Questioning Transphobia

Now online: first mapping of legal and health care situation of trans people in 58 countries

The legal and health mapping was conducted by Transgender Europe’s Transrespect versus Transphobia Worldwide (TvT) research project in close cooperation with activists and experts from all world regions. A comprehensive questionnaire developed by the TvT project’s research team and reviewed by more than 15 researchers and activists from all six worlds regions was distributed to over 70 international activists and experts, who provided detailed information including comments and explanations on the specific situation in the respective country.

The mapping consists of different tables on:

1. Legal Gender Recognition: Change of Name & Change of Gender

The TvT tables provide detailed information on legal measures meant to guarantee a legal change of name and a legal change of gender for trans people. They list requirements such as ‘psychiatric diagnosis’, ‘gender reassignment surgery’ or ‘sterilization’. Unfortunately, the mapping shows that in all listed countries in which a legal change of gender is possible, a ‘psychiatric diagnosis’, i.e. a pathologization of the applying trans person, is required for a legal change of gender. Furthermore, most legal measures list ‘gender reassignment surgery’ or ‘sterilization’ as requirements for legal gender recognition, which clearly violates human rights.

The TvT tables also show the actual legal situation, meaning how legal change of name and gender are enacted in practice in the mapped countries. In some countries with existing legal measures, trans people’s applications are delayed for months and years, whereas in some countries without existing legal measures, trans people find other ways, for instance of legally changing their name. The TvT mapping moreover lists existing proposals regarding the legal change of name and gender in detail. This may serve both as an evaluation of the existing legal measures and situation and as an indicator of existing trans activism.

Click here to open this table

2. Anti-Discrimination, Hate Crime, and Asylum Legislation

The TvT tables provide detailed information regarding the inclusion of trans identity/gender identity in Anti-Discrimination and Hate Crime laws and in the Constitution. They also list the inclusion of trans people in Asylum guidelines. The mapping indicates that ‘gender identity’ is very rarely acknowledged as a ground of discrimination.

It also shows the legal situation, meaning the actual practices regarding these legal measures and guidelines, as well as proposals that challenge existing measures. These proposals very often demand the explicit inclusion of ‘gender identity’ into existing legal measures.

Click here to open this table

3. Criminalization, Prosecution, and State-sponsored Discrimination

The TvT tables show detailed information on the legal measures that criminalize trans people and trans related issues, such as ‘so-called cross-dressing’ and ‘gender reassignment surgery’. In some countries in the Global South and East these laws were introduced by colonial powers and missionaries and are not acted upon today. For instance, in some countries where ‘so-called cross-dressing’ is illegal, trans people are extremely visible and acknowledged within their culture and society rather than being prosecuted. There are, however, other countries where there is no criminalization, yet trans people are prosecuted with other laws that are used specifically against trans people, such as anti-prostitution, loitering or nuisance laws. The TvT tables are designed in a way to clearly show these important differences between legal criminalization and actual prosecution of trans people. They thus aim to provide a comprehensive understanding of the legal situation beyond the mere existence of legal measures.

Click here to open this table

4. Trans-Specific Health Care: Hormone Therapy and Hormones & Gender Reassignment Treatment and Body Modifications

The TvT research has addressed not only the legal situation of trans people but also important aspects of trans people’s social situation. The TvT tables give a first insight into trans people’s health care situation, focusing on trans-specific hormone therapy and hormones as well as gender reassignment treatments and body modifications. The TvT tables show manifold aspects regarding medically supervised hormone therapy and gender reassignment treatments, including requirements like ‘psychiatric diagnosis’ and the availability of funding.

The tables moreover list the existence of alternative practices, such as acquiring hormones on the black market without medical supervision or applying industrial silicone without medical supervision. These ‘alternatives’ exist in countries where trans-specific health-care is not provided as well as in cases where trans people do not meet the requirements for medically supervised treatment. They can lead to serious health problems and in some cases even to death.

