For trans people, access to healthcare is not just a matter of convenience — it is often a matter of survival. Gender-affirming care, which includes everything from hormone therapy to surgical procedures to mental health support, has been shown by decades of research to dramatically improve the wellbeing and quality of life of trans people. Yet access to this care remains profoundly unequal across the world.
In Canada, the country that inspired the Laseebo community, gender-affirming care is covered by provincial health plans in most provinces. Wait times can be long, and geographic barriers are real, but the framework of public access means that trans Canadians do not face the financial catastrophe that care can represent in other countries.
In Thailand, medical tourism has created one of the world's most developed ecosystems for gender-affirming surgery. Bangkok clinics attract patients from across Asia, Europe, and North America, offering high-quality procedures at a fraction of Western costs. For many trans people globally, Thailand represents the only realistic access point to surgical care.
In Iran, in a paradox that confounds simple narratives, gender-affirming surgery is legal and even subsidised by the government. Since a 1987 fatwa by Ayatollah Khomeini classifying transsexualism as distinct from homosexuality (which remains criminalised), Iran has performed more gender-affirming surgeries per capita than almost any country outside Thailand. The reality, however, is deeply complicated: many gay and lesbian Iranians are pressured into surgery as a "cure," and the social context for trans people remains difficult.
In contrast, much of sub-Saharan Africa lacks any legal framework for gender-affirming care, and trans people may be criminalised simply for existing. Community organisations fill this gap with underground hormone networks, peer support, and harm reduction — grassroots healthcare in the absence of any official structure.
In the United States, access to care has become increasingly politicised, with a wave of legislation attempting to restrict gender-affirming care for minors and, in some cases, adults. Trans people are navigating a patchwork of state policies that can make the same care accessible in California and illegal in Texas.
What remains constant, across every country and context, is the determination of trans people to access the care they need — through official channels, community networks, and cross-border travel when necessary. The resilience required is extraordinary. The need for systemic change is urgent.
At Laseebo, we believe that access to healthcare is a human right. We amplify the voices of trans people navigating these systems, and we celebrate the communities building alternatives where systems have failed.