Comorbidity

The name sound deadly with the root word “morbid” with the connotation of being something unhealthy, or disturbing, or unpleasant. But medically it means having coexistence of two or more disease processes. So what it means for us is having one or more mental health diagnoses besides gender dysphoria.

On Facebook this link was just posted…

3 Transition Obstacles I Never Expected as Mentally Ill and Transgender
Everyday Feminism
By Sam Dylan Finch
March 23, 2017

“I think we need to hold off on this,” the therapist tells me, “until you’re doing a little better.”

My heart dropped. I was stunned, sitting in total silence.

This was the third time I’d been given a red light and told not to proceed with top surgery – a surgery I desperately needed, but struggled to access because of my mental illness.

This was a struggle I knew all too well as both mentally ill and trans – a struggle many of my other transgender friends had never even heard of.

Intersectional feminism tells us that the various aspects of our identity will impact our lived experiences – especially as it relates to power and privilege.

This is true for me as a transgender person who is also white, and thus does not experience racism and benefits from white privilege. I think it’s really important to be mindful of the ways that this impacts how I move through the world – and how I can be a better ally to trans people of color.

• The article goes on to list the three roadblocks he faced.

• My Clinicians Have Interfered with My Access to Hormones

• I Keep Being Denied Surgery

• My Clinicians Don’t Have the Research They Need to Help Me – Because It Doesn’t Exist

Being diagnosed with a mental disorder is not a roadblock to treatment of gender dysphoria per se, there are a number of factors that should be considered.

The Standard of Care says,

3. Assess, Diagnose, and Discuss Treatment Options for Coexisting Mental Health Concerns
Clients presenting with gender dysphoria may struggle with a range of mental health concerns (Gómez-Gil, Trilla, Salamero, Godás, & Valdés, 2009; Murad et al., 2010) whether related or unrelated to what is often a long history of gender dysphoria and/or chronic minority stress. Possible concerns include anxiety, depression, self-harm, a history of abuse and neglect, compulsivity, substance abuse, sexual concerns, personality disorders, eating disorders, psychotic disorders, and autistic spectrum disorders (Bockting et al., 2006; Nuttbrock et al., 2010; Robinow, 2009). Mental health professionals should screen for these and other mental health concerns and incorporate the identified concerns into the overall treatment plan. These concerns can be significant sources of distress and, if left untreated, can complicate the process of gender identity exploration and resolution of gender dysphoria (Bockting et al., 2006; Fraser, 2009a; Lev, 2009). Addressing these concerns can greatly facilitate the resolution of gender dysphoria, possible changes in gender role, the making of informed decisions about medical interventions, and improvements in quality of life.

Some clients may benefit from psychotropic medications to alleviate symptoms or treat coexisting mental health concerns. Mental health professionals are expected to recognize this and either provide pharmacotherapy or refer to a colleague who is qualified to do so. The presence of coexisting mental health concerns does not necessarily preclude possible changes in gender role or access to feminizing/masculinizing hormones or surgery; rather, these concerns need to be optimally managed prior to, or concurrent with, treatment of gender dysphoria. In addition, clients should be assessed for their ability to provide educated and informed consent for medical treatments.

Qualified mental health professionals are specifically trained to assess, diagnose, and treat (or refer to treatment for) these coexisting mental health concerns. Other health professionals with appropriate training in behavioral health, particularly when functioning as part of a multidisciplinary specialty team providing access to feminizing/masculinizing hormone therapy, may also screen for mental health concerns and, if indicated, provide referral for comprehensive assessment and treatment by a qualified mental health professional.

So there is no reason for anyone to be denied Cross-gender Hormone Therapy or surgery if they have been diagnosed with a mental illness; as long as they are able to make an informed consent and have the mental illness under control.

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Scott Lively’s Alien Tort Statute Case Update

There is a court case that I am following and it didn’t end well for us. Scott Lively was sued by an organization from Uganda for the violation of the Alien Tort Claims Act (ATCA) (you can read about it here and here) and he got off scot free. However, that wasn’t good enough for him.

Homophobic pastor appeals his own legal victory, because judge called him a ‘crackpot’
Pink News
By Nick Duffy
8th June 2017

In a bizarre twist, a homophobic pastor who escaped ‘crime against humanity’ charges is appealing against a ruling in favour of himself – because he is upset that the judge was mean to him.

