Health Care

Mortality among transgender folk

Conservative forces are concerned that the National Institutes of Health have awarded $189,186 to Emory University to study transgender mortality (project information).

PUBLIC HEALTH RELEVANCE: The purpose of this study is to determine whether transgender persons defined as those who medically change the gender assigned to them at birth (male to female or female to male) have higher or lower risk of death and certain diseases than men and women that do not consider themselves transgender. Participants will be selected from medical records of two large health care systems - the Veterans Affairs Administration and the Kaiser Permanente. Transgender persons will also be asked to join focus group discussions and share their views about factors that may motivate or preclude their participation in research.

Members of the transgender community and health care providers caring for transgender individuals express concerns about mental and physical health problems in this population; however longitudinal studies of transgender populations in the US have not been conducted.

CNS (which is Cybercast News Service, even though many think of it as Christian News Service) felt it necessary to inquire as to whether this was an "effective use of taxpayer funds."

The NIH funded project began in August, 2013 and runs through May 2015



Gender Prison: Aetna eliminates transgender exclusion for federal employees

Last month I reported on the State Department's decision to ask its insurers to remove the transgender exclusion from its insurance plans and its largest insurer, the American Foreign Service Protective Association's decision to honor that request. The exclusion ends in January.

Last week Aetna announced it will follow suit. Aetna will start covering gender reassignment related health care for federal workers in January.

Additionally, Aetna said it will begin rolling out the same coverage in many of its commercial plans over the next couple of years.




Gender Prison: Transgender, mental instability and suicidal ideation

Among the of current links of interest are Suggested Links between discrimination and suicide attempts by transgender people, which delves into a Williams Institute study from much earlier in the year and the Movement Advancement Project's A Broken Bargain for Transgender Workers, which was published about a year ago.

These were woven together in the story of the recent suicide of Kate Von Roeder

One of the most commonly voiced perceptions about transgender people is that because we are transgender we are of necessity also mentally deficient.

This is not a new belief.

When an individual fails to mature according to his (or her) proper biological and sexological status, such an individual is psychologically (mentall deficient). The psychological condition is in reality the disease.

When an individual who is unfavorably affected psychologically determines to live and appear as a member of the sex to which he or she does not belong, such an individual is what may be called a psychopathic transexual.

--David O. Caldwell, Psychopathis Transexualis, Sexology: Sex Science Magazine vol. 16 (1949)




Improving Transgender Health Care

There has been a slew of stories lately on the medical front concerning treatment of transgender people by medical professionals, emanating from Ohio, Washington, Oregon, California and Massachusetts.

To quote one of the authors of the pieces I shall link to:

There has been a long history of lack of access to basic healthcare and systematic discrimination for transgender people.

--Pat Magee, MSW, for Rage Monthly

Seven stories on the other side.



Gender Prison: Washington starts process for equal health coverage for transgender people

Laura Harrington is an employee of the University of Washington. Her twelve-year-old son is transgender. In 2008 she attended a conference to learn how to better raise her son, who first expressed his maleness at the age of 5. While there, she met the man who is now her husband, who is a transman.

Because of exclusions in both her health care policy and that of her employer, many of her husband's treatments are not covered.

There have been times when we've had to decide between paying the electric bill or paying for his hormone therapy. The electric bill has necessarily won out. As a result, he suffers bouts of depression, anger, frustration, stagnation, all of the logical outcomes for someone who isn't living the life they need to live.

--Laura Harrington, to state officials this past spring

Harrington and other advocates contacted the state Public Employees Benefits Board in April about the challenges transgender Washingtonians face.

Last week the benefits board began the process of discovering just how fast such coverage can be included in private and state-run insurance plans serving government employees and retirees. The goal is to require such plans to cover transgender services by January 2016...and to remove specific exclusions to hormone treatments and other care before that date.

This will require careful, thoughtful work on our part and due diligence to develop a comprehensive, evidence-based benefit ... that assures the highest quality of care to people with gender dysphoria.

--Dan Lessler, chief medical officer for the state Health Care Authority




Feces meets fan in Rochester

Effective January 1, 2015 the city of Rochester, NY will cover medical services related to gender reassignment, including medical and psychological counseling, hormone therapy, and cosmetic and reconstructive surgeries, as announced by Mayor Lovely Warren at Empire State Pride Agenda's Spring Dinner on May 17.

The initiative is part of a plan steered by City Councilmember Matt Haag to raise the city's Municipal Equality Index.

Eliminating barriers to health care is simply the right thing to do. The city was the first to support domestic partnerships, and I am happy that we lead the effort to equalize benefits for all once again.

--Mayor Warren

The inclusion of transition-related care in municipal benefits will improve the health and well-being of transgender employees and also send a message to the rest of our state that we need to provide medically necessary care to all transgender New Yorkers. Rochester has long been a leader on LGBT civil rights and this is just one more example of how this great city sets a strong example for the rest of New York state.

--Nathan M. Schaefer, executive director of Empire State Pride Agenda

Additionally, beginning with the 2014-15 academic year, the University of Rochester will offer transition-related health care coverage as part of the student health care plan.

It's a medical necessity. It will also help promote a more inclusive environment and a more healthy and productive student body.

--John Cullen, coordinator of outreach for the Susan B. Anthony Center for Women's Leadership at UR

UR thus becomes the 52nd university in the nation to adopt a progressive health care policy for its transgender students.



Gender Prison: The Third Word


It's a *__________*.



Dr. Norman Spack is a childhood endrocrinologist. He treats transgender kids. But 75% of his clents are located within 100 miles of his base at Boston's Children Hospital. Unfortunately, there are transgender kids all over the country who deserve equally good treatment.

Sr. Spack gave a TED Talk last autumn which has just recently been shared publicly (it was posted to the TED website on April 16). I've been saving this for the proverbial "rainy day" when I don't have time to write a column. And today I'm feeling the drizzle.

Spack talks about his efforts to treat those transgender kids in their journey through puberty.




Illinois Transwoman Refused Medical Care Because Religion

Naya Taylor found out that her primary care physician, Aja Lystila, considered her to be less than human. When Taylor requested the start of hormone therapy in order to treat her gender dysphoria, Lystilla first claimed that she was not experienced enough to supervise the hormone therapy of transgender person. But the clinic in which Lystilla works provides hormone therapy to non-transgender patients every day.

Later the truth of the matter came out, when clinic staff told Taylor,

We don’t have to treat people like you.

When they said, ‘we don’t have to treat people like you,’ I felt like the smallest, most insignificant person in the world. The doctor and office provide hormone replacement therapy for others at the same clinic, they just refused to do that for me.

—Naya Taylor

The Affordable Care Act is partially a civil rights law in that it prohibits health care providers that receive federal funds from discriminating against any individual on the basis of sex for the purpose of health care.

Taylor is being represented by Lambda Legal in a lawsuit filed on Tuesday charging Dr. Lystila and the Carle health care services group which operates the clinic with denying medical care. Lambda Legal claims that discrimination based on sex extends to discrimination based on gender identity or failure to conform to stereotypical notions of masculinity or femininity, as per Title IX.




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