× Expand Evelyn Martinez prepares for the Miss Hispanidad Gay 2016 pageant.

In the apartment she shares with her boyfriend of seven years, Evelyn Martinez has adorned the living room with whimsical stuffed animal toys. Some rest on the coffee table, while smaller ones perch on armrests and electronic devices. Martinez sits on a couch where a slouchy green frog looks over her shoulder. She lifts an orange plastic pill bottle and points to the label marked in clear type: "MARTINEZ, EVELYN."

"This is the only thing that has my real name on it," she says, relaxing her shoulders back against the couch. The frog flops forward as she moves, cocking to the side, as if smiling.

Martinez moved to North Carolina nine years ago as a teenage boy, leaving her parents behind in rural Oaxaca, Mexico, after attempting suicide. She says she never came out to anyone while living there, but her effeminate demeanor made her a target among her peers. She was continuously assaulted, both verbally and physically.

"You come here for a better life, even if you know it'll be hard," she says. "But more than anything, you come here to be accepted. I saw the United States as more liberal, more open."

The facts about the transgender Latinx community in the South are difficult to determine. At Wake Forest University, a team of researchers who work with the Latinx population estimate that more than two thousand Spanish-speaking people in the state are transgender.

Cristina Morales, an LGBTQ advocate at the Durham nonprofit El Centro Hispano, says that about thirty transgender Latina women in the Triangle are part of the group Entre Nosotras (between us). Though just a sliver of the public LGBTQ sphere, Entre Nosotras is helping to bring light to a new Southern community that has been hidden from view.

Morales arrived in North Carolina twenty years ago. She says she led a double life in Mexico City, raised among a family of semi-professional boxers, all men. In her young adulthood as a male, they tried to "fix" her by toughening her up.

Meeting Morales in her office at El Centro Hispano, one does not detect an ounce of meekness in her demeanor. She's a straight shooter. One of the first questions I ask her, admittedly couched in activist rhetoric, is whether she feels that a safe space exists for transgender Latinx in the community. She responds with a loud, sarcastic laugh.

"What? That doesn't exist," she says. "You're not even safe in your own home."

In her office, a canary yellow wall clashes with fluorescent lighting, casting a bright glare on all the little details. A clear plastic container sits on top of a tall filing cabinet, packed with colored condoms that the nonprofit gives away at events and workshops. On the wall above it is a piece of hand-painted artwork. The background is a celestial blue marked with forty-nine twinkling stars in white paint. In the center, a red heart is wrapped with a ribbon that reads, "We Lost 49 Lives." The date, "6/12/2016," is written in the middle, commemorating the Pulse shooting in Orlando. The most telling detail is a monarch butterfly perched atop the heart. Representing the right to cross any border, it has become a symbol of migration for immigrants and allies. This monarch is painted in rainbow stripes.

A woman from Entre Nosotras, which Morales started in order to unify the transgender Latinx community, created the artwork. The group meets at least once a month for workshops with health care providers and lawyers, as well as for social and emotional support.

"I feel very proud," Morales says. "It's very difficult, here in the South, to be accepted, to even apply for political asylum." She established residency in San Francisco for a couple of years in order to be granted asylum in California, where both legal fees and medical treatment have historically been much cheaper.

For uninsured immigrants, the majority of whom lack legal status, a medical transition hasn't always been so simpleor safe. Medical care for transgender immigrants is a recent phenomenon in the South. Both Morales and Martinez were buying hormone therapy on the black market, using painful injections without the proper consultation or treatment for risky side effects.

Piedmont Health Services formalized a program for hormone therapy for transgender patients in 2013. Of its ten North Carolina locations, four are in Alamance County, three in Orange, two in Chatham, and one in Caswell. It offers sliding-scale services for the uninsured, which, in 2015, made up 43 percent of its patients.

Rupal Yu, a doctor at the Carrboro Community Health Clinic, says that for transgender patients, the clinic uses an informed-consent model. This means that a diagnosis of gender dysphoria is not legally required for care, as it is in some places. Yu speaks fluent Spanish and provides general health care for anyone, not just the transgender community.

Yu says that for transgender patients, "continuing the journey with someone requires building a longstanding relationship."

"Cristina has taught me so much and has opened my eyes for resources," Yu says. "Particularly being able to apply for political asylum for gender discrimination, which is amazing. The beautiful thing about this privilege is to walk along people's journeys, to see they've gotten so much healthier. Less depression, more sense of wholeness."

Since 2014, Yu and her colleagues have incorporated teaching models for medical students who conduct rotations at their clinic to learn more about transgender care.

"There's a massive training gap. None of this is covered in medical school," she says. "So people are clueless. They say the wrong things. Patients have terrible experiences and they don't come back. Or people get medicine [illegally] and that's not good. But the tide is definitely turning, even in North Carolina.

"Since we've been able to legitimize people's medication regimes, it's been empowering for me as a provider that we can get this medicine officially from our pharmacy," she adds. "But the medical transition is a very small piece. The social, cultural transition is much more of a bigger issue."

Entre Nosotras recently hosted a Miss Hispanidad Gay 2016 competition at the Hayti Heritage Center. Most of the contestants were transgender Latinas; the others were men in drag. Martinez participated as a contestant. She says the pageant was the first time she felt relaxed in such a large crowd.

"When they dolled me up and I put on my gown, I felt, like, wow! I'm usually very shy, but it turned into a beautiful experience for me," she says. "I personally felt very, very much like a woman. The other contestants wore padding or things to make them look curvy. And I didn't have to. I initially felt small in front of them, but also proud that what I had was all natural."

Martinez will attend her first Pride march this year, and she's already working on her costume with her Entre Nosotras cohort. Her boyfriend will also be attending, his first public outing as an activist.

"I want the public to see that transgender people can be and look as feminine or masculine as we want," she says.

This article appeared in print with the headline "Lost & Found"