This table is in two parts: Click here to open part 1 – and – Click here to open part 2

A characteristic of Transgender Europe’s legal and health mapping is thus that it enables a quick overview of existing laws while at the same time providing detail and complexity regarding actual practices.

At present, 58 countries are listed in the following regions: Africa (9 countries), Asia (13 countries), Central and South America (9 countries), Europe (18 countries), and Oceania (9 countries). For India, a separate set of tables showing the situation in individual states is provided. Further countries will be added in due time, including a separate set of tables for the 8 Australian states and Brazil. The TvT mapping is designed such that it enables a regular update and extension of the tables. Therefore, any information and evaluation of the presented tables is highly welcomed and will be analysed and included in regular updates. In the course of 2012, we will step by step present more elaborated information, including context information, references, law texts, etc. in selected country sections of the TvT website. In these sections, the numerous activists and researchers that contributed to the TvT mapping will be fully acknowlegded.

Transgender Europe’s legal and health mapping can be accessed on the TvT project website at:

http://www.transrespect-transphobia.org/en_US/mapping.htm

New research: In November 2011, the TvT research team together with six partner organizations from Asia, Eastern Europe, Oceania, and South America started a new survey in form of a peer research on trans people’s experiences with Transrespect and Transphobia.

The TvT project is funded by the Open Society Foundations, the ARCUS Foundation, and partly by the Heinrich Boell Foundation.

If you have further questions or if you want to support the research project, please contact the TvT research team:

Dr Carsten Balzer and Dr Jan Simon Hutta

research[at]transrespect-transphobia.org

or check our website:

www.transrespect-transphobia.org

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Cross-posted at Bird of Paradox

This was Emily’s idea, but my post about community sort of covers my own investment as well.

So what QT is missing is a list of resources for trans people – trans-friendly clinics, shelters of all kinds, activist organizations, sex worker organizations, food resources, grassroots organizing, and so on.

I don’t mean transition-related resources. Trans women can find the Transsexual Roadmap if they really need that. There’s no shortage of advice on how to transition, where to transition, who to go to to transition, and so on. I’m more thinking of community resources that can help with practical day-to-day matters, legal issues, health care issues, and legislation. Hopefully this can spin off into more discussion of practical issues, grassroots possibilities, and of course actual realities that trans people already live with. Basically, to make Questioning Transphobia into more of a community resource than it currently is.

I mean, just check this epic fail out:

Tens of thousands of Texas children will be directly affected by the 11th-hour decision of a number of major health insurance companies to stop selling child-only policies rather than comply with the new federal law that requires they cover youngsters with pre-existing conditions.

All insurance companies starting today will accept children in family plans regardless of medical history, but Texas insurers United Healthcare, Aetna Inc. and Cigna Inc. are among the ones that will no longer offer policies just for individuals under 19.

Such plans have grown in popularity in recent years as employee-based policies have cut coverage of dependents.

“What we’re seeing is what we’ve thought all along: Health insurance companies are really only about the bottom line,” said Robert Sanborn, president of Children at Risk, a nonprofit children’s advocacy organization based in Houston. “They pretend to care about families and children, but when it comes down to it, they’re happy to kick children to the side.”

You know, I don’t even really have much to add to this. Insurance companies are fucking evil. Prove me wrong.

Almost a year after it first opened for business to “any woman who was born a woman“, Lu’s Pharmacy, the health collective with its much-criticised policy of serving trans men, but not trans women, closed at the end of June 2010 because it “couldn’t attract the funding and the number of clients it needed“, according to the Vancouver Courier.

The apparently clueless yet alarmingly transphobic former director, Caryn Duncan, said the closure was due to “many complexities” and it’s hard not to wonder if the controversy over the initial policy not to serve all self-identified women, trans or cis, was a factor. (The policy was overturned when, on 21 January 2010, Lu’s Pharmacy began offering its services to trans women).

