Uniting a Family through the Appalachian Trail
Starting the Journey
Bettis started planning the trip in June 2022 and left in March 2023. Initially, she had planned for 2025 but got excited and moved it up. Her main goal was to complete the trail and bring the family together. When they started, they didn't know if they would make it, but they focused on their own reasons for hiking. One of the well-known rules on the trail is to never quit on a bad day, and they stuck to this. They knew that every bad day would end and the next day would be different as long as they had the right attitude.During the hike, they gained a following on their social media page titled "32 Feet Up," representing each foot of Bettis and her 15 children. Two of the children stayed at home and hiked sections with the family.
Overcoming Challenges
Bettis' biggest concerns before starting were the cold and safety around other hikers. She didn't want to jeopardize her kids' safety. But they had enough hiking and backpacking experience to know that most people on the trail are good. With the cold, they were overpacked at first, but they realized they had excess in their packs and began to weed it out.The biggest challenge came when they hit the end of Virginia. They were homesick and realized they were leaving everything familiar. At the halfway point in Harpers Ferry, many of the older kids wanted to go home. But once they openly talked about their fears and addressed them, they picked up and kept hiking.
High Points and Low Points
Each child had a different high point, but for Bettis, it was Franconia Ridge and the White Mountains. It was a powerful day with clear views, and they made it along the ridge line. This was the epitome of the entire hike as it showed they could overcome any obstacle.Despite the challenges, they also had their share of good times. The beautiful vistas and the sense of unity as a family were unforgettable.
Cost and Logistics
People on the internet said the cost of hiking with so many kids was $1,000 a month per person. But Bettis came in under budget every month. Her child support budget was $2,400 a month, and they spent between $1,800 and $2,200 a month for all 16 of them. The months that got expensive were when they needed new shoes as they changed about every 700 miles.Family Bond and Growth
The hike helped reforge the family bond. The kids grew in ways they wouldn't have otherwise. They developed leadership and responsibility, and each found their place within the group. The 19-year-old who stayed home took on resupply duties, and there were leaders and crew members for different tasks.Bettis loves hearing the kids talk about the hike and how it has changed them. It has given them ambition and goals.
Future Hikes
They have plans to hike the Mountains to Sea Trail in April and the Oregon Coast Trail in September next year. Then, in 2026, they will do the Continental Divide Trail. There are still discussions about how many kids will join them on these hikes, especially with the addition of a baby.Despite the challenges, Nikki Bettis and her family have shown that with determination and unity, anything is possible.
Unveiling the Impact of Tennessee's Ban on Transgender Youth Care
Introduction to the Issue
In recent years, conservative lawmakers have been introducing a significant number of bills that directly affect transgender youth. Tennessee's ban on certain treatments for these minors is now before the Supreme Court, with potential consequences that extend far beyond the state. This ban has sparked a heated debate and raised concerns about the rights and well-being of transgender youth.As of now, Tennessee and 25 other states have imposed restrictions on gender-affirming care for minors, despite protests from leading medical organizations. These laws have a profound impact on nearly 40 percent of all trans youth in the country. The plaintiffs in the Skrmetti case include a 16-year-old transgender girl, her parents, and two other families. Dr. Susan Lacy, a board-certified OB/GYN with decades of experience treating trans patients in Memphis, has been at the forefront of this issue.
The Journey of Providing Gender-Affirming Care
Dr. Lacy's decision to expand her practice to include gender-affirming care was a natural progression. After nearly 19 years in a private practice group, she joined a local nonprofit with a mission to provide transgender care. As a gynecologist, she found hormone management to be fascinating and was already familiar with the hormonal aspects of both masculinizing and feminizing care.One patient's story stood out to her. They described feeling like a "Mac" operating with a "Windows system," with their brain and its functioning not aligning with their gender identity. Another patient, a 20-year-old from Alabama, had been misdiagnosed with multiple personality disorder but found relief through testosterone. These examples highlight the importance of understanding the complex relationship between brain chemistry and gender identity.
The Impact on Minors
Before the law was passed, Dr. Lacy had around 25 minors in her practice receiving gender-affirming care. She emphasizes that she never treated pre-pubertal children with puberty blockers, as that requires the input of a pediatric endocrinologist. She often worked in collaboration with a local endocrinologist, with the endocrinologist providing initial treatment and referring patients to Dr. Lacy for contraceptive management as they grew older.When working with minors and their families, Dr. Lacy takes a comprehensive approach. She starts by asking about the patient's journey and their expectations. Parental consent and a psychological evaluation are required, with a letter from a psychologist. The process is not quick; it takes time for individuals to become aware of their gender identity and for parents to come to terms with it.
Addressing Concerns
One common concern is the perception that gender-affirming care is a rapid process. In reality, it is a gradual journey. Voice deepening is permanent, while breast growth is not reversible but also does not happen overnight. Other changes, such as facial hair growth, are reversible. Fertility is an open question as there is not enough data. Dr. Lacy uses analogies with her own family to help parents understand that the goal is to approximate the hormonal environment of the gender with which the child identifies.The minors she treated were often eager to start the process. They were well-informed through online resources and were ready to take the next step. However, the ban on gender-affirming care has had a devastating impact on their mental health. Many feel bewildered and angry when their care is taken away, and they struggle to understand why. Dr. Lacy and her patients had to come up with a plan to continue care, often seeking resources outside of Tennessee.
The Role in the Lawsuit
Dr. Lacy decided to join the lawsuit for several reasons. As an independent practitioner with a trans child, she believes it is important to address these issues and bring them to the forefront. Her experience treating a large number of trans patients has given her a unique perspective that she feels needs to be heard.She also feels that someone has to speak up for the minors. Their voices are compelling, and they deserve to have their rights protected. Many families with trans children are concerned about retaliation in the current political climate, and Dr. Lacy is aware of the risks. However, she is committed to standing up for her patients and ensuring that their voices are heard.
The Chilling Effect on Younger Patients
The ban on gender-affirming care not only affects minors but also has a chilling effect on younger post-adolescent patients. Those between 18 and 25 years old often rely on parental insurance and may not have the support of their families. While they are legally able to seek care, the lack of family support can make it difficult for them to access the treatment they need.The high rates of suicidal thoughts and attempts among trans kids are a significant concern. The ban exacerbates these issues, as it limits the options available to these young people. Dr. Lacy is worried about the long-term consequences of this law and the impact it will have on the well-being of transgender youth.
In conclusion, the ban on gender-affirming care for transgender minors in Tennessee has had a profound impact on the lives of these young people. Dr. Lacy's story and the experiences of her patients highlight the importance of understanding and respecting the gender identities of transgender youth and the need to protect their rights.