The TRANSGENDER Community

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The TRANS(GENDER) Community

• Jerimarie Liesegang, PhD
• Director, Ct TransAdvocacy Coalition
• jerimarie_at_transadvocacy.org
• Diana Lombardi
• Advocate, Ct TransAdvocacy Coalition
• Diana_at_transadvocacy.org
• TransAdvocacy.org

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Collateral for Presentation

• In these challenging days of Global Warming,
  TransAdvocacy minimizes the paper content of its
  presentations.
• All collateral for this presentation is available
  to either view online or download at the
  following TransAdvocacy webpage
• www.TransAdvocacy.org/?page_id65

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Agenda

• About the Trans Community
• Stories
• How do we determine ones Sex?
• Labels and Definitions
• The Trans Community
• Statistics/Needs Assessments
• Risks for the Trans Person
• Providing Trans Competent Services to your Trans
  client

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Denied housing at an Atlanta Homeless Shelter.
Alices automated email response readAs of 14
Dec. I'm one of the homeless. Shelters don't take
transsexuals and I'm not changing back. Looks
like I'm a goner. Thanks for the support over the
past few years. Hugs, Alice. Alice Johnston
Died December 15, 2002
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A Transmans Story

• Robert Eads
• 18 December 1945 17 January 1999
• Died of Uterine Cancer due to Medical Neglect

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Robert Eads
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Ct TransAdvocacy CoalitionMission

• To make Connecticut a Safe and Accepting place
  for the Trans and Gender non-conforming
  individual and community, through Political and
  Social Advocacy.

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Is Sex Determination an Exact Science?
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A Childs SexHow is it determined?

• Sex, Male or Female, is historically assigned at
  birth
• Sex designation is based upon the babies genitals
• Penis, then we declare it is a BOY!
• Vagina, then we declare it is a GIRL!

But wait a SEX! Is it really that simple?
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Is Sex Determination that Simple?
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Medicalization of Sex
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Intersex Birth Statistics
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Case StudyHow does the International Olympics
Association determine SEX?

• Until 1968 Sex determination was by genetilia
  examination
• When this wasnt accurate Chromosomal
  Determination XX Female, XY Male was used
• In 1992 Genetics was used via the SRY Gene, a
  supposed trigger for male sex determination
• In 1996 it was realized genetic makeup was not
  sufficient to ascertain ones Sex
• In 1996 the IOC abandoned the Sex determination
  test and is now handled on a confidential case by
  case basis!

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Transgender

• dont box me in with your labels or stereotypes

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Labels a Marketing Construct that Encourages
Stereotypes and Myths
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Transgender is an Umbrella Termwith so many
labels

• Pre-op
• Non-op
• Queer
• She Male
• Andro
• Boi
• Polygender
• Intergender
• Genderfluid
• Kinda sorta FtM

• Gender Fuck
• Trannie
• Faygeleh
• Boychik
• Two Spirit
• Woman -after-market-upgrade
• Boydyke
• I dont know
• Guess

• Transvestite
• Drag Queen
• Drag King
• Transsexual
• Butch
• Cross Dresser
• FtM
• MtF
• GenderQueer
• Human Being

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Defining Without LabelsNot as fun, though
inclusive

• Gender Identity (Transsexual)
• Gender Identity describes the gender with which a
  person identifies (i.e, whether one perceives
  oneself to be a man, a woman, or describes
  oneself in some less conventional way)
• Gender (Sexual) Identification
• Psychological Sex

• Gender Expression (Transgender)
• Refers to the masculinity or femininity of words,
  persons, characteristics, or non-human organisms
• Gender
• Social Construct

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Terminology specific to this talk Transsexual

• Male-to-female (MtF)
• Birth Assigned male, Gender Identity as
  Female Surgery Optional Many labels
• Female-to-male (FtM)
• Birth Assigned female, Gender Identity as
  Male Surgery Optional Many labels

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CHRO Ruling on Transgender Discrimination

• "In response to Doe's question, the CHRO finds
  that transgender and transsexuals, as defined in
  this ruling, are covered by Connecticuts
  statutes prohibiting discrimination based on sex,
  specifically CONN. GEN. STAT. ' ' 46a-60(a)(1),
  46a-64(a)(1), 46a-64c(a)(1) and 46a-66(a).
• Ruling made in November, 2000

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Needs Assessment Statistics

• Precious few studies specific to the T in LGBT

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Washington DC Needs Assessment 2000

• 42 Unemployment rate
• 29 Have no income
• 31 Incomes lt 10,000
• 47 Lack health insurance
• 43 Victims of Transphobic violence
• 45 Did not finish high school
• 34 Had substance abuse
• 35 Experienced suicidal ideation (16 act)
• 25 HIV positive (32 in MtF) and 22 never tested

stats not atypical
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San Francisco Department of Public Health
Transgender Community Project

