Two months after the Colorado Springs Club Q shooting, U.S. Rep. Jason Crow sat down with 16 advocates at the Transgender Center of the Rockies in Sheridan to discuss the needs and concerns facing the LGBTQ+ community.

“I’ve walked along a certain life path that’s given me certain perspectives and lived experience, but you all have walked different ones and it’s important to listen to that and understand that, so I can understand what I can do better,” said Crow, who represents Colorados’ 6th Congressional District.

“I know there’s a lot more that can be done and I should be doing,” he said.

Sitting around him were representatives of various organizations that serve the LGBTQ+ community, such as the Transgender Center of the Rockies and Mile High Behavioral Healthcare, the YouthSeen nonprofit, the Matthew Shepard Foundation and the Envision:You nonprofit. 

April Owen, director of Transgender Center of the Rockies, said the center was very affected by the Club Q shooting, in which five people were killed and at least 17 others wounded. 

A program of Mile High Behavioral Healthcare, the center offers holistic, gender-affirming resources and services to LGBTQ+ people across Colorado. Since the shooting in late November, there has been an increase in the number of people utilizing the center, Owen said. 

However, the accessibility of gender-affirming care for LGBTQ+ people continues to be a challenge for many, advocates explained during the nearly hour-long conversation. 

“We have an abundance of therapists in Colorado,” said Tara Jae, founder and executive director of YouthSeen and a co-founder of Black Pride Colorado. “Affirming therapists? Not so much. Therapists of color? Handful. And there’s a waitlist for that.” 

Understanding gender-affirming care and its value

Gender-affirming care is defined as a supportive form of healthcare that helps align a person’s outward, physical traits with their gender identity, according to the U.S. Department of Health and Human Services’ Office of Population Affairs. It could include mental health, medical and surgical services for transgender and nonbinary people. 

Examples of gender-affirming care include patients not having to educate their medical provider on matters such as why they use a different name than their birth name or why they have certain pronouns, said Steven Haden, the CEO and co-founder of Envision:You, which is an advocacy and training organization for the LGBTQ+ community.

Research has found gender-affirming care improves mental health and overall wellbeing of gender diverse youth, who are more at risk for mental health issues and suicide, according to the Office of Population Affairs.  

In 2022, the Trevor Project conducted a national survey of nearly 34,000 LGBTQ youth between the ages of 13 and 24. It found that 45% of LGBTQ youth in Colorado seriously considered suicide in the past year, including 52% of transgender and nonbinary youth. 

“LGBTQ young people are not inherently prone to suicide risk because of their sexual orientation or gender identity, but rather placed at higher risk because of how they are mistreated and stigmatized in society,” the survey states.

Transgender and nonbinary youth in Colorado also reported higher rates of anxiety and depression, at 79% and 66% respectively. 

However, 60% of LGBTQ youth in Colorado who wanted mental health care in the past year were unable to get it, according to the Trevor Project’s survey. 

The top reasons for this include being afraid to talk about their mental health, fearing not being taken seriously, being unable to afford services and not wanting to get parental permission, per the survey. 

Several advocates mentioned location can be a barrier as well, explaining many people living in rural areas have difficulty accessing gender-affirming care. 

On top of that, advocates discussed challenges to providing gender-affirming care such as limited training opportunities, a lack of diversity among therapists and regulatory issues that limit therapists’ ability to serve clients. 

Limited training opportunities

Owen of Transgender Center of the Rockies explained mental health professionals typically have to seek out their own training for offering gender-affirming care. 

“I think that really needs to happen in schools and training programs, graduate programs, medical schools throughout the state of Colorado, in the country,” Owen said. “Maybe it’s a little elective somewhere that you can take, but it’s not a robust part of the curriculum and it really does need to be in this day and age.”  

Building on Owen’s point, Jae of YouthSeen said such training should be a part of becoming licensed.

Crow said he thinks there may be an opportunity to incorporate such training at the University of Colorado’s medical school. 

“I’d be happy to go to them with this and maybe see if there’s a collaboration opportunity — say, ‘Let’s, you know, add this into the curriculum as well,’” Crow said. 

Diversifying the field and regulatory challenges

According to the American Psychological Association, 84.47% of active psychologists in 2020 were White compared to 6.18% who were Hispanic, 4.24% who were Black and 3.22% who were Asian. 

“We know that our workforce in Colorado isn’t diverse enough,” said Haden of Envision:You. “So, how are we developing a future workforce that represents the identities of the people that live in our communities?”

In addition to his work with Envision:You, Haden said he works as a mental health therapist for a small practice that primarily serves queer clients. Last year, the practice had a year-long waitlist.

“Poor folks (and) communities of color are not getting appropriate care. And so what happens is people quickly disengage from services, so while they have greater needs, the pool of people that are best equipped to serve them is much smaller,” Haden said, explaining the higher rates of suicidality is partly because people can’t get the help they need.

Jae said something that gets in the way a lot, specifically for therapists of color, is the Department of Regulatory Agencies (DORA), which is Colorado’s regulatory agency that manages the licensing and registration of various professions.

