Breaking Down The Barriers to Inclusive Care: A Conversation with Aaron Steinfeld of the Family Violence Law Center

When it comes to transgender-spectrum youth (TSY) and providers, there are many barriers to access that make seeking inclusive care a challenge. The stigmas that TSY face from society can often be inadvertently recreated or misunderstood by their health providers, resulting in the inability for youth to comfortably obtain the services that they need.

At the same time, many youth providers haven’t been properly educated about gender identity or trans*-related health concerns. This makes it difficult for providers to properly provide service; and in turn facilitates a cycle of stigma that then becomes the burden of trans* youth.

This difficult reality is something that Aaron Steinfeld, Community Educator and Youth Organizer at the Family Violence Law Center, is advocating to change. Aaron has the unique experience of being both a transgender spectrum identifying young adult and as a youth health provider, which makes them the perfect candidate to unpack the politics around this important issue with YTH’s own Christian Bannister.

Chris Bannister: Right off the bat, what are some of the challenges transgender-spectrum identifying youth face when they are looking for a provider?

Aaron Steinfeld: I think of stories from other trans people about things they’ve experienced. So, maybe they’ve found a provider and they think the person might be supportive and inclusive and understanding of their needs but [I think of] the types of communal trauma that has happened with trans* youth and providers. Thus, trans* youth often end up feeling like, “So I found this person who might be good, but because I know so many other people in my life have experienced trauma from providers, can I really trust this person, should I really go to this appointment?”

I think communal trauma is definitely a barrier. And that’s for the young people who end up finding someone who they feel comfortable going to in the first place or finding someone at all. Some young people have their parents set up their doctor appointments, they’ve gone to a family doctor for services before, or they’ve gone to see certain specialists with approval or recommendation of supportive adults in their life. However, a lot of trans* youth are having to navigate finding providers and getting to and from appointments on their own without that support. I think that solitude can definitely be a barrier as well.

C: Right. I feel like for people like us who live in the Bay Area,(or in any other metropolitan area) find access to resources a little bit easier compared to someone who lives in a rural area where transportation becomes a barrier. Also,if the population is small, finding others within the community becomes an obstacle.

A: Right. Totally.

C:  You’re kind of in a unique position because you’re somebody who works for an organization that is involved with trans* youth but you’re also part of the community yourself. Does this allow you to act a bit like a liaison since you’re involved with both?

A: Exactly. I am in a unique position in that, I am a provider and consumer of resources for trans* youth and do straddle both in different moments. In my general way of being, my way of navigating those two worlds is using my personal experience to inform what it could be like for somebody else. Also, knowing that there are certain parts to my identity that might make it easier for me to access resources than it would for another trans* person. For example, my whiteness, my class privilege, and my employment status, all of these things make it easier for me to access services and getting the support I need.

It definitely has informed the way I give support to young people because I’m able to know and have experience [for] what it’s like for a young person to go to a provider and tell them their story and talk through what they need and have that feel really vulnerable and scary. I also know what it’s like to be on the other end of those conversations and can empathize with younger people and hear more about where they are at and what they are looking for.

C: Do you sometimes find it difficult to separate your work from your own personal experiences or do you think that helps to bridge the gap between organizations and trans* youth?

A: Yeah. That’s a world that I’m still trying to figure out how to navigate because I’m definitely in the middle ground right now. I’m 25, so technically I’m no longer eligible for a lot of youth oriented grants which cut off at the age of 24. But, I’m still someone who people see as a young person. Often times, when I’m hanging out with a group of high schoolers, other adults will assume I am a high schooler as well and will treat me as such. So, I am able to see both different worlds and how they inform one another.

A lot of what I do in my work involves translating what a youth might need to other providers, relating what providers are trying to say and trying to do for the youth, and explaining to both groups that there are going to be words and phrases and things that this other group of people need and uses that might not resonate with your experience and your identity.

C: You briefly mentioned your privilege before, would you say that translating between patients and providers also plays into how you navigate your privilege? How do you think other people with privilege can navigate their identities with regards to those around them?

