Everyone deserves access to quality health care, regardless of one’s ability to pay for it. Some cities have clinics designed to treat transgender youth specifically: for example, Callen-Lorde Community Health Center runs Health Outreach to Teens (HOTT) in New York City; Howard Brown offers a low-income walk-in clinic for LGBT people in Chicago; and Dimensions Clinic offers low-cost health services for queer, transgender and questioning youth in San Francisco. Most state Medicaid programs do not cover transition-related health care, but a growing number of states are lifting these discriminatory exclusions (California, Connecticut, Illinois, Massachusetts, Oregon, Vermont and D.C.) If you apply for Medicaid to cover your transition-related health care and are denied coverage, contact Lambda Legal’s Help Desk. Lambda Legal’s fact sheet on “Transition-Related Health Care” has more information about how advocates are working to remove discriminatory barriers to trans health care and can be downloaded at lambdalegal.org/publications/toolkits.

No matter where you live, it may be possible to find doctors with transgender patient experience.

Even if you are incarcerated or in foster care you have the right to trans-affirming health care. Lambda Legal successfully claimed in Rodriguez v. Johnson et al. that a young transgender woman could not be denied access to her prescription hormone medication. In Fields v. Smith, Lambda Legal and the ACLU convinced the court to rule that a blanket ban on health care for incarcerated trans people is unconstitutional.

There is no set age limit for starting on prescription hormones related to transition; some doctors start transgender youth on hormone blockers at the onset of puberty, while others recommend waiting. But doctors need to assess a patient’s situation on a case-by-case basis. If you are under 18 years old, you need parental or guardian consent to begin hormone treatment.

Because getting access to hormones can be difficult, some transgender people look for them without a prescription, but illegally trafficked hormones can cause additional health problems and hormone treatment should be monitored.

TGNC young people often find themselves needing to be self-sufficient before their peers do, struggling to make money to survive on the streets or to pay for health care not covered by insurance or by their own families. Yet they are often passed over for jobs because of prejudice about the way they may look. The National Trans Discrimination Survey—data compiled by the National Center for Transgender Equality and the National Gay and Lesbian Task Force in 2009—found that trans people are nearly twice as likely to be unemployed and that the extreme poverty rate for trans people is four times that of the general population. The shortage of options forces many young TGNC people into street economies, including the drug trade and sex work.

Discriminating against workers for not conforming to sex stereotypes and assumptions has frequently been found illegal, however. The Equal Employment Opportunity Commission (EEOC) recently issued a landmark decision holding that transgender employees are covered by Title VII, the federal sex discrimination law. Lambda Legal recently won an important case in Georgia, for instance, on behalf of a transgender woman who was fired for transitioning on the job. For more information about that, see “Workplace Rights & Wrongs,” another fact sheet in this series, which can be downloaded at: lambdalegal.org/publications/toolkits.

Another great resource is the Transgender Economic Empowerment Initiative, which helps helps empower and educate transgender job seekers in the SF area through mentoring partnerships with other trans people. Their strategies and resources may be helpful in other parts of the country too. Transgender sex workers may benefit from information in the pamphlet Taking Care of Yourself, published by the Sex Workers Education & Advocacy Task Force (SWEAT) available at sweat.org.za.Age may also be a factor for transgender young people looking for work. If you’re under 18, your state may bar it. In most cases, however, you can get a special permit from the Labor Department or a guidance counselor at school.