Cover Stories

A Light in the Desert

As surrounding states pass laws limiting access to gender-affirming services, New Mexico provides refuge

The phone started ringing the first week of June—specifically June 3, the day after Texas Gov. Greg Abbott signed a ban on gender-affirming care for minors into law.

That day, Equality New Mexico Executive Director Marshall Martinez says he received at least five phone calls from across the state line. Everyone asked the same question: “I’m moving my family to New Mexico; what do I need to know?”

The calls have continued all summer.

While families, doctors and the American Civil Liberties Union sued over the law and a state district judge offered a temporary reprieve, last week the Texas Supreme Court overturned that decision and the law went into effect on Friday, Sept. 1.

Texas now joins more than 20 states that have adopted laws to ban or limit gender-affirming care for minors, and others have changed policies to otherwise discriminate against and put up hurdles for LGBTQ+ people. In light of this, New Mexico serves as a refuge following the passage of new laws reaffirming rights and care in the state in the aftermath of the US Supreme Court’s reversal of Roe V. Wade in June of 2022.

That decision began to unwind abortion rights across the nation, as well as gender-affirming health care.

The new legal landscape in New Mexico has advocates and medical providers here preparing for an influx of out-of-state guests—even new residents.

Yet leaders at long-serving resource providers warn lack of resources in other states could over-burden available services here.

Adrien Lawyer, co-director of the Transgender Resource Center of New Mexico, says the state has begun to experience “a very specific pressure” on providers and resources as a result of what is happening in Texas.

“I think it just goes to show that you can’t control these things this way,” Lawyer tells SFR. “Folks are still going to seek this care, but then it just puts a strain on systems that are already strained in a chronically under-resourced state like New Mexico. It just hurts everybody.”

The Transgender Resource Center already had far-flung appeal even before states began rolling back LGBTQ rights.

The center focuses on providing direct services such as helping with legal name changes to transgender, nonbinary and gender nonconforming individuals, as well as promoting advocacy and education. It runs nine different support groups that meet in person and over Zoom, allowing for participation from residents of even the most rural parts of the state. While the organization focuses on New Mexico, Lawyer says over the years, folks have moved to the state in part because of the resource center.

The organization also publishes a directory to help people locate health providers, including Dr. Molly McClain, the residency program director for family medicine for the University of New Mexico’s Department of Family and Community Medicine.

McClain administers gender-affirming care to about 500 patients out of her all-ages clinic Deseo, which is part of the larger UNM Southeast Heights Family Health Clinic in Albuquerque. Right now, she says, the clinic has a waiting list of 70 families from Texas, but she anticipates even more in coming months.

“Most of these folks called when the law was just being discussed,” she tells SFR. “I think, as things develop, it is a smaller number than who is going to end up working with us from there.”

Even prior to the ban on gender-affirming care for minors in Texas, three of her patients had moved to New Mexico as a result of how their families were being treated in other states.

Even as the number grows, she says, it will still only represent a small portion of people who need the care but can no longer access it in their home states. Recommendations for services such as hormone therapy include doctor visits every three months for the first year—a significant time and money commitment for those who need to travel to receive the treatment. (Texas Senate Bill 14 prohibits the administration of pubertal blockade and hormone therapy for the purposes of “transitioning a child’s biological sex” or “affirming the child’s perception” of it.)

“The relationship between patients and medical providers is being interfered with by an exercise of big government from people claiming to support small government,” McClain says. “There’s really a lot of sacrifice to come from Texas to Albuquerque in person, and for every family that makes it, I bet there will be 50 to 70 families who won’t. My fear is that the folks who have the resources will make it and the folks who don’t won’t, and I’m not sure what happens to those people.”

Bans on care like the one imposed in Texas discount the diagnostic criteria established by the American Medical Association for gender incongruence and “consent criteria” established by the World Professional Association of Transgender Health, she explains. Those guidelines affirm medical intervention such as pubertal blockade and hormone therapy for people under the age of 18, but not for reassignment surgeries, which she says “is not at all a part of what anyone has been practicing.”

“It’s really easy for people who don’t know anybody who is gender expansive to look at the debate across the country and feel like there must be some validity to it, but there’s absolutely no major medical association that doesn’t support gender care for people of all ages,” McClain tells SFR, “and there is absolutely no question that the data supports access to medications, both pubertal blockade and hormone therapy, as very powerful suicide prevention.”

