Tag: gender identity

Another Battle for Bodily Autonomy in Trans Youth

On February 10, 2021 the Alabama Senate Health Committee voted to criminalize transgender medicaltreatment for minors. With an 11-2 vote, the committee approved Senate Bill 10 (SB-10), a bill that will “outlaw puberty blocking medications and gender-affirming care for minors.” On March 3, the Alabama Senate passed this legislation, and it is currently awaiting Governor Kay Ivey’s approval. SB-10 empowers the legal system to prosecute clinicians and pharmacists with felony charges if they prescribe medication or provide treatment to aid in the transitional processes of minors. Bill sponsor Senator Shay Shellnutt (R-AL) claims that “minors are too young to be making this decision.” The Senator has also admitted that he’s never interacted with a trans teen before submitting the bill. Opponents of the SB-10 refute Shellnutt’s claim by acknowledging this decision is between the medical care provider, the patient, and the patient guardians. As such, SB-10 infringes on the private rights of parents to care for their children with necessary and proper interventions. Shellnut has mentioned that hormonal treatment and other transgender interventions cause long term issues and that a child is not mature enough to be making such a permanent decision. Shellnut’s claims are false; the effects of hormonal drugs that are puberty blockers are reversible. Also, when evaluating long term effects of gender reassignment surgeries, doctors prefer to wait until the patient is at least 18 years old before they perform the surgery.

A person holding a sign with a metaphor describing gender.
Source: www.mindfulword.org

Doctors must take the Hippocratic Oath which defines their ethical conduct and moral reasoning. There are two main tenets of the Oath: “benefitting the ill and protecting patients against personal and social harm and injustice.” Not only does SB-10 force doctors to dishonor the Hippocratic Oath, but it is also medically harmful to the patient pursuing care and prevents them from confiding in their medical care team. Dr. Marsha Raulerson says it will “take away child’s confidence in trusting doctors with their thoughts and to talk candidly.”

Healthcare providers are only one pillar of the support system for patients wishing to transition. So, when healthcare providers are unable to provide care to these young individuals, it can harm their mental and physical wellbeing and contribute to gender dysphoria. Adolescent and young adult years are incredibly formative. It’s in these years that young people thrive and when they are in need of a lot of support and care. When their support systems and adequate healthcare is taken away “adolescents can feel alone, stigmatized, and undervalued”. Rejection, discrimination, and stigma during these formative years can put young adults at a higher risk of mental health disorders such as depression and anxiety. The aforementioned mental health disorders can lead to the usage of addictive substances like drugs and/or alcohol, and suicidal ideation. These factors contribute to significant health disparities within the LBGTQ+ community. It’s vital the care they receive is given without stigma and affirms the patient’s sexuality and gender identity, but this care cannot be given with government intervention that holds traces of transphobia.

Protestors gathering against the transgender military ban legislation.
Source: www.britishherald.com

Gender is a very dynamic concept, and there is no binary. It is up to the individual to choose their identity. Gender reassignment treatments and procedures are one way to reaffirm and respect an individual’s choice. LGBTQ+ youth deserve to know that they are respected and that they deserve quality healthcare and treatment. Healthcare providers should not be prevented from fulfilling their responsibilities. They should be able to provide quality care and treatment for their patients. If they can’t, they should be able to refer the patient to a doctor who can provide adequate healthcare. This is not the first time SB-10 has been passed to the full Alabama Senate. It was passed all the way up to the Governor in 2020 to be signed into action and is only back on the table due to COVID-19 complications. Advocacy is an important aspect of healthcare, and providers should be willing to advocate the most for marginalized communities. It is important to lift barriers to care for these groups, instead of continuing to make healthcare inaccessible.

