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.
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.
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.
According to the Centers for Disease Control and Prevention, one in three women and one in six men have experienced sexual violence . The term sexual assault refers to “any type of sexual activity or contact that happens without your consent.” Though, the most obvious examples of sexual assault are physical, such as rape and unwanted touching, it can also be found in verbal and visual forms, such as sexual harassment or exposing oneself.
When discussing this problem, it is important that we recognize that not all groups experience sexual assault at the same rates. The people who are most at risk are those from minority communities that typically have less social and political power than majority communities.
Title IX is part of the Education Amendments of 1972 and prohibits discrimination based on sex in federally funded schools. Colleges must have systems in place to deal with sexual assault, since it can have a serious impact on an individual’s educational experience. They should investigate every reported incident and make any necessary accommodations to make sure that the education of assault survivors is negatively impacted as little as is possible.
Secretary of Education Betsy DeVos has proposed some changes for exactly how colleges are to handle reports of sexual assault, but, at the moment, students still have the rights set forth by Title IX and the Clery Act, which include the Campus Sexual Assault Victim’s Bill of Rights. Under the Clery Act , survivors have “the right to receive written explanation of their rights and options,” and colleges must have “a policy on campus disciplinary proceedings” for sexual assault. In these proceedings, both the survivor and the accused have the rights to equal opportunity to have each other present as witnesses, the accompaniment of an advisor of their choosing, and “simultaneous written notification” of any updates.
If you have experienced sexual assault on a college campus, you can report it to your school, get to know your Title IX coordinator and school’s policies, and file a police report.
Exacerbating the problem of sexual assault on college campuses is the prevalence of rape culture. Rape culture consists of the behaviors, language, and beliefs through which sexual violence is “normalized and excused.” This can range from victim blaming, to the use of phrases like “boys will be boys,” to sexual assault itself. This is especially impactful on the relationship between women/girls and sexual assault. Rape culture leads to people asking female sexual assault survivors questions about what they were wearing and whether or not they were drinking, as if those factors are the reasons why people are attacked. As girls grow up, they are taught what steps to take to help them stay safe. The responsibility to prevent rape and assault is primarily placed on the people at risk of experiencing these things rather than being focused on teaching people not to be perpetrators. Rape culture is a huge part of why many survivors do not report their assault . Among survivors on college campuses, more than 90% do not report.
Rape culture is also perpetuated by phenomena such as toxic masculinity, which emphasizes the gender expectation for men to be aggressive and dominant. Many people use this traditional view of what it means to be a man to minimize the significance of sexual assault to simply “men being men.” This idea, as well as rape culture as a whole, frames sexual assault as something that is inevitable or a normal part of life rather than a serious problem that needs to be stopped. This also leads to the assumption that men are always the perpetrators and survivors are always women, which is completely untrue. Men and non-binary individuals can be assault survivors. Women and non-binary individuals can be assaulters. People can be assaulted by someone of the same or a different gender. Sexual assault does not always fit the stereotypes we have been taught.
If you are one of the many people who worries about their safety and about assault on a regular basis, here are some things you can do that will hopefully help you feel a bit more comfortable. If you are not someone who feels the need to think about these kinds of things, this may be an opportunity to broaden your perspective and learn more about the things many of us have do to in order to feel even slightly safe.
Try to avoid walking out alone at night.
If you have to walk alone at night, consider calling someone and staying on the phone until you reach your destination.
Do your best to walk in and park your car in well-lit areas.
Carry pepper spray with you.
If you are out at night, try to make sure that someone knows where you are going to be and at what times.
Check the back seat of your car before getting in.
Make sure you have a reliable form of transportation if you are out at night.
Avoid jogging alone at night.
Always be aware of your surroundings, especially if you are alone.
Consider taking some classes in self-defense.
If you get a drink at a party or bar, watch them make the drink and do not leave it alone.
Consider downloading an app like Noonlight, which can make it easier to contact emergency services if you feel unsafe or if you are unsure if you should call 911.
