The bass line from some forgotten Stevie Ray Vaughan track thrummed through the water-stained ceiling tiles as I descended into the Sanctuary’s familiar embrace, the Christmas lights casting their rainbow fractals through the perpetual haze that clung to our underground haven like a second skin. The concrete steps, painted blood-red but worn to gray patches by countless boots carrying countless stories, welcomed me down into the belly of our chosen family’s gathering place.
Miguel looked up from behind the scarred wooden bar, his sultry voice cutting through the ambient noise with that childlike warmth that never failed to make my chest tighten with something between pride and protectiveness. “Evening, Mom. You look like you’ve been wrestling with the fucking universe again.”
I slumped onto the barstool, feeling every one of my fifty-three years settle into my bones like sediment. “Pour me something that tastes like bad decisions and better choices, Miguel.”
His hands moved with practiced grace across the bottles, settling on a squat bottle of bourbon that looked like it had seen more bar fights than a bouncer. The amber liquid caught the light as he poured, releasing notes of caramel and regret into the thick air. “This shit’s been aging longer than some of our kids have been alive,” he said, sliding the glass across the worn wood. “Seemed appropriate for whatever’s eating at you.”
The bourbon burned like truth going down, and I savored the familiar fire before scanning the room. Ezra had claimed their beanbag throne in the corner, blue hair catching the light like a beacon, waving enthusiastically despite the fact that I’d seen them not twelve hours ago. Della’s voice carried from the tiny kitchenette where she was working magic on what smelled like garlic and onions, probably whipping up some comfort food that would make us all weep for our mothers—the good ones, anyway.
“Rough fucking day?” Keira’s voice materialized beside me, not touching but close enough that I could smell her signature scent of sandalwood and rebellion. She didn’t need to put her hands on me to make me feel grounded; her presence alone did that shit.
“Surgery consultation,” I said, and watched the understanding flicker across her eyes like candlelight. “Four fucking years on HRT, levels stable as a rock, and now I’m jumping through circus hoops trying to qualify for my orchie and top surgery. The new surgeon’s office treated me like I was asking for plutonium instead of basic gender-affirming care.”
Phoenix looked up from where they were perched on the decimated leather couch, their hair currently a shade of purple that reminded me of bruises healing into something beautiful. “Fuck, Wendy. That’s some bullshit. My endo’s been cool, but finding her was like searching for a fucking unicorn in a field of horses.”
“Tell me about it,” River chimed in from across the room, still in their nurse scrubs, the fabric wrinkled with the weight of another twelve-hour shift fighting the system from the inside. “I spend all day advocating for patients, and then I have to fight the same damn battles for my own care. It’s like being asked to perform surgery on yourself with a butter knife.”
Sage, tucked into the corner with their ever-present napkin canvas, looked up from their intricate artwork—tonight it appeared to be a mandala made of intersecting gender symbols. “The medical establishment treats our bodies like fucking science experiments,” they said quietly, their voice carrying the weight of someone who’d been poked and prodded and questioned about the validity of their existence one too many times. “Like we’re asking for something unnatural instead of just asking to feel at home in our own skin.”
Grubby, seated in the shadows where they always seemed most comfortable, shifted slightly in their chair. When they spoke, their voice was barely above a whisper, but it carried the authority of someone who’d been fighting these battles longer than most of us had been alive. “They want to dissect us to understand us, like we’re specimens instead of people. Been through more medical evaluations than a fucking lab rat.”
“The gatekeeping is medieval,” Keira said, her voice sharp enough to cut glass. “They want us to perform our gender dysphoria like it’s dinner theater, want us to hate our bodies enough to convince them we deserve to love ourselves.”
Miguel refilled my glass without being asked, the bourbon catching the light like liquid amber. “My top surgery consult made me feel like I was applying for a fucking mortgage. Three letters of recommendation, psychological evaluation, living as myself for a year—like I hadn’t been living as myself my whole goddamn life.”
“The year requirement is such horseshit,” Phoenix said, their voice rising with the kind of righteous anger that only comes from being twenty-two and realizing the world is designed to crush people like us. “Like there’s some magical timer that goes off and suddenly you’re trans enough for healthcare.”
