Nah, they suck most at governing. People were tired of things getting worse every year under Democrats. Things get worse faster under Republicans, but the Democrats didn't do enough to prevent our societal decay into feudalism. They're corrupt as fuck, especially where they have supermajorities. Every law to address problems is another scheme that helps the rich. They never take a stand against business, not understand that there is currently no way to serve both capital and labor.
Under current rules, you don't need a referral because we have informed consent. So long as you pass a medical check, you can accept responsibility for the effects and start HRT, with no psychological gatekeeping or dysphoria diagnosis. Like I said, places like Planned Parenthood can get you a prescription for a few hundred dollars out of pocket, which is less expensive than jumping through insurance hoops in the long run (I say from firsthand experience)
A ton of progress has been made in the American psychology community, especially compared to places like the UK. Gender affirmation is fairly accepted as the only evidence based method to handle trans patients, at least by academic consensus. Even the trans medicalists here have a hard time denying that we exist and are best helped by affirmation. The data doesn't support any other treatment being anywhere near as effective. It's probably one of THE MOST effective treatments for any psychological issue.
The biggest issue is that the new fascist government will illegally force the psychology community's hand without approval from congress. There will be fierce resistance in academia, but the government will use economic coercion and override the science in the law. However, this will take time, and you will be safest in blue states. Medical science is in grave danger for trans people, women, and anyone who doesn't fit their mold.
I honestly can't predict all the challenges we'll face, but the economy will also tank, so prepare to work outside official channels to get basic things done.
That makes sense. However, there are still things you can probably do depending on how financially independent you are. Even working towards independence in housing and health insurance would be a big move. If you live away from your parents, you can wear and act how you like when not at their house. If you have your own insurance, you can get HRT without them knowing. You can prepare for and start your transition in lead-up to your sibling becoming an adult.
Transitioning is a lot of work, but it's very satisfying and motivating. I wouldn't start HRT till your sibling's last semester, as it will probably become harder to hide over time. Planned Parenthood is very affordable, so long as you have insurance for once you get the medication. You should also look to live in a heavily democratic state, as there'll be more support in those places, even if care becomes illegal.
More importantly, it gatekeeps gender affirming care to people that are fucked up enough by it. Some of us are significantly hindered by it, but many others can still work and function in life without transitioning.
My dysphoria is bad enough to make life as a man impossible, but I didn't even know that was the case until I came out. I also don't think it's fair to gatekeep care from people who can function without transitioning. Being a good worker bee shouldn't be the goal; that bar is too low.
CHARGE YOUR PHONE!!!