“The restrictions that are starting to come down to the point where it makes it difficult for therapists to stay licensed because they are trying to protect their clients,” Jae said. 

When Crow asked what needs to be changed, Jae said the whole agency needs to be reassessed. 

“Specifically around licensing, registry, supports for therapists. While I am fully supportive and understanding on the need for DORA to protect clients, there also needs to be protection for therapists that are doing the work,” Jae said. 

“Protections from what?” Crow asked. “What are the therapists encountering at DORA?”

Jae said, for example, the YouthSeen nonprofit works with young people who are coming out as transgender and nonbinary. 

“And we have to deal with schools, we have to deal with parents. And often the parents are not supportive, so complaints then come in against those therapists who are trying to protect those youth. 

“And then those youth end up being harmed not only from the parents, but also from the school district, also from the insurance companies, and it’s literally therapists trying to support those youth,” Jae said. 

In Colorado, a person 12 years of age or older can get psychotherapy services with or without the consent of their guardian if the mental health professional determines the minor is “knowingly and voluntarily seeking the psychotherapy services and the psychotherapy services are clinically necessary,” according to the Colorado General Assembly’s website. 

“We have parents who will literally call and be like, ‘I know you’re seeing my child.’ And the way that we hold confidentiality, we will say, ‘I have no idea what you’re talking about,’” Jae said.  

“And, because you don’t give that information, a complaint comes into DORA, DORA has to investigate it, and it comes out of our pockets. It goes against our insurance, and we, then, have to find a lawyer to be able to confront them — but then also, it takes away from actually supporting youth,” Jae said, explaining parents sometimes get the school involved, creating another challenge.  

According to the Trevor Project’s survey, 42% of LGBTQ youth identified school as an affirming space. Approximately 22% reported their family as offering high social support, compared to 78% saying their family offered low to moderate support. 

Haden said Envision:You aims to develop an integrated wellness campus that includes transition housing for youth, permanent housing for older adults, a clinic and a wellness center. 

“We’re focused on intergenerational programming (and) how we can create opportunities for young people that are unhoused and have been through extraordinary trauma,” he said, adding he would like to discuss it with Crow. 

Hate crimes 

A focus of Crow’s community listening session was highlighting ways to prevent and address incidences of bias-motivated crimes, otherwise known as hate crimes.

As previously reported by Colorado Community Media, reported incidents of hate crimes in Colorado more than doubled from 2018 to 2020, according to data from the FBI. However, officials still highlighted underreporting of hate crimes as a large concern.  

“People are concerned when the hate crime numbers go up,” said Dana Juniel, the executive vice president of strategy and communications at the Matthew Shepard Foundation. 

“And actually, it might mean that we’re actually doing the work to report the crimes that are happening regardless,” Juniel added.  

Many jurisdictions in the country, including in Colorado, are reporting zero hate crimes occurring in their jurisdictions, Crow said. Thornton, for example, reported zero hate crimes. 

“We know that’s not true,” Crow said. “So, there’s a trust deficit, of course, and a training deficit, both with the community and with law enforcement to figure out: How do we actually get the reporting, get people comfortable with reporting, and officers trained to be able to receive that properly?”

Juniel highlighted the need to get realistic numbers because “we know that money comes from the data,” adding such funding can help support community resources that are affirming for people to go to.

If officers, however, are not properly trained on what hate crimes are, the underreporting of hate crimes will continue, Juniel explained. 

The Matthew Shepard Foundation, in partnership with Out to Protect, offers a “Hate Crimes Investigations for Law Enforcement” course that aims to teach first responders how to recognize, document and investigate hate crimes, according to the training’s website. 

“We are providing scholarships — scholarships to law enforcement who are interested in taking the online training in partnership with Out To Protect,” Juniel said. 

Such training has helped lead to an increase in LGBTQ liaisons at agencies, Juniel said. These liaisons, such as those at the Denver Police Department, aim to strengthen the relationship between police and the LGBTQ community through community involvement and educational efforts. 

“Different from in the mental health space, these resources already exist. We just have to apply it,” Juniel said. 

The need for action 

April Owen, director of the Transgender Center of the Rockies, said the conversation showed her the deficit between the transgender community and the services that are available and how well agencies are meeting the community’s needs. 

“I’m just thinking about how quickly we kind of need to move on this because I think more and more trans people are coming to states like Colorado,” Owen said, explaining she thinks legislation in some states has led people to move. 

“I’m just worried about how to catch up and, kind of, meet the needs of everyone,” she added. 

Jae said last year alone, more than 100 families living outside of Colorado reached out to YouthSeen looking for services in the state. 

At the end of the meeting, Crow said he wrote down action items for him to take. The list included discussing a potential collaboration with the University of Colorado’s medical school to incorporate LGBTQ issues into its curriculum, as well as evaluating law enforcement training and “talk to the chief law enforcement officers in the district and make sure that they understand this is a community priority.”

“Thank you all,” Crow said. “We appreciate the opportunity and (have) some very concrete takeaways.”