It Gets Worse...
A detransitioner’s quest for ethical care
Yesterday, I searched for an alternative to traditional medical insurance: health shares. A health share is a group of people — usually gathered around religious or ethical principles — who voluntarily pool monthly contributions to help pay each other’s medical bills. Health share members willingly forego the guaranteed protection of insurance companies in exchange for this freedom — none of which I knew as of yesterday morning. I had stumbled upon the idea and was looking into it.
The first on my list was Solidarity. According to Grok, this was the Catholic option. I dialed the number, and after just three rings, a real human answered and asked for my name. Her name was Jane.
Off to a good start, I thought.
But I hesitated to tell her my condition– somehow the medical jargon, “acquired absence of testicles in scrotum,” seems even more humiliating than a simpler phrase, but that simpler phrase eludes me, and I try, whenever possible, to avoid it — instead I asked her to explain what makes a health share different from an insurance company. Her answer was just vague enough to pass in the moment without sticking in my mind — something about “corporate profit margins” allowing for their lower price. We shared a laugh about the confusing lexicon.
“I didn’t get it either for a long time,” said Jane. “On my first day, I didn’t know what I was talking about.”
I asked what made Solidarity different from other Christian health shares, and she spoke generally about comprehensive plans that cover preventative care (wellness visits) and pre-existing conditions (with limits) after the first year. She walked me through the limits, which gradually reduced with each year of membership. I asked whether, hypothetically speaking, they might cover elective surgery with an out-of-state doctor. But in the process, I explained what had happened to me and how I was left with an unsightly wound.
“I think there’s a case to be made for cosmetic surgery when it’s corrective, like a cleft lip,” I said.
She paused, then referred back to the exclusions for pre–existing conditions.
“Depending on how it’s billed, you might have to wait a few years– but I agree,” she said hurriedly, “there’s a case to be made.”
Solidarity seemed like a dream come true. But, wanting to do my due diligence, I asked again what made Solidarity different from other Christian health shares and who their top competitors were. She gave the same hazy response as before, along with a few names. I called the next number, Samaritan Ministries, and left my number on a call list, before going to lunch. Over lunch, I talked to my mom about health shares.
“Yes, I know. That’s what your Aunt Mary does. It’s a pot.”
I messaged Aunt Mary– which did she use?
Samaritan– they’re No. 1, she said.
Just then, my phone rang, and I picked up to a cheery Evangelical– let’s call her Barbara. I told her that I was looking for a Christian health share and that I had already spoken with Jane at Solidarity. She interjected,
“A lot of people are jumping ship from Solidarity, so if you’re considering them– don’t.”
“Why’s that?”
“How would you like an unshared bill going to collections?”
Later, I would look into it. She was right — the average wait time for sharing from Solidarity was 1-2 years.
I asked what made Samaritan number one. She spoke frankly.
“You said your faith matters to you. Well, Solidarity doesn’t even have a statement of faith — anyone can get in. We require our members to sign a statement of faith and to be members of a local church. We also share directly, which means you always know what you’re paying for. We do more than just share bills. Every month, you’ll get a card with another member’s story, picture, and prayer request. But paying is non-negotiable– if you don’t pay, you’re out — so everyone’s bills are paid on time.”
I remembered Aunt Mary’s refrigerator, with the pictures of missionary families she supported.
Barbara’s candor was infectious, and I came out with my story, giving thanks to God for my detransition.
“Praise Jesus,” she agreed. But she went on to explain that Samaritan did not share into pre-existing conditions, explaining every rule and caveat in a wide circle, with such warmth that it was impossible to feel left out.
“There is something called a Special Prayer Request that your situation would qualify for, but it’s voluntary. There’s no guarantee.”
I wondered if I had the faith — or stomach — to wait on such a list, paying into unexpected bills for other families, with no guarantee of relief for my own condition.
I wondered if I wasn’t barking up the wrong tree. I called two more health shares and punched in my number for a callback. The first one to get back to me was Zion, a secular health share. The representative introduced herself as Sarah. I felt I had gained some ground since my first conversation and asked if they had a comprehensive plan, including wellness visits and pre-existing conditions. Yes, much the same as what Solidarity had promised. But could they deliver?
