Hi - next month I'm going to be on a panel for a discussion entitled "How can we best support LGBT young people in rural areas?" and as the only trans person on the panel, I want to represent as broad a range of views as possible - so if you're a "young trans person" (they're mostly talking about the 16-25 age group) and up for doing this, please could you say in this thread what are the 3 things you find most difficult about being trans (whether you're out or not, transitioning or not, binary or not, I'm interested) living somewhere rural, why they're difficult, and what you think would be of most help to you in dealing with those things?

Thanks in advance for any responses - this is happening on September 17th, so you have time to mull it over .

I don't know what country you're from but I'm from a rural part of the UK called north Wales. It's basically just miles of mountains and pockets of villages and the odd few small towns.

Biggest concerns for me is lack of facilities and clinics. I know many of us can only get referred to one all the way in London, which is hours on the train.

Rural populations tend to be less informed about these things, and also less accepting.

Whether this is me being ignorant or what I am not sure but another worry I have is that rural medical professionals may not be as understanding about transgender issues as they don't encounter them much like they do in urban areas.

for me, living in the middle of nowhere Oklahoma, there's simply nothing around.....there is a trans support group that meets a long way away....about a two hour drive, but I can't afford to go that far with gas as pricey as it is.....which brings me to my second point.....employment....which again is difficult....the more liberal people tend to exist in cities more frequently....out here in the buckle of the bible belt it's mostly conservative christians....and so I am discriminated against a LOT.  Jobs are already hard to come by and being trans just makes getting one harder.....it's not that people are truly hateful, but it's obvious they don't really approve....some places with help wanted ads or signs won't even take my application.....

The third thing, I think is being just plain lonely....I've only been here two years, and I don't really get much exposure to the outside world....I just get lonely....and I can get by without a support group (though it would be cool to check out) but I wish I had someone close to my age I could just be friends with...someone me and my partner could have a few drinks with or have over for dinner

Quote from: Oriah on August 19, 2013, 10:26:54 AM
for me, living in the middle of nowhere Oklahoma, there's simply nothing around.....there is a trans support group that meets a long way away....about a two hour drive, but I can't afford to go that far with gas as pricey as it is.....which brings me to my second point.....employment....which again is difficult....the more liberal people tend to exist in cities more frequently....out here in the buckle of the bible belt it's mostly conservative christians....and so I am discriminated against a LOT.  Jobs are already hard to come by and being trans just makes getting one harder.....it's not that people are truly hateful, but it's obvious they don't really approve....some places with help wanted ads or signs won't even take my application.....

The third thing, I think is being just plain lonely....I've only been here two years, and I don't really get much exposure to the outside world....I just get lonely....and I can get by without a support group (though it would be cool to check out) but I wish I had someone close to my age I could just be friends with...someone me and my partner could have a few drinks with or have over for dinner

You're so right about more liberal people in cities. Which is logical. More people means more exposure to different people. Which means taking on a more liberal attitude. I really want to move from this place in the middle of nowhere lol

Thanks for the replies, both of you - I'm based in Devon, England, but I'm interested in anyone's experience of this situation. And I personally think in this context "rural" really means "in any isolated community, even if it's in a city".

Our panel discussion is going to be broadcast on local radio, but I hope it will educate some people, and make others feel less alone, and I also hope it'll result in some real action, at least locally.

I know what you mean about small towns and GPs etc., when I started transitioning in a small town in Devon, I pretty much had to educate the staff at the local surgery as I went along - including pointing them to the information that was already right there on their own online advice system for running a surgery! I only ever encountered one GP who was unsupportive, and I think that was mainly through ignorance, so I sent her a copy of the NHS guidelines for caring for trans patients.

I'm surprised you got referred to London, Dream2014 - I would have though the Sheffield gender clinic was way closer.

I'm not within your age range, unfortunately.

I am however a trans woman in rural Kansas (it's the state in the dead center of the United States).

The 3 things I find most difficult about being trans while living somewhere rural, and why they are difficult in my experience are:

1) People out where I live (Rural Easter Kansas) are Ignorant. People here have almost zero knowledge of trans people, or the issues we face. Not only that, but they want to be ignorant on many issues (not just trans issues). This place resists change of any kind. If you try to engage them in dialog on a topic they do not wish to know something about, you are treated as being, frankly, insane for ever even bringing the subject up.

