As a girl who's own surgery date is rapidly approaching, this is the kinda crap I fear the most. My heart goes out to those who were scheduled and lost their appointment. It must be soul crushing, and we deserve better.
Same. The person who wrote that may have had good intentions but apparently doesn't know any Trans people and how we're weird about the news that live saving healthcare is being denied us and how it disrupts the shit out of our equanimity.
Your response with the word equanimity had me googling. I will be using that word a lot from now on. E·qua·nim·i·ty-mental calmness, composure, and evenness of temper, especially in a difficult situation:
Many people choose cowardice, it turns out, once the stakes are real.
I don't think I'm better than the cowards, but I do not have the luxury of a choice. For me, the alternative is death.
I wonder if trans healthcare can ever move past the moral hazard of having our access being determined by cis doctors, cis politicians, and cis corporate officers. This is our community's crushing, fatal weakness: there just aren't that many of us, and we are distributed across the country. There is no trans state, trans congressional district, trans town or even any trans neighborhoods. We are in the minority in every context in which we exist. Not only does this mean our very existence is constantly up for debate; it also means we are required to perform normalcy, excellence, calm, and good health for all to see, all the time. We can never just be ourselves alone.
I do not know how this changes. Even if some of us were privileged enough to pool their resources and create a safe haven for us, or a permanent medical center dedicated solely to delivering care to trans people, I doubt this would be practical or effective for the many millions of us living on the edge.
I do not mean to sound hopeless. I just don't know how we overcome this without, ultimately, great cost to ourselves, our lives, and our dignity.
If any policy gains felt like they could be permanent, then we could tell ourselves it is worth it. But to see the things that those who came before us spent their whole lives building torn down in the blink of an eye - it's an obscenity. It is a moral obscenity.
I agree completely. But we will never be free of cisgender people to controlling our lives. We thought decades of telling our stories, sharing our lives, risking everything by being out and open regarding our experiences and challenges would humanize us and win allies and equality.
NOPE!
The haters are busily forwarding the trajectory of multifaceted processes that will effectively end the existence of transgender Americans while our former allies and friends pretend nothing is happening. All those "both sides" Dems who showed up at rallies and fundraisers and on November 20th?
All. Gone.
Fair weather meffers, indeed.
I expected the conservative Dems and especially White Dems to ditch our asses but the rapidity with which the Gavin Newsoms and Kristen Sinemas and Tom Suozzis turned on us literally took my breath away.
All my life, I will never forget the way the Democrats were almost itching to betray us as soon as the 2024 election was over. The sheer cynicism of it took my breath away too.
And yet the Republicans are basically holding a gun to our heads, giving us little choice but to cross our fingers and vote Democrat in the hopes that maybe - if we're good little constituents - they might prevent the GOP from having us all arrested, killed, and pushed into sex work. Maybe.
We have no agency, no political power at all, and yet there are people who still think we control the Democratic Party.
It just confounds me - why do the Democrats spend so much chasing the votes of people who hate them? Like, if you really are one of the few cis Americans whose vote is driven by anti-trans rage, would you vote for Gavin Newsom just because he said trans women can't compete in sports? Of course not. But the Democrats will go chasing that vote anyway, no matter how many of our bodies pile up under the wheels in the process.
They make such a performance of hating us, like a resentful ex-partner causing a scene in public - "Actually, I never even liked you" - and they will gain nothing for it. But we are the ones who will lose, who must bear the burden for their decades of political malpractice.
Shortly after I read this post, I went to get my daily mail. The Democrats had sent me out an infamous piece of mail with of course, an envelope inside. The inside envelope was prepaid by the Democratic Party. So I wrote a handwritten note and said I will not be donating another dime to the Democratic Party until you stand up for the trans community. If nothing else, I felt better when I dropped it back in the mail. Editing to say that my Oregon legislators have never backed down they stayed strong.
I am a former doc at VUMC specializing in gender affirming care. I resigned in solidarity with the firing of our staff in June 2025. It was a tough but necessary decision for myself as a physician, and it was clear VUMC's values and mine were no longer aligned.