Sexual Assault Is A Human Rights Issue
It is vital that throughout the conversation about sexual assault we recognize it is a human rights issue. It is an issue of equality for people of all genders, sexualities, races, and abilities. Article 26 of the Universal Declaration of Human Rights (UDHR) states, “higher education shall be equally accessible to all on the basis of merit,” but many college classes do not end until it is already dark outside. Safety concerns prevent some people from taking these classes, while other people are able to take any of the available classes they want. According to Article 27 of the UDHR, “…everyone has the right to freely participate in the cultural life of the community,” but many cultural events, such as concerts and educational events, happen at night. If someone fears going out that late and/or has no safe mode of transportation, how can they enjoy this right? How can they use their right to freedom of expression if they are afraid (Article 19)? How can someone live in an environment that supports their mental health and wellbeing if they are afraid (Article 25)? How can they enjoy the equality that all people share if they are afraid?
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.
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.”
Transgender is an umbrella term that includes those that identify on the gender spectrum. It is the term used to describe an individual whose gender identity and expression are different from expected societal norms. Gender identity is the personal sense of one’s own gender, and for the majority, it correlates to the sex assigned at birth. Gender expression is a person’s behavior, mannerisms, interests, and appearance that are associated with gender in a particular cultural context. The social normative gender spectrum in most western cultures has been for centuries, binary: male and female. The basis of this binary was the presence of sexual organs at birth. When I was born, the doctor, based upon the presence of a penis, assigned me male at birth, in accordance with the binary gender spectrum. However, internally I was female.
I identify as female. As a transwoman, I continually fight a battle against erasure of my life and existence. Since transitioning I have suffered erasure by losing a career of 23 years, health insurance that will not cover medically necessary treatments, been refused treatment by medical professionals, and the state will not acknowledge my identity.
To live my life, I had to do this without acceptance from others including family and friends. I did not live on the streets because I remained hidden. I understood from growing up with my deeply religious grandparents that if I were different—my true self, I would be disowned. I made many poor choices, started drinking at age 11 and dealt with anger issues up until I got ordered to anger management counseling by the United States Marine Corps (USMC). It must have been bad for the USMC to think I was too angry to deploy. I grew up before access to the internet (no old jokes), and I had no names for what I knew about myself, so like many I suffered in silence until I figured it out much later in life. I want to make it better for the young transgender and non-binary individuals that are coming out today.
Every level of the social-ecological model, from individual or intrapersonal level, all the way up to the societal or structural level in the transgender community fights against identity erasure. Many, including myself, suffer from internal transphobia. Tran individuals encounter internal transphobia as a byproduct of absorbing negative messages about not following the societal norms. Internal transphobia can occur with something as simple as not using the preferred name or pronouns, and/or through the attempt by family members to “correct” the behavior through abusive methods. For example, if society continued to identity Caitlyn Jenner as Bruce Jenner, then society contributes to the manifestation of internal transphobia she might seek to overcome. Additionally, by not employing gender pronouns like he/him: female transitioning to male (FTM), or she/her: male transitioning to female (MTF), and encouraging abusive practices like conversion therapy or berating about dating/sleeping with members of the opposite sex, society infringes upon the rights of Trans individuals to dignity and personhood.
The feelings associated with internal transphobia are the result of many years of discrimination, rejection, and ignorance about the rejection of gender norms. Depression can result in dangerous behavior. At the interpersonal level, family and friends reject many trans folk when they come out as transgender or gender non-conforming, mainly due to the preconceived notion of a binary gender system. The rejection becomes isolating and often leads to homelessness. In addition, some receive abuse from programs designed to rid individuals of these kinds of thoughts. The non-conformance to traditional gender norms of male and female can lead many to demonize transgender people who are out and trying to live their life. As a marginalized community, members of the transgender population are subjected to violence, harassment, discrimination, and vilification by society as a whole. The National Center for Transgender Equality (2011) survey found that those individuals that are gender non-conforming in grades K-12 were 78% more likely to be harassed, while 35% report surviving assaults. The current situation in the U.S. in regards to which bathroom transgender individuals should use leads to increase harassment. Transgender people are viewed as perverts, and being attacked for wanting to pee in peace. These types of attacks create high levels of anxiety, depression, and isolation.