The one time I ever heard anyone in town discussing something about trans people was because someone 'saw a ->-bleeped-<-' at Wal-Mart 70 miles from here. They were shocked that anyone would do that, stated if anyone like shouldn't be allowed in town, and were 'furious that their tax dollars go toward such disgusting deviation'.

While I'm thinking about it, anyone able to tell me where this government assistance in the U.S. is for trans people that they were talking about?

2) Lack of law enforcement. As I said, the nearest police station is 20 miles away. It's a big deal if a police car even drives through town at all. So, assuming the authorities would actually assist a trans person who is, say, being attacked by someone or a group of people due to transphobia, help is a long way off. Dispatchers often argue over if my city is in one of two counties and often re-route calls to the opposing county who will then send you back to the other ... Getting the authorities to respond to a traffic accident alone is a serious pain, but this would also be a further delay in assistance. The only way to insure your safety as anyone in the LGBT spectrum is to live a closeted life as long as you are here.

3) Lack of resources. I have to drive a good 60 miles to reach my therapist, or the nearest LGBT center or PFLAG organization of any kind, making the net my only real source of information outside of my therapist at the moment. To my knowledge, I would have to drive two hours away to find a doctor capable in assisting with HRT (which I won't start until I move away from this god awful place). There's literally just no resources here for L,G,B or T people.

What would help? Honestly ... I don't know that anything would help, short of moving away from here. Thankfully now that my wife knows, we are slowly trying to find a way to do so.

Outside of that? I don't really know. These people have no knowledge on the subject (and many others), don't want to know anything about it, and are proud they don't know anything about it. It is going to take several generations for this place to change ... if at all.

Quote from: Padma on August 19, 2013, 12:09:51 PM
Thanks for the replies, both of you - I'm based in Devon, England, but I'm interested in anyone's experience of this situation. And I personally think in this context "rural" really means "in any isolated community, even if it's in a city".

Our panel discussion is going to be broadcast on local radio, but I hope it will educate some people, and make others feel less alone, and I also hope it'll result in some real action, at least locally.

I know what you mean about small towns and GPs etc., when I started transitioning in a small town in Devon, I pretty much had to educate the staff at the local surgery as I went along - including pointing them to the information that was already right there on their own online advice system for running a surgery! I only ever encountered one GP who was unsupportive, and I think that was mainly through ignorance, so I sent her a copy of the NHS guidelines for caring for trans patients.

I'm surprised you got referred to London, Dream2014 - I would have though the Sheffield gender clinic was way closer.

Oh I haven't even started therapy yet, I'm just referencing other UK residents experience. I know somebody on here from Wales and the clinic they would be referred to is in London.

Quote from: Dreams2014 on August 19, 2013, 12:43:00 PM
Oh I haven't even started therapy yet, I'm just referencing other UK residents experience. I know somebody on here from Wales and the clinic they would be referred to is in London.

I think since April, when the PCTs got disbanded, the situation is very different, in that you can request to be referred to a specific clinic. There are currently 7 places in England to go - Exeter, Leeds, London, Northampton, Nottingham, Sheffield, and Newcastle.

I was very isolated in Blackpool in 1989 when I finally realised I would have to get treatment for my gender identity disorder.It took 2 months to see a psychiatrist at the local hospital who threatened to section me.I told my doctor I wanted a second opinion from someone else,it took from October 1989 til May 1991 before I was seen at Charing Cross hospital(Leeds were too busy and I was told the wait was even  longer)In January 1990 I started self medicating with HRT bought from a local TS,electrolysis and growing my hair out so I had a good start when I went full time in September 1991.There was no local help groups or national ones in the area,despite having a thriving gay scene  the T part of LGBT was very small 34 years ago.Things are a lot better now though there's still some way to go

What do you class as rural? I'm in the age group and would love to participate, but I don't think my area is rural

I'm not working to strict rules here - but I'm thinking of rural as meaning broadly speaking "in a small isolated community, which may include being isolated in a city (in an ethnic or religious community, just as an example)."

But I'm interested to hear anyone's experience of how this is for them, as it broadens my sense of the issues for young people.

It was a long time ago but I grew up in a very small town in southern Ontario in the 1950s and 60s and the biggest problem was the TOTAL lack of support, both from physicians and from mental health professionals. Not only do the patients need support but so do their doctors and counsellors! I don't know what it is like today but there should be resources available to the professionals. I don't expect them to learn all this during their formal education but the information and guidance should be available to them through their professional organizations.

(P.S. My maternal grandmother was born and raised in Okehampton!)

Thanks so much for all the responses, I'm building up a very good picture, here and elsewhere that I've asked about this.

