Kyle Avery Jones had recently come out as transgender to her parents and friends when her final semester at the University of Connecticut began in January 2020. She wore androgynous clothes to school, sought out gender-neutral bathrooms, and limited her socializing to queer-friendly weekend gatherings off-campus. \u201cEveryone in my classes assumed I was a dude. I didn\u2019t want to show up one day with a face full of makeup and a dress on. I was literally counting down to the end of the semester. I thought, \u2018Once I finish college, I won\u2019t have to do this anymore,\u2019\u201d said the 22-year-old Realtor from South Windsor. Then COVID-19 struck, moving college online. Suddenly, Jones was staring herself in the face all day on a computer monitor, her anxiety rising with each class. \u201cI was very distraught about having stubble on my face; it was an area of gender dysphoria for me. I would shave two or three times a day to make it extremely smooth. There was a lot of stress going on, and I just had to fight through it.\u201d She turned to feminizing hormone therapy to help light the way. \u2018Very Jarring\u2019 While COVID-19 has shuttered businesses and quarantined countless people in Connecticut and beyond, it has also motivated many transgender individuals such as Jones to begin gender-affirming hormone therapy, experts say. The reasons vary from the chance to transition away from gossiping co-workers, to realizing what\u2019s important in life when the death count is daily news, to coming to terms with the self-image looking back during online work, school and socializing sessions. \u201cNinety-nine percent of the time, gender dysphoria is what leads someone to begin hormone therapy,\u201d says Layne Gianakos, director of programming and community relations at Anchor Health Initiative in Stamford and Hamden, which specializes in health care and wellness for the LGBTQ community. \u201cUsually, you\u2019re not looking at yourself speaking at all. It\u2019s very jarring.\u201d Gender dysphoria is the psychological distress that results from a disconnect between how a person identifies sexually and their assigned gender at birth. \u201cIt\u2019s very similar to trauma,\u201d Gianakos said, and it can be life-threatening, particularly for young people. In fact, more than 50 percent of transgender adolescents in the United States who identify as male have attempted suicide, according to a 2018 report from the American Academy of Pediatrics. \u201cThis is a public health crisis that not nearly enough people are addressing,\u201d Gianakos said. Transgender hormone therapy addresses the disconnect. Our endocrine glands secrete hormones into the bloodstream, and these hormones regulate a host of body functions, including those that can help a person better align with a gender. Many transgender women, such as Jones, who undergo feminizing hormone therapy. This includes testosterone blockers and estrogen to promote breast growth, alter skin texture, redistribute weight and slow body-hair growth. Many transgender men, undergo masculinizing hormone therapy. This includes taking testosterone to help develop muscle mass, thicken vocal cords, redistribute weight and increase body hair. Increasingly, transgender youngsters are taking hormone blockers to delay the onset of puberty. Katy Tierney, an endocrinology specialist and medical director of the Middlesex Health Transgender Program in Middletown, says that COVID-19 has rocked the transgender community as it has the community at large. \u201cEither it makes you feel incredibly unstable, or it gives you the opportunity to make all the changes you ever wanted to make. A lot of transgender people were like, \u2018This is the time. It\u2019s now or never.\u2019 I\u2019ve had patients in their 80s start their transition.\u201d When Tierney joined Middlesex Health six years ago, there were no transgender-identified patients in the system. \u201cNow we have more than 1,200,\u201d she says. Her appointments are filled three months in advance. \u2018Little Baby Steps\u2019 One of Tierney\u2019s patients is Paula Degree, 73, the former pastor at a Congregational church in the Oakville section of Watertown. \u201cWhen I came out as transgender, the night I told my council was the last time I entered that building.\u201d There were \u201ca couple of church bullies\u201d who made it clear that now that she was a transgender woman, Degree wasn\u2019t welcome on the pulpit. \u201cOakville is kind of a blue-collar village, and they were just not handling change well. I kind of knew that would happen.\u201d Degree had already been kicked out of her own home. \u201cWhen I came out to my now ex-wife, she physically pushed me away and told me to get out of the house.\u201d Two of Degree\u2019s three adult children have stopped talking to her. Degree visited with a gender therapist prior to starting hormone therapy. \u201cThe first several sessions were very tense. I was under the impression that I had to convince my therapist that I was transgender.\u201d That wasn\u2019t the case, however; Degree discovered that she could identify however she chose. With Tierney\u2019s help, Degree started with an estrogen patch and went from there. \u201cTransitioning is a whole series of little baby steps that when you\u2019re doing them are huge. You just feel so elated,\u201d Degree says. Tierney\u2019s clients do not have to label themselves to seek care. For many transgender patients, this is the first time that they are not pinned to a gender. \u201cThe minute we know what genitals our child has, we have set out a plan for them,\u201d Tierney says. \u201cIt sort of boggles my mind how hard we hold on to that gender expectation. I don\u2019t have any expectations about any pronoun or what they\u2019re wearing. Whatever is safe for them is what works for me. They can wear a suit and tie and take estrogen, and that\u2019s fine with me.