Despite the furore, the closure of any health clinic which does serve trans women, no matter how the policy was decided, is not something to cheer about. There seem to be few enough health clinics that will serve us anyway, and access to healthcare generally is a huge issue for many of us.

Under the circumstances, all I can really say is that I hope Lu’s Pharmacy is able to rebuild its business, as soon as possible, on a firmly trans inclusive basis.

I never know how to react to the debate about healthcare reform. Opponents always seem to put the British National Health Service forwards as a nightmare vision of what socialised healthcare looks like; in the latest iteration, I’ve seen a lot of supporters saying that the NHS actually works fairly well.

When I hear that, I remember that it was an NHS doctor who informed a psychiatrist, based on nothing more than his own assumptions, that “this is all mixed up with feeling that women probably don’t do as well as males in society”. I remember that the NHS psychiatrist concluded I wasn’t a “pure transsexual” because “by sleeping with men, you’re taking a female role”. I remember that the same psychiatrist, when I was looking for support during an extremely unpleasant relationship breakdown, couldn’t see beyond the fact that I was pregnant, since “pregnancy is hard for someone who wants to be a man (sic)”.

I remember, too, the psychotherapist I saw through the NHS, who told me what an attractive woman I was and asked me why I felt the need to convert everyone to my “point of view” about the appropriate pronouns to use for a trans man. I remember the NHS psychiatrist who refused to even refer me to a gender clinic because I couldn’t feign uncomplicated enthusiasm for surgery, who told me he couldn’t ethically let me have testosterone because it would give me cancer, who characterised my response that he was quite comfortable leaving me to commit suicide through dysphoria as manipulative, and who explained that even if I scraped together enough money for a private consultation, the same restrictions would be in place.

This is how the NHS often works. Any attempt to solve the problems is up against the tabloid press, who will immediately scream about the taxpayers’ money being wasted on something they have always portrayed as inherently frivolous. It’s only working well if the suffering of trans people is irrelevant in the greater scheme of things.

And yet…

Speaking as someone who is in no fit state to hold down a job, I have to be grateful for the NHS. If my daughter needs routine healthcare or vaccinations, she can have them. If I go down with a minor illness, I can get treatment. If I ever suffer a major illness or an accident, I won’t have to worry about the cost of treatment. Cissexist healthcare, however problematic it may be, is still preferrable to the stories I’ve heard about uninsured people in the US.

I will never agree with those who say that the NHS is substandard and therefore the US status quo is superior. It’s logically flawed as well as being callously dismissive of the plight of those without health insurance. But neither can I sign onto an unqualified defence of the NHS.

cross posted at Harlot’s Parlour

Since yesterday was World AIDS day I thought I’d drop some stats about seroprevalance amongst trans women, especially sex workers, worldwide.

Studies about HIV infection rates amongst trans women populations overall:

*  14% amongst trans women in Puerto Rico (Rodriguez-Madera and Toro-Alfonso 2005) and Chicago (Kenargy and Boswick 2005)
*  21% in Sydney (Alan et al 2005)
*  24% in Amsterdam (Gras et al 1997)
*  25% in Houston (Risser et al 2005)
*  35% in San Francisco (Clements-Nolle 2001)

Specifics (transsexual unless noted, some included transvestite or travesti sex workers)

*  63% of trans women of colour in San Francisco indicated HIV positive (Clements 2001)
* 74% in Rome among transsexual and travesti who use drugs.  Most notably, the same study found 100% seroprevalence of people who had been in the same milieu for more than four years (Gattari et al 1992).
Rates amongst trans sex workers

*  46% in Lisbon (Bernardo et al 1998)
*  68% in Atlanta (Elifson et al 1993)
*  63.8% in Rio de Janiero (Surratt et al 1996)
* 62% amongst transsexual and travesti sex workers in Bueno Aires (Berkins and Fernandez 2005)

All of these statistics have been taken from Viviane Namaste’s recent research paper “Undoing Theory: ‘The Transgender Question’ and the Epistemic Violence of Anglo-American Feminist Theory” (Hypatia journal, vol 24, no. 3, summer 2009) where she argues that a feminist emphasis on what transsexual and transgender bodies mean has neglected the very real crises of violence and HIV infection amongst our communities.  Namaste argues compellingly that HIV has ravaged communities of transsexual women worldwide, a “lost generation” whose disappearance has largely gone unnoticed.  Looking at these statistics, I can’t say I disagree with her.

