Ash (he/they)
“These anti-trans health care laws and the rhetoric around them makes healthcare [practically] unattainable for trans folks. I have a great primary care doctor, but I got lucky.”
Ash (he/they)
Austin, TX
Tell me about the moment you found out about your cancer diagnosis?
In October of 2022 I went in for gender affirming top surgery and my surgeon found a tumor. I ended up having breast cancer.
So your diagnosis wasn’t through a regular screening?
I had a mammogram earlier that year. They saw something and had me come back in for an ultrasound, but it didn’t show anything. Six months later I had my top surgery. They didn’t do any pre-testing because of [my previous mammogram] and I didn’t have any symptoms. No one had a clue. My surgeon didn’t have any idea until she was operating. She knew exactly what she was looking at when she found it, and made sure to remove it with clear margins so it could be sent off to pathology. If I hadn’t had the surgery, my prognosis could have been much worse. When they say, ‘gender affirmative care saves lives’, in my case it may have literally saved my life from cancer.
So your top surgery averted a potentially worse health outcome?
Exactly. It’s very hard to process when you’re in the middle of it, and I’ve got a little distance from it now, but it’s still sometimes hard to wrap my mind around this ever happened to me. If it weren’t for my ability and access to gender affirming care, this would have been much worse. I’ve dissociated from my chest my whole life. I’ve avoided dealing with it at all costs, and getting myself to the point of doing a mammogram was incredibly difficult. I truly don’t know when I would have gone back. I know how important preventative care is, and I made myself do it that time, but I don’t know if I would’ve done that every year. It’s not lost on me just how fortunate I am that it went the way that it did.
What has treatment been like for you?
After chemo, I did radiation. Currently I’m in remission. I’m actually in some of the best shape I’ve ever been in. I’ve been exercising a lot, in therapy, and taking care of both my physical and mental health. I’m still on some medications related to my cancer treatment but I’m feeling pretty good.
What effect has anti-trans legislation had on you and your local community?
These anti-trans health care laws and the rhetoric around them makes healthcare [practically] unattainable for trans folks. I have a great primary care doctor, but I got lucky. I moved to Texas in 2019, and I had no clue how to find an affirming provider when I was ready. Better policies would’ve made that so much easier for me.
There are many healthcare providers and regular folk fighting to make change within the healthcare system, but legislation in Texas hamstrings them. The more legislation that’s on the books eroding trans rights the worse the entire system gets. There’s no support from the state in making the system better for marginalized folks. I’m sure systems could be implemented that address microaggressions so that I can walk into the doctor’s office with some dignity, and not be marginalized, but there’s none. I should be able to go to the doctor just like cis people get to get care.
There’s a large and active trans and queer population in Austin which is arguably the most progressive city in Texas. Does living there make it easier to access care?
It’s been a herculean effort [even] in a big city like Austin. There’s a lot of push and pull. There’s people in the city government that are fighting for change, but a lot of what happens is Austin’s mayor and the Governor get in fights, and it feels like things go nowhere. Last summer, during the legislative session, there were huge protests and movement on awful bills. Some of those bills didn’t even make it through the session. People are fighting, but the fight is so hard and the progress is so minimal it doesn’t feel like progress. Being in the blue dot, red state situation is a unique moment where you’re surrounded by community, but it’s very hard to make any progress.
If you could talk to President Biden, what would you want to tell him?
First I’d say that trans people are no less in need of medical care than everyone else. We deserve the exact same access as everyone else. If part of my medical needs include hormone therapy, I should have access to that. Why is it a cis man can have access to hormone therapy to deal with low testosterone, but I can’t have access to testosterone to live and present the way I feel most comfortable? There’s no difference. We deserve the same care. If I’m talking to President Biden, it’s about healthcare access and getting employers to work with insurance companies that cover GAC nation-wide. Getting healthcare shouldn’t strip away someone’s dignity, but it does when you’re trans because of the micro and macro aggressions we experience. Although I may not experience discrimination directly sometimes, that doesn’t mean it doesn’t happen behind my back or to other people. Getting care and dealing with medical trauma is hard enough, why strip away my dignity in the context of that? National policy should champion the fact that trans people can’t access their needs and normalize the fact that we exist. We’re not going anywhere, and we don’t deserve to be treated like second class citizens.
And how about your state governor, Greg Abbott? What would you say to him to try and move the needle towards access to healthcare should be equal for all?
I’d love to speak about our shared humanity. Greg Abbott has a disability, and has to live in a world designed without him in mind, so how can he be so uncompassionate for trans people or anyone else that has to do the same? I don’t know how to convince him that someone’s basic human needs should be met. I don’t know that there’s any amount of scientific or anecdotal data that would ever change his mind. He’s another politician who cares more about money than people. Politicians like him care about continuing to create a divide between people and he’ll play into that divide to get re-elected. I don’t know that having a conversation with Greg will get us anywhere but getting him the hell out of that office might get us somewhere. I think that’s where elections matter and where grassroots collective action matters. It’s on us and our allies to oust these assholes.
Do you ever find yourself wanting to leave Austin or the South?
Before my top surgery, my plan was to move to the West Coast after I recovered. The company I was working for was based in San Diego, but I got cancer, so I didn’t go. Ultimately, Austin’s where I feel the work I’m trying to do fits best with the groundswell of energy, activism, and advocacy that’s happening in Austin. Some folks say, “ Well, if everyone leaves, we’re never going to be able to make change. Someone has to stay and fight.” I’m seeing Austin as a place where my voice can make a difference not just there, but even beyond Texas. I’ve thought about not fighting and just trying to live life. I do want to live my life, but I want to fight for this, too, and I’ve seen both sides of that coin. Right now, I’m hanging out in Austin for a little while.
What do you want larger organizations to do in response to what’s going on?
Get in the fight. We need organizations to get involved in policy change. All we’re fighting for is fairness. We’re just asking to be able to live our lives the same way everybody else can which means meeting specific needs. Guess what? Cancer survivors have different medical needs. Does that mean just because somebody had cancer, they shouldn’t have access to this because they have special needs around their health? Nobody would ever buy into that for cancer patients, right? But they buy into it for trans folks. Our care is not elective. It’s not just because we feel like it. This is lifesaving care. This is medical care.