The reasons the surgeons are leaving and the programs are closing are a complicated. The political pressure certainly plays a role. It breaks my heart that our patients will be forced to travel for necessary care.
It would be easy for me to just pick and up move. But, I am born in Nashville, and this is my home just as much as anyone that lives here. As a queer doctor, trained in the south, we deserve just as excellent care as anywhere else. I am fortunate enough to continue proviging gender affirming care in Nashville, now in a private, community-based clinic (Chosen Family Medicine if anyone needs somewhere to go).
“We care deeply about you” and yet are yanking the rug out and leaving you gutted. Awful. Vanderbilt can be added to list of medical providers actively doing harm. 😤😤😡😡🏳️⚧️🏳️⚧️
I'm on a soapbox today. As a cis gender ally I have to wonder how many of those wanting to ban medical care for the trans community have had elective non-medical plastic surgery.
Once again a major medical institutions start bending the knee to political intimidation, we are in dangerous territory.
The decision by Vanderbilt University Medical Center to close transgender-affirming surgeries under pressure from Donald Trump and his allies is not “neutral policy.”
It is capitulation.
It sends a chilling message that evidence-based medicine can be overridden by partisan threats and ideological crusades.
Healthcare decisions belong to patients, their families, and qualified medical professionals — not to politicians seeking to score points by targeting a vulnerable minority.
When a respected academic medical center retreats from established standards of care because of political pressure, it undermines medical ethics, patient trust, and the core principle of equal protection under the law.
Transgender people are not pawns in a culture war.
They are human beings entitled to the same constitutional protections, dignity, and access to medically necessary care as anyone else.
Bending to intimidation only emboldens further attacks — on civil rights, on academic freedom, and on the independence of our healthcare system.
History does not look kindly on institutions that stayed silent or complied when fundamental rights were under assault.
The moment demands strong unbending courage, not compliance.
Medical centers should stand with science, with their patients, and with the Constitution — not with political fear.
Just another institution that lacks the moral fortitude to stand up and be counted
I received my top surgery through VUMC two years ago now, and to say that it was life-improving beyond my dreams is an understatement. Local access to that care, not having to drive, fly, rent a hotel, and incur hundreds to thousands of dollars in additional expenses was crucial to being able to receive care. I don’t feel surprised, but I do feel dread. This is such a letdown in a place where trans and queer people who love this place and have also survived this place are increasingly being legislated out. I have no desire (or means!) to leave, but the pain of watching my home try to write trans Tennesseans out of existence is gutting.
Once again, EitM comes through with information no one else has reported on, in this case the explanation of the surgeon suddenly being unavailable. But WHY? This is the same reason the poor patients at UMass were given - the surgeon suddenly being unavailable. When it happened at UMass, it was a solitary incident and we could chalk it up to "maybe the surgeon has an unavoidable life emergency they need to deal with or something". But now it's happened twice and we are in that uncertain gray area of 1) another isolated incident? or 2) is this a pattern now that will keep repeating? The trans community desperately needs to hear from these specific surgeons for their point of view and personal explanation. Until we do, the situation will continue to boil in a stew of uncertainty and speculation. We need, and deserve, answers because it's happened in both a red state and a blue state. What are we to make of that?
I live in a red state and just had my bottom surgery consultation two weeks ago. The consultation went really well and I was approved for surgery, but it's been two weeks and they haven't contacted me to schedule the specific surgery date yet. Has something happened? Am I being paranoid? But I might get a call tomorrow with that date for all I know. But then I get to wonder for the next eight months (their rough estimate at the consultation) whether I might suddenly wake up to find a message from the clinic letting me know the surgeon is suddenly "unavailable" and my surgery is cancelled. Damn this political climate. I hate not knowing and having to live with uncertainty. I have a feeling I'm not going to rest easy until I wake up from the anesthesia and know it's done. Ugh!
