s a very like anecdotal network, almost cause there aren’t very many official channels.”
Wiedenfeld said this is one of many reasons having community support is vital while receiving gender-affirming care. Because of the difficulty of accessing information, Wiedenfeld said lots of information regarding how to get care is shared through word-of-mouth and that groups like T-Files can increase access to comprehensive information.
Cost can pose an additional barrier to seeking care. When Rivero first started seeking hormones a year into their transition, their insurance would not cover the cost, in part because they had lived under their gender identity for less than three years. Rivero ended up using one of their COVID-19 stimulus checks to cover the out-of-pocket cost of hormones.
Keele’s insurance does cover some of the cost of her prescription but only for a month’s supply at a time. She said the persistent costs associated with her care is a consideration as she moves into the workforce after graduating next month.
“Being trans is expensive,” Keele said. “There’s all sorts of things I want to do that cost money. … And so this company I’m looking at, one of their founders is trans, which is super rare in the aerospace industry. So that’s why I’m looking at them, especially. And they have really good insurance, like they list that as one of the things. That’s really my priorities.”
The political climate surrounding gender-affirming care can make it scary to seek, particularly in North Carolina, which has a history of bills targeting transgender people.
In spite of this, Wiedenfeld, Rivero and Keele describe the outcomes of the gender-affirming care they’ve received as overwhelmingly positive.
“I’m so much happier than I was,” Keele said. “I don’t know if that’s a result of the medicine or the fact that I’m being myself around people. It’s probably both.”
To learn more about resources at NC State, visit the LGBTQ Pride Center’s Transgender Resource Roadmap.
