This blog originally appeared at The Washington Post.

A swath of adjoining states in the South now ban transition-related care for minors, forcing families of trans youth to travel long distances for care.

Like any family, Katie and her son Ray had their road trip staples. They always packed sour peach candy. They talked more than they listened to music, and they played a game they called Nature. Anyone who spotted an animal racked up points, though the exact number depended on the species and an in-the-moment car vote.

Katie wanted to win. She looked for turtles as she pulled her SUV onto the highway around 9 one morning in early May, but her eyes went blurry with fear. She couldn’t make out anything in the distance.

“I’ll play once we get closer,” she told Ray.

Katie had done all she could to prepare for this trip. She’d asked a relative to pick up her two younger boys from school. She’d researched how to change a tire, and she’d spent hours on Google Maps, searching for the closest Walgreens in Alabama. She’d finally found a destination in Thomasville, a rural town nearly 200 miles from their suburban Mississippi home, but much remained unclear. Would they make it by noon for Ray’s telehealth appointment? Would the pharmacy give him testosterone?

Katie looked at her boy, a thin 17-year-old with wavy hair and an easy grin, and she asked herself the question that had begun to matter least: Was she breaking the law?

Two months earlier, Mississippi had banned transgender young people, like Ray, from accessing hormones or other gender-transition treatments. By mid-spring, nearly half the country had passed similar bills, according to the Movement Advancement Project, and now, 1 in 3 trans children lives in a state with a ban. Conservative lawmakers said they’d pushed the bills to protect young people, but Katie felt like they’d done the opposite. Testosterone had allowed her son to embody himself for the first time. Ray was present, happy. The ban would take that happiness away.

Across the country, families were doing everything they could to protect their trans children. Some uprooted their lives in red states for the promise of protections in blue ones. Others filed lawsuits. Katie couldn’t afford to move, and she needed a solution faster than the courts could offer, so she’d settled on a cheaper, quicker plan: She’d take a day off from her nursing job, and she and Ray would travel out of state for his medical care.

“It says we’ll be there by 11:48,” she said.

She knew that Mississippi’s law contained a rare aid-and-abet clause that prohibited adults from helping a minor transition. She didn’t understand the particulars, and she didn’t know what would happen to her if she broke it, but she cared less about penalties than she did about Ray, and so, the day the ban passed, she decided she’d do anything to keep her son well. (Katie and her family spoke to The Washington Post on the condition that they be identified by only their first names out of concern they could face legal consequences.)

Initially, Katie didn’t know where to go. Nearly every state within 700 miles had banned gender-affirming care for minors, and a trip to Illinois would have taken three days. She didn’t have vacation time or hotel money to spare, so the Midwest was out. The best option, she decided, was a tenuous one. A year earlier, Alabama lawmakers had passed one of the country’s first bans, but a judge had temporarily blocked the legislation, which meant teenagers could still get hormones there, at least for now.

“I guess I’m just going to Meridian, then a little farther,” she said. “I know how to get to Meridian, right?”

“I have faith in you,” Ray said.

He reached across the console, and Katie’s stomach twisted. She had told Ray she would fix this one way or another, and he believed her. But Katie couldn’t control lawmakers, and she had no idea what the pharmacist would do.

The border appeared a few minutes after 11, and Katie relaxed just a bit. She grabbed Ray’s hand.

“Welcome to sweet home Alabama,” she said. “Where you’re safe, for now.”

Care disrupted

Katie used to think Ray was lucky to be born when he was. Earlier generations of trans people had little or no access to gender-affirming care, but by 2019, when 13-year-old Ray told Katie he was a boy, even conservative states like Mississippi had a handful of providers who knew how to help him.

Nearly every major medical association has endorsed gender-affirming care for minors since 2012, and by the time Katie and Ray’s dad, Jody, found a pediatric endocrinologistat an LGBTQ clinic at the University of Mississippi Medical Center, the treatment was fairly standardized. Ray saw a therapist for a year, then, when he turned 15, a doctor prescribed Depo-Provera, an estrogen suppressantsometimes used as a puberty blocker. The clinic staff monitored his bloodwork and bone density.

At the time, no state prohibited transgender children from taking puberty blockers or cross-sex hormones. But in March 2021, a month after Ray started blockers, Arkansas passed a ban.

Katie figured Arkansas was an anomaly. A year passed, and in February 2022, she gave Ray his first testosterone shot. Then, seemingly overnight, the mood shifted. Texas authorities opened child abuse investigations into families with transgender children, and Alabama lawmakers approved the country’s second ban. Human Rights Campaign workers told Katie they believed Mississippi might be next.

No, Katie told them. Mississippi wouldn’t do that. The trans community was so small, it hardly seemed worth the public resources. Ray didn’t know any other kids receiving gender-affirming care, and public hospital data shows that the LGBTQ clinic treated just nine minors in fiscal 2020, and only 15 in fiscal 2023. None had surgery.

Katie understood some Mississippians might be slow to accept trans people. She hadn’t wanted to believe Ray at first, and her heart broke when he first cut his hip-length blonde hair to his chin. But she’d listened to him, and she’d trusted his doctors, and she’d seen the difference the care made in his life.

click here to see full blog: https://www.washingtonpost.com/dc-md-va/interactive/2023/mississippi-youth-transgender-care-ban-aftermath/

Citizenship offers greater rights, participation in governance, security, travel privileges, national identity, and intergenerational benefits compared to residence.