Story here:

The federal government would be banned from funding sex change operations and other services for transgender individuals if social conservative activists get their way.

There’s no sponsor yet for an amendment to the health care overhaul – and it may remain in the dustbin of unrealized wedge issues – but culture warriors are shopping the proposal to Republican senators.

The language is written: “None of the funds authorized or appropriated under this act (or an amendment made by this Act) shall be used to cover any part or portion of the costs of any health plan that includes coverage of” any sex or gender reassignment procedure, surgery related to such a sex change, hormone therapy for a sex change or pre- and post-operation treatments for a sex change.

A senior aide to a Republican senator said that a public insurance plan could easily end up covering sex-change procedures if that’s not specifically banned in the bill.

“It’s not that hard to imagine that a new federal health plan crafted and implemented by this administration would cover sex-change surgeries. Anything not explicitly prohibited in the bill is effectively on the table. Most Americans probably would prefer that their tax dollars not pay for or subsidize transgender surgery,” the aide said.

Advocates for transgender people note that it is often difficult for them to obtain insurance that covers medical needs related to their transition and say that sometimes basic medical care has been unfairly denied.

“Unfortunately, some insurance companies broadly interpret language excluding transgender-related care and services to deny coverage for non-transition-related procedures for transgender individuals. Insurers justify these exclusions by stating that your current medical problem is somehow related to your transition,” the Transgender Law Center wrote in a fact sheet posted on its Website.

The ironclad language of the funding-ban amendment suggests the type of prohibition conservatives want to see on coverage of abortion if a new health care exchange includes a government-backed insurance option.

House Democrats say they have a plan that would segregate federal funds to prevent taxpayer support for abortion services, but abortion critics say the proposed firewall would not fully shield taxpayers from footing the bill for the practice. In its first iteration, the House version of the health care bill didn’t mention the word abortion – though it carried significant implications for the availability of insurance coverage for the procedure.

Several Democratic aides – and Sen Roland Burris (D-Ill.) – declined to comment on the proposal.

All I can say is: Contact your representatives. This is vile and ridiculous.

h/t Aureantes on the Transgender LJ Comm

Massachusetts Transgender Political Coalition (MTPC) has available for free download the following two brochures addressing the issue of trans suicide:

• Saving Our Lives: Transgender Suicide Myths, Reality, and Help

  Information for transgender people, family, friends, and allies. Includes warning signs, do’s and don’ts, helpful tips, contact information, and myths and realities.

  Click here to download PDF

• Preventing Transgender Suicide: An Introduction for Providers

  Includes definitions, warning signs, victimization and PTSD, systemic stressors, protective factors, where to learn more, and references.

  Click here to download PDF

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Cross-posted at Bird of Paradox

The Massachusetts Department of Public Health (DPH) has published the results of “the largest survey to date comparing the health of lesbian, gay, bisexual and transgender (LGBT) residents to heterosexual and non-transgender residents in Massachusetts”.

[Click here to download a PDF copy of the report, The Health of Lesbian, Gay and Transgender Persons in Massachusetts]

The Executive Summary points out that the health of trans people is worse than amongst cis people; and that we also have “worse outcomes with respect to self‐reported health, disability status, depression, anxiety, suicide ideation, and lifetime violence victimization”.