The constant threat of discovery lead many to remain in hiding, leading to increased suicidal ideology. For example, the Transgender population suffers from an abnormally high suicide rate of 41% compared to 1.6% of the general population in the US. The murder rate of transgender continues to climb each year here in the US. Since 2013, an average of 25 trans women have been murdered, and there have been 18 killed this year. According to Bauer et al., a high social support network showed a 48% decrease in suicide ideation and of those with ideation, 82% decrease in attempts of suicide. The population suffers from many forms of social exclusion, and one of the main determinates is that this population is rarely counted; thereby, resulting in the marginalization of the transgender population.
At the societal level, this population is highly marginalized, even within the LGB community and the “T” not well represented. Due to fear, many of those who identify as transgender, are unable or unwilling to make their voice heard. This discriminatory practice reinforces an individual’s ability to care for one’s self. Few policies provide protection for, and individuals gender identity or expression. The lack of protections at the local, and state level allows discriminatory practices to continue, contributing to the overall marginalization of the transgender community. The use of conversion therapy to cure this non-compliance with gender norms is only illegal a few states and the District of Columbia.
The current data suggests there are about 1.4 million adults within the US that identify as transgender. This estimate is double the widely used previous estimate, and many organizations believe this number remains far too low. The lack of research and information on transgender issues is a direct result of this form of social exclusion and leads to incorrect assumptions about the population. Individuals suffer from social exclusion by losing family and friends when they “come out,” or being bullied at school, work, or on social media sites because they are different and challenge the gender norms. Most Trans folk keep their identity private due to discrimination and harassment. Ninety percent of Trans adults report experiencing attacks or discrimination because of their identity. In the workplace, 47% of Trans folk are fired, denied a promotion, or not hired. I lost my career of 23 years when I transitioned.
I lost my job as a fire department captain/paramedic. When I began my transition I believe that my history of good performance and exceptional results over the years of service would provide a buffer for any negative concerns that were raised. However, this was not the case and upon my coming out to the fire chief and deputy fire chief it was clear they did not wish to continue my service to the community. Things were rocky, but the mayor and personnel director had taking my side in the arguments that developed. But, to my dismay the chief had work with the city council and gathered enough votes to begin my termination. I had 23 years in public safety and two more years till retirement. Due to the lack of protects for transgender workers, there were not many options available at the time. However, I had returned to school to build my education, fearing that this might happen I wanted to be prepared.
Despite the setbacks, I have accomplished what many transgender individuals are unable to do. I returned to school, completed my undergraduate and graduate coursework, and graduated with a Master’s in Public Health. Now, I work at UAB which has been accepting and minus a few speed bumps been inclusive of my gender expression/gender identity. I hope to make a difference in the local transgender community here in Alabama by starting the conversation and showing that Tran men and women positively contribute to society and only want to live their lives just like everyone else. So please come join the conversation with UAB’s Institute for Human Rights and Department of English as they present “A Human Rights Approach to Transgender Issues.”
I am just a woman trying to leave a better place than what I found and live my life authentically.
On July 26th, 2017 President Donald J. Trump tweeted the following:
“After consultation with my Generals and military experts, please be advised that the United States Government will not accept or allow… Transgender individuals to serve in any capacity in the U. S. Military. Our military must be focused on decisive and overwhelming… victory and cannot be burdened with the tremendous medical costs and disruption that transgender in the military would entail. Thank you”
The Real Cost to Transgender Americans
Transgender individuals, many of whom already face daily harassment and discrimination for their gender identity, have been shown to actively avoid situations where hostile confrontations may arise. In 2016, after a political storm erupted out of North Carolina and the then-governor Pat McCrory’s “Bathroom Bill”, a landmark study on the lives of 27,715 transgender persons documented several startling changes that occurred in the lives of transgender persons. These include:
59% of transgender persons avoiding bathrooms for feared confrontations
12% report being harassed, attacked, or sexually assaulted
31% avoiding eating or drinking to avoid needing to use public restrooms
8% contracting a kidney or urinary tract infection as a potential consequence for avoiding the use of public restrooms
Similar studies also document the prolonged and repeated stress endured by transgender individuals, when using public restrooms, after the “Bathroom Bill” was proposed. Situations in which their minority status is negatively highlighted or emphasized, such as the use of public restrooms, are loaded events for transgender individuals. Until recently, the link between a culture of antagonism towards issues related to transgender individuals and the subjective experiences of these individuals themselves has been suspected but unsupported. A study published earlier this year in the Journal of Abnormal Psychology examined the gravest mental health crisis experienced by transgender persons: suicide.
