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Access to competent and affirming healthcare is a critical issue. A staggering 61% of LGBTQ+ individuals report having had a negative experience with a healthcare provider, and a . These barriers are compounded by political efforts to restrict access to gender-affirming medical care. For example, in 2025, the U.S. Supreme Court upheld a Tennessee law prohibiting certain medical treatments for transgender minors, a decision that has influenced similar legislation across the country. Nearly 40% of transgender youth live in states with such bans, forcing some families to travel across state lines for essential care.

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Pioneered by Black and Latine trans women and queer youth in Harlem during the late 20th century, ballroom culture created "houses" that served as alternative families. This culture gave birth to voguing, runway categories, and linguistic terms like "spilling tea," "throwing shade," and "work." Access to competent and affirming healthcare is a