A separate companion bill (HB-391) is currently in the Alabama House. This bill would restrict transgender students from participating in school athletics with the gender they identify with. Lawmakers that support the bill claim that it protects fairness for female and “keeps them from having to compete against transgender athletes who were born male.” The biggest difference to make right now is to call Alabama Senate representatives and tell them the harms these bills will cause to LGBTQ+ youth and to the healthcare providers that try to help them.

“Denial” – A Conversation About Justice

An image of power lines, with smoke and smog from factories rising behind the electrical towers.
Electric Towers During Golden Hour. Source: Pixabay, Creative Commons

On Saturday, September 21st, 2019, the Institute of Human Rights co-sponsored an event with Alabama Young Democrats that featured former Vermont gubernatorial candidate Christine Hallquist. Hallquist’s visit to UAB focused on a screening of her released documentary “Denial” which covers her time as the CEO of Vermont Electric Cooperative while she advocated for sustainable energy and processed her gender identity.

Upon announcing her 2018 gubernatorial campaign in Morrisville, Hallquist officially became the first openly transgender major party nominee for governor. Her campaign focused on increased broadband access, universal healthcare, and an aggressive stance on climate change. After winning the Democratic nomination, she ran against incumbent Phil Scott and gained over 40% of the popular vote. Though losing the gubernatorial campaign, Hallquist continues to be an activist addressing climate change and being a fighter for all those experiencing discrimination or fear based on gender identity.

“Denial” details the life of Christine Hallquist, discussing two major issues, her gender dysphoria (as David in the film) and the increasing threat of climate change in people’s lives. As the CEO of Vermont Electric Cooperative, Hallquist pushed to promote cleaner methods to produce energy, such as wind turbine farms, solar energy, and smart meters. The movie also explores Hallquist’s transition into womanhood through the lens of her son, Derek, who struggles to accept that his father has transitioned into a woman. Asked by her son as to why she didn’t speak out earlier in life, Hallquist responds by explaining how if she were truthful at 15, she would be placed in a mental institution. If she were truthful in her 20s, then she wouldn’t be married nor have any children. She then spoke about her dream, which was to “spend every waking moment as a woman. But if I went to work in a dress,” she says, “I would be unemployed.” These sentiments speak to the barriers trans people face as they navigate their daily lives.

 

Christine Hallquist, in front of a screen showing her film "Denial" talking to the audience.
Hallquist addressing the audience about her film. Source: UAB Institute for Human Rights

During the film’s Q&A session, an audience member asked Hallquist what she has done since leaving Vermont Electric Cooperative. She said she became aware that action would be needed at the executive level in order to induce change and propel Vermont to employ cleaner energy practices; by realizing the severity of the crisis, she transitioned from being perceived as a centrist to that of a staunch progressive. As a result, she wrote the North American Solution to Climate Change, which detailed ways in which the climate crisis could be hindered in favor of saving the Earth. She claimed we are “fighting for the future of this country” and that we have to “collaborate across the world to solve the problem. We need to learn how to work with each other!”

 

An audience member, surrounded by other members looking at him, talking to Christine Hallquist about her work for Climate Justice.
An audience member questioning Hallquist about her work for Climate Justice. Source: UAB Institute for Human Rights

Does it take effort and a willingness to accept change in order to make a difference? That is a question that each one of us must answer. Looking at the future, should we all push towards climate action like Hallquist? Or should we take a step back and plan our movements to avoid being too rash? Hallquist raised an interesting point when she claimed that we as humans are not very well used to change. We decide much of the time to stick with tradition and avoid getting out of our comfort zone. Rather, we should embrace change and grow with our own experiences. We can start by teaching ourselves to challenge what we know about gender as well as to learn more about the impacts of climate change. These issues are imperative to upholding our basic human rights because all people deserve to live in a healthy, safe, and welcoming environment.

