"It wasn't fun," Hennessey, who uses they/them pronouns, said.
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Gender-affirming surgeries allow transgender and gender non-conforming people to feel like their truer, inner selves. But in the spring of 2020, many hospitals delayed or canceled these surgeries, along with other elective or nonessential procedures to make space for COVID-19 patients.
Hennessey, who is the director of education and programs at the LGBT Center of Raleigh, said they heard from many other transgender community members in similar situations.
"There were a lot of people that were really struggling because they were looking forward to starting surgery, looking forward to starting hormones, but all of that just got knocked out," Hennessey said. "There wasn't a whole lot that we could do, that anyone could do, except provide a space where people could just talk it out."
While Hennessey said they understood why hospitals needed to delay the surgeries, others had more trouble reconciling the change.
"Most people were of the mindset of, 'This got canceled and I scheduled this a year and a half ago, so I'm probably never going to get this done. It probably means it's going to be another year and a half or more. What if they never schedule me again?'"
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Hospitals were able to reschedule many of the delayed surgeries, including Hennessey's. But doctors say the mental health impact of these disappointments could have lasting effects.
"They have plans to move forward," said Dr. Deanna Adkins, a pediatric endocrinologist at Duke Health and the director of the hospital's transgender health clinic. "A lot of times they plan the particular timing of the surgery years ahead of time to correlate with graduation and moving to college and other important things that just aren't going to wait. It can be tough to ask them to put it off for another month."
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Adkins added that some students have even delayed starting college because of a rescheduled surgery. She added that even outside of surgeries, teaching hormonal injections over telehealth is difficult and that access to mental health care is crucial for this population.
One of the major players in mental health care for this community is the Trevor Project, the world's largest suicide prevention and crisis intervention organization for LGBTQ youth. The group is working to build support for change that ensures the needs of transgender and "non-binary" people in the health care system are not ignored or misunderstood.
"For many young people, getting surgery and getting care that allows them to be their true self--that for some people is the most important thing that has happened or will happen in their lives. And for many young people, they wait for years, for years to be able to get the surgery and care that they need."
And, Paley added, one of the critical steps in pushing for better health care is recognizing the necessity of the treatment--challenging the medical classification of "elective."
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"These are not optional, nice-to-have procedures and surgeries," Paley said. "These are medically necessary procedures to support trans and non-binary young people."
A spokesperson for Duke Health said of the approximately 2,180 delayed procedures between March 2020 and January 2021, nearly all have been rescheduled--including gender-affirming surgeries.
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Now, Hennessey is working with the LGBT Center on a number of transgender-focused initiatives, including helping members of the community legally change their name and gender markers.
"This is an essential, life-changing surgery for everyone that goes through it," Hennessey said.
The Trevor Project's crisis line is available 24/7 via phone at (866) 488-7386, text at 678-678, or online chat here.