Gender-affirming care helps Long Islanders 'be their authentic selves'

Coragan Richter, 16, who is transitioning from a female to a male, at his home in Sayville, Thursday, June 9, 2022. Credit: Newsday / Steve Pfost

The soft-spoken 18-year-old who felt misplaced in dresses and disconnected from their own body.

The 36-year-old social worker who endured years of bullying before nearly taking his own life.

The 53-year-old disability advocate who waited decades to begin transitioning, in part because of how the transgender community was perceived by society.

They come from different generations and communities but share a universal truth.

Each of these Long Islanders knew they were assigned the wrong sex at birth. And refused to live a lie any longer.

For more than a decade, thousands of Long Islanders have stepped out of the shadows and sought gender-affirming care to help them transition to their affirmed gender and ultimately live their truest self.

For some, it meant help with social and emotional issues such as selecting the pronoun they felt most comfortable using. For others, puberty blockers or hormone therapy helped them look to the outside world how they felt on the inside. And some take the final step: top or bottom surgery.

Their decisions and respective journeys are uniquely personal, even as the issue has become political. More than a dozen states across the country have restricted or proposed laws prohibiting gender-affirming care, with some carrying severe penalties for health care providers and families who seek treatment for minors.

"We just want to make sure that people can be happy and healthy, physically and mentally, both now and in the future," said Dr. David Rosenthal, medical director of the Center for Young Adult, Adolescent and Pediatric HIV at Northwell Health, which has seen more than 3,000 patients since its inception in 2014. "That's what's really most important."

'Help people be their authentic selves'

Gender-affirmation care refers to a host of treatments that support transgender or nonbinary individuals in their transition.

Several medical institutions on Long Island provide the care, including Northwell and Stony Brook University Hospital. And while facilities treat individuals of any age, most patients, doctors said, are teenagers and young adults. 

The process most often begins with addressing a patient's gender identity, such as a potential name change, pronouns, hairstyle and clothing choices, and using the bathroom they're most comfortable with, Rosenthal said.

The second phase focuses on endocrinology — delaying puberty for preteens and hormone therapy to lessen particular gender traits, such as facial hair, muscle mass and breast growth, as well as changing vocal characteristics.

The final step, and one that not all patients consider, is surgery on the chest, genitals or face.

'People need to transition at the rate and phase in which they're comfortable.'

— Dr. David Rosenthal, medical director of the Center for Young Adult, Adolescent and Pediatric HIV at Northwell Health

Credit: Danielle Silverman

No treatment is provided to minors without parental consent and some surgery is restricted to patients 18 and older. In most cases, health insurance covers gender-affirming care.

"Our goal is to really help people be their authentic selves," Rosenthal said. " … These are all options that are available. But not everyone chooses to do any of the options or all of the options. People need to transition at the rate and phase in which they're comfortable."

In total, 1.3 million Americans ages 13 and older identify as transgender, according to a new report from the Centers for Disease Control and Prevention's Behavior Risk Factor Surveillance System and Youth Risk Behavior Survey. While the percentage of adults who identify as transgender has remained consistent, the report found the number has grown steadily among youth ages 13-17.

Dr. Allison Eliscu, medical director of the Adolescent LGBTQ+ Care program at Stony Brook Medicine, and division chief of Adolescent Medicine at Stony Brook Children's Hospital, said she's referred significantly more patients for gender-affirming care in recent years. She attributes the increase to improved access and availability and more young people feeling comfortable enough to be true to themselves.

"Some individuals come out very young and really wanted their outside of their body to align more with their inside and how they identify themselves," said Eliscu, the co-chair of the Stony Brook Medicine LGBTQ+ Committee, which creates hospital policies and training guidelines for the transgender community.

"And we have actually a large population of patients who have told their parents, friends, teachers or school staff and have been completely accepted," Eliscu added. "To the point where sometimes the peers say, 'OK, that's great. So what? It's not a big deal.' Which is reassuring for a lot of people."

'It made me feel so miserable'

Growing up, family and friends would frequently make comments about how masculine Jonas Figueroa looked. 

Figueroa, 18, of Bay Shore, wanted to wear male clothing as a child and associate with boys but never got the opportunity. Figueroa now uses they/them pronouns.

Jonas Figueroa, who began hormone therapy at Stony Brook in 2020, talks about their transition journey. "I feel like I'm me," the Bay Shore resident says. Credit: Newsday/Alejandra Villa Loarca

By middle school, Figueroa wanted to begin transitioning but their mother, Marianne Figueroa, was resistant, arguing that Jonas was too young and didn't understand the consequences of the decision.

"So I was like, 'She must be right. She's my mom. She raised me and has to know me,' " Jonas Figueroa said. "And I would do things like make myself super feminine and try to be so girlie. And it made me feel so miserable."

As Jonas struggled with the mental health issues associated with gender dysphoria, Marianne made peace with her child's choices and authorized them to begin hormone therapy at Stony Brook in 2020.

'I have never been so happy to be alive as I have been now because I'm finally me.'

— Jonas Figueroa, 18, of Bay Shore

Credit: Newsday / Alejandra Villa Loarca

"The biggest change is that I like the way I look at myself. I don't hate looking at myself," said Jonas, who is seeking approval for top surgery. "I don't feel as insecure. And it's kind of great."

And Jonas said their mother can see the difference the treatment has made.

