Michigan group offers counseling to trans clients in states where they otherwise might go without

Stand with Trans tent at Motor City Pride. June 9, 2024. Photo by Jon King

Gender-affirming care. 

It’s a phrase that evokes a myriad of opinions, many of them focused on hormone treatment and surgery for trans individuals. And yet, long before either of those options becomes a possibility, therapy is almost always a requirement, especially when adolescents are involved.

But where and how trans-identifying youth obtain that therapy can be a major barrier to receiving the proper care. 

According to the latest report from Human Rights Watch, nearly 114,000 transgender youth between the ages of 13 and 17 live in the 24 states that have enacted a ban on youth access to gender affirming care as of April. That equates to 38% of all transgender youth nationwide.

With that in mind, a Michigan-based organization has initiated a program to surmount those barriers, regardless of geography.

Farmington-based Stand with Trans isa nonprofit that was created in 2015 by Roz Keith after her own child had come out as transgender, has recently launched a Therapy Assistance Program (TAP) to provide trans-affirming mental health care for transgender and non-binary youth.

Eridian Dempsey, TAP coordinator for Stand with Trans

“Any trans person that’s 24 or under can apply through the form online to receive assistance so that they can see a therapist, but it’s not just any old therapist. We make sure that they’re equipped to deal with trans issues and have experience working with people in the age range,” Eridian Dempsey, the TAP coordinator who also leads the Stand with Trans Youth Advisory Board, told the Michigan Advance.

The appointments are done online, making it available to individuals no matter where they live.

“The program runs in Michigan, Utah, Wyoming, California, but only in the Bay Area in California, and Florida,” said Dempsey. “Some of those areas don’t necessarily have a lot of resources for trans, or even just queer folk in general, so it’s kind of a resource in those areas where there isn’t a lot.” 

Dempsey says they have also recently added Ohio, Indiana and Tennessee to the program.

Having that resource can make all the difference in how positive an outcome that trans youth experience. 

The World Professional Association for Transgender Health (WPATH) is an international organization of health professionals whose mission is to “promote evidence based care, education, research, public policy, and respect in transgender health.”

According to their latest Standards of Care, health care professionals working with gender diverse adolescents should “undertake a comprehensive biopsychosocial assessment of adolescents who present with gender identity-related concerns,” prior to considering other options such as using puberty blockers or initiating hormone treatment.

“Treatment in this context (e.g., with limited or no assessment) has no empirical support and therefore carries the risk that the decision to start gender-affirming medical interventions may not be in the long-term best interest of the young person at that time,” states WPATH. 

Providing care where it is needed most

For youth in a red state like Florida, where the political and social climate is actively hostile to health care for trans and non-binary individuals, Dempsey said, opportunities to receive therapy are limited at best.

“Around the start of this year we got funding from the Feel Something Foundation, that was for Florida, in particular,” they said. “And I think that came at a really crucial time because Florida’s not not been great, but it feels like over the past year it’s just got so much worse.”

Dempsey says having spoken with LGBTQ+ people living in Florida, the level of bigotry being experienced day-to-day makes it clear how much of a need there is.  

“I often will do things to outreach over there and it’s like, ‘You are going to universities?’ And they’re like, ‘We’re no longer allowed to have an LGBTQ center.’ And I’m like, ‘Are you kidding me?’” said Dempsey. “It is shocking, so to have this as a resource for people in those states is so important.”

Even in states like Michigan, which has added  protections for the LGBTQ+ community into law, finding a therapist to properly assist trans and non-binary youth can still be difficult.

“When you live in a small town, how many therapists that you go to are going to respect your pronouns and understand the special issues that come with being part of the LGBTQ+ community? Probably not many,” Amber Kennedy told the Advance.

Kennedy is a licensed therapist in Michigan specializing in transgender and non-binary youth who works with MichiganSafeSpace.com (MSS), which in turn partners with Stand with Trans to provide counselors for the Therapy Assistance Program. 

She says Stand with Trans is great at surmounting one of the initial barriers for many: the cost.

 “They reached out to us when they started the program,” said Kennedy. “It was aimed at helping those who are within the LGBTQ+ community, specifically trans youth that maybe didn’t have access to good insurance, where copays were a barrier to gaining service, to get them basically a stipend.”

Kennedy says that instead of billing insurance, they receive a payout from Stand with Trans that covers whatever copays or other fees are required. The organization is funded by donations and grant funding, including from the Community Foundation for Southeast Michigan.

“It removes that barrier of ‘I can’t afford therapy so I’m not going to receive therapy,’” she said, adding that she had some clients whose insurance changed and no longer covered the sessions, but by applying and being accepted for the Therapy Assistance Program, they could continue. 

“So that was also really cool to be able to do. It’s actually helped my clientele outside of Stand with Trans to become a part of Stand with Trans so that they didn’t lose services,” said Kennedy.

Once cost is no longer an issue, she said it then comes down to finding an affirmative therapist.

“Which is a way of saying, ‘I see your identity, I accept your identity, I’m gonna honor your pronouns,’ etc. And finding those locally,” she said. “But the problem with that is when you live in a small town, how many therapists that you go to are going to respect your pronouns and understand the special issues that come with being part of the LGBTQ+ community? Probably not many.”

Kennedy says TAP helps to overcome that barrier and give people the opportunity to receive the therapy that they need and might otherwise not get.

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Expanding Stand with Trans grows to meet a growing need

The TAP is just one manifestation of the expansion that Stand with Trans has undergone in recent years, especially since the pandemic made clear the isolation many in the trans community were struggling with.

Lev Levett is the organization’s program manager and oversees all programming. 

“We’re now a national organization, especially with TAP being in Florida, Wyoming, Utah, the Bay Area, Michigan, of course,” they told the Advance.