The issues are a little different in the UK, because the distances involved are a lot less on the whole, but 10 miles vs 1000 miles makes no difference if you have no transport.

The main things I'm hearing are:

1: dependence on parents/guardians for transportation, finances

2: difficulty of contacting/meeting any other LGBT individuals due to isolation

3: extreme deprivation of privacy due to close and confined living conditions

4: lack of local access to facilities , clinics, info

5: increased likelihood of prejudice in more traditional communities

6: increased likelihood of GPs, therapists not having experience with LGBT people (and of them being prejudiced)

7: the tension between coming out and staying closeted is much stronger in any isolated community, since they're the only people you've got, and so potentially alienating them has much greater implications

Well, I'm neither young nor rural - I live in Bristol - but I think there's a major problem in terms of service provisioning in many parts of the UK. If you don't live near one of the 7 GICs you face difficult, inconvenient, expensive travel to get to someone who can treat you. I have to head down the M5 to your neck of the woods, or head along the M4 to London, if I want to see anyone who knows anything about trans* issues. Each journey takes at least 1.5 to 2 hours by car and it costs a small fortune via public transport. It's manageable for me as an employed adult with my own car... but how is an 18-year-old student who can't afford a car supposed to get there? What if their parents can't or won't take them there?

I was fortunate that my GP has an MtF patient so she at least had a clue what to do, but she still needed plenty of education. She had no idea what to do about routine exams I need such as smears and mammograms - I'm due for my annual mammogram next month and haven't received a letter yet so I'd imagine I've simply been dropped from their list.

That's the problem, I think. There's a complete lack of joined-up thinking in the NHS. Each separate department or speciality has its own mini-fiefdom that is jealously guarded by those in charge, so nobody talks to anyone else. So we, as the patients, have to take charge and direct our own treatment if we want to get anything done. There is also a tick-box culture that says that as long as a service is being provided, it doesn't matter how good or how accessible it is. As long as it exists somewhere, that's all that matters.

Bristol has no specialist services for trans people at all. There are a couple of user-led support groups, but they're exclusively MtF (although Qwest has recently started up a local meeting). Despite the extortionate amounts we pay to the local councils, there is no organisation or planning at local or regional level. I called my council to see what services they provide for trans* people: the answer was 'none'. If you want support, it's up to you to figure out how to provide it for yourself. 

Yes, there are problems with transitioning in rural areas where everyone knows who you are... but there are also problems with transitioning in inner-city areas that have high concentrations of recent immigrants (and their children) from communities where being LGBT isn't tolerated. Imagine transitioning in a class full of students whose parents raised them to believe that LGBT people deserve to be killed...

Most of the time I live in the city and not in a rural area. but as I see it it about the kind of pattern of people mix together and the understanding of diffrence.

ex' I went to school around where my dad live, he live in the middle of nowhere far from everything, but since the school where pretty muliti cultural I didn't felt very diffrent + we where social always hanging around so we got to talk to people we normaly woudlnt talk to and I belive it made another kind of asmosphear.

right now I'm in a school who is rather close to the centrum but I feel alot more isolated and diffrent. I think in a way it because the people in my class socilise with those they feel simular to, girls talk to girls boys talk to boys, the imigrents speak with the imigrents and the street guys with the street guys, it easly become a us-them felling and people dont get to get this "view" on the other groups which I belive is important for understanding and acceptence.

I havent had problems in Rural areas where I felt belonging in the school/area group, but if I went to the city in a school where everyone came from 1 part of the town and I from another then I felt very diffrent, so for me its a matter of having the chance to get to know diffrent kind of people and when you then got that being open to include and talk to them.
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I also feel theres a problem with information, all the LGBTthings always happents in the city, and deep down the small towns may be what need it the most.

i live in Maryland, and even here, where I'm right in-between two major cities, there are plenty of problems. though how many of them are in my head is another story.

two of the ones that I'm working around though...

1) support groups. many of them are not really trans support groups, at least not any of the ones i can easily get to. and most of them are at times i can't show up to any ways with my job. it would be nice to find something that isn't on a Tuesday or a Friday when i work. or at least one that's actually trans.

2) the other problem is qualified professionals to help me. many of them might care, but they aren't trained for this sort of thing, and don't really have any sort of prior experience either. it seems that help with gender identity confusion isn't a big enough concern in general to make the help more afffordable or available for many.

oh, and 3) it would be nice if there were more gender neutral bathrooms around, i might not be welcome in the ladies bathroom yet, and i don't want to make any one uncomfortable, but I am not comfortable in the men's bathrooms some times any more.

