For transgender people in the South who are looking to transition, accessing the health care they need can be daunting. Hormone replacement therapy can run around $1,500 per year, and some of the services associated with it may not be covered by health insurance. What’s more, some doctors are not always sensitive to the needs of people who are transitioning.

Planned Parenthood has tried to fill that gap. Hormone replacement therapy is now offered at Planned Parenthood South Atlantic in Raleigh, Chapel Hill, and Asheville, and soon will be available in Charlotte as well. The nonprofit has also updated its language and programming to be more inclusive.

“We’ve reduced our costs quite a bit by removing the barriers that are often in place with other providers,” says Jenny Black, PPSA’s president and CEO. “So we don’t require psych exams or other costly lab workups, which reduces the cost quite a bit. It’s my understanding that a lot of these services aren’t covered by insurance, making reducing those out-of-pocket expenses important.”

The INDY spoke with Black about PPSA’s services for transgender peopleand issues associated with offering them in a state whose government is openly hostile toward LGBTQ rights. Our lawmakers, after all, weren’t especially fond of Planned Parenthood to begin with.

The INDY: What services do you provide to transgender people?

Jenny Black: Right now, twenty Planned Parenthood health centers across seven states offer hormone therapy for transgender people. We really want to help transgender people fully realize who they are. Part of our mission is to help people live the healthiest life possible. We treat them with respect and dignity. We try to provide care that is radically compassionate.

Planned Parenthood is already under attack. Was there a fear that expanding into this area could increase that scrutiny?

We have a deep belief that reproductive rights are connected with LGBTQ rights and health. We’re not afraid to do what’s right even if it’s not going to make us more popular with North Carolina legislators. But since 2010, the legislature has passed increasingly hostile legislation to marginalized people: people of color, working-class people of all races, and frankly, the entire LGBTQ community.

We’re really proud to provide this service in particular. Our staff is well-prepared to deliver compassionate, quality health care, and there’s no reason we can’t do that for the trans community. It’s the right thing to do.

What are some problems that trans people face when receiving health care services?

We see our role as removing barriers to care for all people. In addition to discrimination and harassment, LGBTQ people face lower rates of health insurance coverage, are more likely to have HIV or cancer, and are more likely to be discriminated against, even if it’s not intentional. We stand firmly in that space to make sure all people have access to high-quality services, but transgender people face extra barriers, so we’re making sure we’re removing those.

Have you seen an increase in transgender patients since HB 2 passed?

It’s one of our fastest growing patient population groups, and it may be that word is getting out that we provide this service. It’s hard for me to tie that to HB 2, but we’ve been dealing with this since 2010, since the legislature started passing all sorts of legislation, so we are seeing patient volumes increase from people of color and the LGBTQ community, especially transgender patients. As North Carolina is making it more and more difficult to access care without barriers, Planned Parenthood has become more and more necessary.