Transgender individuals, as compared to the general public, are 14 times more likely to think about committing suicide and 22 times more likely to attempt suicide. This horrifying trend holds in countries outside of the United States, and these rates may even be higher in transgender adolescents. With this new data and analysis, the role of culture, across 2 different theoretical models, was shown to significantly impact the rate of suicide ideation in transgender individuals. Suicide ideation was significantly predicted by factors such as victimization (specific attacks on an individual for their status as transgender), rejection (social reluctance to engage with transgender individuals), and non-affirmation (the active reminding of a transgender individual their gender identity is not accepted or validated). To restate the findings, transgender individuals were more likely to seriously contemplate suicide, or wantonly envision a future in which they are not alive, if surrounded by a culture characterized by isolation, discrimination, and outright antagonism. An important caveat remains: researchers will never be able to interview transgender individuals who have completed the act of suicide. The ‘edge point’, or the final motive impelling a transgender individual to successfully end their own life, can be hinted at but will never be known with absolute certainty. However, combining previous research on the statistical likelihood of suicide and suicidal ideation in transgender individuals, coupled with the recently supported theory that culture is a major implicator in the suicide risk of transgender individuals, presents the concerned public with startling information. For these victimized individuals, a culture of transphobia can exacerbate a predisposition for suicide, potentially resulting in a public health crisis with deadly results.
Culture, according to Riane Eisler, is in constant flux. People choose both their internal response to the forces of culture around them and their externally exertion of control over culture in future interactions with others. According to Eisler’s Cultural Transformation Theory, a culture of transphobia (the ignorance, fear, or outright hatred of transgender individuals) can change to a culture of empathy, partnership, and mutual understanding. Likewise, a culture of tentative acceptance can be quickly reversed to one of arbitrary discrimination and empowered domination. One way a pro-social Eislierian cultural transformation for transgender persons can occur is through the creation, maintenance, and protection of human rights for transgender individuals (Eisler, 1988). In the United States, transgender rights have a high degree on variance, mostly along state or jurisdiction lines (a graph displaying specific issues related to transgender rights in the US can be found here). The scant federal rulings on the rights of transgender persons have involved only a few aspects of life for transgender persons, including discrimination in the workplace, marriage equality, and conversion therapy. The rights of trans persons are still in flux, and the Trump Administration may indeed roll back these protections as their time in governance continues. Rollbacks of trans rights might, as is supported by Testa et al.’s and the National Center for Transgender Equality’s research, create a public health crisis for transgender persons. Creating a culture accepting of and empathic to the needs of transgender persons must include comprehensive human rights legislation protecting this vulnerable group without fear of retraction from a hostile administration, such as the Trump administration.
President Trump, under the guise of “medical costs” and unit “disruption”, attempted to used his public platform to instill a culture of blatant disregard for the patriotism, self-sacrifice, and protection of freedom offered by transgender persons who volunteered, volunteer, and may yet volunteer to serve in the United States Armed Forces. The costs he associated with transgender persons serving in the military are non-issues, and a sober analysis of his proposed logic illuminates a stunning disconnect from the actual militaristic consequences of allowing transgender persons to serve in the US Armed Forces. The literature, including both personal and academic accounts, reveals a population within America severely prone to self-harm, suicidal thoughts, and suicide attempts in the aftermath of public controversies regarding a fundamental part of their very identity. The oppression of the transgender community has been shown to have far-reaching and oftentimes permanent consequences for trans persons- such as suicide. The cost to the trans community from attacks such as these far outweigh the illusory costs to the Trump Administration in allowing trans persons to live a life unencumbered by blatant discrimination.
If you or someone you know is contemplating suicide or self-harm, here are resources to contact:
National Suicide Prevention Lifeline (press 1 if you are a US military veteran in crisis): 1-800-273-8255
Trans Lifeline: 877-565-8860
The Trevor Project (youth service): 1-866-488-7386
GLBT National Help Hotline: 1-888-843-4564
Call 911 if you believe there is an immediate threat to your and / or someone else’s physical safety and wellbeing.
Eisler, R. (1988). The Chalice and the Blade. San Fransico: Harper.
