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Navigating a fractured system

Mother’s Day 2012. Hayden Moffitt decided to take his mother out to eat to celebrate. Moffitt came out as gay two years earlier, but his mother was unaware of the transition that Moffitt had started.

“I was studying for a test at the time, and my mom had been running errands all day,” Moffitt, senior in architecture, said. “I was like ‘Hey, it’s Mother’s Day. Let’s go get lunch.' It was just us two.”

Moffitt was carrying a men’s wallet, an accessory that Moffitt’s mother was not fond of.

“She asked me if I wanted to be a boy,” Moffitt said. “In the simplest way possible, I said ‘yeah.’ [Her reaction] was not good at all.”

Moffitt is now the president of Gamma Rho Lambda, a social sorority for the LGBTQ and ally community. Though his family has grown to accept his identity, Moffitt faces challenges presented by a health care system that has yet to accommodate the trans community.

“Doctors are saying that they are not able to serve trans students because they do not have the knowledge or expertise to do so,” said Brad Freihoefer, director of the Iowa State LGBTSS Center.

“That circumstance may not provide an option [for those individuals] in the city of Ames for certain care needs.

In 2011, the National Center for Transgender Equality and National Gay and Lesbian Task Force distributed a survey dubbed the National Transgender Discrimination Survey. Nineteen percent of the sample (about 7,500 respondents) reported being refused care because of their transgender or gender non-conforming status, with even higher numbers among people of color.

“Health care providers, to my experience, don’t know anything,” Moffitt said. “[Providers] having general knowledge about trans individuals would be great.”

Twenty-eight percent of respondents were subjected to harassment in medical settings. Fifty percent reported having to educate their medical providers about transgender care.

“A lot of our trans men on campus have this challenge where they may need gynecological care, but when they walk into [health care] places, people are really confused,” Freihofer said. “It’s an awkward struggle [for students] who have to make sure that they get asked the required questions for basic gynecological care.”

Freihoefer went on to say that it can be very difficult to determine whether a student's health insurance will cover trans-inclusive care since it depends on the state in which they reside. 

“It’s really case-by-case, which can make it complicated and a little scary for students who are navigating that," he said.

To the delight of trans and gender non-conforming students at Iowa State, coverage for health care services related to medical transition have recently been expanded under Iowa State’s Student and Scholar Insurance Plan.

“Certain benefit packages will cover transition-related care, others will not,” Freihofer said. “Some of it depends on the doctor, and how they write up a request.”

Freihofer said students have been known to pay between $130 and $180 per month for prescription hormones. Chest reconstruction surgery, a procedure that many trans students have gone through, can cost more than $6,000, a cost typically paid for out of pocket. Many students have turned to the popular fundraising site GoFundMe in an effort to raise funds for their operations.

“Some of our students would fundraise over $6,000 to [undergo chest reconstruction surgery],” Freihofer said. “That [money] would set them up with a good doctor in Florida who could do that surgery.”

One individual who underwent the previously mentioned operation was Derrick Moeller, 31, an Iowa Stat Alum.

“I identify as transgender and male,” Moeller said. “If you look at me, I have the privilege of passing pretty well as the gender I prefer.”

Moeller is a trans-man. He was assigned the gender of female at birth, but made the transition to match his gender identity, socially and eventually physically, after his undergraduate career at Iowa State.

“For me, it felt right to go further and beyond social transitioning by using hormones to match my gender identity,” Moeller said. “Not everyone does that, wants that or needs that, but that was one step of my process.”

An active member of the LGBT community, Moeller bore several leadership roles during his undergraduate years. Moeller began questioning his gender identity during his time at Iowa State, causing him to explore different avenues of expressing his identity.

He graduated in December 2010 with a bachelor’s in child, adult and family services, going on to earn his master’s of education with student affairs in 2014.

“I’ve always liked helping people,” Moeller said. “I thought I wanted to work with students in a college setting. That’s still a passion of mine.”

Growing up in the '90s, Moeller felt that there wasn’t much education and language with regard to gender identity. Moeller identified as gender queer going in to Iowa State as a transfer student. He began transitioning using hormone replacement therapy (HRT) in 2011.

“It’s a challenge to find health care professionals that are knowledgeable and comfortable with providing services [to trans individuals],” Moeller said. “I had to travel down to Des Moines to a doctor that could help me out.”

The Theilen Student Health Center, at the time, did not have a medical professional on its team who could provide care to trans individuals. Moeller relied on the support of Freihofer, along with other LGBT faculty members, who in turn referred Moeller to several medical professionals who could provide the care he needed.

Moeller decided to take his physical transition further in 2012 by deciding to undergo chest reduction surgery. At the time, there were only two well-known surgeons in the nation who were willing to perform the procedure on transsexuals. One of them resided in Florida.

The procedure would cost Moeller $8,000. He travelled to Florida, with his mother, to have the procedure performed.

“To my knowledge, there’s not a doctor in Ames that is knowledgeable enough to provide care to transgender students, and that’s an issue,” Moeller stated. “I’m in San Francisco now, so I have greater access to health care professionals that are more knowledgeable.”

Moeller currently attends the California Professional School of Psychology in pursuit of a PsyD in clinical psychology.

“I’m at a point where I’m satisfied with where I’m at with the transition,” Moeller said. “I’m at a good place.”

Freihofer said the LGBTSS center is currently in the process of helping students access information about trans-inclusive health care. The LGBTSS website contains tabs and links dubbed “Trans @ ISU” that contain tips and information for students.

“Process, service and accessible opportunity for people who are trans and gender non-conforming has always been my hope,” Freihofer said. “There are some [inclusive] things that the university is doing very well, but there’s still work to be done."

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