Here we go. I know so many of us are jeeping our fingers crossed that we will get our surgeries. I'm scheduled for top surgery in May. Probably followed by bottom surgery next fall. Holding my breath. We should not be subject to disinformation and religious prejudice.
I feel so bad for all the women waiting for surgery. It's going to be like this until we get rid of all of these people. Everyday, I wake up hoping to read a certain obituary. No luck.
For a while, people may have to go out of the country for surgery. I certainly hope it doesn't come to that. Why can't they just leave us alone?
That message is a not-pology soaked in more corporate weasel-speak than a middle-managers' Monday morning zoom meeting.
"We care deeply about your health and wellbeing" has the exact same energy as the "thoughts and prayers" that follow every massacre in this bloody country. We know they don't mean it. They know we know they don't mean it. It's the most craven kind of CYA, designed to preempt justified outrage with the thinnest veneer of civility- because the 𝘢𝘯𝘨𝘳𝘺 one is always in the wrong, dont'cha know?
After the Fugitive Slave Act and Dred Scott in the 1850s permitted red states and federal authorities to persecute non-whites under suspicion of being escaped slaves or undocumented/insufficiently documented posing as free people AND to investigate and arrest Whites under suspicion for aiding and abetting criminality, we saw the EXACT SAME THING. Only took the United States 161 years to forget the bitter lessons of the consequences of attempting to dissolve our union in order to dissolve our democracy and collective freedom. April 12, 1861 is happening again, by bits and by pieces, slo-mo, but no less hateful and tragic.
It's happening in Minneapolis.
It happened in DC, LA, Chicago, coming soon to blue cities in red, blue, and purple states.
It's happening in the move since 2022 of 25% of transgender Americans from their state of origin to safer blue states that still have the rule of law.
It's happening in States where White men can carry a military rifle and brandish it anywhere but the most common reason for police to publicly and summarily execute Black people is "they were suspected of having a weapon".
It's happening when 70% of Republicans now believe that 60%+ of all mass shooters are and have always been transgender.
It happened when the Republican party realized the only way to achieve the deliverables demanded by the billionaire oligarcucks was to get serious about genocide and we Trans and gender expansive folk were picked to go first. The rest of our LGBTQ+ community is next....but if you're a billionaire you can probably buy an honorary heterosexual visa. Our deaths by despair, disease, discrimination, disrespect, and dehumanization are the 21st century April 12th, Charleston Harbor, and make no mistake.
It's happening as the GOPMAGAs secure permanent ownership of power structures and Infrastructure, of public goods and commons, of the profits of undertaxing and over-privatizing, as the corporate GOPMAGA owver-investor class consumes the administrative state (see Cory Doctorow!)... just as red states did in the spring of 1861, seizing federal property, bases, ports, institutions, and funds.
Should Americans have been listening for decades to our Black and immigrant siblings? Should we have taken the necessity of DEI and intersectionality more serious? As it turns out, deadly serious? Because the MAGAs openly calling for our blood sure as hell believe it a threat to their anschluss!
It's happening.
Civil war is here, and it is ugly, bloody, and somehow worse even than expected. And I've been saying this is coming, I've been saying it for a decade. But if you know your Greek classical mythology, you'll know that seers and prophets come to a bad end, especially if they're women...just ask Cassandra...and even worse if they were RIGHT.
I expect the same, however the war turns out. I try not to get angry when I prognosticate and someone says "I don't see any civil war coming, you're a doom scrolling shit disturber making things WORSE!" But how much more needs to happen? What more must Trans people bear before cishet people start wondering if perhaps our lives should have a value but clearly no longer do in MAGAmerica, FKS the formerly United States of America?
As a girl who's own surgery date is rapidly approaching, this is the kinda crap I fear the most. My heart goes out to those who were scheduled and lost their appointment. It must be soul crushing, and we deserve better.
When I read "We care deeply about your health and wellbeing, and we understand this is disappointing news." my anger hit. Then sadness for everyone.