Some of the results do stand out – they may not be particularly surprising, given the amount of anecdotal evidence one hears from conversations with other trans people, but they do seem to confirm it:

• While 10.4% of heterosexual respondents and 7.8% of gay men and lesbian respondents did not have a personal doctor, 17.6% of bisexual respondents and 17.3% of transgender persons indicated that they did not have a personal doctor.
• With respect to overall health, respondents were asked if their general health was excellent, very good, good, fair or poor. Heterosexual respondents had 82.5% responding Excellent or Very Good while gay men or lesbian respondents reported 78.0%, bisexual respondents 73.5% and transgender persons 67.3%. Self‐reported general health has been found to be a good indicator of an individual’s actual health status.
• Respondents were asked to report how many days in the past 30 days they have felt sad, blue or depressed. Heterosexuals reported 3.97 days, gay men and lesbians 4.18 days, and bisexuals 6.38 days. Transgender persons reported 7.79 days, higher than non‐transgender respondents (4.29 days).
• Respondents were asked if during the past 12 months they had seriously considered attempting suicide. Among heterosexuals, 2.3% reported having considered suicide and among gay men and lesbians, 4.4% reported suicide ideation. Transgender persons (30.8%) and bisexuals (7.4%) reported higher rates of suicide ideation.
• Respondents were asked if they had ever been threatened with physical violence by an intimate partner. Among heterosexuals (12.3%) reported a lifetime history of being threatened with intimate partner violence victimization, compared to gay men and lesbians (14.0%), bisexuals (18.4%). Transgender persons (34.6%) were more likely to report being threatened with physical violence by an intimate partner than non‐transgender persons (13.6%).
• Respondents were asked to report whether they had ever had an HIV test. Gay men and Lesbians (72.2%) had the highest rate, followed by bisexuals (66.7%), transgender persons (65.4%) and heterosexuals (49.0%).

To my mind, what’s missing from a lot of these data is the “why” aspect: why are trans people less likely to have access to a doctor than gay and lesbian people, why do we feel depressed more often than cis people, why do we feel suicidal more often, why are we more likely to report being threatened with physical violence by an intimate partner than cis people, and so on. Of course, those reasons will undoubtedly vary widely between individuals, but it would have been interesting to know if any patterns had emerged, and if there were any differences between trans and cis populations.

Overall, I think the report is to be welcomed, cautiously – but I also hope that a more rigorous (and bigger) survey can be carried out in the near future. If nothing else, it suggests that the problems we face in our everyday lives are in urgent need, not only of study, but positive and supportive action by the mainstream cis society which oppresses us in so many ways. However, I also think that for there to be any real improvements in our circumstances there first needs to be a substantial change in cis people’s attitudes to us – and that doesn’t look likely to happen any time soon.

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Curtsey to Stefani for the heads up

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Cross-posted at Bird of Paradox

Via The Center:

GIP Presents: NYAGRA’s 1st Public Directory of Trans-Sensitive Providers Launch Event

Event Date
Tuesday, July 21 2009 : 7:00pm

Location
The Center

Description
Gender Identity Project will be hosting the following event:

The New York Association for Gender Rights Advocacy (NYAGRA) has compiled the first public directory of transgender-sensitive providers in the New York City metropolitan area and will be distributing hundreds of copies of the directory to members of the transgender community.

NYAGRA’S 1st Public Directory of Trans-Sensitive Providers

The 26-page directory – which includes of physicians, mental health professionals, acupuncturists, and AIDS agencies as well as other health care providers – is a project of the Transgender Health Initiative of New York (THINY), a community organizing project established by the Transgender Legal Defense & Education Fund (TLDEF), NYAGRA, and the Center GIP in 2004.

Some of the providers listed in the provider directory will be on hand at the event, along with light refreshments. Come get your own copy of the directory and meet some of the providers!

Find this event on Facebook, and invite your
friends!

Price
Free

For More Information
For more information please contact: Kelly White (760) 473-2476 or Pauline Park (212) 675-3288, ext.338

If only there was a similar initiative here in the UK, she murmurs, wistfully…

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Cross-posted at Bird of Paradox