By Lily Alexander, Source New Mexico
Kylie Pucella, 21, a trans woman and senior at the University of New Mexico, began hormone therapy when she was 18. Since President Donald Trump’s inauguration in January, she has worried that the legal protections for her care in New Mexico—often described as a safe haven for LGBTQ+ people—might not last amid presidential executive orders that target transgender rights.
She’s not the only one.
“People are really scared about losing their access to care,” Adrien Lawyer, co-founder and executive director of the Albuquerque-based New Mexico Transgender Resource Center told Source. “But in New Mexico, that’s very unlikely to happen.”
That’s because the state created a legal framework well in advance of federal rollbacks of trans rights. But that hasn’t stopped legal challenges here, nor fully assuaged the fears of people who consider the care lifesaving.
The care
Gender-affirming care typically includes medication and surgical options that help people feel more aligned with the gender they know themselves to be, according to Dr. Molly McClain, a physician who provides gender-affirming care in the state. Medications include ones to suspend puberty, as well as hormone therapy to initiate puberty aligned with someone’s gender, McClain said. People 18 and older also have surgical options.
“The very important thing for everyone to recognize is that the way that someone feels affirmed in their gender is really, really individually dependent,” McClain said. “So not everybody needs to be on medications, not everybody needs to get surgery, and everyone has their own journey that they are embarking on.”
In New Mexico, most medical practices are doing their best to continue providing gender-affirming care while paying attention to the federal changes, McClain noted.
“I think we have a lot of protections here and a lot of support that kids in other states don’t—a lot of people who see them and hear them and love them,” McClain said.
The legal landscape
In 2023, Gov. Michelle Lujan Grisham signed the Reproductive and Gender-Affirming Health Care Act into law, which in part prohibits public bodies from restricting or discriminating against a person’s right to access gender-affirming care. The act defines gender-affirming care broadly, according to Jazmyn Taitingfong, a reproductive rights and gender equity attorney with ACLU of New Mexico.
“It’s described as psychological, behavioral, surgical, pharmaceutical and medical care services and supplies to support a person’s gender identity,” Taitingfong said. “So that’s a very wide definition, and that’s on purpose so that it protects people from discrimination from public bodies.”
The same year, Lujan Grisham signed protections for reproductive and gender-affirming health care providers and patients into law, preventing public bodies from releasing information or using their resources to assist outside investigations that seek to impose civil or criminal liability on medical providers who provide this care in New Mexico.
“The reason that is so important is that many people are being forced to flee their home state to get certain types of health care—mainly gender affirming care and abortion health care,” Taitingfong said. “And so that is a level of protection if people go back to their home state.”
After taking office in January, Trump signed an order halting the use of federal funds for gender-affirming care for youth under 19 years old. While a federal court blocked the other, NPR reports some hospitals across the country have stopped performing gender-affirming surgeries and providing other care nonetheless.
According to Trans Legislation Tracker, eight anti-trans bills were introduced in the most recent legislative session, one of which would have largely prohibited health care providers from providing gender-affirming care to minors, and opened up doctors to liability. The New Mexico Attorney General’s Office commented that many of the provisions of that bill may have been unconstitutional.
Ultimately, none of the bills made it through the legislative session.
New Mexico’s protections have been long in coming, Lawyer said, noting that LGBTQ+ advocates have worked for decades to create statewide protections.
“We’ve had activists here for a long, long time—30 years—trying to proactively create a legislative climate at the state level that’s incredibly protective, and it’s worked,” Lawyer said.
Fear persists
Despite the legal protections New Mexico offers, McClain said she worries about the impact of the federal climate on her trans patients and their families.
“What I’m seeing for all of these families is just a much higher level of stress and of fear,” McClain said. “I think we’re going to see a huge uptick in all the things that make trans and nonbinary kids sick already.”
Heather Johnson, also a trans senior at UNM, said she is concerned about the future of insurance coverage for hormone therapy. Earlier this month, the Centers for Medicare & Medicaid Services released a proposed rule that would prohibit individual and small business health insurance plans under the Affordable Care Act from covering gender-affirming care as an essential health benefit, according to KFF.
“As soon as insurance denies it, it’ll at least triple in price,” Johnson said. “A lot of this stuff is rather expensive, and insurance takes care of a fair amount of it. And so the real fear is that we’ll just be priced out of the medication we need to live.”
Johnson said the care allowed her to live a life that feels normal.
“It’s legitimately a life-saving care,” she said. “Without it, I wouldn’t be here, I guarantee that.”
For Pucella, access to hormone therapy allowed her to become a full version of herself. While she feels relatively safe in New Mexico, she worries that could change as national anti-trans sentiment and federal action continues.
“I’m not really sure if—given the climate of things if they keep on going the way they’re going—there really is going to be a safe haven anywhere in the U.S. for trans people,” Pucella said.
Danielle Prokop contributed reporting to this story.
Source New Mexico is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Source New Mexico maintains editorial independence. Contact Editor Julia Goldberg for questions: info@sourcenm.com.
