Invisible Voices: Amicia Huelsman Talks About Trans Rights
St. Louis local and public school high school teacher Amicia Huelsman discusses Trans rights and access to healthcare. "Trans care should be understood as life saving care," says Huelsman.
1.) Some background on you. Where are you from and what is your profession?
I’m a lifelong citizen of St. Louis and work as a public high school teacher.
2.) When did you transition? How did you feel about the process?
I began socially transitioning just over three years ago, I started hormones a few months later. There were a lot of ups and downs, and at times I doubted myself, but I have no regrets and consider transitioning the best decision I’ve ever made. For the first year I was very scared to go out in public while presenting as a woman, but presenting as a man, or boymoding, was very stressful and took a toll on my mental health. After that first year I became more comfortable with how I looked and started to figure out my personal style and was more confident with being in public.
The process was rocky at first, but having started my transition as an adult made things easier because I am able to make decisions for myself. I’m independent so I didn't have to worry about being cut off from anything for transitioning. I wasn’t in a relationship so I didn’t have to worry that being true to myself could possibly end one. Unfortunately, starting later also meant that I was less likely to develop certain features, the later trans women begin taking estrogen the less likely they are to develop feminine hips due to bone growth. My doctors, therapist, friends, and coworkers have all been supportive.
3.) What are your concerns regarding the restriction on trans rights with the current political administration?
I think the Trump Administration so far is really just letting the mask slip. While he has been far more hostile to trans people, and many groups in general, we weren’t really ever protected by previous administrations. For example, as President, Joe Biden made an unforced concession of allowing school districts to ban transgender athletes from participating on sports teams of their gender. Recently, California Governor Gavin Newsom went on a podcast of the far-right figure Charlie Kirk and said that he was in line with him as far as trans people on sports teams.
There really aren’t that many trans athletes, out of over 500,000 NCAA athletes, less than 10 are transgender. The reason that this is talked about so much despite being a non-issue is that it’s divisive. Trump’s agenda of cutting social programs, escalating the genocide in Gaza, attacking education, and most recently waging a war on free speech by arresting Mahmoud Khalil, a student activist who recently graduated from Columbia University, for being “adversarial to the foreign policy and national security interests of the United States” isn’t popular. Where do attacks on transgender people, or more broadly DEI or federal workers, come in? While we fight amongst each other about these, we aren’t able to focus on the other attacks against the working class, the ones that make the hundreds of millions of working class people in this country less free, less safe, and poorer.
But rights have never come from benevolent politicians, they’ve always been taken through struggle, forcing those in power to concede them. That’s how we got the New Deal and labor laws, that’s how we ended Jim Crow apartheid, that’s how we won the right to an abortion, and that’s how we ended the Vietnam War. We once again need a mass movement that combines these different struggles, the women’s movement, labor movement, the movement for Black liberation, for immigrants, for LGBTQ people, the anti-war movement, etc. because at the end of the day we are all struggling as workers, we want housing, healthcare, good jobs, to be able to live a life of dignity. Our rights that we once won are on the chopping block because even though working people outnumber those in power, the billionaires, we don’t have political power. So if we don’t want to have to keep fighting the same fight, we need a new system where political and economic power are in the hands of all of us, not a tiny clique of ultra-wealthy billionaires.
4.) Have you acquired medical debt from receiving trans care or another medical procedure? If so, how has it affected your life?
Some, I took on some debt for laser hair removal on my face. I’ve had to consider taking out loans for a potential hair transplant to feminize my hairline. I don’t know anyone who has taken on a lot of debt to help transition, or at least none that have told me about it. I do know people who have started crowdfunds to help with procedures.
5.) Do you get insurance through your job or have a marketplace plan? What have been the advantages/disadvantages to this? What’s covered and what’s not covered?
I do have insurance through my job. My hormones are partially covered and if I choose to undergo sex reassignment surgery that is covered as well. Unfortunately, things like facial feminization surgery or laser hair removal are not covered because they’re considered cosmetic. When I first started hormones I was seeing an endocrinologist once every three months, then six months, then nine, now I go once a year for blood work. Each visit costs me about $200.
To get any kind of gender affirming surgery I had to speak with two mental health professionals, a psychiatrist and my therapist. I’m lucky that my insurance fully covers both, but for many that’s not the case.
6.) Did you ever forgo any medical treatment because it wasn’t covered under insurance or you couldn’t afford it? If so, what happened?
Electrolysis to remove the lighter hairs on my face is a long, expensive, painful process. It’s not something I’ve decided not to do, but I am hoping to remove as much hair as possible through laser treatment to minimize everything. Lasers can’t treat light hair and can have poorer results for those with darker skin just due to the physics of lasers.
Sex reassignment surgery requires a lot of research and I’ve found it very overwhelming. You have to find surgeons, find reviews, look at results if available, see how long you’d have to wait, see if they’re in network, among so many other things. Even though the cost isn’t prohibitive, the lack of information available makes things harder.
7.) What hopes do you have for the future regarding healthcare accessibility, particularly trans care?
I hope and believe that we will one day have a system that prioritizes people over profit. All healthcare, trans care or otherwise, would be available for free and patients would be treated with respect and care by their doctors. I want trans people to be believed when we say who we are. Puberty blockers are safe and reversible so trans kids should be able to receive them. A typical puberty itself is irreversible so it makes no sense to say a child must go through one type of puberty but that it’s too risky to go through another type.
There are some trans people who will take on tens of thousands of debt. Trans care should be understood as life saving care. Seeing our bodies change in ways that isn’t consistent with how we understand our gender, such as transgender women growing a lot of body hair or transgender men having wide hips or breasts, is very distressing. My transition changed who I am fundamentally, when I see pictures of myself before it really feels like I’m looking at a different person and not just because I look so different. I’m so much happier now because I have the correct hormones in my body and because I’m treated as a woman.