Same. The person who wrote that may have had good intentions but apparently doesn't know any Trans people and how we're weird about the news that live saving healthcare is being denied us and how it disrupts the shit out of our equanimity.
Your response with the word equanimity had me googling. I will be using that word a lot from now on. E·qua·nim·i·ty-mental calmness, composure, and evenness of temper, especially in a difficult situation:
Cowardice.
Many people choose cowardice, it turns out, once the stakes are real.
I don't think I'm better than the cowards, but I do not have the luxury of a choice. For me, the alternative is death.
I wonder if trans healthcare can ever move past the moral hazard of having our access being determined by cis doctors, cis politicians, and cis corporate officers. This is our community's crushing, fatal weakness: there just aren't that many of us, and we are distributed across the country. There is no trans state, trans congressional district, trans town or even any trans neighborhoods. We are in the minority in every context in which we exist. Not only does this mean our very existence is constantly up for debate; it also means we are required to perform normalcy, excellence, calm, and good health for all to see, all the time. We can never just be ourselves alone.
I do not know how this changes. Even if some of us were privileged enough to pool their resources and create a safe haven for us, or a permanent medical center dedicated solely to delivering care to trans people, I doubt this would be practical or effective for the many millions of us living on the edge.
I do not mean to sound hopeless. I just don't know how we overcome this without, ultimately, great cost to ourselves, our lives, and our dignity.
If any policy gains felt like they could be permanent, then we could tell ourselves it is worth it. But to see the things that those who came before us spent their whole lives building torn down in the blink of an eye - it's an obscenity. It is a moral obscenity.
So well written. I have had two transgender friends that had surgeries in Canada. Is that still an option?
Sort of. I mean, the US government can't shut down care in Canada. I am hoping to have my procedure done in Thailand, when the time comes.
There's just the two issues of paying for it, and safely travelling there and back.
I agree completely. But we will never be free of cisgender people to controlling our lives. We thought decades of telling our stories, sharing our lives, risking everything by being out and open regarding our experiences and challenges would humanize us and win allies and equality.
NOPE!
The haters are busily forwarding the trajectory of multifaceted processes that will effectively end the existence of transgender Americans while our former allies and friends pretend nothing is happening. All those "both sides" Dems who showed up at rallies and fundraisers and on November 20th?
All. Gone.
Fair weather meffers, indeed.
I expected the conservative Dems and especially White Dems to ditch our asses but the rapidity with which the Gavin Newsoms and Kristen Sinemas and Tom Suozzis turned on us literally took my breath away.
All my life, I will never forget the way the Democrats were almost itching to betray us as soon as the 2024 election was over. The sheer cynicism of it took my breath away too.
And yet the Republicans are basically holding a gun to our heads, giving us little choice but to cross our fingers and vote Democrat in the hopes that maybe - if we're good little constituents - they might prevent the GOP from having us all arrested, killed, and pushed into sex work. Maybe.
We have no agency, no political power at all, and yet there are people who still think we control the Democratic Party.
It just confounds me - why do the Democrats spend so much chasing the votes of people who hate them? Like, if you really are one of the few cis Americans whose vote is driven by anti-trans rage, would you vote for Gavin Newsom just because he said trans women can't compete in sports? Of course not. But the Democrats will go chasing that vote anyway, no matter how many of our bodies pile up under the wheels in the process.
They make such a performance of hating us, like a resentful ex-partner causing a scene in public - "Actually, I never even liked you" - and they will gain nothing for it. But we are the ones who will lose, who must bear the burden for their decades of political malpractice.
Shortly after I read this post, I went to get my daily mail. The Democrats had sent me out an infamous piece of mail with of course, an envelope inside. The inside envelope was prepaid by the Democratic Party. So I wrote a handwritten note and said I will not be donating another dime to the Democratic Party until you stand up for the trans community. If nothing else, I felt better when I dropped it back in the mail. Editing to say that my Oregon legislators have never backed down they stayed strong.
Well done, Shirley! Good for you!