Representation and Respect: Addressing Transgender Rights at UAB and Beyond

On Thursday, September 13, the Institute for Human Rights had the opportunity to host Joan Rater and Tony Phelan, parents to actor and student Tom Phelan; and Brianna Patterson, a transgender activist, veteran, former firefighter and UAB health educator. Joan covered her journey as a parent supporting her transgender son and advocating for trans representation on television, while Brianna shared her story of being a transwoman from the South, moving from social isolation to embracing her womanhood.

Brianna, Joan and Tony Engaging with the Audience. Source: UAB Institute for Human Rights

 

Joan opened with a presentation titled “Transforming My Family”, where she spoke about Tom’s transition that began at 17 but addressed his once reserved feelings about his gender. Tom was very confident as child, but this withered with his teens, becoming suicidal and even briefly moving from Malibu to Boston with his family so he could receive outpatient treatment. One day, after his mental health improved, while being dropped off at school, Joan and Tony received an email from Tom as he walked to class. The email was Tom’s proclamation of being transgender, at the time using they/them/their pronouns, while including resources for his parents to better understand. Usage of the internet and technology has proven to be a positive resource, not only for people in the transgender community to communicate, but to inform allies about the transgender experience, allowing to amplify these traditionally marginalized voices.

A year into his transition, with support of his parents, Tom pursued “top surgery” which is the process of removing one’s breasts through medical procedure. As soon as he had his doctor’s approval to workout, he began jogging without a shirt, feeling a sense of liberation. Soon after, Tom debated the idea of hormone therapy that would ultimately change his voice, becoming a compromise between his options as an actor and happiness. Tom chose the latter, eventually leading to a role as a trans teen, Cole, on ABC Family’s The Fosters. Once Joan saw her son’s role validating the experience of transgender fans, she saw it was her and Tony’s obligation, as television producers/screenwriters, to amplify such voices through media representation. This led to emergence CBS’s Doubt, including Laverne Cox as Cam, a transgender law graduate from Yale University who often litigated for underrepresented clients, contributing to the mainstreaming of complex, genuine transgender identities.

She then demonstrated the importance of voting in support of transgender rights and, if possible, donating to people and organizations who fight injustice professionally. Joan closed by insisting that when facing transphobia, we must be brave and cannot allow intolerance to go unchecked.

Brianna Patterson, an Alabama native and current health educator at UAB’s 1917 Clinic, shared the challenges and accomplishments throughout her journey, including her transition that began in 2012. Brianna expressed the first time she “felt different” was in 1st grade, not knowing how to identify these feelings and consistently using the girls’ restroom. Also, with being raised by strict grandparents, Brianna claimed to have been disciplined violently when caught experimenting with her grandmother’s clothes. At the age of 14, Brianna experienced her first suicide attempt, followed by self-isolation in high school, poor grades and an immediate retreat to the United State Marine Corps (USMC) at 17.

Brianna felt her new home in the USMC gave her the unconditional love she didn’t receive back home. Although, she described having internalized transphobia because she didn’t feel masculine enough. However, after serving her term in USMC, which included tours during the Somalian civil war, Brianna, still, didn’t feel masculine enough. This led to her joining the fire service at a local department in Alabama, which she served for 23 years. Toward the end of this career, Brianna pursued hormone therapy, but was first refused care by nine different physicians throughout the state, demonstrating the discrimination transgender patients experience in the health care field. One day, after producing her driver license with her new name, following a traffic accident, the local officer spread the word about Brianna’s identity. As a result, two years before being eligible for retirement, the city council voted to demote Brianna’s Captain status, highlighting how Alabama doesn’t provide protections for the transgender community.

Soon after, Brianna finished her Master’s in Public Health, first working for Planned Parenthood and now representing UAB’s 1917 Clinic, a job she loves because she gets to address vaccine education, recruit research participants and address health issues salient to the transgender community. Although there was a silver lining in Brianna’s story, many don’t include such an ending, demonstrating the need for local, national and international protections for the transgender community.

