Health Care

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




New study calls for improved medical care for transgender patients

Daphna Stroumsa, an obstetrics and gynecology resident at Henry Ford Hospital in Detroit, has published research on medical discrimination against transgender people whichis available in the American Journal of Public Health: The State of Transgender Health Care: Policy, Law and Medical Frameworks. Access to the full document requires APHA membership or paid subscription, which I do not have.


I review the current status of transgender people’s access to health care in the United States and analyze federal policies regarding health care services for transgender people and the limitations thereof. I suggest a preliminary outline to enhance health care services and recommend the formulation of explicit federal policies regarding the provision of health care services to transgender people in accordance with recently issued medical care guidelines, allocation of research funding, education of health care workers, and implementation of existing nondiscrimination policies. Current policies denying medical coverage for sex reassignment surgery contradict standards of medical care and must be amended.

Dr. Strousma is a graduate of The Hebrew University Haddassah Medical School in Jerusalem, Israel. She calls for the medical establishment to immediately address of the situation.





Gender Prison: Colorado transsexual woman denied breast cancer screening by Planned Parenthood

It has been more than a decade since Jennifer Blair underwent gender confirmation surgery. Like most transsexual women Jennifer takes a daily maintenance dose of estradiol, a synthetic estrogen drug.

That dose also does put me at an elevated risk for a variety of tumors, including breast cancer.


Blair began to notice an unusual breast growth, so she went to Planned Parenthood of the Rocky Mountains in Denver for a mammogram paid for by the Women's Wellness Connection. That's a state-run program which offers free cancer screenings for women living on low incomes.

I don't have any health insurance.


Jennifer seemed to meet all the requirements, but she was still denied a screening…because she was born male.

I was shocked. I was hurt.





Immigration and Transgender People

I've written about the problems of undocumented transgender immigrants living in the US before.

Transwomen Incarcerated

Trans legalities

Crossing Over - Documentary on transgender immigration

Transgender Heroes #4: Ruby Corado

"I have never met a transgender detainee who hasn't experienced some kind of sexual harassment"


As you might notice, most of those actually concern the efforts of the federal government to remove transgender immigrants from this country.

Part of what has been lacking has been actual data about transgender immigrants. So the National Center for Transgender Equality has striven to address that lack, releasing a new report last Friday, Our Moment for Reform: Immigration and Transgender People. To aid in the roll-out, BuzzFeed's Tony Merevick interviewed transgender immigrant and immigration advocate Johanna Vasquez.



Hellraisers Journal: Mother Jones, an Elephant , and a Senator on the Children's Crusade

You ought to be out raising hell. This is the fighting age. Put on your fighting clothes.
-Mother Jones

Tuesday July 28, 1903
New York City, New York - Senator Platt makes his escape from the Industrial Army.

Mother Jones and the Industrial Army set out from Bostock's Wild Animal Show yesterday morning at about 7:00 o'clock. They headed for the Oriental Hotel at Manhattan Beach, where Mother said she had an appointment with United States Senator, Thomas C. Platt. One of Bostock's elephants lead the way, a mahout sitting on his neck, and the fife and drum corps in the howdah. Behind the elephant came the Textile Army, lined up behind Mother Jones and Marshal Sweeney.

The Army made its way up Neptune Avenue to Sheepshead Bay and across the bridge to the Oriental Hotel. They soon were at the front of the building with the band playing a lively marching tune. As Mother was headed up the front steps, the Senator made his escape out the back door. The Senator hoped to conceal himself in the 8:23 morning trolley, but the elephant found him. Crouching down on the tracks, the big beast began throwing sand at the Senator's car delaying his departure for New York City by 5 minutes. This was not enough time for Mother to find him, however, for by the time she reached the trolley station, the Senator was gone.

Mother later told the story of how the Army got their breakfast at the hotel:

I asked the manager if he would give the children breakfast and charge it up to the Senator as we had an invitation to breakfast that morning with him. He gave us a private room and he gave those children such a breakfast as they had never had in all their lives. I had breakfast too, and a reporter from one of the Hearst papers and I charged it all up to Senator Platt.




hashtag morethanmarriage

Yesterday's diary ended with a link to information about transgender advocates one might try to emulate. Today's diary will continue in that vein.

The Transgender Law Center has a new campaign, called #morethanmarriage, which calls attention to the issues of youth, violence, racial justice, immigration, health care, and economic justice.

Sometimes we get accused of being narrowly focused when we write about transgender issues. But issues of gender affect us all and connect with an astounding number other issues.

Freedom to marry is important. Many people, including transgender people, are impacted by the legal recognition of our relationships and families. And, our community needs more than marriage to survive. #morethanmarriage is a community-based campaign to amplify the voices of our community and raise awareness of the critical issues we need to address in order to thrive - including marriage, immigration, bullying, health care access, family rights, employment, and more.

You can join the campaign here.

Come inside for more heroes.




Gender Prison: Vermont steps up

It seems like only a couple of weeks since California became the third state, after Colorado and Oregon, to require health insurers to cover the medical needs of transgender residents of the state. Oh, hey, it wasjust two weeks ago.

On April 22 Vermont's Department of Financial Regulation's Division of Insurance issued a new health bulletin which requires insurance companies wishing to do business in the state to cover "medically necessary services" for all transgender residents. That includes sex reassignment surgery.

DFR is committed to ensuring that Vermonters do not face discrimination in accessing medically necessary health care benefits, including those based on gender identity and gender dysphoria.

This is both a simple question of fairness and a matter addressed by existing insurance law and DFR regulation.

--DFR Insurance Bulletin 174 (pdf)



Gender Prison: Lives will be saved

California's Department of Managed Healh Care (DMHC) issued guidelines last Tuesday to implement the state's Insurance Discrimination Act of 2006 with regards to transgender people.

Funny thing: the state is insisting that INDA 2006 applies to us as well as other people.

This is an important step in protecting the health of all Californians, including transgender individuals. No Californian should be denied care and treatment because of their gender identity or expression. Implementation of California’s Insurance Gender Non-Discrimination Act (IGNA) is a simple matter of fairness and equality in health care.

--California Assembly Speaker John Pérez

The guidelines can be simply stated:

If an insurance company authorizes a treatment for non-transgender individuals, it needs to extend that same doctor-perscribed treatment to the trans community.




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