Transgender people face roadblocks in accessing healthcare, and it’s not going away even after archaic rules denying healthcare access to transgender people are lifted and more of us become insured.

Over a decade ago I came out as a transgender woman and began to navigate my transition. That’s when I was confronted by the harsh fact that transition-related healthcare was often not covered by insurance and instead largely paid for out of pocket.

This month, the United States Department of Health and Human Services announced new proposed regulations that would expand healthcare access to transgender people. That’s exciting news, especially for those currently denied insurance coverage or who have have experienced discrimination at the hands of a healthcare provider because of their gender identity.

Only 10 states currently prohibit insurance exclusions for transgender healthcare. And if approved, the rule would increase access to medically necessary and potentially life-saving healthcare services for transgender people.

As a transgender woman, it’s heartening to witness this kind of progress. Unlike a decade ago, my transgender related healthcare is now covered through my employer’s insurance plan. And that kind of access has made a positive difference in my own transition, underscoring my right to determine what is best for my body with the help of an informed medical provider.

Yet it hasn’t been an easy or seamless process. Navigating our healthcare system can already be complex. And it becomes even more convoluted for transgender people seeking even the most basic of services.

For an overwhelming majority of transgender people, finding competent and affirming medical providers can be daunting. Even for someone like myself living in an urban center like New York, only a few places are qualified and prepared to care for transgender patients.

I had to find a new primary care physician after coming out to them as a transgender woman. I was frequently misgendered and referred to as “sir” and “mister” at my appointments despite informing them of my gender identity. And I was met with silence when I repeatedly expressed a need to access transition-related health care. Sadly, this experience is common. Almost a fifth of transgender people have been refused care because of their gender identity, according to the 2011 National Transgender Discrimination Survey.

Thoroughly humiliated, I left in pursuit of a new medical practice capable of caring for my entire well being with dignity and respect. I eventually sought services at a community health center that had created a transgender health program. Since then, I have witnessed an increase of other transgender patients in the reception area whenever I have an appointment. These kinds of resources are in high demand from an underserved and highly vulnerable population in dire need of care.

It has been exhausting to research how to best approach my transition and which medical providers would assist with my own healthcare needs. For years, transgender people have faced similar barriers to accessing information. As a result, many individuals have stepped forward to crowdsource reviews of medical providers and advice, offering models for how to approach a transition by those who have already experienced it.

I recently began researching surgeons experienced with gender affirming surgery for myself. In my own research, less than a dozen of these providers are located here in the United States and specialize in transgender-related procedures.

This has been and will continue to be a major problem. It’s roughly estimated that about 700,000 transgender people live in the United States. And while transgender people approach their transitions differently, the number of existing providers equipped to care for me and others remains profoundly low.

Perhaps more surprising is the fact there are no surgeons located in New York to serve transgender patients and their transition needs. I will have to travel out-of-state and incur additional expenses when I pursue any kind of gender affirming surgery.

But some institutions are beginning to take steps to get ahead of this shortage. Mount Sinai Beth Israel hospital is making preparations to become the first in New York state to offer gender-affirming surgery for transgender patients. But achieving this goal won’t occur overnight; training competent medical professionals that specialize in this practice takes time and careful planning.

Fortunately, resources are available to assist health care professionals. Groups like the Center of Excellence for Transgender Health and the World Professional Association for Transgender Health, including its Standards of Care – an established set of clinical guidelines for providing care to transgender people – exist to train health care providers about the specific needs of transgender people.

We need sustained investment in the field of transgender health, so all of us can receive quality care for our needs in an open and respectful environment. Transgender people can lead longer, happier and healthier lives – but only if we are allowed the same level of healthcare access and treatment as everyone else.