When Travis Covitz arrived in Rochester, in upstate New York, in 2022, he moved into an apartment owned by gay landlords on a major thoroughfare where shop windows displayed LGBTQ+ safe-space stickers.
Covitz, a 23-year-old transgender man, ended up in Rochester somewhat by accident for a medical research job after graduating from Cornell University, a two-hour drive south in the progressive college town of Ithaca. “This is giving me similar vibes,” he thought upon his arrival in Rochester. He felt safe walking through the city dressed in drag, to the gay club where he eventually took a second job as a barback.
The culture of Rochester marked a noticeable contrast from his home state of Arizona, which has banned trans girls from school sports and tried to stop students from using pronouns and bathrooms that align with their gender identities. In many ways, the environment for trans people in Arizona has become worse since Covitz graduated from high school there in 2018. And while he didn’t leave the state specifically for that reason, he’s grateful to be living in a place like Rochester.
He’s not alone. Community leaders and healthcare providers in Rochester say they’ve seen a significant influx of trans residents, many of whom are fleeing states that are hostile to their rights.
The entirety of New York is a self-declared sanctuary state for trans individuals, but the obvious destination of New York City is too expensive and overwhelming to be a realistic option for many of those looking to relocate. “Something about that seems to be driving people to reach out to Rochester,” said Andrew Moran, president of the Rochester Rainbow Union, which maintains a “Lilac Library” and community space in the city.
To the outside eye, upstate New York is often seen as little more than a sea of reliably red counties – indeed, much of the state outside New York City voted for Donald Trump in 2020. But floating in that sea is a handful of blue islands: the cities of Albany, Syracuse, Buffalo and Rochester. In all four places, the Democratic bent translates to inclusivity; Albany, Syracuse and Rochester (whose Pride celebration stretches into July, because “one month isn’t enough for us – we need two!”) earned perfect scores of 100 in Human Rights Campaign’s most recent municipal equality index, and Buffalo scored a 97.
So while this striving city of 200,000 bisected by the Genesee River does not have a national profile as an LGBTQ+ haven, Rochester has long been a queer-friendly magnet in an otherwise conservative region of the country. And it’s now emerging as an especially attractive landing spot for transgender Americans in search of safer ground and, in particular, access to gender-affirming care.
Rochester benefits from an established network of gender-affirming care providers – which turn up quickly in Google searches and Reddit threads. Trillium Health is the best known, and its patient load is ballooning. Patrick Pitoni, who manages Trillium’s Transgender Center of Excellence, said the clinic’s number of trans patients had risen from 200 to 2,100 over the last six years, with that growth accelerating. The clinic, whose gender-affirming medical care is only available to adults (Trillium’s separate pediatrics clinic offers affirming care for LGBTQ+ kids), just recently started tracking how many of those patients have moved from out of state, so it’s impossible to put a hard number on it. But anecdotally, Pitoni is seeing it happen very frequently.
Adult patients from Florida, Texas and Alabama are showing up at Trillium already on hormones, for example, looking to pick up the same care in their new adopted home of Rochester, according to Pitoni. Many of the trans adults he talks to – he’s welcoming 16 new patients every week – are coming with their entire families, and they often pepper Pitoni with questions about which neighborhoods, school districts and employers might be the most accepting. Some are couch-surfing until they can find more stable housing.
Landon, a trans man, is one of Trillium’s newer patients. He fled Florida with his kids this summer after living there for only a few years. “Florida was a disaster the entire time, and it just got progressively worse,” he said. Landon saw clinics start to cut off care in 2022 under threat of new legislation, and he lost his prescription for testosterone. The impacts on his physical and mental health were a nightmare. “Once you’re on hormone therapy for a period of time, your body adjusts to that. And then when it stops, for a short period of time you’re OK, and then things start to deteriorate.”
It took Landon (who asked to use a pseudonym to discuss his family) a year to move to Rochester, after finding a remote job and searching, for many months, for an affordable apartment. He’s now back on his prescription and has settled in with his new providers, including Trillium. Despite some administrative hiccups, he’s mostly satisfied with the clinic.