In comparing citizenship to residence, it becomes clear that citizenship holds a distinct advantage in terms of belonging, rights, and opportunities. This essay delves into the legal, political, and social benefits of citizenship, highlighting why it surpasses mere residence. By recognizing these differences, we gain a deeper understanding of how citizenship fosters integration and personal fulfillment within a country.

Citizenship offers numerous advantages and surpasses mere residence status in several ways. Firstly, citizens enjoy a wide range of legal rights and protections granted by the country’s constitution and laws. These include freedom of speech, voting rights, access to public services, and protection against deportation. Additionally, citizenship enables individuals to actively participate in the political process, influencing policy decisions and contributing to the governance of their country. Citizens also experience greater security and stability, benefiting from the diplomatic support, consular services, and defense forces of their home country. Moreover, citizenship provides enhanced mobility and travel privileges, access to a broader range of government benefits and services, a sense of national identity and belonging, and the ability to pass on nationality to future generations. Overall, citizenship offers a deeper connection and commitment to a nation and its values, providing individuals with a more comprehensive and enduring status within their country of choice.

This blog originally appeared at CNN US.

A year after the reversal of Roe v. Wade, medical professionals describe a world of uncertainty in the field of reproductive healthcare. The landmark decision, which gave states the right to ban abortion, has led to a patchwork of abortion access across the country, with some states imposing severe restrictions or outright bans on abortion. This has created significant challenges for healthcare providers and patients seeking reproductive care.

(CNN)_ It’s been over a year since Roe v. Wade was overturned by the US Supreme Court, eliminating the constitutional right to abortion nationwide. The opinion was one of the most consequential Supreme Court decisions in decades and paved the way for states to pass laws to limit or ban access to the procedure.

Abortion has already become one of the defining issues of the 2024 campaign and is expected to continue to be a key topic as candidates face questions about whether they support banning the procedure on the local and national level.

CNN spoke with doctors and medical professionals who responded to a request for stories about how people’s lives have changed in the wake of the ruling. Those who responded all shared stories of their professional lives being disrupted by abortion bans and severe restrictions — including in Idaho and Arizona.

Some no longer want to practice in states with limitations on the procedure. Others worry about the safety of their patients as more bans loom in the future.

Below we share the stories of three medical professionals who agreed to give us full interviews about their experiences.

Katie A., Michigan

Idaho native Katie A. had plans of returning to her home state to practice as an obstetrician/gynecologist, but after Roe v. Wade was reversed and the state passed a near-total abortion ban, she is unsure of where she will go when she completes her residency in Michigan.

Katie, who asked CNN not to use her full name due to safety concerns, was born and raised in Boise, Idaho, and went to medical school in Washington state to specialize in rural patient care.

“As I was doing my clinical rotations in Idaho, I could really see myself working with the population there,” she told CNN. “Idaho is a state that for a long time has had a shortage of physicians. There’s a huge centralization of medicine in Idaho, most of the hospitals and specialists are in Boise.” Because of this, Katie said many people outside of the city do not have easy access to care.

The medical resident told CNN that she envisioned making a difference in the state, especially by specializing in gynecological and obstetrics care.

“I was really excited about the idea that I get to move home with this population that I grew up with — I could make a difference,” she said.

When Roe v. Wade was overturned, Katie’s plans to practice in her native state quickly changed as she witnessed the medical landscape transform there.

“I really felt called, like I felt that was where I could still make the most difference and it was really important to me to continue to pursue obstetrics and gynecology — whatever that might look like,” she said.

“But for my safety and for my ability to really treat my patients, I knew as soon as Idaho started passing laws, criminalizing transportation across state lines and all that sort of thing that it would not be a hospitable place for me to practice medicine. And that you know is sort of heartbreaking, right?” the medical resident added.

See where abortions are banned and legal — and where it’s still in limbo

Idaho made abortions illegal last August — with only two exceptions: if the mother’s life is in danger, and in the case of rape or incest, but only after a police report has been filed and provided to the doctor. Since then, doctors who care for pregnant people and perform abortions have been fleeing the state due to new abortion restrictions.

In April, health care providers sued the state’s attorney general after he wrote in a legal opinion that the state’s abortion ban prohibits medical providers from referring patients out-of-state for abortion services. Gov. Brad Little, a Republican, also approved legislation that makes it much harder for minors in the state to obtain out-of-state abortions without parental consent. The law creates an “abortion trafficking” crime that makes it illegal for adults in the state to assist a minor with obtaining an abortion without informing the pregnant person’s parents or guardians.

Katie hopes that once she finishes her residency in four years, the situation will have evolved, helping her to more easily decide where she could eventually practice.

“I think wherever I practice; it might be Michigan, it might be Washington — I don’t know, it could be anywhere — will really depend on what local politics are and what protections are in place for physicians and patients,” she told CNN.

For the time being, she feels a sense of relief for matching with a program in a state without restrictive abortion laws.

Katie’s decision is on trend with new data which suggests that these restrictions are having an impact on where — and what — future doctors plan to practice.

The number of medical school seniors who applied to residency training programs went down by nearly 2% last year, and applications to programs in states with abortion bans dropped the most, dipping by 3%, according to an analysis in April from the Association of American Medical Colleges.

Interest in the Ob-Gyn specialty took a notable dip, according to the analysis, with applications dropping 5% nationwide and twice as much in states where abortion is banned.

click here to see full blog: https://edition.cnn.com/2023/07/23/us/doctors-reactions-roe-v-wade-reversal/index.html