Massachusetts hate preacher Scott Lively has become one of the world’s most notorious homophobes, by helping ‘export’ anti-LGBT laws to suggestible countries around the world.

The pastor faced a ‘crimes against humanity’ lawsuit from LGBT activists for his role in securing Uganda’s 2014 Anti-Homosexuality Act, but a federal judge dismissed the lawsuit this week.

The judge in the case, Michael A Ponsor, described Lively as a “crackpot bigot” who has caused “immense harm” around the world, but ruled that there was no case to be heard as the actions did not take place on US soil.

In a surprise move, Lively has now confirmed he will appeal against that ruling, even though the court ruled in his favour.

From my reading of the act, I think that the judge was wrong; the Alien Tort Act was designed for actions by U.S. citizen abroad and it doesn’t have to involve the actions taking place on US soil. (I know Wikipedia is not a great source to use but here is their description of the Alien Tort Act)

So who is representing Lively?

His legal team from the Liberty Counsel, which is the same ultra-evangelical law firm that represented homophobic Kentucky clerk Kim Davis, accused the judge of pandering to an “LGBT agenda”.

What are some of the other cases they were involved in?

The HRC reports that…

Liberty Counsel’s Staver Defended Reparative Therapists, Calling Laws Banning The Practice “One Of The Greatest Assaults On Children And Families That Has Risen In Recent Times.” Mathew Staver, in an audio report on BarbWire.com called Freedom’s Call, said “Last week I had the opportunity to submit a brief to the U.S. Supreme Court and to testify before Congress regarding the attacks on religious freedom of licensed mental health professionals, minors, and their parents. Homosexual activists have attempted to enact laws throughout the country that would silence mental health professionals from expressing the truth that an individual can successfully reduce or eliminate unwanted same-sex attractions behavior or identity. These efforts are nothing more than an attempt to censure any viewpoint concerning scriptural teaching on human sexuality. They represent one of the greatest assaults on children and families that has risen in recent times.” The name of the post was ‘Liberty Counsel Defends Minors Against Homosexual Political Activists.”  [Barb Wire, Freedom’s Call, 6/19/2014, AUDIO]
[…]
Liberty Counsel’s Staver Said A Third Party Would Take The Place Of Republicans If GOP Gives Up On Marriage, “That’s What Happened With The Issue Of Slavery.” According to World Net Daily, “Mathew Staver is the chairman of Liberty Counsel and has represented the traditional marriage position in in many states around the country. He is appalled at the suggestion that Supreme Court has effectively ended the political debate over marriage. ‘That’s ridiculous. In fact, you can’t have anything such as marriage or life over as a political issue. It’s [absolute] stupidity to have that kind of an opinion. You cannot just simply sit back and allow the Supreme Court or any justice or any judge to undermine something as basic and as fundamental and as necessary and as important as marriage,’ said Staver, who is furious what he sees as the GOP wilting on this issue once it stopped being an easy political winner for the party. ‘They’re cowards, and if Republicans don’t stand up for this, the party will become a non-issue. There will be a third party that will ultimately take its place,’ he said. ‘That’s what happened with the issue of slavery, and there’s no party that’s immune from the situation.’” [World Net Daily, 10/8/2014, AUDIO]
[…]
Liberty Counsel Advocated For Biological Mother In Custody Dispute In Jenkins V. Miller Case. According to the Windy City Times, “There have been a number of recent cases across the country in which a biological or adoptive parent tries to claim the other parent has no parental rights. Best known among them is the case of Janet Jenkins and Lisa Miller, which has grabbed headlines nationally. Miller, the biological mother, asked courts in both Virginia and Vermont to deny Jenkins visitation and custody, and has taken issues to the U.S. Supreme Court five times, without success each time. Miller was eventually ruled in contempt of court for defying a Vermont court order that she allow Jenkins visitation. The court then granted Legal custody to Jenkins. But Miller went hiding with the girl at the end of 2009, and a man accused of helping her leave the U.S. was arraigned in a federal court in April…. In several of these cases, notably Miller v. Jenkins, attorneys from conservative legal organizations such as Liberty Counsel and the Alliance Defense Fund have represented the biological mothers.” [Windy City Times, 9/14/11]