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As bans on transgender care for minors grow, a migration of sorts is underway

The Egerton family unpacked at at their new home in Concord. They moved from Austin, Texas, to Massachusetts a few weeks ago to provide a better life and home for their transgender daughter, Willow.Suzanne Kreiter/Globe Staff

After days of frenzied packing and tearful goodbyes, the Egertons and their two dogs piled into the family’s Honda CR-V on a hot morning in early June and drove away from Austin for good — the Muppets’ “Movin’ Right Along” playing on the car stereo and Google Maps set for Concord, almost 2,000 miles away.

It was an emotional moment. The family of four had just taken a last walk through the 1,000-square-foot bungalow they’d called home for 18 years, the house where Owen and Jodi Egerton’s younger daughter, Willow, had been born a boy in their bedroom nearly 15 years earlier.

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They were leaving behind grandparents, friends, and a community that supported them. But they were also leaving Texas, a state that no longer felt like a safe place for their family — a place where state officials ordered child abuse investigations of parents who helped their children access transgender-related care and where a new law barring kids from taking puberty blockers and hormone therapies was about to go into effect.

Three days later, the Egertons drove into Massachusetts. They rolled down the windows and let in the crisp, cool breeze — and headed to their new home in the woods near Walden Pond. For Willow, who has identified as gender fluid since the age of 7 and as transgender since 2021, being in a state without oppressive temperatures or transgender rights restrictions was literally a breath of fresh air.

She remembers thinking: “This is exactly what Texas is not right now.”

Fourteen-year-old Willow Egerton flopped onto her bed in her new home in Concord. (Suzanne Kreiter/Globe Staff)
Egerton decided where to hang her disco ball in her new bedroom. (Suzanne Kreiter/Globe Staff)

Laws banning or restricting transition-related medical care for youths have been rolled out in 20 states in the past two years, mostly in conservative areas in Southern and Central parts of the country. Some bans haven’t gone into effect, and others have been temporarily blocked by courts (a lawsuit was filed in Texas state court this month arguing that the ban violates parental rights and discriminates against transgender youth), but some families have already started relocating to places with stronger LGBTQ+ protections. Many people who can’t move are planning to seek care in other states, where wait lists are growing, or face the prospect of having their child stuck in a body they don’t identify with. But for those with the means to do so — who have friends or relatives to stay with, jobs that can be done remotely, or the willingness to split up their families — a migration of sorts is underway, a small but notable exodus dividing the country into slightly deeper shades of red and blue.

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The new laws are having a ripple effect, said a trans woman planning to leave Florida: “The bigots are just emboldened.”

More than 93,000 minors identify as transgender in states that have passed bans on gender transition care, nearly a third of all trans youth nationwide, according to estimates by the Williams Institute at the UCLA School of Law, based on Centers for Disease Control and Prevention survey data. Transgender youth have higher rates of depression, anxiety, and suicidal thoughts than their nontransgender peers, studies show, and starting hormone treatments in adolescence has been linked to better mental health and fewer substance abuse problems in adulthood, according to a Stanford University School of Medicine study. Some clinicians disagree on the timing and criteria for transition care for minors, but several major organizations, including the American Medical Association and the American Academy of Pediatrics, support the need for it.

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In the states where Republican-dominated legislatures have blocked access to gender-affirming care, the prevailing argument has been that children don’t have the maturity to consent to what can be irreversible treatments. But for transgender children and their families, it’s about more than health care and hard choices. It’s also about being in a place where they don’t fear having their children taken away if they’re receiving transgender-related care. It’s about maintaining the freedom for their children to be called by the pronouns they identity with and go to the bathrooms where they feel most comfortable.

In some states, care for trans adults is also being curtailed. In Florida, for instance, all such care must now be administered in person by doctors, eliminating the ability for patients to use telehealth or see nurse practitioners. Many health care providers for transgender adults are “hitting the pause button,” said Nic Zantop, deputy director of the TransInclusive Group in Florida, noting that Planned Parenthood has stopped accepting new patients seeking gender-affirming hormone therapy.

