Sunday, February 07, 2016

Healthcare

How many times have we had to training our healthcare providers about trans healthcare? At one doctor’s appointment before I transitioned I was reading off a list of my meds and when I got to estradiol he asked what I was taking that for and I told him that I’m trans. He closed his laptop and said I was his first trans patient do you mind if we talk about it. It was great that he wanted to learn, but it was really not the time or place to learn, but I did do a short Trans 101 for him.

Online there is a research paper published by Mary Ann Liebert, Inc. publishers about the amount of transgender training that student doctors get.
Transgender Health
Implementation and Evaluation of a Pilot Training to Improve Transgender Competency Among Medical Staff in an Urban Clinic
Published in Volume: 1 Issue 1: January 13, 2016

Introduction
Despite increasing awareness of their extreme marginalization, transgender individuals (TGI), who identify their gender as different from their sex assigned at birth, continue to face widespread discrimination, maltreatment, and ostracism, including in social and healthcare services. Providers often lack expertise in adequate transgender (TG) care due to limited specialized training. A survey of 150 US and Canadian medical schools found that the median total time dedicated to LGBT-related content was 5 h, with zero instruction hours during clinical years. The least represented areas of the curriculum regarding TGI were aspects related to medical and surgical transition care.

In addition, many social service and medical providers hold transphobic beliefs that result in denial of services, and verbal and physical abuse directed toward TG patients. Consequently, TGI evidence low rates of healthcare utilization (HCU) and increased morbidity and mortality than other groups, especially evident among TGI of color.

Hostile service-provision environments and lack of cultural competence have been linked to TGI suboptimal care and elevated risk behaviors. In a national survey (N=6450) examining experiences of TGIs including in the healthcare domain, 19% were refused medical care due to their TG identity, 50% had to teach their providers about TG issues, and nearly a third (28%) postponed seeking care due to anticipated discrimination or financial difficulties (48%). TGIs of color experience most discrimination.
[…]
Examples of health system level barriers include the challenges associated with ordering tests that appear to be discordant with a person's affirmed gender, for example, obtaining a cervical pap smear for a TG male or prostate-related tests for a TG female. Other problems can arise with billing systems that reject codes on the basis of perceived “incorrect” gender, or insurance companies that may reject claims based on apparent gender discordance. Other barriers to care include refusal of commercial insurance to routinely cover gender-affirming services, and the designation of TG persons as having “gender identity disorder,” which is regarded by many community members and healthcare workers as pathologizing. The barriers most cited about clinical experience with TG patients are related to inadequate knowledge about the general and transition-related health needs of TG clients.
I am just waiting for annual checkup to see have my new insurance company handles me having a mammogram and PSA test done at the same time.

A Race To The Bottom

It seems like it is a race to see which legislator can come up with the most demeaning legislation and in Virginia the race is in full tilt.
6 Anti-LGBT Bills in Committee Tomorrow – TAKE ACTION!
EQUALITY VIRGINIA
February 3, 2016

Tomorrow, an unprecedented number of anti-LGBT bills will be heard in the House Subcommittee 4 on General Laws sometime after 2PM on 2/4! These blatantly prejudiced bills seek to harm gay and transgender Virginians in a number of ways, from discriminating against LGBT families to prohibiting transgender people and youth from using the appropriate restrooms in schools and government buildings. Read the individual bills below:
  • HB 77 (Marshall): Allows for discrimination in violation with federal policy
  • HB 385 (Marshall): Removes discrimination protections covering more than 1/4 of gay and transgender public school employees
  • HB 397 (LaRock): Contradicts federal policy and narrowly defines sex and gender to exclude transgender people from any protections against discrimination
  • HB 663, HB 781 (Cole): Stigmatizes transgender youth and forces them to use incorrect public accommodations
  • HB 773 (Gilbert): Provides a license to discriminate against gay and lesbian families
Right now, we need your voice more than ever to ensure these discriminatory and hateful bills never make it out of committee tomorrow. Take action by clicking here to contact your legislator! In just two steps, you can urge your delegate to side with the majority of Virginians and stop these harmful bills in their tracks.
And on a national level NCTE reports in an email blast that,
It’s not our style to bother you, but we need your help. Now.

The backlash against trans people that we’ve been expecting for years is here. As of today, we’re fighting against 29 pieces of anti-trans legislation in eleven states. And more are coming. And if we lose even one, our opponents will only accelerate their efforts.

We need your support to stop each and every one of these bills.

Make no mistake, these anti-trans bills are not only attacking trans adults, but they’re attacking trans youth. Our children. They’d make it illegal for transgender students to use the restroom at school and even place a bounty on their heads—rewarding classmates for turning them in.
And on their website they list all the bill in the different states…
A wave of anti-trans state bills is sweeping across the country.

Here’s what you can do to help us stop these bills in their tracks. We need trans people of all ages, as well as family, friends, and especially parents to take action!

Check back for updates or click here to make sure you are on NCTE’s email list. We will send out emails whenever there is an urgent action needed in your state.
Even in Massachusetts where they are trying to pass the pro-trans bill to include public accommodation there is a counter bill to take it away.
House Bill 1320
What it does: Requires people to access single-sex facilities (like restrooms, changing rooms and living accommodations) and educational, athletic and therapeutic programs according to their “anatomical sex.”
Status: Introduced and referred to Joint Committee on the Judiciary.

How you can help defeat the bill in Massachusetts:
The one thing all of these bills have in common is that they all have been introduced by Republicans and by voting for Republicans you are endorsing these bills because your Republican legislators are voting for these bills.

