Transgender Health and the COVID-19 response in Minnesota
On March 20, 2020, Minnesota Governor Tim Walz issued an executive order which, among other things, postponed indefinitely “all non-essential or elective surgeries and procedures, including non-emergent or elective dental care, that utilize [personal protective equipment] or ventilators.” According to the order, “A non-essential surgery or procedure is a surgery or procedure that can be delayed without undue risk to the current or future health of a patient.”
Rainbow Health has received multiple inquiries from transgender Minnesotans whose access to some forms of transition-related care has been interrupted because of this executive order. We, too, share the concern which some have expressed that transition-related care might be considered “elective.” Much of our advocacy work related to coverage for such care is based on the World Professional Association for Transgender Health (WPATH) Standards of Care, which explicitly note that “in no way” can these procedures be considered elective.
Having consulted with several of the leading providers of transition-related care in the Twin Cities area, it is clear that the medical community agrees; as one provider put it, “we very much recognize that medical transitioning and maintenance of hormones is medically necessary and that putting some components of this on hold while we respond to the current worldwide COVID-19 crisis might feel like we aren’t taking the needs of the T/GNC community seriously. Nothing could be further from the truth.”
That said, some people will experience disruptions to their care plans because of the current circumstances. As another provider put it, their facility “is limiting all visits to telephone or telemedicine unless absolutely necessary, to limit exposure risk to health care staff and other patients. This puts limits on what hormone care we can do without any kind of physical exam (including vitals), or the ability to demonstrate/teach injection techniques.”
“Every clinic is approaching care differently, but most patients will likely be able to get medical (non-surgical) care by phone until it is safer to be seen in person,” said a third provider, with the concurrence of a fourth. “Everyone should speak with their individual provider/nurse/coordinator about their specific needs and allow those medical personnel to triage appropriately for everyone's safety.”
Nobody fails to appreciate that these are difficult times, and that learning that one’s critical care is being postponed indefinitely will be painful for many. Individuals who have access to mental-health professions might want to reach out to them; as one provider observed, “Having access to therapists is incredibly helpful—it is times like these that I most appreciate when my patients have a relationship with a therapist. My patients without that support to fall back on may struggle more.” Many therapists, including those at Rainbow Health, are now seeing people via teletherapy systems, as they, too, are affected by the COVID-19 situation.
Rainbow Health stands with the transgender community in advocating for access to transition-related care. While the Governor’s executive order remains in place, our work to challenge coverage barriers continues, even if the current extraordinary circumstances interrupt people’s ability to get this care at a particular time. We will remain in close contact with our trusted allies in the healthcare field to assure that services are resumed as soon as it is possible to do so.