Data shows a huge need for such prevention: According to The Trevor Project’s 2023 National Survey on the Mental Health of LGBTQ Young People, 41% of youth seriously considered suicide in the past year, and people who are transgender, nonbinary and/or people of color reported higher rates.

But access to gender care isn’t the only factor adding to stress on established services and systems.

New Mexico has already experienced an influx of people from other states seeking medical care for reproductive services now prohibited in other states with the fall of Roe v. Wade last year. Gov. Michelle Lujan Grisham vowed at the time that the state would “stand as a brick wall against those who seek to punish women and their doctors just because they seek the care they need and deserve.”

According to the Carnegie-Knight news project America After Roe, New Mexico’s Planned Parenthood clinics exhibited a 97% increase in appointments in comparison to the 10-month period before the Supreme Court decision, with 57% of patients hailing from Texas.

One of the bricks in Lujan Grisham’s wall comes from the state’s new Reproductive and Gender-Affirming Health Care Act, adopted by the Legislature and signed into law this spring to restrict public bodies, such as local municipalities, from denying, limiting or discriminating against a person’s right to use or refuse reproductive health care or health care related to gender.

The law is one of the reasons the Movement Advancement Project names New Mexico among states with favorable conditions for LGBTQ people, rating it 32 out of a possible 43.5 on a LGBTQ Policy Tally. Texas, by contrast, earned a -1 on the scale that scores the laws and policies that shape LGBTQ people’s lives, experiences, and equality in categories including relationship and parental recognition; nondiscrimination; religious exemptions; youth; health care; criminal justice and identity documents. Research from The Williams Institute in 2020 estimated that around 85,000 LGBTQ+ people over the age of 13 lived in New Mexico.

Equality New Mexico worked on the frontlines advocating for the bill, action typical of its work, which focuses on changes at the system, policy and cultural levels.

“Queer and trans people are part of every family, work in every sector and live in every community, so every issue is an LGBTQ issue,” says Martinez. “What we try to do most is to ensure that LGBTQ folks are centered in new policy solutions from the beginning.”

Lawyer says “it’s not a coincidence” that reproductive health care and gender-affirming care were combined into a single law—both have been under attack across the nation.

This year’s Legislature also adopted a change to publication rules for legal name changes so that the state no longer requires individuals to take out newspaper advertisements to accomplish the task.

“It was a really old-timey law that was so out of date and really dangerous, so we got rid of it,” Lawyer says, noting Transgender Resource Center of New Mexico lobbied for the law.

Organizations like his and Equality New Mexico understand the strength of such state laws.

“They passed a couple of different laws that made us one of the safest states for LGBT people in the country because we were not just responding to negative legislation, we were trying to pass more protective legislation for the population,” he says.

Just weeks after Texas Gov. Abbott signed the treatment ban for minors, thousands attended Pride celebrations in New Mexico’s capital city—a turnout the Santa Fe Human Rights Alliance says was its largest ever.

According to data compiled by the Santa Fe Data Platform using geofencing technology, more than 9,000 people turned out for the parade and other events. Heather Hunter, data concierge for the platform, says approximately 60% of those who celebrated were from a 30-mile radius, while 40% came from outside that range. Guests traveled from as far as New York, Delaware and Maryland, according to collected ZIP codes.

“It’s really an important time for the community to come out and show up,” Santa Fe Human Rights Alliance Executive Director Kevin Bowen told SFR before the event, “and to make sure that we keep doing that.” Living in New Mexico, “we’re very lucky to have such great protections that have been put through legislative actions, but we can’t let our guard down.”

Santa Fe enjoys a reputation for progressive values, including maintaining safe spaces for queerness.

New Mexico Coalition and Sexual Assault Programs Director of Prevention Jess Clark says today’s LGBTQ+ community benefits greatly from the city’s history of a large gay presence and existing services.

“I grew up in Santa Fe in the time that I was coming of age and a queer trans person early on, and things were very different then in terms of media representation, social acceptance, governmental protection, all of that,” Clark tells SFR. “Still, I had access to an incredible community of young folks and adults, and even services, in the early 2000s.”

But as tensions boil in the nation and other regions take backward steps for civil liberty, the city has not remained immune to hate speech or efforts to thwart equality. For example, a Progressive Pride Flag the city painted in the Plaza was defaced following Pride when someone drew a cross over it, along with the words “Jesus Saves.”

