Elevated Access takes flight for gender-affirming care, reproductive rights

Senate Bill 254, described by Florida’s Republican-controlled state legislature as “comprehensive parental empowerment and child safety legislation,” was filed by state Sen. Clay Yarborough and co-introduced by Sen. Keith Perry in March 2023. It was signed into law by Gov. Ron DeSantis in May of last year and has had far-reaching consequences for trans Floridians ever since.

According to the Williams Institute, Florida has the second largest population of transgender adults in the country, an estimated 94,900 people, and the law mandates that a physician be present to oversee any health care related to transitioning. It also requires for people to see that doctor in person and requires that adult patients seeking trans health care sign an informed consent form. Those rules have proven difficult because many people receive care from nurse practitioners and use telehealth.

It is a crime to violate the new requirements, putting the providers who care for them at significant risk of losing their licenses. The bill’s language is vaguely written, making it hard to interpret when understanding its implications.

The U.S. District Court in Northern Florida heard a landmark case, Doe v. Ladapo, on Dec. 13, 14, and 21, fighting for the rights of transgender adults seeking gender-transition medical care and for transgender minors, including their parents. A subclass was created for minors totally prohibited from treatment due to not initiating it before the effective dates of SB 254 and the Board of Medicine rules. State law forbids youth from obtaining this care during puberty and adolescence without being grandfathered in.

In a joint press release from the GLBTQ Legal Advocates & Defenders, Human Rights Campaign Foundation, Southern Legal Counsel, National Center for Lesbian Rights and Lowenstein Sandle, the group presented evidence that SB 254 and the BOM rules were motivated by Florida’s disapproval of transgender people, have no rational justification and deny transgender Floridians and parents of transgender individuals equal treatment as guaranteed by the U.S. Constitution.

Sarah Warbelow, Legal Director of the Human Rights Campaign Foundation, stated, “Despite living in a state that has shown blatant discriminatory intent toward transgender people, the families, and plaintiffs involved in this case have put their bravery, resilience, and humanity center stage. This trial showed that there is no sound reason to deprive people of the ability to make best-practice, medically-necessary healthcare decisions for themselves — especially when the trade-off is the heartache and distress of children and parents.”

As plaintiff Lucien Hamel also explained in the release, “Being forced to abruptly stop my medical care this summer has been devastating for both me and my family. I received my care from a competent medical provider that I really trusted. Then I was told that Florida law suddenly won’t let APRNs and Nurse Practitioners provide the care I need. I can’t get an appointment with a physician anywhere in the state. There’s no medical basis for this change – it’s just preventing transgender Floridians like me from getting care. I’m scared and frustrated because I know my health will continue to decline the longer I have to wait, putting incredible stress on me, my wife, and our child.”

While the new law effectively requires transgender adults to leave Florida to obtain necessary care, Hamel testified that, like many others, he can’t just uproot his family, abandon Florida and move across the country.

Anonymous plaintiffs also spoke on behalf of their transgender children, Susan and Gavin.

“My worst nightmare is having to watch my child suffer because I can’t get her what she needs,” one parent shared. “Seeing Susan’s own fear about what will happen to her because of this ban has been one of the hardest experiences we’ve endured as parents. Nobody with a heart could ever do this to her.

“If you have children, you will do anything and everything to protect them, to provide what they need. SB 254 is prohibiting my ability as a parent to do that,” they continued. “I am unable to get Gavin the care he needs in Florida and am greatly concerned about what that means for his mental health and his overall well-being.”

A month prior to SB 254’s signing, DeSantis also signed a six-week abortion ban, replacing a 15-week ban enacted in April 2022. In Florida and elsewhere, gender-affirming care and reproductive rights are inextricably linked because they both stem from the basic right to bodily autonomy.

This legislation will only be enforced if the State Supreme Court nullifies Florida’s existing protections for abortion rights, which is also being challenged. Activists at Florida Protecting Freedom are working hard to ensure abortion rights appear on the Florida ballot this November, something Florida Attorney General Ashley Moody has taken legal action against to try and prevent.

LGBTQ+ activists note that it is disheartening that these and other barriers still exist for those in need of health care. It’s why Elevated Access, a nonprofit organization founded in Illinois in 2022, has emerged as a beacon of hope for those seeking gender-affirming care and abortion services in states like Florida across the country.