Following Joan and Brianna’s presentations, the guests, alongside Tony, fielded questions from the audience, including insurance coverage for gender confirmation surgery, internet support networks, advice for coming out and how to be a genuine ally to the transgender community. Brianna responded to the latter by confidently saying, “The best way to be an ally: Treat everyone like a human being. Educate yourself. And if you wouldn’t ask a cis woman that question, you shouldn’t ask a trans woman that question.”

Identify: An Olympic Spotlight on Transgender Athletes

The Olympic rings modified with male and female gender symbols
Sex LGBT Olympics. Source: Nevit Dilmen, Creative Commons

The Olympics are often heralded as a celebration of international cooperation, but they also reflect the current political and cultural moment in which the games take place. Explained in the book The Games: A Global History of the Olympics, the first modern Olympics in 1896 were only composed of white males, mirroring those who had sole power in society. As the decades passed and the world changed, other races, women, and those with disabilities were added to the Olympic competition roster. This path of progress wasn’t free of setbacks, but the addition of these athletes put out a signal to the world that these groups were to be seen as Olympians; on equal footing as those who had come before. This process of inclusion is still ongoing, and within the past few years a new set of competitors have been given approval to go for gold.

In July 2017, the Olympic Channel launched a new original series, Identify, following the stories of five athletes in the US who identify as transgender, defined as “a person whose gender identity differs from the sex the person had or was identified as having at birth.” Those interviewed ranged in level from a Division III college volleyball player to a professional hockey player, but each of their stories share common threads in terms of their deep passion for their sport and the difficulties of navigating the regulations around being a trans competitor.

The choice to produce the show did not come out of a vacuum. As addressed at the beginning of each video, text appears reading, “In 2016, the International Olympic Committee (IOC) advised that transgender athletes can compete without undergoing surgery, making history in the sports world.” This sentence is referring to a meeting that took place in late 2015 aimed at revising the previous rules on transgender athlete eligibility. Dr. Richard Budgett, Medical Director of the IOC, describes that prior to the new ruling, the IOC policy recommended that in order to compete as a trans man or woman in their desired category the athlete must undergo full lower surgery with internal and external modifications.

Chris Mosier is the first transgender athlete to compete for Team USA. The old policy did not permit him to race at the Sprint Duathlon World Championship so he decided to challenge the ruling. “My whole thing was that I qualified for Team USA just like the rest of the guys on the team, and I knew that I belonged at the starting line representing our country. What it did was position me as a name and a face to say ‘I’m a real athlete who is not able to compete because you’re asking me to modify my body in a way that I don’t want to.’” Pushed by his advocacy, the International Olympic Committee reconvened with their medical advisors to review the current scientific literature, and from the session drafted the “IOC Consensus Meeting on Sex Reassignment and Hyperandrogenism”.

In the document, there are three categories of athletes covered under the new recommendations. The first category addresses transgender men and states that “Those who transition from female to male are eligible to compete in the male category without restriction.” This allowed Chris to be able to join his team at the world competition, but also opened the door to other athletes profiled in the series, such as Schuyler Bailar.

Schuyler Bailar speaking at 2017 Pride and Prejudice Conference
Schuyler Bailar. Source: Wymzee, Creative Commons

For his piece in the Identify series, Schuyler begins by recounting how ever since he was little he has been in the pool. “I’ve just always loved being underwater… and it’s always that kind of moment of ‘This is the only thing I’m supposed to be doing right now, this is the only place I need to be.’ That brings me a lot of peace I think that I don’t have in my daily life.”

An injury in high school afforded him the space he needed to process his identity outside of swimming, and soon after he began identifying as transgender. However, he says that “It took me another year until I told most of my friends and asked them to call me male pronouns and refer to me as a boy and solidify the idea of ‘Oh, this has actually always been me, and I’m not actually changing myself, I’m just presenting the truest part of myself.’”