“We have a lot more national attraction and we’re out there, so we’re trying to help as many people as possible, and it’s definitely tough being a small organization, but we are growing and I think that we’re absolutely having an impact on anyone that we service,” said Levett.

They said while TAP is absolutely an important piece of what they provide, SwT also has a variety of engagement programs that bring people together over shared interests. One of those they are most excited about is the Banned Books Club.

Funded by a grant from the Flagstar Foundation, the fully free and all-virtual program picks books from queer and trans authors that have been banned in one form or another. Levett says it provides an important way for members to both express their lived experiences and also learn new perspectives.

“We had our first meeting in February, and for each quarter there’s a theme,” they said. “So those themes are BIPOC voices for January, February, March, being [as] Black History Month [is in] February, and it’s a very important voice of course. Relationships was another one. Intersectionality. And then trans voices specifically, which most of these books have some sort of queer trans element to it.”

Levett said that each quarter they invite an art therapist to host a portion of the program who helps participants create a piece around that month’s selection using simple supplies that people would have at home. 

They also said while Stand with Trans typically serves 13- to 24-year-old trans and non-binary youth, the Banned Book Club is open to all ages.

“So if you have a 6, 7-year-old with a parent [or] guardian to watch over during that session, they’re more than welcome because 25% to 30% of the books for the year are children’s books,” said Levett. “We have a lot of tween books, teen books, and anything that is, you know, maybe 18-plus or even 13-plus. We always give a warning about that content, trigger warnings and stuff. But it is essentially for anyone.”

Levett says the club is just another example of providing spaces for individuals to be themselves and feel safe, which they also do through the myriad of support groups they offer.

“The support groups were pretty much the bread and butter for a long time, and still are definitely essential to our model and our organization in general,” they said. “Some are virtual, some are in person. The in-person ones would take place in different parts of Michigan, but we have all different kinds. I mean, we have a trans-male group, a trans-woman group; we have parents of trans-kids groups, parents of trans-teens, tween groups, non-binary.”

Levett emphasized that the facilitators who run the groups are licensed professionals, with a preference for trans, non-binary, or queer identifying individuals to offer that kind of representation, although it isn’t a requirement.

“It’s important to have a space that you can be safe, comfortable, be yourself, meet other people like you, especially if maybe it’s not a good environment at school for you to be out or you don’t have a supportive family,” they said. “Doing this work is super-important. Now more than ever, things are terrifying and hard and scary. So, people need our services now more than ever, and I’m happy to be a part of that.”

A rock in your shoe

Because she specializes in working with clients as young as 7 years old, Kennedy is often asked whether it’s appropriate to be talking about gender identity issues with children. However, she says one thing she has learned in her position is that the kids themselves will often have the answers before adults can even figure it out.

“I think that the best way it was described to me from a 7-year-old. Somebody had asked this young client of mine, ‘Why are you non-binary? How do you know?’ And my client looks at me and they go, ‘Amber, when did you know that you were a girl?’ And I was just like, ‘I always knew that’ and they were like, ‘Exactly!’ and just kind of stared at me,” said Kennedy. “And this coming from a 7-year-old. And in that moment I think it just kind of opened my eyes. Why are we questioning these kids?”

Kennedy says it can get tricky when first talking with the parents of her younger clients, in which she tries to determine where everyone involved is at in what she likes to call the child’s “gender quest.”

“Are we changing our pronouns? Do parents accept that? Do parents use pronouns at home? I can see a parent’s perspective, and so I try really hard in navigating that, of trying not to overstep boundaries,” she said. 

However, Kennedy says as the process plays out, even open and accepting parents will learn things about their own child they hadn’t expected.

“I have had youth, upon intake, I think that they’re just queer [because] that’s how parents have presented them,” she said. “And then the next session when parents aren’t present, the kid is like, ‘Oh, I’m actually non-binary, these are my pronouns, this is my preferred name.’ And parents don’t know this yet. They’re accepting of their sexuality, but they’re not accepting of their gender identity.”

Participants in the Portland Pride Parade on Congress Street. June 15, 2024. Photo: Jim Neuger

But once those issues are settled, Kennedy says just navigating the world at large becomes overwhelming for some of her clients. She saw that with the February death of Nex Benedict, a 16-year-old nonbinary Oklahoma teen who died a day after being knocked unconscious in a fight in a school bathroom. Despite authorities ruling the death as as suicide, Kennedy says she believes it was still the result of the harassment they endured and that several youth who came into their TAP session the week after it happened had what she called “extra heaviness.”

Kennedy says many of her clients are forced to see the world through a lens that sometimes the adults in their lives aren’t able to process and are keenly aware of anti-LGBTQ+ measures in states like Florida.

“There was one youth I had whose parents were like, ‘Let’s go to Disney World this summer’ and [the client] came to session and was like, ‘I don’t feel safe in Florida. I don’t know if I want to go to Disney World.’ And for a kid to turn down Disney World because they don’t feel safe in the state? So yes, the political climate, definitely, as long as the kids are aware of it, they definitely bring it to session,” said Kennedy.

And in a society in which LGBTQ+ youth are more than four times as likely to attempt suicide than their peers with at least one attempt every 45 seconds, Kennedy says providing the counseling that TAP makes possible is more critical than ever.

“Imagine a pair of shoes, if they fit perfectly and they’re comfortable, you’re not going to notice you’re really wearing them, right? But if they don’t fit and they’re too tight, or there’s a rock in your shoe, you’re going to constantly focus on that,” she said. “You’re not going to be able to complete your basic needs until you get that rock out of your shoe. So how can we expect these kids who are living in a body that feels foreign to them and wrong to be functioning members of society, when they don’t feel at home in their own body?”

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