As the LGBTQ+ community continues to face disparities in care, Elevated Access has taken the battle to the skies — literally — to address this pressing issue. The nonprofit firmly believes in bodily autonomy and the freedom to make private healthcare decisions without government intervention, and was founded to make health care more accessible and equitable in all states.

Elevated Access operates as a volunteer pilot program that provides free air transportation to individuals who require gender-affirming care or abortion access to states where such care is legal. A community of 1,350 volunteer pilots has completed 400 flights since its founding in 2022.

In response to these challenges, Elevated Access has forged a network of pilots — each of whom completes a vetting process to confirm their values align with the nonprofit’s mission and goals, and who willingly donate their time, skill and aircraft — to transport passengers anonymously. These patients, providers and support staff are taken to and from clinics to receive care.

The nonprofit understands the sensitive nature of the services it supports, and so passengers are protected by a veil of confidentiality. Pilots are not made aware of the reason for their passengers’ travel, discretion allowing individuals to maintain their privacy during a challenging time in their lives.

Elevated Access pilots can fly into 3,000 airports nationwide, with 90% of the U.S. population living within 30 minutes of these regional airports.

As a transgender female of color, Angel P. — a Central Floridian whose full name has been redacted to protect her anonymity — understands firsthand the ramifications of Florida’s restrictive laws. It’s why she wanted to do something to help others in her hometown.

Motivated by personal experiences, Angel is part of a diverse group of volunteers challenging the status quo. As a female pilot at Elevated Access, she is a rarity, as most of the volunteers are white men. According to the April 2023 report by Pilot Institute, less than 10% of U.S. pilots are women.

While piloting may still be a boy’s club, at Elevated Access, Angel emphasizes their commitment is to the organization’s mission. “There’s one thing we all care about, that we’re involved in this organization,” she says. “That’s what it comes down to — we are good pilots. That’s all that matters.”

Angel fell in love with flying at an early age and knew she would be a pilot starting through the Reserve Officers’ Training Corps. Between the Obama and Trump years, she came out as transgender, and the latter president’s transgender ban disrupted her time in the ROTC. She worked in politics to fight for equality and let that passion fuel her goal to get back into the sky. She eventually quit her job and began flying full time, studying to become a commercial pilot.

“I love flying and nothing else I have ever done really compares,” she says.

When the opportunity arose to fly and volunteer to make a difference in the lives of those facing medical challenges, she jumped at a chance to earn her wings. She is just months away from her Elevated Access maiden flight.

“I heard about Elevated Access and saw that they had this amazing mission for helping folks get gender-affirming care and abortion access. It took me back to a time where I needed this same gender-affirming care and I couldn’t get it,” Angel says. “Knowing that I had the ability to help — it wasn’t something that I could walk by without doing something. Being able to help someone get access to the care they need and get them where they need to go is so important to me.”

Elevated Access recognizes the multitude of challenges faced by individuals seeking these services, particularly when living in areas with limited access or facing financial constraints. Patients flown by these pilots often face extreme barriers to accessing health care, including lack of funds, time away from work, inadequate transport, unavailable childcare and a bevy of hostile laws restricting access to care.

The organization opens its aircraft doors to anyone who needs to travel for gender-affirming care or to access abortion. This includes those who are low-income, uninsured or live in areas with limited access.

While Elevated Access offers free transport, partner organizations help to alleviate the financial burdens associated with expenses like ground transportation, lodging, food, child care, medical care and more. By doing so, they ensure that the journey to care is not only accessible but also less daunting for those in need.

Through eliminating these financial barriers, Elevated Access and its partners ensure that those in need can access care promptly. According to the 2023 Elevated Access Impact Report, their “typical passenger is a person of color, very likely living paycheck to paycheck and with no means to access this support on their own.”

“40% of the abortion patients we work with have children already, which could mean that every hour spent away from their everyday lives has repercussions,” the report reads. “Every mile flown instead of driven saves precious time. Time that can be translated directly into hours spent caregiving, or being available to continue working and putting food on the table instead of missed shifts that could lead to unemployment.”

To access the services provided by Elevated Access, individuals must be referred by trusted partner organizations, such as funders, reproductive health clinics and LGBTQ+ advocacy groups. This initial step helps ensure that the individuals seeking care are connected to the program efficiently.

Once a referral has been made, dedicated flight coordinators work closely with partners and make all necessary flight arrangements for the individuals who are flying. The organization’s commitment to providing a seamless experience is evident at every stage of the process.

