Supporting Trans Youth in Puerto Rico: A Conversation with True Self Foundation

Point of Pride is proud to partner with True Self Foundation, a Puerto Rico–based nonprofit dedicated to uplifting and empowering the LGBTQ+ community. Through this collaboration, we’re donating gender-affirming chest binders for True Self to distribute to trans and nonbinary people in need across the island.

Puerto Rico’s trans community has long faced systemic barriers to care, safety, and visibility — challenges that have only been compounded by recent policy changes. In June, a new ruling restricted access to gender-affirming healthcare to individuals age 26 and older, leaving many young people without access to vital care and support.

In this Q&A, we spoke with True Self Foundation’s Executive Director, Dr. Miguel Vázquez Rivera (he/him), about how their team is continuing to meet the needs of the community, the impact of the recent healthcare ruling, and why affirming resources like binders can play such an important role in the lives of trans people.

Q&A with True Self Foundation

For those who may be unfamiliar, can you share a little bit about True Self Foundation’s mission and the communities you serve?

At True Self Foundation, our mission is to promote social mobility and general wellbeing of the LGBT+ community in Puerto Rico. We strive to build a more just, inclusive, and equitable Puerto Rico for LGBT+ people. We focus on creating safe spaces, providing access to health and educational resources, and addressing systemic inequities that harm our community. We serve LGBT+ people of all ages, with a particular emphasis on trans and nonbinary youth who too often face stigma, discrimination, and barriers to care.

How does access to gender-affirming resources (like chest binders) impact the well-being of trans and nonbinary people you work with?

Something as simple as a binder can be life-changing. For many trans and nonbinary people, binders help align how they feel inside with how they are seen in the world. That affirmation reduces anxiety, builds self-confidence, and fosters a sense of safety in public spaces. These resources are not cosmetic—they are essential to mental health and survival. In Puerto Rico, access to gender affirming resources like binders is scarce.

Video caption translation: "Thank you @pointofprideorg! The binders you donated to our XChange program help us continue to serve our trans masc presenting community."

Puerto Rico recently implemented a new policy restricting gender-affirming healthcare to people over the age of 21. How has this ruling affected your organization’s work and the community you serve?

This policy has been devastating. It strips young trans people of their right to medically necessary care and sends the harmful message that their identities are not valid. Also, this inhumane measure was made into law immediately which left the trans community without their life saving treatments from one day to the next. At True Self, we’ve had to step in by strengthening peer support, developing collaborative agreements with national nonprofits to provide access to care, and advocacy efforts. We are mobilizing with allies to challenge this injustice and to make sure our youth know they are not alone.

What are some of the unique challenges trans people in Puerto Rico face when it comes to accessing care, compared to the mainland U.S.?

Beyond the healthcare ban, Puerto Rico has fewer providers trained in gender-affirming care and many young people must travel long distances for even basic services. Economic instability and colonial status also mean our health systems are underfunded and often inaccessible. For trans people, that adds another layer of difficulty to an already challenging journey. Also, LGBT+ philanthropy is limited specially for us since US philanthropy sees us as international and international philanthropy views us as part of the United States. So, local nonprofits are left with limited resources to serve and increasing need.

What keeps you motivated in the face of these obstacles, and what moments of joy or resilience have stood out to you recently?

The resilience of our community is my constant motivation. Recently, I witnessed a group of families of trans youth supporting each other during a support group session—laughing, sharing tips, organizing and reminding one another that they are not alone. In those moments, I see the future we’re fighting for: a Puerto Rico where LGBT+ people don’t just survive, but thrive. This time of day is a reminder that our strength is rooted in our community and we will uplift each other.

How can people outside Puerto Rico support True Self Foundation’s work and the trans community on the island?

There are many ways to help: donate directly to support our programs thru our website, amplify our stories on social media, and advocate for LGBT+ rights wherever you live. Solidarity matters — when people outside Puerto Rico raise awareness, it brings pressure and visibility to the struggles happening here. Every act of support helps us build a safer and more affirming world.

Miguel, what inspired you personally to take on the role of Executive Director at True Self Foundation?

I founded True Self with a friend of mine, and it became, and still, is the only foundation dedicated to the LGBT+ community in Puerto Rico. As a gay cisgender man and a clinical psychologist, I’ve seen firsthand the harm that stigma and lack of access can cause. I wanted to use my skills and my voice to create a space where LGBT+ people could feel affirmed and supported at a larger scale than a therapy session. Leading True Self Foundation is deeply personal for me — it’s about building the world I wish had existed for me and so many others growing up.

What’s one lesson you’ve learned from the community you serve that has shaped the way you lead and live your life?

I’ve learned that authenticity is powerful. Trans and nonbinary people remind me every day that living your truth—even when it’s hard—can transform not only your own life but the lives of those around you. That lesson guides how I lead, how I connect with others, and how I show up in every space.

What’s one message of love, strength, or hope you’d like to share with the trans community in Puerto Rico and beyond?

You are seen, you are worthy, and you are not alone. Even when systems fail you and the government is against you, there is a community that will stand beside you and fight with you. Hold on to your truth, because your existence is powerful and it is shaping a more beautiful and just world for us all.

At Point of Pride, we believe affirming care—whether it’s access to a gender-affirming surgery, a supportive community space, or a simple garment like a binder—can be life-changing. We’re honored to stand alongside True Self Foundation in their mission, and we hope this partnership serves as a reminder to trans and nonbinary people in Puerto Rico that they are seen, valued, and supported.