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In May of 2020, my family moved so I could attend a clinical mental health doctorate program at the University of Iowa. I remember being so excited about the program’s LGBTQ Counseling Clinic, where I would be the assistant director and where I would get to focus on providing much-needed therapeutic care for queer folks. It was the deciding factor for me on what program I ended up attending.
At that time, I would never have predicted that the same clinic that had drawn me to Iowa would no longer exist when my family would be forced to flee the state in 2025.
At the beginning of our Iowa adventure, my kids were 9 and 12, and the plan was to stay at least until our oldest graduated from high school in 2026, if not longer. A few years into our time in the Hawkeye State, my oldest child came to us because they wanted to start on puberty blockers, since they were trans, and wanted to delay bodily changes that didn’t match their gender. When my child first came out, I was worried that because I’m a trans clinician who works in gender-affirming mental health care, others would assume my child’s choices were influenced by me. I was very careful to make sure they knew that whether to pursue gender-affirming care was entirely their own choice. The most important thing was that they knew we loved them and that we would support whatever choice they made.
By early 2023, my 15-year-old was sure they wanted to start puberty blockers, so we followed the World Professional Association for Transgender Health standards to get them started, including getting a letter of support from a doctorate-level mental health clinician after a thorough evaluation. At first, my child felt relief and joy; they were glowing, and so happy that they could do something to slow the changes to their body that did not feel congruent with who they actually are. But that lightness would soon be crushed by a statewide ban on care for transgender minors.
The fact that children would be denied medically necessary, age-appropriate care did not matter to the Iowa legislators who passed the ban. It did not matter to Iowa legislators that this ban didn’t change the fact that my child was trans—something I think they believe (or at least hope) they can control. It did not matter that this ban meant my child would have to wait three more years to access a well-researched, basic standard of care supported by multiple professional organizations, including the American Academy of Pediatrics, the American Psychological Association, the Endocrine Society, and more. It also did not matter that this ban means my child will have to undergo far more expensive and invasive procedures down the road than they would have if they had been able to stay on puberty blockers at 15. After years of unnecessary stress and pain, that child started gender-affirming care the week after they turned 18.
In the summer of 2025, we were packing our bags yet again. Less than a month after my child was finally able to access trans care, my two kids and I moved to Colorado. I had just spent the last five years completing a Ph.D. in Couple and Family Therapy and a Master of Arts in Educational Measurement and Statistics. My now-18-year-old, a summer baby, had one more year of high school left. Where originally we wanted to make sure they were not moved mid-high-school, we now desperately did not want them coming of age in the state whose legislature had just voted to roll back civil rights protections from trans people like them and myself, including the right to be free from discrimination when it comes to education, employment, housing, and existing in public.
With that vote echoing in our minds, my partner and I realized we had to get our family out of Iowa and to a safer state. So I took our kids and moved to Colorado, even before my spouse was able to find a job. Our family spent the next six months apart, with my spouse flying in for milestones like the first day of school, birthdays, and Christmas (not an inexpensive arrangement). We navigated pictures and live video calls for major events, like our youngest’s first and oldest’s last high school band concerts, or when they played at a University of Denver basketball game. Finally, just last month, my spouse started a job here, and our family is together again.
But sadly, we are not living our happily ever after. Instead, our family seems to be experiencing a terrible storyline—one that trans families across the country are becoming increasingly familiar with. We thought we were safe, but now I see the same types of warning signs in Colorado that led to my family fleeing Iowa.
Recently, a Colorado primary care provider reached out asking if I knew of any private practices they could transfer trans kiddos to since the system they are with won’t allow gender-affirming care of minors moving forward. A few years ago, I had a nearly identical conversation with a PCP in Iowa, and more recently, in the summer of 2025, an Iowan PCP reached out because they were running out of queer-friendly mental health providers to refer their trans patients to. It is not difficult to draw a correlation between these two asks and see a similar scenario looming in Colorado’s future. This is a state that already faces a shortage of mental health providers in general.
My family chose to almost double our average cost of living by moving to the Denver metro area, drawn by the strong state protections here. However, even without a state ban on minors’ gender-affirming care for now, actual access to that care is being removed as health systems decide to stop providing some or any care to trans minors in response to anti-trans federal and political pressures. I have already watched one state decide that trans minor health care was an acceptable sacrifice. I know what this looks like.
I have to wonder what is preventing the folks who are making and supporting these decisions from understanding that every delay in care has a cost, whether financial, medical, emotional, or loss of life itself. I have to wonder if folks who repeat talking points drawn from flawed and biased information sources like the U.K.’s controversial Cass Review—such as in a recent New York Times opinion piece titled “Medical Associates Trusted Belief Over Science” (which, ironically, pushes belief over science)—understand that that cost is being paid by young people and their families who did nothing wrong and who deserve access to the right care. And I have to wonder if the issue is actually that they do understand, but that their unwillingness to admit their ignorance, error, or outright bigotry outweighs any concern for the well-being of trans youth.
I’m grateful every day that my child survived the wait for gender-affirming care. But data and statistics—including a study that found anti-trans state laws increase suicide attempts by 72 percent among transgender individuals, corroborated by recent data that showed a sharp trans youth mortality spike following the Bell v. Tavistock ruling in the U.K. (which increased gatekeeping around puberty blockers for trans children under 16)—warn us in no uncertain terms that some other trans children will not make it. I wonder what it will take for folks to understand that the cost we are all paying for prejudice and political cynicism is the very lives of our children.
Colorado is not the only state that stands in front of a line that Iowa crossed years ago. I remember the feeling of dread when Iowa passed its ban, despite being explicitly warned it would mean that “Iowa children will die” as a result. I remember realizing that trans children’s lives were an acceptable loss for those in power in Iowa. I also remember how, even before that ban passed, gender-affirming care was becoming harder to access. What begins as temporary pauses and institutional “caution” due to “the political climate” ends with children being denied care and families being forced to choose between safety and stability. If states like Colorado want to remain places families flee to rather than from, they must treat access to gender-affirming care for minors as essential and nonnegotiable, and they must do so immediately. The map of viable trans life in the United States has already contracted to a frightening degree—we can’t afford to give up any more ground.
