NCTE Joins Brief in Michelle Kosilek Case

Michelle Kosilek

The National Center for Transgender Equality is proud to have joined seven other organizations last week in filing a friend-of-the-court brief with the First Circuit federal appeals court in the case of Kosilek v. Spencer. The case, which has received significant public attention in recent months, is the latest in a series in which Massachusetts prison officials have refused to provide medically necessary treatment to transgender prisoners. In September, a federal court ordered the state to provide sex reassignment surgery for Michelle Kosilek after prison doctors determined it was the only adequate treatment for her severe gender dysphoria.

NCTE’s position in this case is driven by two core principles: First, that hormonal, surgical, and other medical treatments for gender dysphoria are medically necessary for many people and should be treated like any other medically necessary care, based on the medical needs of an individual as determined by qualified medical providers; and second, that people who are incarcerated and cannot provide for their own care have an unquestionable, constitutional right to adequate medical care. Participation in cases like this one is critical to establishing the legitimacy and necessity of treatments for gender dysphoria and ensuring all people have access to adequate health care in every setting.

UN Report: Forced Sterilization of Trans People “is Torture”

On February 1, the United Nations Special Rapporteur on Torture (SRT) issued a report on abusive practices in health care settings that has important implications for LGBT people and people with intersex conditions.

The report calls for repealing laws allowing “genital-normalizing” surgery on children with intersex conditions, and ending practices whereby LGBT patients or those with intersex conditions are subjected to unethical experimentation or made a subject of medical display without consent. The report also condemns the practice of so-called “reparative therapies” or “conversion therapies” that purport to change an individual’s gender identity or sexual orientation. Especially notable for transgender people was the Special Rapporteur’s call for ending forced or coerced sterilization of transgender people as condition of recognizing their gender identities.

Section 39 of the report says, “…Medical care that causes severe suffering for no justifiable reason can be considered cruel, inhuman or degrading treatment or punishment, and if there is State involvement and specific intent, it is torture.”

Veterans Health Admin. Renews Trans Health Care Directive

The Veterans Health Administration has issued a renewed and updated directive on providing health care for transgender veterans and veterans with intersex conditions. VHA originally issued this directive in June 2011, and like other VHA directives it carried a technical expiration date, and was intended to be updated or included in other, permanent VHA policy documents in the future. While the expiration date passed in late 2012, actual VA policy never changed, and the new directive is effective for at least the next five years.

The renewed VHA directive is essentially identical to the 2011 version, but is accompanied by an official FAQ document that provides helpful clarification on patients’ rights to be treated according to their gender identity for purposes of pronouns, restroom access, and room placements, as well as on how to update gender markers in VHA patient records. There is also additional guidance for VHA health care providers who may be treating a transgender or intersex patient for the first time.

Cervical Health Awareness Month: Check It Out, No Matter Your Gender

Cervical cancer screenings prevent cancer and save lives. But for many transgender people, getting these basic screenings is fraught with anxiety and fear. Both the very real fear of disrespect and discrimination, and the dysphoria many people feel about this part of their body, make going for these tests feel anything but routine. In the National Transgender Discrimination Survey, we found that forty-eight percent of transgender men delay or avoid getting preventive care due to the fear of encountering discrimination.

It doesn’t help that, even during this Cervical Health Awareness Month, virtually everything we hear about the subject is framed in alienating gendered terms. For example, a quick survey of online articles on cervical cancer testing  refer only to women and do not address the need for cervical cancer screenings among people of other genders. Any mention of trans people’s needs for cervical screenings is limited to blogs and other trans community spaces.

National Institutes of Health Issues Progress Report on LGBT Health Research

In 2011, the Institute of Medicine (IOM) released the most comprehensive report to date on LGBT health, focusing heavily on the lack of adequate research and health data on LGBT populations. This month, the National Institutes of Health (NIH) issued a progress report that surveyed what federally-supported LGBT health research has been done and what still needs to be done.

A number of areas were given as needing attention including addressing methodological issues (how to study LGBT health effectively), improving the cultural competency of health providers/researchers and increasing communication between the NIH and those doing LGBT research and the other federal agencies.

Honoring Trans Veterans

On this Veterans’ Day, NCTE salutes the contributions and sacrifices of transgender veterans. According to the National Transgender Discrimination Survey, 1 in 5 transgender adults has served in the armed forces. These brave Americans have served in silence, and often been denied the benefits they worked so hard and risked so much to earn.

In recent years, we have begun to make progress. In 2011 the Veterans Administration issued a directive calling for respectful and appropriate treatment for transgender veterans seeking health care. NCTE has continued to work with the VA to implement that directive across the country, from providing guidance to VA medical staff to updating patient records to reflect a person’s gender identity. And with the repeal of “Don’t Ask, Don’t Tell,” we have finally begun a much-needed conversation about open military service for transgender people.

There is still much to do. Trans people are still forced to serve in silence, as our non-trans gay, lesbian, and bisexual brothers and sisters thankfully no longer have to do. Trans veterans are still denied their hard-earned health benefits when it comes to medically necessary transition-related surgeries. NCTE will keep working to fulfill our promises to trans servicemembers and veterans.

NCTE’s resource on VA benefits and the VA transgender directive can be found here.

Read the Veterans Health Administration Directive here.

XIX International AIDS Conference: The Beginning of the End?

Sunday marked the start of the International AIDS Conference: Turning the Tide Together, being held in the United States for the first time since 1990. This conference allows professionals working in the field of HIV, individuals who are living with HIV, and advocates to come together, share new research from the field and strategize a plan to end the AIDS pandemic. The historic return of the conference to the US was made possible by the elimination in 2009 of the notorious ban on people with HIV traveling to the US.

Findings in the National Transgender Discrimination Survey show alarmingly high rates of HIV in trans people with rates skyrocketing trans people of color:

• Respondents reported over four times the national average of HIV infection with 2.46% compared to 0.6%.
• 24.90% of African-American participants reported being HIV positive compared with national rate of 2.4% African Americans
• 10.92% of Latino/a participants reported being HIV positive compared with national rate of .08% Latino/as.

Transgender advocates from around the nation and the world are sharing strategies, research, and stories at the conference. If you are in the Washington, DC area, you can hear and network from these activists and many others in the conference’s Global Village, which is free and open to the public.

Trans Americans Celebrate Health Care Victory at the Court

In response to today’s landmark Supreme Court decision upholding the Affordable Care Act, NCTE issued the following statement.

Decision Affirms Ban on Cancelling Care for Trans People and People Who Are HIV+

The nation’s leading organizations advocating on behalf of transgender people celebrate the ruling and express strong support for implementation of the law’s key protections over the next two years.

Today the United States Supreme Court delivered a huge victory to nationwide efforts to establish a health care system that works for everyone, including transgender communities and the 1.2 million people living with HIV/AIDS in the United States. By upholding the Affordable Care Act (ACA), today’s decision delivers on the promise of health care for more than 30 million uninsured Americans.

In response to the U.S. Supreme Court’s health care decision, NCTE Executive Director Mara Keisling said, “the Supreme Court’s decision is a historic ruling affirming a historic law.”