When he’s not at practice for the Men’s Swimming and Diving Team at Harvard, Schuyler can be found speaking in front of audiences about the experiences he has gone through as his public sport’s career and personal identity have intersected. “I love motivational speaking because I’m really invested in sharing my story, and sharing the possibility for this kind of happiness and this kind of peace with yourself, especially with something so complicated as being transgender, but also so simple as just wanting to be happy.” Introduced as the “first openly transgender athlete to compete in any sport on an NCAA Division I team,” Schulyer takes the stage and begins speaking to a crowd of administrators, sharing with them how important a role his teachers and coaches have played in supporting him throughout his life.

As trans men, Chris and Schulyer are both now free to compete for a spot on Team USA just like any other male athlete, without restriction. For trans women however, the rules become more complex. The IOC consensus states that a trans women is allowed to compete in the female category as long as she 1) agrees to make permanent her female gender identity for a minimum of four years, 2) shows that her testosterone level is not above 10 nmol/L at least 12 months prior to her first competition, and 3) submits to testing of these levels.

The focus on testosterone is one which has been hotly debated around the discourse surrounding the inclusion of trans athletes, and it stems from the fear that trans women will have an advantage over other women in competition. The only episode in the Identify series to follow a trans woman featured Chloe Anderson, a Division III volleyball player for the University of California, Santa Cruz. Out of the five episodes posted on Youtube, she has the largest dislike ratio, coming in at just under 50%. One comment sums up the negativity towards her by stating incredulously, “So, basically they allow cheating in the form of men competing versus women but steroids are an ‘unfair advantage’?”

When closely examined however, the general assumptions on what makes a man “better” than a woman in sports, or even how to properly define those categories, becomes much more nuanced and mired in legal battles. Aside from the discussions on whether nationally funded training programs, genetic variations, and economic privileges give some athletes a competitive advantage over others, a recent dispute over testosterone levels in women’s sports shows how difficult it is to pinpoint a single variable for developing a winning athlete.

Dutee Chand bites her medal on the left while standing with her three teammates.
Dutee Chand, Srabani Nanda, Himashree Roy And Merlin Joseph Of India (Bronze Winners). Source: Athletics Federation of India, Creative Commons

Dutee Chand is an Indian sprinter with hyperandrogenism, defined by the Gale Encyclopedia of Medicine as an “Excessive secretion of androgens (male sex hormones).” The New York Times reports that Chand was “barred from competing against women in 2014 because her natural levels of testosterone exceeded guidelines for female athletes” by the International Association of Athletics Federations (IAAF). This decision to draw a line in the sand as for what constitutes a female athlete caused anger in the sports community, and after the court ruled in Chand’s favor by allowing her to race in the qualifiers for the 2016 Olympics in Rio, the decision-making panel released a statement remarking that “Although athletics events are divided into discrete male and female categories, sex in humans is not simply binary… As it was put during the hearing: ‘Nature is not neat.’ There is no single determinant of sex.”

The IOC specifically addressed this ruling during the consensus meeting, and the discussion around the ruling also sheds light on the reasons the IOC amended its policy on transgender athletes. Trans women are now beholden to the limit of 10 nmol/L of testosterone, within the range of the average female competitor, even though there may be other women who may match or exceed that level. Chloe gives a personal description of what it was like transitioning, disclosing that “Transitioning is like going through puberty backwards, the other direction, twice as far. There’s a noticeable difference in my athleticism… It was pretty challenging at first, just having all my muscle basically melt off my body.” With the legal decision and the current body of evidence, the IOC and the IAAF have both come to the conclusion that opening the female division to trans women who have not undergone surgery still meets the requirements of an equal and level playing field.

While the door has opened wider for transgender athletes to join Team USA, there will be no openly trans athletes competing in PyeongChang this month. However, should you still like to support the LGBTQ+ community at the Winter Olympics, the Human Rights Campaign has made a detailed list of several athletes to cheer for on their website, including skier Gus Kenworthy and figure skater Adam Rippon. Good luck you two!