I am a former doc at VUMC specializing in gender affirming care. I resigned in solidarity with the firing of our staff in June 2025. It was a tough but necessary decision for myself as a physician, and it was clear VUMC's values and mine were no longer aligned.
The reasons the surgeons are leaving and the programs are closing are a complicated. The political pressure certainly plays a role. It breaks my heart that our patients will be forced to travel for necessary care.
It would be easy for me to just pick and up move. But, I am born in Nashville, and this is my home just as much as anyone that lives here. As a queer doctor, trained in the south, we deserve just as excellent care as anywhere else. I am fortunate enough to continue proviging gender affirming care in Nashville, now in a private, community-based clinic (Chosen Family Medicine if anyone needs somewhere to go).
It's a devastating loss.
“We care deeply about you” and yet are yanking the rug out and leaving you gutted. Awful. Vanderbilt can be added to list of medical providers actively doing harm. 😤😤😡😡🏳️⚧️🏳️⚧️
Soul-crushing.
I'm on a soapbox today. As a cis gender ally I have to wonder how many of those wanting to ban medical care for the trans community have had elective non-medical plastic surgery.
At the very least, 𝘦𝘷𝘦𝘳𝘺 MAGAt sporting "Mar-A-Lago Face."
Once again a major medical institutions start bending the knee to political intimidation, we are in dangerous territory.
The decision by Vanderbilt University Medical Center to close transgender-affirming surgeries under pressure from Donald Trump and his allies is not “neutral policy.”
It is capitulation.
It sends a chilling message that evidence-based medicine can be overridden by partisan threats and ideological crusades.
Healthcare decisions belong to patients, their families, and qualified medical professionals — not to politicians seeking to score points by targeting a vulnerable minority.
When a respected academic medical center retreats from established standards of care because of political pressure, it undermines medical ethics, patient trust, and the core principle of equal protection under the law.
Transgender people are not pawns in a culture war.
They are human beings entitled to the same constitutional protections, dignity, and access to medically necessary care as anyone else.
Bending to intimidation only emboldens further attacks — on civil rights, on academic freedom, and on the independence of our healthcare system.
History does not look kindly on institutions that stayed silent or complied when fundamental rights were under assault.
The moment demands strong unbending courage, not compliance.
Medical centers should stand with science, with their patients, and with the Constitution — not with political fear.
Just another institution that lacks the moral fortitude to stand up and be counted
I received my top surgery through VUMC two years ago now, and to say that it was life-improving beyond my dreams is an understatement. Local access to that care, not having to drive, fly, rent a hotel, and incur hundreds to thousands of dollars in additional expenses was crucial to being able to receive care. I don’t feel surprised, but I do feel dread. This is such a letdown in a place where trans and queer people who love this place and have also survived this place are increasingly being legislated out. I have no desire (or means!) to leave, but the pain of watching my home try to write trans Tennesseans out of existence is gutting.
Once again, EitM comes through with information no one else has reported on, in this case the explanation of the surgeon suddenly being unavailable. But WHY? This is the same reason the poor patients at UMass were given - the surgeon suddenly being unavailable. When it happened at UMass, it was a solitary incident and we could chalk it up to "maybe the surgeon has an unavoidable life emergency they need to deal with or something". But now it's happened twice and we are in that uncertain gray area of 1) another isolated incident? or 2) is this a pattern now that will keep repeating? The trans community desperately needs to hear from these specific surgeons for their point of view and personal explanation. Until we do, the situation will continue to boil in a stew of uncertainty and speculation. We need, and deserve, answers because it's happened in both a red state and a blue state. What are we to make of that?
I live in a red state and just had my bottom surgery consultation two weeks ago. The consultation went really well and I was approved for surgery, but it's been two weeks and they haven't contacted me to schedule the specific surgery date yet. Has something happened? Am I being paranoid? But I might get a call tomorrow with that date for all I know. But then I get to wonder for the next eight months (their rough estimate at the consultation) whether I might suddenly wake up to find a message from the clinic letting me know the surgeon is suddenly "unavailable" and my surgery is cancelled. Damn this political climate. I hate not knowing and having to live with uncertainty. I have a feeling I'm not going to rest easy until I wake up from the anesthesia and know it's done. Ugh!