"I feel like now she understands," Jonas said. "She sees that this is me. I'm going to be happy in life and this is how I'm going to live."

And while the journey has been difficult, Jonas said, I would take this path 100 times over. I have never been so happy to be alive as I have been now because I'm finally me. And that's the best thing in the world.” 

From bullied to boxer

Kerry Thomas can recall the moment he knew he was different. 

Thomas, 36, of East Northport, who was assigned female at birth, was in kindergarten and lined up with the girls to select a toy. But the bag of dolls didn't interest him. He wanted the toys the boys were selecting.

Kerry Thomas, who began taking testosterone at age 18, talks about his transition journey. The East Northport resident credits Northwell Health for bringing gender-affirming care to Long Island, after he had to travel a health clinic in San Francisco for his first surgery in 2008.  Credit: Newsday/Alejandra Villa Loarca

As Thomas got older and gravitated toward flag football and other male-dominated sports, the bullying from his peers got worse. Eventually, he made an attempt at suicide.

"It was when I was recovering in intensive care that I told people, 'I'm going to live my life as a man, whatever that could mean,' " said Thomas, who works as a social worker supporting people with HIV. "I didn't know at the time what medical interventions were available. But being that I did wake up from a serious attempt, that was my opportunity to go forward and do what I needed to do to live my life."

'I think we can do better for our youth and making things more inclusive and welcoming.'

— Kerry Thomas, 36, of East Northport

Credit: Newsday / Alejandra Villa Loarca

Thomas began taking testosterone at age 18 and in 2008, traveled to a health clinic in San Francisco for surgery on his chest. Four years ago, Thomas completed his surgery at Northwell.

Now, he has taken up boxing and helps train other transgender people to fight in the ring. He's also become a vocal advocate for the transgender community, helping organize a food drive for more than 200 struggling families.

"I have a great career. I have a rewarding job. I'm very comfortable with myself," he said. "Things are good. And the challenges I've gone through have given me a lot of perspective. But I think we can do better for our youth and making things more inclusive and welcoming."

Finding happiness and her true self

Jennifer Suchan was 45, had supportive friends and family and a job she loved. But something was missing.

'I reached a point where I said, 'my life is more than half over. I'm not going to continue to live in a body that I don't feel comfortable in.'

— Jennifer Suchan, 53, of Nassau County

Credit: Newsday / Alejandra Villa Loarca

"I reached a point where I said, 'My life is more than half over. I'm not going to continue to live in a body that I don't feel comfortable in.' And I'm not going to represent myself as something other than who I feel I am," said Suchan. " … I sat down and had an honest conversation with myself and said, 'What's going to make you happy? Is it money? Is it is it living somewhere else? And I had to honestly say to myself, 'Well, I always felt I should have been born female.' "

Growing up in the 1970s, Suchan said transgender individuals were vilified or ignored in popular culture, portrayed as villains or mocked for comedic points. So Suchan buried her true self for decades.

"I didn't know who I was or what I loved. I just knew that this is the way that I felt," said Suchan, the coordinator of agency training at Family Residences and Essential Enterprises, an Old Bethpage nonprofit for individuals with intellectual and developmental disabilities. 

Suchan, 53 and living on Nassau's South Shore, began transitioning at Northwell in 2015, first with hormone therapy and then with surgeries.

While she's now comfortable in her own skin, Suchan concedes, "It's very challenging to live in society sometimes as a transgender person … I face the world and I do it the best that I can with a smile. And it's allowed me to be much more comfortable at work and with friends. But it's challenging at times. Life is much harder. But better."

A surprising reaction

Coragan Richter, 16, sat his parents down a few years back to break what he thought was major news. The Sayville teen announced he was trans.

His parents' reaction was surprising.

"My husband and I looked at him and said, 'But what's the big thing that you have to tell us?' " said Coragan's mother, Stacey Richter. "I'm just glad that he's comfortable enough to tell us and feel safe with us. At that point, we said, 'You tell us what you want to do.' "

Coragan Richter began receiving care from a Stony Brook pediatric endocrinologist at age 13. He started hormone replacement therapy two years later and had top surgery earlier this year.

'There's a higher chance of us dying at a younger age, and without the medical care for transition, it raises the chance of depression.'

— Coragan Richter, 16, of Sayville

Credit: Newsday / Steve Pfost

After struggling with mental health issues, he said the care is a true lifesaver.

"There's a higher chance of us dying at a younger age, and without the medical care for transition, it raises the chance of depression," he said. "It saves lives.”

Stacey Richter urges parents to support their children and love them unconditionally.

"The biggest risk to an unsupported member, especially somebody who's trans, is the suicide rate," she said. "It’s much higher. So, the more support they get, especially at home, the lower the chances that they'll self harm.” 

A 2021 study published in the peer-reviewed journal JAMA Surgery found that transgender individuals who had received one or more gender-affirming surgical procedures had a 44% reduction in suicidal ideation compared with those who had not yet undergone any.

Coragan Richter is finishing his junior year at Sayville High School while also taking culinary classes at Eastern Suffolk BOCES. He dreams of one day opening an LGBTQ-friendly cafe.

"I'm more confident. I'm more outgoing. I'm more active. I've gotten healthier. I do more hobbies that I enjoy and I've made more friends," he said. "Because I love myself more. I'm more happy with me."

Newsday LogoSUBSCRIBEUnlimited Digital AccessOnly 25¢for 5 months