‘What If I Had Gotten a Head Start on Hormones?’

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Last week, Arkansas lawmakers passed a bill that could have life-threatening consequences for transgender youths. HB1570 — the Save Adolescents From Experimentation (SAFE) Act — bans any trans person under 18 from receiving gender-affirming health care, including puberty blockers and hormone therapy. Arkansas is the first state to pass these extreme measures, though at least nine other states are considering similar bills and more than 45,000 trans youths could be affected.

While the lawmakers who support HB1570 claim to be protecting kids from making medical decisions they “can’t take back,” they are actually putting them at risk. Studies have shown that not only do transgender children very rarely regret these treatments but their rates of depression and suicide are greatly reduced by them. One study found that access to hormone therapy over the course of one year decreased suicide rates in transgender youths by 75 percent. This law cuts them off from potentially life-saving options.

The Cut spoke with 19-year-old Vaniel Simmons, who was raised in Arkansas, about how access to gender-affirming health care saved his life.

By the time I was 15, I felt confident that I was trans. I started wearing a binder and three layers of clothing to hide my body, even in the summer. A year earlier, I had come out to my family as bisexual, but that never felt quite right. They were more or less supportive but would still pressure me to wear makeup or dresses. It made me incredibly uncomfortable, but I couldn’t articulate why. I couldn’t put into words why I would have a panic attack every time my mom tried to take me shopping. I just knew that I couldn’t stand looking at myself in the mirror. I started getting really depressed and began self-harming. I starved myself and overexercised, thinking weight was the reason I didn’t like my body.

I did not fit in at my school, which was filled with homophobic or incredibly religious people. Every day, other students would tell me, “You’re gonna go to hell. You need to come to a Christian fellowship group.” One girl walked around wearing a T-shirt that spelled fag in sign language, and the teacher and principal said they couldn’t do anything about it. But every year on National Coming Out Day, I would do a fun outfit — when I showed up in a rainbow cape, they said I had to take it off. By my junior year, I had decided to transfer somewhere else. I applied to a boarding school in Hot Springs, Arkansas, where people dyed their hair blue and green and wore sparkly shoes. My mom was supportive, since it was a very academically prestigious place, and as I was a low-income student, they would pay the tuition. I felt a desperation that I needed to be anywhere but here.

I started finding online LGBTQ groups where people explained trans identities. I started thinking, Maybe that’s me, and using he/him pronouns. I began researching hormone treatments. I was watching famous trans YouTubers and Googling, “What does testosterone do to your body?” and “How can I get top surgery?” Any provider I called said I had to be 18 to make an appointment, and I didn’t have a family doctor I trusted enough to talk about these kinds of issues. I was resigned to waiting.

I felt stuck. I knew that starting hormone therapy would help. Knowing what I needed to do and not being able to do it was soul-crushing. By the time I was 16, I couldn’t picture a future. That Christmas, I had a full panic attack. My family kept misgendering me, and I remember sitting on the floor of my room, crying. My grandmother came in, and I told her: “I’m a guy. I don’t know why they can’t see that.” She is very accepting; whatever makes me happy will make her happy. About a month later, I got in an argument with my mom — I don’t remember exactly what about — and I stormed out of the house. My stepdad would make uncomfortable comments about my body, and we were arguing a lot about him. My grandmother followed me to the nearby lake, and I told her, “I’m hiding who I am at school. I don’t feel safe at home. I would rather not exist at all than continue to exist like this.” That was my lowest point. And she was like, “So you’re going to move in with me.”

I didn’t expect to live long enough to have access to the health care I needed. If a teenager can make the major life decision to want to harm or kill themselves, why wouldn’t they be able to make major life decisions about their health? I couldn’t stand the thought of living this way any longer. Every single day was a hellscape. That feeling is more torturous than taking testosterone and deciding later on “I don’t want to do this anymore.”

In 2018, I started boarding school, and my first semester was definitely the hardest. Everyone there was great, and they didn’t mess up pronouns but I still had to live in the female hall with the girls. Then I found a booth for the Arkansas Children’s Hospital Gender Spectrum Clinic at a pride event and booked my first appointment to talk about hormone therapy. I was 16 at the time. I told my mom that if she refused her support, I’d just do it when I was 18 and resent her. She showed up for the first appointment but not to any others. They did a full psychological evaluation of me, my mother, and my grandmother. They wanted every detail. Then the doctors conferred to make sure hormones were the right option for me, and there was another three- or four-month waiting period to make sure I was feeling consistent. I wasn’t able to actually start the treatment until seven months after the first consultation. But while waiting, I successfully petitioned the school to move me to the guys’ hall in my second semester. The other students just started letting me exist as a dude, though it was still slightly dysphoric for me. They all had their deep voices, and I was still trying to get there.

About six months into testosterone treatment, my voice finally started to drop. I was 17. I remember walking into school after the Christmas break and greeting a counselor. She said, “I didn’t recognize your voice for a second” because of how much it had deepened. It felt like, You’re finally able to hear me as I actually am. That feeling was like Christmas all over again.

These lawmakers don’t understand that these treatments aren’t just something trans people want; they mean actual life or death for a lot of us. This bill is a death sentence. It takes away people’s chances to live. I am happy with myself now — I had top surgery last August. But there’s always the thought in the back of my head, How much further could I be had I gotten a head start on hormones? My teenage years were mostly spent hating my body and isolating myself so I didn’t have to be around people who saw me as a woman. I didn’t get to experience having casual fun with my friends on the weekends. It took me years to get to the place where I’m at now. I could have spent all those years being happy.

In the U.S., the National Suicide Prevention Lifeline is 1-800-273-8255.

‘What If I Had Gotten a Head Start on Hormones?’