\u201d The transgender program at Middlesex Health is one of at least six hospital-run transgender programs in Connecticut. UConn Health opened its Transgender Medicine Services in the thick of the pandemic last year. The program includes a dedicated gender-affirming hormone therapy clinic in Farmington, in addition to services such as cosmetic surgery, urological care and voice therapy. Due to COVID-19, these programs now offer telehealth services, which many transgender people credit with easing the path to transitioning. For years, lack of transportation, access to transgender-friendly doctors\u2019 offices, even hostility in some medical settings left many transgender individuals skittish about seeking services. Thanks to telehealth, patients can seek care from wherever they want, wearing whatever they choose, presenting however they feel comfortable. Even at places such as Anchor and Planned Parenthood, which served the LGBTQ community long before hospital programs came on the scene, most new transgender patients during COVID-19 have opted for telehealth. Statistics vary on how many transgender people live in Connecticut. Data derived from a 2017 National Institutes of Health survey estimate the number of transgender adults here at 7,000. A 2016 report by the Williams Institute at UCLA, however, hikes that figure to 12,400. Last month, the state\u2019s LGBTQ Health and Human Services Network launched its first-ever needs assessment survey, which could result in a more accurate count. Gianakos suspects the numbers may be higher than estimated. Anchor Health fielded 42,961 client calls from March 1, 2020, to Nov. 30, 2020, up about 10 percent from the same period in 2019. Some calls came from concerned parents who, sequestered at home instead of at work all day, came face-to-face with their transgender child\u2019s struggles. \u201cParents are saying, \u2018I didn\u2019t realize how miserable my child was,\u2019\u201d Gianakos says. \u201cI\u2019ve been dealing with one high school right now that is not respecting a teen. It\u2019s an absolute nightmare.\u201d Incredible Joy Angel Roubin of Essex is a clinical psychologist who provides help to transgender clients, many under 18. She says that COVID-19 has underscored to many transgender children how little control they have in their life. \u201cThese kids are on Zoom every day for school. It\u2019s a constant reminder of \u2018I don\u2019t fit in. I\u2019m not who I want to be. I\u2019m living a lie. I\u2019m literally flunking all my classes. I can\u2019t function. I\u2019m so distraught.\u2019 It\u2019s so overwhelming. It\u2019s a trap you literally can\u2019t escape.\u201d Roubin began working during the pandemic with a teenager who \u201clives in a very unsupportive home. This person is already wearing a (breast) binder. He has breast growth. He is already getting a period. Menstrual cycles are horrendously hard, and so is showering. The parents have seen this kid day in, day out, suffering.\u201d The teen begged his parents for masculinizing hormones, but the father worried that the youngster would change his mind down the road. The father had a change of heart in November, Roubin said, when the teen told him, \u201c\u2018Every day that I\u2019m not on testosterone, irreversible things are happening to me.\u2019 The kid was saying \u2018I can\u2019t live like this much longer.\u2019 The person transitions, but the family has to transition, too.\u201d Not every family changes, and this has wreaked havoc on living situations, especially during the pandemic, and especially for transgender adults ages 18 to 26. Says Gianakos, \u201cI\u2019ve been seeing a huge increase in housing instability for trans people since the first stay-at-home order. Clients are living with family, they start hormones, and the family says \u2018no, absolutely not,\u2019 and they get kicked to the curb.\u201d He estimates that 23 percent of transgender people have been homeless in Connecticut and, with shelters operating at about a third of their capacity, \u201cit\u2019s a really dire situation.\u201d Some parents have discontinued health insurance coverage for their transitioning offspring. Couple that with skyrocketing unemployment due to the pandemic and many young transgender people have found themselves scrambling for health care. \u201cSome people lose their job, lose their insurance\u2014and lose their hormones,\u201d Degree says. \u201cA lot of people turn to the black market.\u201d Indeed, without insurance, money for a co-pay, or a doctor to write a prescription during quarantine, some transgender people on hormone therapy have resorted to transgender-friendly Google documents, Facebook groups and subreddits to try to crowdsource their hormones from peers with a surplus stash. In June, the federal government repealed provisions of the Affordable Care Act that protected transgender people from sex discrimination and ruled that a person\u2019s sex is determined by their biology at birth. Connecticut, however, mandates that health insurance cover transgender medical care. \u201cI\u2019m lucky; my mom has really good insurance,\u201d says Jones, who graduated from UConn with a business degree in May. She\u2019s a real estate agent now and will be responsible for her coverage once she ages out of her mother\u2019s policy. Nearly the same day that Connecticut\u2019s stay-at-home order took effect 10 months ago, Jones began her hormone therapy. Prescriptions in hand, she went to CVS, waited for her friend Olivia to show up for moral support, then swallowed her first testosterone blocker. The pair marked the occasion back at Jones\u2019 house with a beverage that Jones, a former bartender, concocted: colorful liqueurs stacked atop each other to look like an LGBTQ rainbow. Jones followed the drink with an estrogen chaser. Two weeks in, Jones \u201cstarted to feel more relaxed,\u201d she says. A couple of weeks later, her acne disappeared. At three or four months, she noticed breast tenderness. She kept up her laser hair removal and went clothes shopping as her weight redistributed itself, her pants too snug in the hips and too loose in the waist. \u201cI have breasts now. They\u2019re still growing. And the fat in my face is more feminine,\u201d she reports. \u201cI\u2019d never viewed myself as attractive, but it happened for the first time a couple of months ago\u2014that feeling of appreciating your body and who you are. That\u2019s the most amazing thing because I never thought that would be the case. The joy that that brings is really incredible.\u201d This story has been edited since it was first posted to correctly characterize references to transgender residents undergoing transition. The story was reported in partnership with the Connecticut Health Investigative Team (c-hit.org), a nonprofit health news organization.