FTMDiaries, I agree that provision is very localised in the UK at the moment - this is one of the things Dr Dean and his new steering committee want to address, he told me.

At least once young people get a referral, if they're on low income or benefits they can claim their travel expenses to attend gender clinics (and all other accompanying visits necessary). Of course, it's much more difficult for the under-18s, though there is some provision - and the current setup is very poorly managed for the handover from one system to another when someone trans* turns 18 here.

The panel discussion I've been invited to join in on has this specific remit that is "How can we best support LGBT young people in rural areas" but I'm going to broaden out that discussion if I can do so gracefully, because as I said (and as you people are pointing out), isolation needn't be just geographical. We only have an hour, and I'm only one of several panellists, but I hope to get the message across about both the incredible diversity within the gender forest (including intersex folk, who rarely get a mention in these situations), and the very specific difficulties young trans* people face, wherever they are. And I hope I'm going to be able to start a more in-depth dialogue in the process.

Support groups is quite an issue - the ones around here, for example, are mostly populated by older trans men and women, some of whom have very rigid views about things, and are dismissive of younger people and of non-gender-stereotypical identities and presentation. This is part of the reason why I started the non-binary support group down here, so that younger people have a safer environment in which to discuss this stuff. The Support groups for younger adults tend to be LGBT, and this usually means G, some L, a bit of B, and a pinch of T if you're lucky.

So more dedicated support networks and groups for young trans people is very high on my list of proposed solutions, as well as help getting them to meetings - I've proposed a funded Travel Buddying system, where suitably vetted people can drive younger folk to and from meetings, without anyone where they live necessarily having to know where they're going.

This gets more complex where minors are concerned, as permission from parents/guardians would be necessary, but anything that makes it easier for the young folks and puts the initiative more in their hands is worth pursuing. If a parent says "I'm not willing to keep taking you there" and they're able to reply "That's okay, with your consent I can get a free lift", I'll be very happy.

Quote from: Padma on August 21, 2013, 09:52:44 AM
Support groups is quite an issue - the ones around here, for example, are mostly populated by older trans men and women, some of whom have very rigid views about things, and are dismissive of younger people and of non-gender-stereotypical identities and presentation. This is part of the reason why I started the non-binary support group down here, so that younger people have a safer environment in which to discuss this stuff. The Support groups for younger adults tend to be LGBT, and this usually means G, some L, a bit of B, and a pinch of T if you're lucky.

Agreed. The ever-silent 'T' is a problem, particularly if its a diverse group including (for example) anti-trans radfems.

Another problem that is difficult to solve is what to do about putting MtFs and FtMs in the same room. It can work (Susan's is a very good example of us getting along pretty well) but IRL I have in many cases detected an undertone of - it's hard to describe - distrust? distaste? directed towards me by some MtFs simply because I'm FtM, even in wonderfully laid-back environments such as Dr Dean's place.

Quote from: Padma on August 21, 2013, 09:52:44 AM
So more dedicated support networks and groups for young trans people is very high on my list of proposed solutions, as well as help getting them to meetings - I've proposed a funded Travel Buddying system, where suitably vetted people can drive younger folk to and from meetings, without anyone where they live necessarily having to know where they're going.

An excellent suggestion, and I'd be willing to volunteer as a driver if it takes off. Dr Dean knows me; feel free to PM me if you ever want to take me up on this. This could also be useful for not-so-young patients who struggle with public transport for various reasons.

Quote from: Padma on August 21, 2013, 09:52:44 AM
This gets more complex where minors are concerned, as permission from parents/guardians would be necessary, but anything that makes it easier for the young folks and puts the initiative more in their hands is worth pursuing. If a parent says "I'm not willing to keep taking you there" and they're able to reply "That's okay, with your consent I can get a free lift", I'll be very happy.

Are minors not still limited to the Tavistock?

I'm not talking about stuff to do with The Laurels here, just more general local issues.

So the Travel Buddying is something the Proud2Be folk in Totnes are going to try out, and the idea (whether for young adults or for minors) is to get them to support groups they want to be at, wherever they are that's within reasonable driving distance - Exeter, Totnes, Plymouth, etc. For example, there's an existing LGBT youth group in Exeter (where I'm hoping to volunteer) that's for 16-25 year-olds, so the under-18s would need parent/guardian permission, probably (and the drivers will need an enhanced DBS check).