President Donald J. Trump tweeted the following on July 26, 2017:
“After consultation with my Generals and military experts, please be advised that the United States Government will not accept or allow… Transgender individuals to serve in any capacity in the U. S. Military. Our military must be focused on decisive and overwhelming… victory and cannot be burdened with the tremendous medical costs and disruption that transgender in the military would entail. Thank you”
A History of Inclusion
The service of members of the LGBTQIA community in the US military has remained a highly contentious and passionately-fought issue on all sides of the political (and gender) spectrum. The battle for inclusion in the American Armed Forces first involved inclusion along ethnic lines, then involving lesbians, gays, and bisexuals, and more recently the rights of transgender persons to openly serve.
On July 26th, 1948 President Harry S. Truman signed into effect Executive Order 9981: Establishing the President’s Committee on Equality of Treatment and Opportunity in the Armed Services. The order essentially desegregated the United States Armed Forces, stating “… there shall be equality of treatment and opportunity for all persons in the armed forces without regard to race, color, religion, or national origin”. President Trump’s tweet banning the service of transgender American soldiers comes on the 69th anniversary of President Truman’s executive order. This Executive Order jumpstarted the battle for inclusion in the American Armed Forces, first included ethnic lines, then sexual orientation, and finally gender identity.
President Bill Clinton, in October of 1993, executed a new law known as “Don’t Ask, Don’t Tell, Don’t Pursue, and Don’t Harass”, though it’s commonly referred to as “don’t ask, don’t tell” (DADT). DADT reversed the long-standing statutory ban on gay, lesbian, and bisexual individuals from serving in the United States military. Gay, lesbian, and bisexual individuals had long served in the US military with their sexuality largely kept secret. DADT was first met by suspicion and hostility from many politicians and military personnel alike, citing fears of ‘undermining morale’ if gays, lesbians, and bisexuals were permitted to serve in any capacity. Again, gays, lesbians, and bisexuals had long served the US military, but not to the explicit knowledge of their commanding officers or fellow servicemen and servicewomen.
President Barack Obama, in December of 2010, after both the House of Representatives and US Senate successfully voted to repeal the practice, signed into law a full reversal on DADT. The practice of forbidding gay, lesbian, and bisexual service-members to be ‘out’ about their sexuality and serve in the US military was effectively over.
Throughout the battles fought for gays, lesbians, and bisexuals to openly serve in the military, transgender individuals were explicitly told they must ‘pass’ as their biological sex if they wished to serve in the US military. Transgender persons have myriad ways of expressing their sexual orientation, including: dressing in accordance with their gender identification, changing their name, hormone treatment, and medical procedures that alter their body to conform with their gender identity. So far as the military was concerned, transgender individuals could be threatened with discharge for an enlistment violation if they did not ‘pass’ as their sex assigned at birth. That is, until June of 2016, when Secretary of Defense Ash Carter lifted the ban on transgender individuals from openly serving. In his public statement on the reversal, Carter explains:
“Our mission is to defend this country, and we don’t want barriers unrelated to a person’s qualification to serve preventing us from recruiting or retaining the soldier, sailor, airman, or Marine who can best accomplish the mission. We have to have access to 100% of America’s population for our all-volunteer force to be able to recruit from among them the most highly qualified – and to retain them.”
Taking our lead from Carter, Obama, Clinton, and Truman, a question remains if military service is a civil right, civil liberty, or both. The distinction between these terms can be found here. Under current US federal law and military policy, American citizens over the age of 18 of sound body and mind can volunteer to serve in the US Armed Forces. As it relates to transgender persons, the civil right to serve in the military without discrimination and the civil liberty to openly serve have been supported by legal precedents. If President Trump’s blanket ban is codified in policy, any resulting legal action will clarify how civil rights and liberties are applied in the case of transgender Americans wishing to serve.
The President’s tweets may indeed be a precursor to an executive order (such as the case with President Truman and military desegregation), a bill-turned-law (Presidents Clinton and Obama with the creation and repeal of DADT), a policy change (Secretary Carter and the service of openly transgender soldiers), some other legally binding option, or it may remain what it is today: a tweet. The likelihood of the president issuing a policy directive is arguably uncertain. However, based on the information the American public has on President Trump’s proposed transgender military ban, we can make an educated analysis of his arguments for a ban. A thorough and exhaustive examination of his full public statement (341 characters, not including spaces) reveals two justifications the president offers for his transgender military ban: “tremendous medical costs” and “disruption that transgender in the military would entail”.
