MORGANTOWN — For freshman Kennedy Hawkins, between Army ROTC training and business classes, his first year at West Virginia University was all about finding his routine.
On the other side of campus, as junior Koen Korstanje balanced a passion for fashion design and sculpture, his schedule became busier than ever.
Although the men appear to have different days on their dockets, their schedules share one thing: Testosterone shots.
For Hawkins once a week and Korstanje every other week, a shot of ‘T’ is part of their hormone replacement therapy. These men are two of the many individuals living in West Virginia who are transgender and choosing to undergo gender confirmation treatment.
Though they have this in common, their experiences couldn’t be more different. Both go to WVU, but Korstanje was born in Huntington, while Hawkins is from just outside Philadelphia. While Hawkins gets his “T” shipped in bulk for self-administered doses each week, Korstanje drives to Pennsylvania to meet with an endocrinologist twice a month.
“It’s completely covered there.” Korstanje said. “Not even through insurance, they just take care of it. It’s really great. But there’s nothing like that near me in West Virginia.”
Like Hawkins, Korstanje’s transition is medically based, but for him, that means he has to travel to the Central Outreach Wellness Center in Washington, Pa., to receive what he describes as “really wonderful” care.
He falls into the demographic of trans West Virginians who get care from a state that isn’t West Virginia. According to a 2019 health survey of transgender West Virginians conducted by Fairness WV, 36% traveled out of state to seek care, and nearly half had to travel over an hour to do so.
The first transgender elected official in the state, Wheeling City Council member Rosemary Ketchum, grew up in East Liverpool, Ohio, before moving to Wheeling.
“LGBTQ resources both in mental health and physical health were just not available,” Ketchum said, “and, for my parents, we would have had to travel to Pittsburgh or Cleveland to get trans-specific health care.”
Although Ketchum’s transition is not medical, her family sought out a counselor when she was a child beginning to have questions about her identity. Even then, Ketchum said her therapist had only given care to one other LGBTQ patient.
Ketchum’s experience reflects the larger issue many rural trans people face. Professionals in places like West Virginia may have little to no experience with someone who is transgender. Which means therapy for youth experiencing gender dysphoria and gender-affirming surgical procedures and hormone therapy can be difficult for trans people to find readily in the Mountain State.
Yet in Preston County, a Federally Qualified Health Center, FQHC, family physician Dr. Mary Gainer is one of the health practitioners in the state who defies that expectation. She has over a dozen transgender patients in her care.
“Transgender health care is just primary care.” She said, “It’s not that complicated… most family doctors could easily sprinkle gender care into their practice, so that a person doesn’t have to go 300 miles to the one gender clinic.”
Partnered with a therapist, Gainer took the initiative to enroll in a year-long fellowship to train to meet transgender-specific needs. She said she did this to meet the needs of her community.
“It’s really about exposure,” Gainer said. “I think some doctors feel like this is outside their scope of practice, when really after you do it for a little bit you realize it’s much more complicated to manage an uncontrolled diabetic. But that’s just something we’re used to.”
Gainer is one example of the growing options trans West Virginians are gaining for care.
She is putting experience working with the trans community towards advising Hawkins in his pursuit to reimagine the hormone therapy process.
In his short time at WVU, Hawkins has teamed up with fellow freshmen, Aidan Priest and Dylan Cunningham, to invent a new way to administer hormones. Under the guidance of the WVU Launchlab, the “Shark Tank”-esque innovation center on campus, the team is developing T.H.E. POD, an insulin-pump-inspired device that could make hormone therapy simpler and more efficient.
“If you have a system where it is attached to you and is just like insulin,” Hawkins said, “it becomes the same thing as somebody who’s in the military with diabetes. Plus, It’s 100% less painful.”
Hawkins said he thinks the team’s invention has potential to move mountains of inaccessibility to hormone replacement therapy as their streamlined alternative makes long-term usage easy. For West Virginians like Korstanje, this invention could make those travel expenses disappear.
Transgender youth and hormone therapy have been at the forefront of many West Virginians’ minds after the state passed the controversial HB 3293 to ban transgender student-athletes from playing on sports teams that match their gender identities.
Gov. Jim Justice’s told MSNBC on April 30, that West Virginia only has 12 kids “that are transgender type kids,” who would be impacted by this legislation. But a 2017 Williams Institute study estimated West Virginia has the highest percentage of trans youth in the country.
Ash Orr (they/them) is Morgantown’s chair of the Human Rights Commission and outreach coordinator for Morgantown Pride and they have been on the frontline of this debate in Charleston.
“West Virginia has the highest amount of trans youth per capita,” Orr said. “So it’s mind-blowing to present this data to these delegates and senators and have them say, ‘you don’t exist’ or ‘you’re mentally ill.’”
At the NCAA and Olympic level of sports there are rules that regulate the participation of trans athletes based on hormone levels. But there are fewer regulations at the middle and high school levels. In West Virginia, there were no rules regulating transgender participation in secondary school sports, but instead of adding a regulation, HB 3293 bans trans athletes from particpating on teams other than the gender on their birth certificates.
“They have been presented with scientific data, with factual stories, with first-hand accounts on how this is going to impact students across the state, and they just tossed it all out,” Orr said.
Since West Virginia passed its legislation, a number of other states have considered or passed similar bans on trans athlete participation, while states like Connecticut allow student participation based on gender identity without any limit .
A proposed solution, that still has its share of debate, is having states like West Virginia adopt a degree of NCAA standards in hormone regulation for secondary sports, rather than banning trans athletes from competing in sports according to gender identities.
The option to undergo hormonal therapy for trans youth who seek medical transition, according to Gainer, is to help them live their “fullest, best lives.”
“Look at Kennedy,” Gainer said. “Look at someone who has been able to live his exact life. And come up with this brilliant idea.”
The next steps for Hawkins and his team are to meet with industry professionals, pitch the idea, acquire funding and get T.H.E. POD patented. Soon they hope to have the idea available for the transgender community across the state and country. And for those early in their transition like Korstanje, that could mean making that change all the more easily.
Adam Payne is a student in the WVU Reed College of Media. This article was written as part of the multimedia storytelling capstone class and offered to The Dominion Post for publication.