One trusted Tampa Bay partner is the statewide organization Florida Access Network, the only queer, BIPOC-led statewide abortion fund in Florida. The company was founded in 1996 and changed its name from Central Florida Women’s Emergency Fund to Florida Access Network to be more inclusive to people of all genders who need abortion access.

Partnering with organizations like Florida Access Network, Elevated Access ensures a seamless experience for individuals seeking care. Stephanie Loraine Pineiro, Executive Director/CEO, and Gin, Director of Client Services, highlight the importance of the partnership in offering discreet opportunities for clients to access services outside of their communities.

“We discovered Elevated Access through our partners who were already utilizing them. We realized what they do aligns with what Florida Access Network does and that we wanted to work together,” explains Gin. “Because our clients have to travel out of state for abortion services, we partnered with Elevated Access to offer more discreet opportunities to fly out of the state. The confidentiality helps our clients feel safer.”

Pineiro says that it creates a pathway for people in rural communities to access care. She notes that “over 70% of Florida residents don’t have an abortion clinic in their communities. That’s going to increase even further once the six-week abortion ban goes into place.”

“It’s a grim reality, but we are inspired by states like Ohio that enshrined in the state constitution the right to an abortion up to 24 weeks,” she continues. “That brings us hope and comes on the heels of fellow abortion-funding organizations who were instrumental in getting the word out that this was on the ballot in Ohio and were unapologetic about abortion access.”

Pineiro adds that the organization has seen people overwhelmingly support bodily autonomy nationwide, while politicians have used the topic to drive a wedge between people.

“The people most impacted by abortion restrictions are people who are already marginalized,” she explains. “It’s important for people [with] life experience in navigating barriers to healthcare access [to have this care.] We are at the forefront of this work.”

Despite the challenges posed by Florida’s restrictive laws, Florida Access Network has already pledged over $350,000 in direct abortion access support to 1,300 Floridians. “We are more hopeful than ever that we are doing the right work at the right time to support people who could be going through a really tough moment,” Pineiro says.

For Elevated Access passengers, they meet their volunteer pilots at designated airports on the day of their flight. These pilots fly them to the clinics where they will receive their care and after the appointments, passengers are flown back to complete the nonprofit’s cycle of support.

These flights are often the fastest and most convenient means of transportation for individuals facing long distances to reach their providers. The program recognizes the urgency of accessing these services and streamlines the process.
“Safety and redundancy are most important,” Angel says.

Elevated Access’ endeavor, like any other, demands a collective effort. There are various avenues for individuals to become involved and make a meaningful impact.

For those who possess the necessary skills and resources, volunteering their time and aircraft as pilots can be as transformative as it is for those in need.

“If you’re in a position where you are a pilot and you can help, I say 100%, don’t think twice, make the leap,” Angel asserts. “It’s so rewarding. The people you meet, the things you are doing, and how you feel about it, hands down, I’ve never had a negative experience with Elevated Access and don’t know any people who have. It’s hard work, but it’s very rewarding as well. Everyone is striving for the same mission.”

Financial support is also crucial for sustaining their work. Every donation plays a pivotal role in ensuring the organization’s continuity, and raising awareness helps as well. By disseminating information about Elevated Access and its services, individuals can help connect those in need with the support they require.

Elevated Access embodies a lifeline for those it serves, a poignant reminder that this access to care remains elusive for many. The nonprofit offers essential transportation to individuals who might otherwise be unable to access vital abortion and gender-affirming care, the absence of which could have dire consequences.

“Being a pilot for Elevated Access has taught me to be more kind and open. It’s one of the first times in my life where the rules have been reversed — I’m in the position to help someone else,” Angel says. “It’s taught me to do my best and really lend a helping hand.

“In addition to that, it’s got me angry,” she adds. “I’m seeing the injustices and the need for this organization to exist, which frustrates me because this is not what I imagined 2024 would be like when I was younger. Yet here we are, and we still have to fight this fight. I am willing to fight it, but I also hope we won’t need to fight it for too much longer.”

Until then, Elevated Access will continue to rise above to support Floridians in need — because as the nonprofit advises on social media, “we believe that access to healthcare should be just plane simple.”

To donate, volunteer or learn more about Elevated Access, visit ElevatedAccess.org. For more information about Florida Access Network, visit FLAccessNetwork.org.

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