Post submitted by Carl G Streed Jr. MD, MPH (Research Lead), Jennifer Siegel MD (Medical Director), Center for Transgender Medicine & Surgery at Boston Medical Center

By now, we all have seen the impact of COVID-19 on our daily lives. We have been quarantining and physically distancing from our loved ones, witnessed hospitals overwhelmed by the crisis and seen people lose their jobs and livelihoods. Some of us may have already experienced personal loss. We know LGBTQ communities are particularly vulnerable to both the economic and health impacts of the virus--because they are more likely to work in industries highly-impacted by the pandemic, such as service industries--and they may have more health risk factors that exacerbate the disease, like smoking.

As part of their response to the pandemic, hospital systems across the country have postponed non-emergency surgeries and procedures in order to prioritize care for COVID-19 patients. This includes many gender-affirming procedures, which are now unfortunately on hold.

We know that gender-affirming medical and surgical care are essential to the long-term well-being of our transgender and gender diverse patients, families and communities. Just because these procedures have currently been classified as non-urgent does not mean we consider them to be non-essential. We know that gender-affirming care is indeed lifesaving, but we also know that right now the immediate health of the public is paramount. While our transgender and gender-diverse patients understand this, we know that understanding reasons for postponing procedures does not make these postponements any less distressing.

As health care professionals, we recognize that the postponement of these essential surgeries can take a dangerous mental health toll on our patients, many of whom have waited years and gone through a long--and often painful--process in order to finally get them scheduled. We want to be sure that our patients know that we are still here for them during this stressful and painful time. If you or a loved one has had gender-affirming care postponed due to COVID-19, you are not alone.

Our Center for Transgender Medicine & Surgery at Boston Medical Center is still fielding phone calls, conducting telemedicine visits and managing hormone therapy. We do not know of any shortages of hormone therapy at this time, and we ask that patients do not "stock up" or "hoard" medications as that could potentially lead to a temporary shortage. We need to look out for each other and be sure that everyone is getting the care they can at this time -- so please reach out to your trans siblings to let them know they are supported and loved.

If you are struggling, please find some resources below. And please reach out to your doctor or local LGBTQ center for any personal questions:

HRC Resources:

• HRC’s COVID-19 Resources (click here)
• Direct Online and Phone Support Services for LGBTQ Youth (click here)
•  Healthcare Equality Index: List of LGBTQ-friendly hospitals (click here)

 External Resources:

• The National Center for Transgender Equality has an information and resource page called The Coronavirus (COVID 19): What Trans People Need To Know. (click here) 
• The LGBT Cancer Network has an information and resource page called CoronaVirus Information. (click here)
• Fenway Health has an information and resource page called COVID-19 Information  (click here) , they also have a information packet called COVID-19 and Considerations for People Living with HIV and LGBTQIA+ People (click here)
• The CDC has a website for COVID-19 information, resources, and guidelines. (click here)

Mental Health:

• Mental Health America has a list of COVID-19 resources (click here) 
• Trans Lifeline provides a peer support hotline and grants for trans people in need. You can call their hotline at 877-565-8860. (click here)
• Trevor Project (click here) provides access to counselors to youth by phone call (1-866-488-7386), online chat, or text (text START to 678678). They also have an online community for LGBTQ youth ages 13-24.
• SAGE runs a National LGBT Elder Hotline that provides crisis response and helps connect people with community resources. Call their hotline at 877-360-LGBT and request to speak to someone in either English or Spanish. (click here)
• Fenway Health runs an LGBT Helpline and a Peer Listening Line, which people can call from across the country. Call 888-340-4528 for adults 25+. Call 800-399-PEER for those under age 25. (click here)
• National Suicide Prevention Lifeline (click here) or call at 800-273-8255.
• CenterLink provides a directory of LGBT community centers. (click here)
  • Note: do not walk into a community center if you are sick or have been exposed. Call them and ask if there are virtual support groups. 
• The Grayken Center for Addiction at Boston Medical Center has a website page for COVID-19 recovery resources. (click here)
• Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) has a Disaster Distress Helpline, call 1-800-985-5990 or text TalkWithUs to 66746.
•  LGBTQ National Help Center provides peer-support, community connections and resource information to the LGBT community. They have multiple hotlines and chat rooms. (click here)
• Crisis Textline that provides crisis resources, and where you can text or message a crisis counselor about COVID-19. (click here)
•  The Association of LGBTQ Psychiartrists (click here) is a community of psychiatrists that advocates on LGBTQ mental health issues. They have a directory to search for psychiatrists. (click here) 
• National Queer and Trans Therapists of Color Network provides mental health resources for queer and trans people of color. (click here)
• Talkspace (click here) and Better Help (click here) are both online therapy platforms, each have searches where you can find therapists providing LGBT care.
• Pride Counselling connects you with licensed therapists online who specialize in the LGBT community. (click here) 

Medical:

• The U.S. Department of Health & Human Services has a map of community health centers you can search. (click here to find a local one)
  • Note: Do not just walk into a community health center - make sure you call ahead.
• GLMA: Health Professionals Advancing LGBTQ Equality has trans specific resources about health care. (click here)
• Point of Pride created these information slides about navigating COVID-19 and chest binding. (click here)

Mutual Aid Resources: 

• Mutual Aid Hub is a map of member-led groups providing resources and aid to community members around the country. (click here to find a local one)
  • This is a database of localized resources, including many mutual aid resources. (click here)
• Collective Care provides a database of mutual aid resources and information. (click here)

Housing:

• If you experience trans discrimination in relief shelters and services call the contacts below.
  • Lambda Legal National Help Desk, toll free: (866) 542-8336
  • FEMA Hotline: (800) 621-3362 
  • Equal Access for Transgender People: A Guide for Shelters (click here) 
  • The Centers for Disease Control provides resources to support people experiencing homelessness. (click here)
• Citizens’ Housing and Planning Association provides updates (click here) and resources (click here) around affordable housing and other social services for people living in Massachusetts.