“Actually, we have a very good reputation for that,” said Sarah.
I took a deep breath and began to ask if they would cover elective surgeries, but I stumbled and came out as a detransitioner again. When she spoke, her voice was hushed.
“I don’t think we’re a good option for you. Generally, we don’t cover those things.”
I asked her to elaborate on “those things.”
“Gender transition or detransition. Or cosmetic surgeries,” she spoke with slow deliberation, and I got the feeling our conversation was over.
Dispirited, I returned to what I had been avoiding all along: the application for government healthcare. I scrolled and clicked through boxes with big numbers and small print– numbers three times the amount I already pay. The surgeons I need to see for chest and genital reconstruction are out of state, but the state healthcare is restricted to in-state networks.
Unless– could I be reading things wrong?
I called the number to speak directly with a public health insurance agent and waited on hold for twenty minutes. In the meantime, I researched the private market, clicking and scrolling as the sky grew dark and a miserable snow blew outside the window.
I received a call from an Unknown Caller, and I switched lines automatically. A boyish voice sang in my ear.
“Hi, is this—-?”
I could hear the chatter of voices behind him. I had somehow accidentally entered my number onto a call list for insurance brokers. I hung up and blocked the number.
And went back on hold. No sooner had the public insurance agent answered the phone than I received a call back from the last of the health shares. I apologized to the state representative before hanging up to focus entirely on the incoming call.
I was tired and came out immediately as a detransitioner. The blow came swiftly, catching me mid-sentence.
“I’m sorry we can’t help you, but I’m sure somebody can.”
I tried to explain, but he had already hung up. My phone rang again. It was another insurance broker. Her name was Sadie. She was calm and professional, but an incoming call interrupted her introduction.
“I’m sorry– can you just wait– did you say you worked for the state?” I asked.
She said she worked with, but not for, the state. The incoming call was another broker, buzzing– and then another and another called — interrupting our conversation.
In piecemeal, I told Sadie about my situation: a pre-existing condition, a monthly pharmaceutical bill, and surgeries on the horizon.
“What’s your condition?” she asked.
Finally, I collapsed.
“Acquired absence of testicles in scrotum.”
I was too exhausted to care. I explained that I don’t like talking about it– that I hate talking about it — but that it’s why I’m taking hormone replacement therapy and seeking cosmetic surgery. At first, she was taken aback, but when she recovered, she tried to soothe me.
“Now what’s your yearly income?”
When I answered in four digits her voice lost all warmth and color.
“You need to be on Medicaid.”
It was the final, humiliating blow.
I remembered the conversation with my surgeon before the orchiectomy over five years ago. She’d asked me if I was aware of the increased risk of osteoporosis, and that I would need to continue taking hormone replacement therapy for the rest of my life— at the time, she meant estrogen — in which case, the increased risk would be the same as a “natal woman’s.”
I’d simply nodded along, “yes,” thinking of a picture I’d seen on Instagram– from a transgender influencer, singer-songwriter, and tattoo artist: the lockbox full of estrogen vials and syringes, which he had stockpiled for his tours through Europe.
This is not what I had in mind.
Last night, the pale flurries were barely visible outside the cold, dark window. I turned off the lights and went to bed. This morning, I awoke to a fresh coat of snow and an incoming call from an unknown caller.
Forrest Smith, born in 1995, lived openly as a trans woman for five years before detransitioning in the fall of 2020. With the support of family, faith, and resilience of body, he has pursued recovery and reflection. Over the past year, he has completed a memoir manuscript, chronicling that journey.
Forrest Smith is an ambassador for the Resilience Health Network, which provides helps detransitioners with medical needs.
To learn more about Forrest’s work follow his Substack.
Genspect publishes a variety of authors with different perspectives. Any opinions expressed in this article are the author’s and do not necessarily reflect Genspect’s official position. For more on Genspect, visit our FAQs.
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Thanks to Forrest for bravely sharing his story and for exposing the brutal landscape of detrans healthcare. My heart goes out to him and everyone on this difficult journey. Let us all continue to fight for detransitioner healthcare!