Here we go. I know so many of us are jeeping our fingers crossed that we will get our surgeries. I'm scheduled for top surgery in May. Probably followed by bottom surgery next fall. Holding my breath. We should not be subject to disinformation and religious prejudice.
Meanwhile the major entertainers located in and around Nashville sit quietly on the sidelines while our community’s basic healthcare is taken away
I feel so bad for all the women waiting for surgery. It's going to be like this until we get rid of all of these people. Everyday, I wake up hoping to read a certain obituary. No luck.
For a while, people may have to go out of the country for surgery. I certainly hope it doesn't come to that. Why can't they just leave us alone?
That message is a not-pology soaked in more corporate weasel-speak than a middle-managers' Monday morning zoom meeting.
"We care deeply about your health and wellbeing" has the exact same energy as the "thoughts and prayers" that follow every massacre in this bloody country. We know they don't mean it. They know we know they don't mean it. It's the most craven kind of CYA, designed to preempt justified outrage with the thinnest veneer of civility- because the 𝘢𝘯𝘨𝘳𝘺 one is always in the wrong, dont'cha know?
Ugh.
After the Fugitive Slave Act and Dred Scott in the 1850s permitted red states and federal authorities to persecute non-whites under suspicion of being escaped slaves or undocumented/insufficiently documented posing as free people AND to investigate and arrest Whites under suspicion for aiding and abetting criminality, we saw the EXACT SAME THING. Only took the United States 161 years to forget the bitter lessons of the consequences of attempting to dissolve our union in order to dissolve our democracy and collective freedom. April 12, 1861 is happening again, by bits and by pieces, slo-mo, but no less hateful and tragic.
It's happening in Minneapolis.
It happened in DC, LA, Chicago, coming soon to blue cities in red, blue, and purple states.
It's happening in the move since 2022 of 25% of transgender Americans from their state of origin to safer blue states that still have the rule of law.
It's happening in States where White men can carry a military rifle and brandish it anywhere but the most common reason for police to publicly and summarily execute Black people is "they were suspected of having a weapon".
It's happening when 70% of Republicans now believe that 60%+ of all mass shooters are and have always been transgender.
It happened when the Republican party realized the only way to achieve the deliverables demanded by the billionaire oligarcucks was to get serious about genocide and we Trans and gender expansive folk were picked to go first. The rest of our LGBTQ+ community is next....but if you're a billionaire you can probably buy an honorary heterosexual visa. Our deaths by despair, disease, discrimination, disrespect, and dehumanization are the 21st century April 12th, Charleston Harbor, and make no mistake.
It's happening as the GOPMAGAs secure permanent ownership of power structures and Infrastructure, of public goods and commons, of the profits of undertaxing and over-privatizing, as the corporate GOPMAGA owver-investor class consumes the administrative state (see Cory Doctorow!)... just as red states did in the spring of 1861, seizing federal property, bases, ports, institutions, and funds.
Should Americans have been listening for decades to our Black and immigrant siblings? Should we have taken the necessity of DEI and intersectionality more serious? As it turns out, deadly serious? Because the MAGAs openly calling for our blood sure as hell believe it a threat to their anschluss!
It's happening.
Civil war is here, and it is ugly, bloody, and somehow worse even than expected. And I've been saying this is coming, I've been saying it for a decade. But if you know your Greek classical mythology, you'll know that seers and prophets come to a bad end, especially if they're women...just ask Cassandra...and even worse if they were RIGHT.
I expect the same, however the war turns out. I try not to get angry when I prognosticate and someone says "I don't see any civil war coming, you're a doom scrolling shit disturber making things WORSE!" But how much more needs to happen? What more must Trans people bear before cishet people start wondering if perhaps our lives should have a value but clearly no longer do in MAGAmerica, FKS the formerly United States of America?
I know I sure don't know.