“These bills basically have a chilling effect,” said Zantop. “There’s so much gray area that people don’t necessarily know how the laws will be enforced.”

Most parents of trans children don’t have the “extreme privilege” to pick up and move, said Andrea Segovia, senior field and policy adviser at the Transgender Education Network of Texas. And many can’t afford to seek care out of state, meaning their children could lose medical treatment and be forced to detransition to a body they don’t identify with. Segovia tries to help these families come up with solutions and reminds them to put the current backlash in perspective: “Hey, it’s been worse,” she tells them. “It used to be that trans people couldn’t even walk down the street.”

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Still, more than a quarter of trans adults reported moving to a different neighborhood, city, or state in search of greater acceptance, according to a survey late last year by The Washington Post and KFF (formerly called the Kaiser Family Foundation).

Elevated Access, a volunteer pilot network that last year started flying women seeking care to states where abortion is still legal, now also provides transport for transition-related care — and recently started getting calls from people looking to move altogether. The planes are too small to transport people’s household items, but the organization is doing what it can to provide access to care and recruiting more pilots willing to donate their services, said Fiona, a spokesperson who asked to be identified by her first name.

“It’s a full-blown humanitarian crisis,” she said. “We have created our own refugees: Americans who are fleeing from state A to state B.”

One transgender girl moving to the Boston area from Florida with her family said she felt forced out, according to her mother. Shortly before they left, her daughter told her: “I’m so sad they’re deporting me.”

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Governor Maura Healey and Lieutenant Governor Kim Driscoll took part in the Boston Pride parade last month.John Tlumacki/Globe Staff

In Massachusetts, legislation is moving the state in the opposite direction of those banning transgender care. Last summer, lawmakers codified protections for patients and providers, and roughly two dozen bills on Beacon Hill would further expand LGBTQ+ medical care and protections. Maura Healey, one of the first openly lesbian governors in the country, hosted a drag show on the State House steps earlier this summer and jogged through the Boston Pride parade in rainbow Converse sneakers.

“There are people all across this country looking to us who need a safe haven,” Healey said at the Pride flag-raising at the State House.

Just over the border in New Hampshire, however, the Legislature this year considered bills that would have criminalized or banned transition care for minors, both of which failed this session.

The Massachusetts-based gender-affirming care provider Transhealth has gotten so many inquiries from people looking to relocate to New England that it’s considering partnering with community organizations to create a welcome packet with a list of LGBTQ+ friendly resources.

“We live in a time now where we’re actively going to see many, many people flee to states like Massachusetts,” said chief executive Dallas Ducar, who requested that Transhealth’s location not be published to protect its staff and patients. The clinic has 50 employees and is in a “massive hiring push” to deal with the rising need, she said.

“We live in a time now where we’re actively going to see many, many people flee to states like Massachusetts,” said Dallas Ducar, the chief executive of Massachusetts gender-affirming care provider Transhealth.Jessica Rinaldi/Globe Staff

Ruth, the woman whose daughter felt she was being deported, is moving from South Florida to the Boston area next month with her 13-year-old transgender daughter, leaving her husband and 15-year-old daughter behind. Ruth, a lawyer, and her husband can both work remotely and plan to switch off at the end of the year, with Ruth heading back to Florida and her husband coming here.

Ruth, who asked to use her middle name to protect her daughter’s privacy, grew up in Massachusetts, and knows she’s fortunate to be able to stay with her parents. But the situation is far from ideal. Her daughters won’t get to see each other much during the school year, and neither will she and her husband. “My daughters are both anxious about the stress that this split will have on our family,” Ruth said.

“All kinds of people are . . . being robbed of the freedom to be their true selves in [Florida],” she said. “It is a huge relief to know that there are safe places in this country.”

Fenway Health in Boston, the largest gender-affirming care provider in New England, has had a “notable increase” in calls to its trans health program from out-of-state-families. Director of health policy research Sean Cahill, who has closely followed anti-LGBTQ+ campaigns through the decades, said that what’s happening now, with hundreds of bills filed this year alone, is unprecedented. “We’ve never seen anything this intense,” he said.