In 2016, the RAND Corporation, a nonpartisan think tank offering research and analysis in operational strategy related to the US Armed Forces, published a report titled Assessing the Implications of Allowing Transgender Personnel to Serve Openly; the full text can be read here. This report, commissioned in response to growing questions about the reality of allowing transgender individuals to openly serve in the military, assessed: 1) the health care needs of transgender individuals, 2) the population size of transgender individuals in the US military, 3) the likelihood & potential costs of gender-related healthcare services to the US military, and 4) the ‘potential readiness’ of the US military to allow transgender individuals to openly serve. This report helped inform Secretary Carter’s decision to allow transgender individuals to openly serve. This widely-respected and cited report directly addresses both of President Trump’s justifications for banning military service of transgender individuals: medical costs and “disruptions” to unit cohesion.
The medical cost President Trump is likely alluding to is the extension of healthcare coverage to transgender individuals in the US Armed Forces to cover gender-transition related treatment. As previously stated, this includes procedures such as hormone treatment, surgeries such as hair removal or breast implantation, and gender reassignment surgery. Given the ongoing and bitterly contentious debate in the US Congress on Obamacare repeal / reform, President’s Trump’s focus on costs accrued from health does make sense, given the current political climate. Politicking aside, the RAND Corporation did indeed find an increase in costs to the military in extending healthcare to include gender-transition related treatments. Using cost estimates based off public employers, private employers, and treatments likely to occur in transgender persons in the military, allowing the health extension would cost the military between $2.4million and $8.4million per year (by comparison, the US military spends $84million / year in treatment for erectile dysfunction for US servicemen- 10x the amount of gender-transition related treatment). The US military currently spends $6.2billion per year in healthcare-related costs. Therefore, allowing transgender soldiers to have access to gender-transition related treatment would see a 0.13% or 0.0013 yearly increase in the US Armed Forces healthcare budget. These specific estimates can be found between pages 33-37 of the RAND Report. To put this in further perspective, one of President Trump’s foundational arguments against the military service of transgender individuals is an unwillingness to spend a potential $2.4m-$8.4m / year, for individuals committed to protecting the United States from enemies foreign and domestic, in healthcare procedures that are entirely optional and may or may not be utilized. For the president, these “medical costs” are simply too high.
President Trump’s second and final argument against the military service of transgender individuals is the “disruption” they present to their fellow soldiers, sailors, airmen, and Marines. This very argument has been used before, most notably in the follow-up to President Obama’s repeal of DADT. Critics of the repeal feared if other members in the unit found out an individual was lesbian, gay, or bisexual, this would inhibit unit bonding, and therefore negatively impact unit cohesion and situational readiness. This argument has long been dismantled, and data indicate this trend holds for transgender individuals serving in the military as well. In fact, individuals with negative attitudes towards transgender individuals are more likely to change those attitudes towards a positive outlook, given more interactions with a transgender person. This specific instance of Mere Exposure Effect (or as social psychologists would say, “Familiarity Principle”) has been found in militaries across the world, including in the US. The RAND Report summarizes these studies (pages 39-47), stating the presence of one or more transgender individual in a military unit has no significant impact on cohesion, operational effectiveness, or readiness. “[D]isruption that transgender in the military would entail”, cited by President Trump as a reason for the transgender military ban, is simply not supported by the evidence.
Reaction to President Trump’s tweet was mostly surprise. While conservative circles welcomed the move, news outlets, advocacy groups, members of the US Armed Forces and private citizens have all expressed their ire, frustration, and disbelief at the transgender military ban. What is more disturbing than this sudden announcement are the potential effects of President Trump’s statement on the lives of transgendered Americans. It serves as an illustration of discrimination and oppression of transgender people in general. This attack and other attacks like it, while disguised in seemingly innocuous rationale such as “medical costs” and unit “disruption”, do real and tangible damage to transgender persons. Reaching equality for transgender persons has just become more difficult.
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