When Christie Macias' child came out as transgender at age 11, the first visit with their Santa Barbara pediatrician was not as supportive as she would have liked.
“The doctor’s response was, 'that’s awesome. I totally support you. But I don’t know how,’” Macias said.
Her child, Ash, is now 12 years old. Ash uses they/them and he/him pronouns. In the Macias' experience, it’s difficult to find doctors on the Central Coast who know how to treat Ash. Macias said some doctors have trouble using Ash’s pronouns correctly, and lack knowledge of medical routes Ash could take regarding affirming his gender.
“I think as a doctor, if they don’t know, it sounds scary for them. And so their assumption is that they’re not [cleared] to do it and they don’t look into it,” Macias said. “They assume that you need a specialist. And there’s no specialist for us here. And so it’s just like, 'we love you, we support you. Do you want a hug?’”
Ash said they have to travel out of Santa Barbara, mainly to Los Angeles, to be seen by a physician with a focus on transyouth healthcare.
“It’s actually pretty boring, because we have to go on so many trips just to go to the doctor,” Ash said.
The Santa Barbara Transgender Advocacy Network (SB-TAN) was founded two years ago by local transgender and gender-nonconforming people and their families. It’s a non-profit, and a resource for families of trans kids who want support from others experiencing similar situations.
This weekend, the organization is hosting a conference on the University of California Santa Barbara campus for healthcare providers. The two-day training is aimed at educating medical professionals about best care practices for transgender people.
SB-TAN Board President Phillippa Bisou, who is a transgender woman, said the conference will start with the basics of how to respectfully interact with trans and gender-nonconforming people, like using pronouns the patient prefers. Sessions will also cover discussing treatment options for those who want to pursue hormone therapy or surgery that will affirm the patient’s gender.
“The essential thing is to be what I like to call ‘trans competent,’ like any healthcare provider,” Bisou said. “And these classes, these trainings, they talk about hormones and blockers, especially with trans youth.”
Bisou said healthcare for trans and gender-nonconforming people is different and personal for every patient, and the options out there are changing as new technology develops.
Macias and Ash have considered using puberty blockers for Ash. It’s typically for younger patients. This treatment will block adult male or female anatomy from developing in puberty. SB-TAN advocates said that can help circumvent psychological issues for some trans and gender-nonconforming youth as they grow into adults.
Macias said she’s been trying to get the treatment since June, but she can’t find anyone in Santa Barbara willing to provide puberty blocking treatment for Ash. And right now, the wait list for getting an initial appointment at the Center for Transyouth Health and Development at Children’s Hospital in Los Angeles, is approximately four months.
“[They’re] saying that we’re at risk for passing the timeframe for we can get blockers. And there are no doctors available for [our youth] who need blockers to just pause puberty, so we don’t have body development that maybe we don’t want in the future,” Macias said. “And it’s heartbreaking. There’s tears every time we go into the doctor.”
Bisou said it’s important for providers to understand the changing nature of gender identity, especially when it comes to healthcare.
“Pronouns keep changing, and the ways to expression keep changing,” Bisou said. “But doctors want to be sure. And parents are taking a bold, bold move to honor their children’s authenticity. So doctors really need to know that this is what’s at stake.”