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Ban on gender-affirming care would have an outsized effect on Oklahoma's two-spirit community

The Oklahoma State Capitol
Jackie Fortier
StateImpact Oklahoma
The Oklahoma State Capitol

The term “two-spirit" is meant to describe people within the Native community who identify as LGBTQ.

"The original intent was to create an English language term that describes this umbrella existence of gender variance in Indian Country, across Turtle Island, you can say," explained Cori Taber.

Taber is a Muscogee and Cherokee transgender woman who is originally from Oklahoma. Today, she works as a real estate agent in both Oklahoma and Arizona.

"Historically there were people in different tribes and different communities and bands that took on the behaviors or lifeways of somebody from the gender opposite that which they were born," she said.

Cori Taber
Cori Taber
Cori Taber

In her real estate business, Taber says she focuses on helping Native people and specifically LGBTQ and two-spirit people buy homes.

Taber is also very serious about helping her younger Native relatives in Oklahoma that identify as transgender.

That's why she's concerned about measures making their way through the Oklahoma legislature that would ban gender-affirming care like hormone blockers for young people under the age of 18 and criminally charge doctors for providing it.

"These two young people are under the age of 16," explained Taber. "One of them is under the age of ten, and we are very concerned about their ability to access gender-affirming care should the need arise. And we feel like that is likely, and we feel like that is probable, and we are concerned about our ability to take care of our relatives."

One of the bills is Senate Bill 613. The measure's authors say they’re concerned treatments available for transgender youth can be harmful later on in life.

The bill was approved by the Senate in mid-February. On Tuesday, the House passed a similar measureHouse Bill 2177 — off the floor.

Lawmakers were met with protestors at the Capitol over the bill and at OU Health, as families and friends of trans people asked for gender-affirming care to stay legal.

Gov. Kevin Stitt has indicated he’ll sign a bill banning gender-affirming care for young people if it makes it to his desk.

“Minors can’t vote, can’t purchase alcohol, can’t purchase cigarettes… We shouldn’t allow a minor to get a permanent gender altering surgery in Oklahoma,” Stitt said during the State of the State address.

Research presented by the Health and Human Services Department and the Mayo Clinic says that not providing gender-affirming care for young people can lead to significant mental health problems-including thoughts of suicide.

A 2021 survey of LGBTQ youth found that 52% of those who identify as transgender had considered suicide. That same study found that 12% of non-Native LGBTQ youth had considered suicide compared to 31% of Indigenous LGBTQ youth. Providing gender-affirming care doesn't just mean hormone blockers — it's also good mental health care, says Kelley Blair, the CEO of the Diversity Center of Oklahoma and a licensed therapist.

"We get referrals for folks every day requesting gender-affirming care," said Blair, who is Choctaw, Cherokee and Seminole and identifies as two spirit-transgender nonconforming. "And when I say gender-affirming care, I mean people that just need therapy."

They said it's not people needing letters to have their name or gender changed or for surgery, but people who need support.

In addition to mental health care, protection from violence is also needed.

Studies by the Department of Justice find Native women suffer some of the highest rates of violence, and those who identify as transgender are even more in danger of being murdered or going missing. Case in point is Aubrey Dameron, a transgender Cherokee woman who disappeared from her home in Grove four years ago and has never been found.

Blair said they're hearing from families who are scared about the new law taking effect.

"People are worried that they may not be able to get surgeries that they are eventually wanting. They're worried that they're not going to get to come to therapy…that they won't have health insurance to cover things," said Blair, who does worry about third party billing related to insurance that might normally cover therapy and other services related to transgender youth they see.

KOSU spoke with one family who says they will travel out of state to get the hormones they need for their transgender son, which will add a layer of expense and risk. The family didn’t want to be identified or speak on tape for their safety.

Taber said tribal leaders could and should do more to protect their trans and two spirit citizens in the face of legislation that seeks to deny care.

"I think it would be an ideal opportunity to really show Oklahoma who tribal communities are by way of creating and promoting acceptance and inclusion. I just don't know that that's going to happen," Taber said.

Indian Health Service, the main health care provider for Native people throughout the United States, does have a two spirit working group that helps providers in Indian country be more culturally sensitive to health care needs of LGBTQ people. The group educates providers about the health needs of transgender people seeking care at IHS facilities. It's unclear though what exactly IHS provides for transgender youth in Oklahoma. Requests for comment from IHS officials went unanswered.

Taber is pretty blunt about the outcomes if young people don't get the health care they need.

"I'm a transgender adult….I made it to 40 and most transgender people don't,” she said.

Corrected: March 2, 2023 at 3:55 PM CST
An earlier version of this story did not clearly distinguish between LGBTQ youth and youth who specifically identify as transgender when describing results of a 2021 survey.
Allison Herrera covered Indigenous Affairs for KOSU from April 2020 to November 2023.
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