A: I continuously check in with myself about how other people perceive me and often times that helps guide me in moments where I’m like, “Okay I really just avoided an unsafe situation because of my whiteness.” Or, “Wow, I was really put into an unsafe situation because of my gender.” I think more people should anticipate those moments and anticipate ways that their identities might benefit them positively in some moments and negatively in others. But, I think because of my own experiences that I have been able to work with young people by sharing my stories to help young people anticipate what they might experience in a given setting or context.

C: Awesome. So, I think another thing I wanted to touch on is the recent surge in, trans celebrities like Laverne Cox, Laura Jane Grace, and Janet Mock who have kind of paved the way for modern day trans* visibility and empowerment within the trans* movement. On top of that, we have more political action happening right now with regards to trans* civil rights. However, I noticed that patient/provider care seems to be a topic that kind of gets overlooked in the mainstream media. Why do you think there’s a discord on reporting between trans* patients and their providers but there’s visibility in other areas?

A: I think that happens for a number of reasons. One of the main reasons is when we think about things that are most often talked about, we’re rarely talking about interpersonal interactions with people. We’re talking mostly about what policies look like, how these conversations look like in a macro scale rather, and we have trans* celebrities coming out supporting certain legislation or opposing certain legislation and they’re talking about how these decisions are going to affect the community broadly. And at least how I’ve seen it, we haven’t had a lot of conversations where we’re wanting to see how those policies then trickle down to two people interacting with each other in a bathroom in a school. Right?

So, you have this bathroom ban that affects everyone in the country, at least for public school students, and then we’re saying things like “This is going to be bad for trans* youth,” but when someone walks into a bathroom of a gender that they don’t identify with, what is likely to be their thought process, what is the thought process of their peers? What are their teachers going to think? What is actually happening to that young person at school? I think when we talk about patient provider interactions, it’s again that small interpersonal twenty minute conversation that is easy to brush off and say “It’s hard,” or, “It’s challenging,” and while all that is true we’re not talking about words that doctors use that make trans* people feel like they’re not being listened to or the ways that mental health providers are talking to trans* youth that makes them feel unsafe to come out in that space.

C: Right. I feel like a lot of those aforementioned thoughts don’t get considered when it comes to patients and their providers because when we do look at what’s visible right now in the mainstream media, everything almost seems finalized. With celebrities it’s like, “Oh, here they are. They’re a celebrity.” We don’t focus on their journey or how their journey has led them to where they’re at. We don’t consider all of the different layers to their identity and how it relates to their providers and their health care physicians and how something like a bathroom bill plays just as much of a role in trans* identity as a behind closed doors healthcare provider appointment would.

A: Right. When we see celebrities, we’re not really seeing them in transition phases. We’re seeing celebrities like—I don’t really like to talk about her that much but—Caitlyn Jenner, who sort of dropped off a little bit when she was doing her transition and then sort of appeared on the cover of this magazine as this totally formed version of herself.

C: Totally.

A: Right? She’s someone who has a lot of privilege. She is an Olympic athlete with lots of money who regularly appears on TV. She was able to go underground while transitioning and then reappeared as a totally formed version of herself. We don’t often get to see public stories of transition and because we’re missing those stories we’re missing a part of the conversation. I think as more people feel safe coming out mid-transition the more we can have productive conversations about what those people need as a society and a culture.

C: Awesome. Thanks for your time and sharing your insight with us, Aaron.

A:  Thank you!


trans* is an umbrella term that refers to all genders who identify within the trans* spectrum

For more help navigating trans* inclusive care visit our they2ze project page. they2ze is currently available and free download for both Apple and Google Play

If you’d like to learn more about getting connected to a provider or to a trans* inclusive care service please visit the following resources:

Lambda Legal’s Resources for LGBTQ Youth By State

National Center for Transgender Equality (NCTE)  (advocacy)

The LGBTQ Youth Space (Santa Clara County, Family & Children Services/Advocacy)

TransThrive (San Francisco County, Safe Space Drop-In Center)

Transgender Law Center (TLC)  (legal services and advocacy)

The Trevor Project‘s 24/7 Lifeline at 866-4-U-TREVOR (866-488-7386) or Trevor Chat, the Trevor Project’s online messaging service

ZonaSegura ZonaSegura is a trauma-informed youth-centered innovative mobile solution to address teen dating violence in Honduras. Learn more about ZonaSegura on our program page.