Della’s voice carried from the kitchen, seasoned with the kind of wisdom that comes from watching too many of us fight these battles. “It’s control, plain and simple. They want to make sure we want it bad enough, like we’re not already living it every fucking day.”
River leaned forward, their elbows on their knees, scrubs pulling tight across their shoulders. “I had a patient last week, trans kid, maybe seventeen. Their parents brought them in for therapy to ‘fix’ them, and I had to sit there professionally while they talked about their child like they were broken.” They paused, running their hands through their hair. “I wanted to scream that the only thing broken was their inability to see their kid’s beauty.”
“The parents are the hardest part sometimes,” Miranda said softly, her voice carrying the weight of someone who’d fought that particular battle and won, but still bore the scars. “My mom came around eventually, but those first few years… fuck. She mourned me like I’d died instead of celebrating that I’d finally learned how to live.”
Sage looked up from their napkin art, their hands still moving in precise patterns. “My family still uses my deadname at Christmas dinner. Like my transition is some phase I’m going through instead of the reason I can finally breathe.”
Brandon shifted in his chair, his expression thoughtful. “I remember when I came out, my family acted like it was a choice I was making to hurt them. But at least I didn’t have to convince doctors I was gay enough to deserve… I don’t know, relationship therapy or something. The medical piece adds this whole other layer of bullshit you shouldn’t have to deal with.”
The room fell into one of those silences that feels heavy with shared understanding, the kind that happens when people recognize their own pain reflected in someone else’s story. From the shadows near the back corner, Grubby shifted in their chair—so quiet most people forgot they were there, but their presence felt like bedrock beneath all our storms. They rarely spoke, but when they did, it was with the weight of someone who’d lived at the intersection of every marginalized identity and found peace in the spaces between words.
“Four years is long enough to prove anything,” Grubby said quietly, their voice carrying across the room like a stone dropped in still water. “The waiting game is just another way to make us question ourselves.”
Their words hit the room like a benediction, and I felt something in my chest loosen—the way it always did when Grubby chose to share the weight of their understanding. They saw through all the medical gatekeeping bullshit to the simple truth: we knew who we were long before any doctor decided to believe us.
“You know what the fuck gets me?” I said, taking another sip of bourbon that tasted like liquid courage. “I’m fifty-three goddamn years old. I’ve been on hormones for four years, my levels are perfect, my mental health is solid, and I’ve raised three kids. But the moment I walk into that surgical consultation, I’m reduced to my chromosomes and my childhood trauma like nothing else I’ve ever accomplished matters.”
Grubby nodded almost imperceptibly from their corner, and somehow that small gesture felt like the strongest validation in the room.
“The audacity of asking us to justify our existence is staggering,” Keira said, her voice carrying that edge that made me fall in love with her fierce heart. “Like we woke up one morning and decided being trans would be fun, like we chose the hardest possible path for shits and giggles.”
Phoenix laughed, but it was the kind of laughter that lives right next door to sobbing. “Yeah, because being rejected by family, discriminated against at work, and fighting for basic healthcare is everyone’s idea of a good time.”
“The medical trauma is real though,” River said, their voice dropping to that professional tone they used when they needed to distance themselves from the emotional weight of truth. “We carry that shit in our bodies, all those appointments where we had to perform our pain, all those doctors who looked at us like we were delusional.”
Miguel wiped down the bar with movements that suggested this conversation was hitting close to home. “My surgeon was incredible, but getting to him… Jesus fucking Christ. The hoops, the letters, the waiting periods. Like my chest dysphoria was going to magically disappear if I just waited long enough.”
“And the fucking insurance battles,” Miranda added, her voice gaining heat. “Fighting for coverage like hormones are cosmetic surgery instead of life-saving medication.”
“Surgery coverage is even worse,” I said, feeling the familiar burn of frustration rise in my throat. “Four years of perfect hormone compliance, stable mental health, living my truth every goddamn day, and they still want me to jump through hoops like I might change my mind about needing an orchie. Like my testicles are suddenly going to become useful to me after half a century of causing nothing but dysphoria.”
