From the Arkansas Advocate:
Sabrina Jennen’s family has deep roots in Arkansas, but she said moving to Maryland three years ago brought them a sense of safety they didn’t have in the Natural State.
The Jennens were one of four families who sued Arkansas in 2021 over its law banning gender-affirming healthcare, such as hormone replacement therapy, for transgender youth like Sabrina, now 20.
Key points
-Arkansas in 2021 became the first state to enact a ban on gender-affirming medical care for transgender youth. The law also prohibits Arkansas doctors from referring minors elsewhere for such care.
-The ban, Act 626, was struck down by a federal judge in 2023 who had blocked its enforcement two years earlier. The ban was reinstated by federal appeals judges last year after the U.S. Supreme Court upheld a similar Tennessee law.
-The Williams Institute says nearly half of transgender adults have moved or considered moving from states with laws targeting them.
Both Maryland and Massachusetts, where Sabrina attends college, have shield laws protecting gender-affirming healthcare. She and her family have also found that states with more accepting LGBTQ+ policies have stronger foundations in other areas, such as education.
“When I talk about my home state of Arkansas with my peers, I really hype up the natural geography, but I make sure to disparage the politics because it truly is a limiting factor, not only for people like me, but also just normal Arkansans,” Sabrina said in an interview.
The Jennens’ choice to leave Arkansas wasn’t unique. The growing number of Republican-led states imposing restrictions on transgender youth — and sometimes adults — on matters ranging from pronouns to medical decisions have forced families to make difficult choices. Some are choosing to stay, but many have looked to other states.
State and national trends
Nearly half of transgender adults in the United States have moved or considered moving from states with laws targeting them to states with safer legal and social environments, according to a survey last year from the Williams Institute, a research center on gender identity and sexual orientation at the UCLA College of Law.
“For those transgender people who do pursue relocating, service providers, businesses, and state and local governments should both consider the costs of losing members of their communities and support and welcome those who are making new homes,” the Williams Institute states.
A federal judge struck down Arkansas’ ban on transgender minors’ healthcare in 2023, around the same time the Jennens moved. Another family that challenged the law, the Dennises, also moved to another state where Brooke Dennis, 14, faces no legal barriers to her healthcare.
The U.S. Supreme Court upheld Tennessee’s similar ban last year, and an appeals court responded by allowing Arkansas’ ban to go into effect. The federal government has since proposed banning hospitals from providing transgender minors’ healthcare as a condition of participating in Medicare and Medicaid programs.
The bans on gender-affirming care have been opposed by most major medical organizations, including the American Medical Association.
Healthcare for transgender adults has also become more difficult to access thanks to sweeping federal orders.
However, some transgender Arkansans prefer to stay or don’t have the means to leave the state.
Yara Sandefur and one of her four children are transgender. Leaving isn’t financially feasible for their family, but staying can be frustrating due to Arkansas’ conservative leadership and the professional obstacles that arose for Sandefur after she came out, she said.
“I just want to be able to breathe like normal folk,” she said.
"Right now, staying with our friends, family, loved ones and community is outweighing the other variables."
– Marie Mainard O'Connell, a Presbyterian pastor and mother of a transgender teen from Little Rock
'The fight is here’
Tien Estell grew up in Arkansas and works for the state’s only transgender-owned community center, Intransitive. Estell’s work includes helping LGBTQ+ people obtain health insurance.
Estell’s work and their family, both biological and chosen, would be difficult to replicate in another state, they said.
“My heart is with my people, and the fight is here,” Estell said. “The fight is in the South.”
That fight comes forth in elected officials’ statements in addition to the legislation they approve. Gov. Sarah Huckabee Sanders declared June in Arkansas “Fidelity Month.” Other Republican-led states such as Utah and Tennessee made similar declarations as a counter to LGBTQ+ Pride Month.
Additionally, President Donald Trump’s administration released a counterterrorism strategy in May that calls for “the rapid identification and neutralization of violent secular political groups,” including those considered “radically pro-transgender.”
“What does it look like to move from one pocket of hatred, one pocket of erasure, to move somewhere else in this country where we still have a president who thinks I’m a terrorist?” Estell said.
‘Continuity of care’
Arkansas “has always felt like home” to Marie Mainard O’Connell, a Presbyterian pastor and mother of three, including a transgender 18-year-old who attends college in-state. When lawmakers propose bills targeting LGBTQ+ people, O’Connell routinely speaks against them.
“As I see the Legislature dog-whistling to try and distract from the real issues that are facing Arkansans, it seems all the more important to stand up for our humanity,” O’Connell said.
She is a founding member of the Central Arkansas Queer Collective, which provides support and social events for LGBTQ+ people and families. O’Connell said her own family considers Arkansas worth staying and fighting for, but it’s been “painful to lose good people to other places, simply because they need something Arkansas won’t give them.”
Shea McGinnis is among those people. His transgender 11-year-old was receiving gender-affirming healthcare in Oregon for over a year before the family moved there in May.
“We had the opportunity to keep that continuity of care for our kid and go to a place where we knew we would be protected and safe and be able to thrive,” McGinnis said.
He also said he has more peace of mind about his own healthcare, since the Trump administration has issued directives discouraging gender-affirming care for trans adults. Arkansas is one of two states with a law allowing private insurers to refuse to cover gender-affirming care.
When Arkansas became the first Southern state to expand Medicaid under the Affordable Care Act in 2013, Estell was part of a team assisting LGBTQ+ people with enrollment. Over a decade later, Estell is among many Americans whose insurance premiums spiked this year because Congress did not extend Affordable Care Act subsidies by the end of 2025.
“Moving to another state doesn’t solve my lack of access to healthcare,” Estell said.
‘Moving parts’
Whether to stay in Arkansas or leave is a decision with “a lot of moving parts” for O’Connell’s family, and the most important thing for them at the moment is to stay with the people they love in their home state, she said.
“Right now, staying with our friends, family, loved ones and community is outweighing the other variables, and I recognize that that’s going to be different for every family,” O’Connell said.
Dozens of Arkansans — including O’Connell, McGinnis, and Sabrina’s father, Aaron Jennen — pressured lawmakers into scaling back a 2023 proposal that would have criminalized adults entering a restroom that doesn’t match their gender assigned at birth. The state passed a law similar to the original policy last year, drawing more public frustration. O’Connell told lawmakers it was “not good for our community, and it’s not good Christian values.”
What gives O’Connell hope for LGBTQ+ people’s future in Arkansas, she said, is her belief “in the resilience of human nature.”
“People, and Arkansans in particular, are fundamentally kind and want to be kind to each other,” she said.
Sandefur said she and her family lost some of their support system when she came out, but what remains of that system is in Arkansas.
“It’s my state too, and it’s my home too, and I should feel welcome here,” she said. “Part of me wants to stay and fight and part of me wants to flee, so I’m caught in the middle, but right now, it makes sense to stay and hope for the best.”
Editor’s note: The key points for this story were written by an Arkansas Advocate journalist.