Saturday, February 06, 2016

Saturday 9: Sorry

Crazy Sam’s Saturday 9: Sorry (2015)

Every Saturday I take time off from written on serious topics to have some fun…
Unfamiliar with this week's tune? Hear it here.

1) This song is a plea for a second chance. Are you good at forgiving/forgetting? 
Yes, holding a grudge is not in nature. It is a waste of time and energy.

2) Justin asks his girl to "forget this." What have you done/said recently that you wish could just be forgotten?
I have forgotten it.

3) Mr. Bieber says he needs just 6 hours sleep every night. How about you? How much sleep do you require to feel sharp?
I wish I could have 6 hours of sleep. I usually wake up around 2 and not get back to sleep until 5 if I am lucky.

4) Justin prefers D&G underwear, which can cost as much as $102/pair. Sam may be crazy, but there's no way she'd spend that much on underwear. What's something you're willing to splurge on?
Camera equipment. I see a prime lens in my future, a Nikon  AF-S DX NIKKOR 35mm f/1.8G Lens with Auto Focus.

5) He may be picky about underwear but not cuisine. He loves Big Macs. If we were going to McDonald's, what would you order?
I had to Google this because I haven’t stopped at McDonald’s in ages, so it is an Artisan Grilled Chicken Sandwich but the one sandwich is over my carb limit and has way too much salt. I think the last time I stopped there was when we lost power for a week, I used to go there to have a hot meal that I didn’t have to cook on my camp stove and to charge my batteries on my laptop and phone. They put out charging strips in the restaurant (very smart of them).

6) When it comes to healthier fare, Bieber has told fans he enjoys snacking on bananas and grapes. What do you reach for between meals?
Now it is antipasto, no carbs in olives and peppers.

7) Performing in Germany, Justin Bieber told a girl who approached the stage, "Ich liebe dich” ("I love you") and she fainted. Have you ever fainted?
Not in a very, very long time.

8) As a kid, Justin was teased for being one of the shortest in his class. What do you recall being teased about in school?
My glasses.

9) Random question: Will you be watching this weekend's Super Bowl?
Nope, I’m going out to eat a lobster instead.

Friday, February 05, 2016

You Would Think That This Would Have Been Settled

Once the Maine Supreme Judicial Court ruled that the non-discrimination law covers bathrooms, but Maine’s governor doesn’t want to hear it.
Conflict erupts over how Maine should deal with transgender students
Bangor Daily News
By Beth Brogan, BDN Staff
Posted Feb. 04, 2016

AUGUSTA, Maine — The Maine Human Rights Commission last month issued guidelines for public schools to use when dealing with students who identify as transgender.

Following a 2014 Maine Supreme Judicial Court decision that guaranteed the right of a Maine transgender student to use the school bathroom designed for the gender with which she identified, the commission in October 2015 proposed rule changes to guide school administrators on how to abide by the court’s decision.

But Gov. Paul LePage’s administration did not allow the rights commission, working with the Department of Education, to proceed with the rulemaking process, so the commission instead issued guidelines, outlined in a Jan. 13 memo from MHRC counsel Barbara Archer Hirsch.
What is the governor’s hang-up?
Rep. Mattie Daughtry, D-Brunswick, who serves on the Legislature’s Education Committee, said Wednesday the administration’s decision was “another case of the governor not following the law.”

But Adrienne Bennett, spokeswoman for LePage, said the governor did not authorize the rulemaking because he is waiting for the Legislature to make Maine law clearer.
What does he need cleared up? The Maine Supreme Judicial Court made it very clear, the law covers bathrooms, no ifs, ands, or buts!
“In the wake of the law court’s decision in the Maines case, I think the question of whether students are entitled to use the bathrooms and facilities of the gender with which they identify — I think that’s pretty clear,” Amy Sneirson, the commission’s executive director, said by phone. “But I think a lot of other things are not clear.”
If you remember late last year , Maine Governor LePage supported an effort in federal court in Virginia to challenge the U.S. Department of Education Office of Civil Rights ruling that Title IX covers gender identity under sex discrimination, which many federal courts have ruled that it does cover gender identity.

You Would Think That They Would Obey The Law

After all they are the police, but they seem to have a problem with Title VII.
Transgender Police Officer Banned From Workplace Restroom
Lambda Legal
By Peter Renn, Staff Attorney
February 2, 2016

Can the government require genital surgery as a condition for equal treatment at work? That’s essentially the question that Brad Roberts faced.

For more than two decades, Brad has worked as a police officer for Clark County School District (CCSD) in Nevada, protecting the safety of the school community.

CCSD is the largest employer in Nevada, with more than 40,000 employees, and is the fifth largest school district in the country.

Brad is a man who is transgender. Although assigned female at birth, his gender identity is male. He began living openly as a man as part of his gender transition. That included using the men’s restroom, like other men.

But CCSD put a stop to that. In 2011, it banned him from the men’s restroom. He could only return if he submitted proof of genital surgery to conform his body to what CCSD believed was appropriate for a man.
Nevada has a gender inclusive non-discrimination law and Title VII of the Civil Rights Act covers sex discrimination which it seems that the school district is ignoring.
Employers don’t get to impose their sex stereotypes on employees. And that protection does not stop at the restroom door. Access to appropriate restrooms is an essential element of all workplaces, and one most of us take for granted.
It is too bad that it takes legal action to get them to obey the law.