Grubby’s eyes met mine across the room, and in that look was a lifetime of understanding what it meant to have your body questioned, analyzed, and deemed insufficient by people who would never inhabit it.
Della emerged from the kitchen carrying a plate of what looked like loaded potato skins, the cheese still bubbling and the bacon crispy enough to hear from across the room. “Food helps,” she announced, setting the plate down on the bar. “And before anyone says they’re not hungry—eat the fucking food. You need fuel for this fight.”
“The fight never ends, does it?” Sage asked, but it wasn’t really a question. “Even when you get the hormones, the surgery, the documents changed—there’s always another battle, another person who thinks they know your body better than you do.”
“That’s what I don’t fucking get,” Brandon said, leaning forward with the intensity of someone trying to wrap his mind around an injustice he’d never personally faced. “When I needed antidepressants, my doctor wrote the prescription. When I needed therapy after I lost my boyfriend, I got it. But you all have to prove you deserve basic healthcare? It’s fucking medieval.”
“But we keep fighting,” Phoenix said, and despite their youth, their voice carried the weight of someone who’d already faced down more discrimination than most people see in a lifetime. “Because the alternative is letting them win, and fuck that noise.”
River nodded, pulling off their hospital ID badge and setting it on the table like they were shedding their professional armor. “I see kids in the ER sometimes, trans kids who’ve been beaten up or kicked out, and I think about how different things might be if we had better access to affirming care. If families had resources, if doctors had training, if society didn’t treat us like we’re inherently broken.”
“Change is happening though,” Brandon said, his voice carrying a hope that felt hard-won from watching his own community’s long fight for acceptance. “Slow as molasses in January, but it’s happening. My nephew’s school has a trans kid in his class, and the other kids just… accept it. Like it’s not a big deal, which is how it should be.”
“The next generation gives me hope,” I said, feeling the bourbon warming my chest and loosening the knot of frustration that had been sitting there since my appointment. “But I’m tired of waiting for change. I’m tired of being grateful for basic human dignity.”
“So we make our own spaces,” Keira said, gesturing around the basement that had become our sanctuary. “We create places where we don’t have to perform or prove or justify. Where we can just exist.”
Miguel raised his own glass—something clear that probably cost more than my car payment. “To existing loudly in a world that wants us quiet.”
We drank to that, the bourbon burning away the bitter taste of another day spent justifying our existence to people who would never understand the courage it takes to live authentically in a world designed to break us. The Christmas lights continued their rainbow dance, Della’s cooking filled the air with the scent of home, and for a moment, in this basement sanctuary, we were exactly who we were meant to be—no performance required, no justification needed, just us, perfectly fucking imperfect and completely whole.
The night was young, the bourbon was strong, and we were surrounded by the kind of family that chooses you back. Tomorrow would bring new battles, new doctors, new forms to fill out and hoops to jump through. But tonight, we had this—our underground haven where existing was enough, where being was celebrated, and where every scar told a story of survival that deserved to be honored.
And in the end, maybe that’s all any of us really needed—a place to belong, people who understood, and the knowledge that we weren’t fighting alone.
In the basement sanctuary where Christmas lights paint rainbow promises across sweating brick walls, we gather not as patients seeking permission but as humans demanding recognition. Here, beneath the weight of a world that questions our validity, we transform medical trauma into shared strength, turning every gatekeeping battle into proof that we are more than the sum of our scars. Our bodies may be sites of translation, but our spirits remain untranslatable—fierce, uncompromising, and beautifully, defiantly whole.
“I may defend to the death your right to exist as you are, but I will fight even harder against those who would make you prove that existence is worthy of care.”
You captured my balance of realism and optimism, and the circumstances weren't far off.
Sanctuary: A place of refuge and safety. Hundreds of places in the US for animals of various forms. And nothing for trans humans. That used to be the case for abused and battered women until the country slowly awoke to the injustice of it. Trans is the new battered. I want there to be hope but, damn, Americans are so fucking slow to recognize that they have just added a different group to a very old problem. And the next question, who is the next group??