There is a question that no family should ever have to answer together: is it safe enough to stay where we live? Not safe in the abstract sense, but safe in the immediate, practical, visceral sense: can my child access the healthcare they need, can we afford to leave, and if we go, what do we lose? That is the question facing transgender Arkansans and their families right now, and the Arkansas Advocate has reported on it with the care and specificity it deserves.
Sabrina Jennen is twenty years old and attends college in Massachusetts. Her family moved to Maryland three years ago after joining one of four families who sued Arkansas over Act 626, the 2021 law banning gender-affirming healthcare for transgender youth. The law also, remarkably, prohibits Arkansas doctors from referring minors elsewhere for such care, as if the goal were not just to restrict treatment but to make sure families couldn't find a way around the restriction. Sabrina says she hyps up Arkansas's natural geography when she talks about home with her college peers, then makes a point of disparaging the politics, because the politics are, as she puts it, a limiting factor. Not just for people like her. For everyone.
That framing struck me. She is not describing Arkansas as a place that hates her. She is describing it as a place that makes itself smaller than it needs to be, that trades breadth and generosity for a narrow, frightened version of what a community can look like. The loss is real on both sides, even if only one side is being asked to bear it.
The Dennis family also sued and also moved. Brooke Dennis is fourteen now, and wherever her family landed, she faces no legal barrier to her healthcare. Another family, the McGinnises, moved to Oregon in May. Their eleven-year-old had already been receiving gender-affirming care there for over a year before the move, and continuity of care was part of the decision. Shea McGinnis says he wanted to go somewhere his family would be protected, safe, and able to thrive. He also mentions his own healthcare, since federal directives have been discouraging gender-affirming care for trans adults too, and Arkansas is one of only two states where private insurers are legally permitted to refuse to cover it.
The Williams Institute found last year that nearly half of transgender adults in the United States have moved or considered moving from states with hostile legislation. That is an enormous number of people quietly doing the arithmetic of belonging: what they stand to gain, what they stand to lose, what they can afford, and what they can bear. The families who have left Arkansas are not abandoning it. They are making a calculation that Arkansas's own lawmakers have forced upon them.
But not everyone can leave, and not everyone wants to. Yara Sandefur has four children, one of whom is transgender, and she is transgender herself. Leaving is not financially feasible. She has faced professional obstacles since coming out, and Arkansas's conservative leadership is a daily frustration. What she said in the piece stayed with me: "I just want to be able to breathe like normal folk." That is not a political statement. That is a human being asking for the most ordinary thing imaginable.
Tien Estell works for Intransitive, Arkansas's only transgender-owned community centre, in Little Rock, helping LGBTQ+ people navigate health insurance. Estell grew up in Arkansas. Their community, their work, their family, biological and chosen, are there. "My heart is with my people," they said, "and the fight is here. The fight is in the South." Estell also makes a point that cuts through the moving-versus-staying framing entirely: moving to another state doesn't solve a lack of access to healthcare. The federal landscape has narrowed for everyone. When Trump's administration released a counterterrorism strategy naming groups considered "radically pro-transgender" as targets for neutralisation, Estell asked what it means to move from one pocket of erasure to another while the same president is in office. It is a fair question. There is no state that fully insulates a trans person from federal hostility right now.
Marie Mainard O'Connell is a Presbyterian pastor and mother of three in Little Rock, including a transgender eighteen-year-old at college in-state. She speaks at the legislature when anti-LGBTQ+ bills come up. She co-founded the Central Arkansas Queer Collective. She says her family considers Arkansas worth staying and fighting for, and that it has been painful to lose good people to other places simply because they need something Arkansas won't give them. Right now, she says, staying with friends, family, and community is outweighing the other variables.
I find myself thinking about what connects all of these people. Not the politics, not the law, but the fact that every single one of them is making a decision under conditions that were imposed on them by people who will never have to make it themselves. Governor Sanders declared June "Fidelity Month" in Arkansas as a counter to Pride. The legislature that did this is not asking itself whether it can afford to leave. It is not wondering whether its children's healthcare will survive the next appeals court ruling. It is not calculating the cost of community against the cost of safety. It has the luxury of certainty, and it is using that certainty to make other people's lives harder.
Act 626 was struck down by a federal judge in 2023. Then the Supreme Court upheld Tennessee's equivalent law, and an appeals court reinstated Arkansas's ban. That is what legal whiplash looks like for a family trying to plan a child's care. The bans have been opposed by most major medical organisations, including the American Medical Association, because the evidence for gender-affirming care is clear and the harm of withholding it is also clear. The law does not reflect the medicine. It reflects a political choice to treat trans children as a problem to be solved rather than people to be supported.
What I take from this piece is not hopelessness. The people in it are too alive for that. Sabrina Jennen is at college and doing well. Tien Estell is still showing up to work every morning in Little Rock. Marie O'Connell is still going to the legislature and saying what needs to be said. These are not people who have been defeated. They are people who are bearing an unreasonable weight with extraordinary grace, and who deserve, at the very minimum, to be seen clearly.
If there is a news story you would like me to cover then just let Sammy know.
Dr Helen Webberley is a gender specialist, medical educator, and founder of GenderGP. She writes about gender diversity, trans healthcare, and the lives at the centre of both.