Not everyone is content with their experience of healthcare in Rochester: in 2021, two trans men decried incidents of discrimination they said they had experienced at the city’s Highland hospital. And Rochester has also had its share of anti-trans crime: a 30-year-old trans man fell victim to a violent assault in 2020, and in 2013 a trans person was killed in a stabbing, though Rochester police said gender identity was not a factor.
Housing is one of the more acute challenges for new arrivals in Rochester, according to Moran and Brittan Hardgers, a community organizer. “A lot of people are coming with nothing,” said Hardgers. That often means no job or home lined up, making smaller and more affordable upstate locales a better choice than the big city. But Rochester is dealing with the same issues of housing scarcity that many metropolitan areas grapple with, and it became less affordable during the pandemic.
“We definitely have a major hole, a major void when it comes to housing for queer folks, especially queer folks who are homeless,” Hardgers said.
Hardgers, the director of advocacy and community engagement for the New Pride Agenda, also sees the need for more gender-affirming care providers. He wonders if Rochester, and New York as a whole, can attract doctors from the 18 states where such care for trans youths is outlawed, exposing doctors to criminal liability or other penalties should they continue to provide it. “The work being done here in Rochester is truly life-saving,” he said.
The power of word-of-mouth promises to keep the momentum going. A 25-year-old trans elementary school teacher was looking to escape to a midsize city near his family in New England. A queer author with a trans wife and trans child was looking for a safe place to live outside the south. A trans woman and her family were hoping to escape Florida in search of a more accepting community. All three posted to Reddit, where Rochester stood out as an appealing option. Pitoni and Moran have seen many recently arrived trans people in Rochester talking up their off-the-beaten-path refuge to friends back home.
“A lot of people in our community create a new family, a chosen family,” Pitoni said, which is what many are doing when they move to Rochester – and upstate New York more generally.
Jennifer Harris Dault is one of them. She had never set foot in New York when she started considering a move from her home state of Missouri. “The St Louis area itself is great,” Harris Dault said, “but the state itself made it impossible.”
As a wave of anti-LGBTQ+ legislation swept Missouri, Harris Dault worried it was no longer a safe place to raise her trans daughter. “The mental toll, even when nothing passes, is astounding,” she said. This summer, something did pass: Missouri enacted anti-trans school sports and healthcare bans, and Harris Dault decided it was time to relocate. “Where do we have someone who can make this a home?” she asked herself. Rochester and Chicago were two places where she had chosen family, and she picked Rochester for its relative affordability.
Since arriving in July, Harris Dault and her family have had an almost universally positive experience. Her kids are easily making friends in a diverse school district, and she’s been especially encouraged to see pronouns on name tags at local libraries, churches and museums. “This is all visible, and it’s OK and normal.”
There are bumps in the road – the family is living in a rental home that doesn’t meet their needs, and the grownups haven’t made friends as easily as the kids have – but Harris Dault is satisfied: “The cost of living is great, and it’s a lovely place.”
Covitz has also settled in well, though it took him a while to find his place in a city dominated, it seemed, by longtime local residents and college students. Everyone at work in his research lab knows he’s trans and accepts it, including a colleague from a small town who was previously unfamiliar with trans people, he said.
That Rochester can be this refuge is bittersweet to its trans residents, new and old. Covitz is astonished by the surge in anti-trans hostility since he left Arizona just a handful of years ago. “When I was a trans youth,” he said, “there wasn’t all this.” In 2023 alone, 589 anti-trans bills have been proposed in US statehouses, with 84 becoming law.
Pitoni also marvels at this state of affairs. As a trans man who grew up in Rochester, Pitoni has always known the city to be a relatively safe place. He transitioned 40 years ago, and while there were certainly fewer resources back then, there were also fewer barriers. “There weren’t any laws telling me I couldn’t do it,” he said. “I feel like we’ve gone backwards 50 years.”
