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On Saturday, June 13, Austin transgender musicians and drag performers will come together to raise money for gender-affirming surgeries, working to fill a gap in the health-care system created by anti-trans sentiment in both the federal and state governments.
Christened Tops and Bottoms, the fundraiser, at Swan Dive on Red River Street, grew out of problems Austin musician Theo Nesland faced when trying to get top surgery, gender-affirming plastic surgery to help their chest better match their gender identity.
Nesland scheduled their surgery for February at a center in Austin that specializes in the procedure. But just before the surgery date, Nesland found out that their insurance company had dropped coverage for the treatment.
The news was devastating. Nesland, who works at Franklin Barbecue, couldn’t hope to pay for the surgery out-of-pocket. Nesland’s friends suggested setting up a GoFundMe, but Nesland struggled with the idea.
“Asking for help is not one of my strong suits,” Nesland said. “What I’m good at is working, so let me work for support. That would make me feel good as a human.”
Doing it for themselves
In January, Nesland had helped found an event-organizing group called Trans Mission, which held its first event on Valentine’s Day. After their insurance fell through, Nesland’s friends encouraged them to turn their expertise towards a shared fundraiser. Trans Mission began reaching out to queer and trans musicians — as well as to transgender drag performers — who might need gender-affirming surgery.
Such surgery isn’t cheap. Without insurance, top surgery can cost $5,000 to $15,000. Other types of gender-affirming surgery can be even more expensive. Even when insurance does cover the surgery, recovery can incur additional expenses and force recipients to lose time at work.
Tops and Bottoms will feature musical acts and drag performances, with proceeds split among the artists and other contributors to the show who may need financial support for gender-affirming care. Nesland said their band, Maiden Mother Crone, will perform at a later date with proceeds also added to the fundraiser. A souvenir T-shirt is available for purchase as a way to donate.
“I want it to be fun, I want to be rambunctious,” Nesland said of the fundraiser. “I want people to just let their spirits go free and feel safe, first and foremost, and I want people to see hope.”
A toxic atmosphere
Nationwide, trans people are increasingly encountering barriers to gender-affirming care. Such care for minors was banned in Texas in 2023, and in 2025 the Supreme Court upheld such state level bans in U.S. v. Skrmetti.
Conservative lawmakers have targeted adults as well. Last year, the Texas Legislature passed a law requiring insurance companies to pay for any medical treatment required by someone who believes they were harmed by gender-affirming care.
Although studies show that few people regret their transition, LGBTQ+ advocates raised alarm bells, concerned that the law could result in Texas insurance companies dropping coverage or making it harder to access some forms of gender-affirming care. “There’s always the worry that they’ll … choose the path of (least) resistance and their bottom line,” said Landon Ritchie, a policy coordinator at the Transgender Education Network of Texas.
Credit: David Haddad
Let’s play
At least one artist scheduled to appear at the Tops and Bottoms fundraiser has encountered such problems.
An Air Force veteran who performs under the stage name Tiny Taurus said that he has struggled to receive even routine care from the Veterans Affairs Department. Federal health plans now block access to gender-affirming care for many adults as well as their children, and in 2025, the VA rescinded policies that had previously protected access to gender-affirming treatments.
Taurus recalled one recent visit where he contacted the provider in advance with his chosen name and pronouns.
“I was trying to do everything on the front end before I went in to make sure that they had everything they needed to make sure I was comfortable,” Taurus said. “Literally none of that was used.” The provider instead deadnamed Taurus and declined to use their right pronouns.
A single show can’t deal with all of that, of course, but Nesland told Austin Free Press they believe that LGBTQ+ people and their allies can sustain each other during hard times if they work closely together.
“I want … the community coming together and making things happen,” Nesland said. “And the government can try to tell us ‘No,’ and we can fight together and show them that we can do this.”
Kit O’Connell is a GLAAD Media Award-nominated freelance journalist and the former Digital Editor of Texas Observer magazine. They live in Austin with their spouse and two cats.