In May, within a week of Florida Governor Ron DeSantis signing a flurry of legislation — banning transition-related care for minors, forcing people to use bathrooms that align with their gender at birth, and restricting discussion of personal pronouns in schools — Christine and her husband put their Miami house on the market and started house-hunting in Connecticut, where they have family and where transgender care is readily available. Their 11-year-old daughter, who was born male, is almost ready to start hormone blockers but couldn’t get a prescription from her endocrinologist. Not being able to use she/her pronouns and being forced to use male restrooms would have also been devastating for their daughter, Christine said: “She has such an incredibly negative response when she gets misgendered. You can just see the light drain out of her face.”

Florida Governor Ron Desantis has signed legislation banning transition-related care for minors, forcing people to use bathrooms that align with their gender at birth, and restricting discussion of personal pronouns in schools.NICOLE CRAINE/NYT

Christine, who asked to be identified by her middle name, works as a financial analyst for her husband’s law firm, which they will continue to run remotely. But Christine is leaving behind her elderly parents in the city where she’s lived her entire life. And, she said, there are many other families facing the same predicament. “Everyone’s leaving in droves.”

Jennifer Solomon, president of the South Miami chapter of the LGBTQ+ support network PFLAG, knows of at least five families actively leaving the area. “As a parent of an LGBTQ youth in Florida, it’s something you have to think about,” she said. “Florida is not a free state.”

In Texas last summer, a number of families with trans members tested the waters by vacationing in states with strong LGBTQ+ protections, and a wave of them are moving now, said Segovia, of the Transgender Education Network of Texas. She advises them to consider cities ranked high on the Human Rights Campaign’s municipal equality index and to connect with other families who have relocated there.

But even in a comparatively liberal, welcoming place like Austin, the atmosphere changed when the state bans passed, said Jodi Egerton, who moved with her family to Concord this summer. She can work remotely as the chief executive of a graphic design agency, and her husband, Owen, a filmmaker, performer, and writer, starts as a screenwriting professor at Emerson University in the fall. He applied for the job weeks after Democrat Beto O’Rourke lost his challenge to Governor Greg Abbott — and they lost hope that transgender rights would be upheld.

The Egertons’ story was first reported by the Austin NPR station KUT.

Fourteen-year-old Willow Egerton put on an old mask as she and her family unpacked their belongings in their new house. (Suzanne Kreiter/Globe Staff)
Egerton (center) played chess with her sister Arden, 18. (Suzanne Kreiter/Globe Staff)

Jodi Egerton’s parents had been spending half the year in Austin, and Owen Egerton’s parents relocated there after he did, as did his sister and older brothers; Sundays were often spent gathered at one family’s house or another. Willow was at a progressive private school that allowed her to keep playing on the girls’ volleyball team wearing knee-high “Trans Pride” socks.

But they couldn’t stay in a place where the government declared their daughter “unwanted,” Owen Egerton said. In May, amid a state investigation of an Austin pediatric hospital’s transgender care, Willow lost access to the doctor who had written prescriptions to ease her gender dysphoria — the profound discomfort caused by a person’s gender identity not aligning with their biological sex — and the need to leave became more urgent.

Since arriving in Massachusetts, though, the feeling of moving away from something dangerous has started morphing into the feeling they’ve moved toward something good. They’re excited to explore Walden Pond and the area’s rich literary history, as well as its antique stores and farm stands.

When the Texas bill banning transition care was being debated, the Egertons protested and testified at the state capitol. They worry that if queer families leave states where restrictions are passed, the fight to protect trans rights there will be abandoned. But at the same time, they’re relieved to be in a place where Willow’s identity doesn’t have to be a political statement.

Willow plans to stay active in trans rights but likes not being in “fight or flight” mode. Her guard is still up, and the political storm is still raging, but at least in Massachusetts, she said, she’s free to be herself: “It’s safer here.”

Fourteen-year-old Willow Egerton entered her new bedroom. Suzanne Kreiter/Globe Staff

Katie Johnston can be reached at katie.johnston@globe.com. Follow her @ktkjohnston.