“All across the country, homophobes are attacking the queer community and we are fighting for our very right to exist,” City Manager John Blair said in a press release following the incident. “There’s no place for Christian nationalism anywhere in this country and there is absolutely no place for this hate in Santa Fe.”

Just last month, the City Council scrapped a proposal to have voters weigh in on creating a new Office of Equity and Inclusion overseen by a Human Rights Commission out of fear that if it went to voters without adequate preparation, as Bowen wrote in a letter opposing the proposition, it could serve as “a lightning rod for hate and discord.”

City Councilor Signe Lindell voted against the measure—which ultimately failed—for the same reason.

She cited the possibility that failure to pass could turn back the “hard-fought-for rights” for the LGBTQ+ community and adding, “the consequences for myself feel dire.”

“I’m no kid,” Lindell tells SFR in an interview later, “I was on the front end working on what we then called gay rights, and it wasn’t always as celebratory as it is today. It was obligatory. To take any risk at all when we don’t need to is unnecessary. The mood of the country has certainly been far from favorable to the LGBTQ community, and although Santa Fe is a progressive community, I don’t feel like getting risky and potentially having something like that get turned over by some fringe group.”

As groups across the country continue to advocate for legislation that limits the rights of LGBTQ individuals, local leaders say it’s important to keep Santa Fe’s community protected and empowered.

Bowen says he also received phone calls from out-of-state families with questions about moving to New Mexico and accessing gender-affirming care. While Bowen wasn’t always as involved politically, he says Santa Fe’s draw for LGBTQ people opened an opportunity to form community and explore their sexual identities.

“I think the community that ended up here throughout the years even prior to my tenure came because it was an artist’s colony or [because] it’s eccentric, unique and nurturing,” Bowen says.

While there weren’t many legal protections in place for queer people at that time, the “night and day” difference from then to now, he says, comes in the overt efforts to hurt queer people in other states. According to the Human Rights Campaign, legislators have introduced over 500 anti-LGBTQ+ bills across the country so far this year, with more than 200 specifically targeting transgender and nonbinary people—both record numbers.

One local business leads efforts to further support the targeted community through a weekly queer night: Monday nights from 5-11 pm, visitors of El Rey Court’s La Reina bar can grab a drink, enjoy music and socialize, with a portion of the proceeds going to support the work of the Transgender Resource Center.

Santa Fe Human Rights Alliance runs several other initiatives with the goal of community building. Bowen encourages queer folk of all ages, with a special emphasis on younger generations, to participate through monthly conversations or at Drag Bingo night. He says a disconnect between older and younger LGBTQ+ individuals could be solved through a more “broad-based dialogue” of the issues.

“To me, that’s what we have to do. We can’t let our guard down to think that we can stay as such a safe state without active participation by our community,” Bowen says.

The Mountain Center of Santa Fe’s New Mexico Genders and Sexualities Alliance Network takes seriously its mission for LGBTQ youth involvement, including a Youth Council and activist camp where members learn how and what it means to advocate “for themselves and for their own lives,” according to ío María Escamilla, program manager.

“We wanted to have a really robust age range of people who could tell us what is the pulse of the community for someone their age,” Escamilla says.

Last year, the organization served approximately 3,600 people. Escamilla tells SFR the network focuses on those ages 13 to 24 because oftentimes this age group requires more support.

“We see a lot of people who don’t feel supported at home, and they need social spaces where they can go and be themselves,” Escamilla says. “They need queer adults who can help tell them everything is going to be okay, and, in a lot of cases, that they should keep living.”

While the organization has yet to work with youth from surrounding states seeking resources and gender-affirming care, Escamilla says a large portion of clientele comes from more rural areas of New Mexico, and many of those people are learning how to navigate resources for the first time.

Still, the sting remains for advocates like Equality New Mexico’s Martinez, who tells SFR not all trans people want to play an advocate role. Many just want to live their lives, and leaving home to access resources shouldn’t be necessary in the first place, he says.

“We’ll welcome and try to support anybody who travels across state lines, whether it’s moving or just visiting, to access care,” Martinez says, “but quite frankly I’m pissed that [trans and non-binary youth] have to come here. Not because we don’t want them, but because nobody deserves to have to leave their hometown, or really their neighborhood, to get the health care they need.”

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