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  • Writer's pictureOutReach

To our Transgender, Non-Binary, and Gender Expansive Community ~

August 25th 2022

To our Transgender, Non-Binary, and Gender Expansive Community: we see you, we support you, and we promise to continue to do our part as OutReach LGBTQ+ Community Center to provide services, resources, community education, intracommunity support, and spaces for community building, affirmation, and celebration as acts of love and resistance.

We are disgusted by the attacks on transgender, nonbinary, and gender expansive folks by right wing media outlets. It is important and necessary to name their attacks as violent hate speech that aims to harm some of the most vulnerable members of our community. The selective outrage at transgender, nonbinary, and gender expansive people seeking gender affirming medical care is devoid of factual information.

There are significant barriers that most transgender, nonbinary, and gender expansive folks experience trying to even gain access to any form of gender affirming care let alone access to safety, health, community support, and freedom from being targeted by hateful rhetoric or use as political fodder. The transgender, nonbinary, and gender expansive community deserves the same protections that the cisgender community are granted under the law.

These attacks are especially egregious as they attempt to frame the issue as “protecting children,” but if they really wanted to protect children they would see that providing support and affirmation for LGBTQ+ children protects all children, a message that is supported by research as well as the generations of LGBTQ+ folks who have survived the violence of their childhoods. In the LGBTQ+ community we know that their homophobic and transphobic rhetoric aimed at “protecting children” results in alienation, bullying, violence, and worse outcomes for LGBTQ+ youth, especially transgender, nonbinary, and gender expansive youth.

And while we know that the outlets that are targeting our community do not care about the facts, it is necessary to provide truthful and accurate information to our community.

1. Gender affirming surgery is not available to minors.

a. Transition care is generally less accessible and more prohibitive for minors

as it usually requires parental approval as well as provider approval, in many

cases is not covered by insurance, and there are few experienced medical

professionals providing gender affirming care of any kind.

2. It is not an easy, quick, or affordable process to access gender affirming

medical care. Letters of readiness are one piece of a process that takes months,

if not years, to complete in order to access gender affirming surgeries. In order

for transgender, nonbinary, and gender expansive adults to pursue gender

affirming healthcare in the state of Wisconsin they are required to meet the

following conditions:

a. Diagnosis of significant and persistent gender dysphoria.

b. At least one letter from a licensed mental healthcare provider, but most

often two.

c. Unless contraindicated due to other health conditions or medications (with

documentation), must have undergone one year of hormone therapy.

3. Gender affirming medical care is simply too expensive for many people in our community. The costs associated with accessing care, including finding

affirming, safe, and competent mental health care providers, means that most

transgender, nonbinary, and gender expansive people wait years if not decades

before they reach a point where they can pursue gender affirming surgeries.

It cannot be understated that gender affirming care is lifesaving care. The vast majority of adults who pursue gender affirming medical care are satisfied with their medical decisions and report significantly improved quality of life, including lower rates of depression and suicidality.

OutReach LGBTQ+ Community Center must also acknowledge that we cannot prevent harm to our community from occurring, however we are committed to responding to harm committed against our community with tangible support and affirmation to those most impacted, with education to those who are open to learning and growing and supporting our community, and with continued disruption and resistance to those who seek to harm our community.

~ Jill Nagler - OutReach Board President, A.J. Hardie - OutReach Program Director, and Steve Starkey - OutReach Executive Director

Below are links to resources and additional information:

OutReach LGBTQ+ Community Center staff can provide peer support for people in the transgender, nonbinary, and gender expansive as well as community education for allies and supportive organizations. Visit our website at

The Madison Area Transgender Association, a program of OutReach, coordinates community support for transgender, nonbinary, and gender expansive folks, including a social and support group that meets four times each month and events like the Trans Care Package Drive and Celebrate Trans Joy community event. Learn more here:

Other resources:


Freedom, Inc.:

Diverse and Resilient:


World Professional Association for Transgender Health:

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