• 392 MTF participants
• 80 sex work
• 65 history of incarceration
• 31 incarcerated in past year
• 13 with college degree
• Median Monthly income 744
• 47 homeless
• 2/3 of African Americans HIV

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Myths

• Transsexual women are really gay men in drag
• Transsexual men are really women pretending to be
  men
• All Transsexuals have surgery
• All Trans people are homosexuals
• All Transsexuals are sex workers
• All Transsexuals are 24X7
• All Transsexuals have legal documentation
• All Trans people are out
• All Trans people embrace the gender binaries

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Transphobia

• Fear, hatred, aversion, contempt, prejudice
  toward people who challenge accepted norms of
  gender expression.
• Individual behavior institutional practices
  that discriminate against people who seem to
  challenge gender norms, while granting unearned
  privilege to those who adhere to them.

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MH Concerns of Transgender People

• GLBT disproportionately use MH services 40 do
  not seek tx resiliency
• Feel need to hide gender identity during therapy
  due to c/o adverse impact of disclosure may be
  hard to hide GI
• Acceptance in community often unwelcome
• Trans folk are viewed as pathological by medical
  providers
• Study in SF found many are chronically
  underserved
• Avoid tx for depression because fear that sx will
  be attributable to transgenderism
• Victimization while involved in tx MH staff
  slow to discourage this behavior and majority
  unreported (Lucksted, 2004)

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Current DSM-IV-TR Dx

• GID in adolescents adults (302.85)
• GID in children (302.6)
• GID NOS (302.6)
• Transvestic fetishism (302.3)
• Each dx requires evidence of distress or
  impairment in fx fx impairment solely due to
  societal prejudice based on perceived social
  deviance does not meet this criterion
• Being Transgender does not constitute a Mental
  d/o
• We consider these dx pejorative GID is often
  viewed as stigmatizing of nonnormative gender bx,
  in much the same way that homosexuality was
  pathologized prior to its removal from DSM in 1973

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Substance Abuse issues for Transgender People

• Studies have focused on lesbians and gay men so
  lack of national data
• A 1999 study in SF found transwomen to use the
  following ETOH (72), marijuana (64), speed
  (30), crack cocaine (21) and transmen marijuana
  (43)
• Contributing factors to SA lack of educational
  and job opportunities, low self-esteem,
  marginalization/isolation
• Need for safer locations to gather and socialize
• Inaccessible SA Tx due to lack of sensitivity,
  verbal and physical abuse, allowed only to wear
  clothes, shower and sleep in areas appropriate to
  their gender.

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Service Impacts on Trans Clients

• Beds or Housing are typically male- or
  female-only. Trans people may not be allowed
  entrance due to their gender/genital/legal
  status.
• Because Trans is eroticized and sexualized, many
  providers believe trans people want to be
  objectified and abused - totally denies the
  prevalence of DV/SA in relationships involving a
  trans person.
• Many victims fear losing their privacy or not
  being able to maintain anonymity within care
  settings.

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Societal Barriers for Trans People

• No Trans Education in Medical Training

• No Clinical Research

• No Prevention Efforts

• No Targeted Programs for Trans People
• Mental Health
• Substance Abuse

• High HIV Risk Behavior

• Low Self Esteem

• Social Marginalization

• Lack of Education

• Poverty

• Employment/Housing Discrimination

• No Legal Protections

• No Health Insurance Coverage

• Transphobia

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Putting Policy into Practice

• Recognize the fears and inherent anxiety in a
  Trans person seeking services
• Create visible signs of acceptance for trans
• Avoid Gender Assumptions
• Get the Pronouns Right
• Get the forms of address right
• Welcoming Intake
• Will most likely be awkward at first
• Be open and honest
• Preferred name and pronouns
• Confidentiality!!
• NEVER ASSUME ASK if unsure

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Is your client Trans?Your intake process can
help

• May not be open due to high level of fear and
  discrimination to trans. Create a safe
  environment during intake
• Be sure your staff is educated to gender identity
  and expression
• Establish your confidentiality policy regarding
  sexual orientation, gender identity and
  expression
• Disclosure not required!
• Intake forms Preferred Name, Gender as a fill in
  and note near gender that trans are welcome

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Be sure your T is not written in disappearing
Ink?

• Does your program, publication, or policy refer
  only to sexual orientation or do you also
  include gender identity or expression?
• Does your program, publication, or policy
  acknowledge that the needs of pre- or
  non-operative transsexuals differ from the needs
  of post-operative transsexuals?
• Does it address cross-dressers, bi-gendered
  persons, and other gender non-conforming people
  who are not transsexual?

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Be sure your T is not written in disappearing
Ink?

• Do the in-person and printed materials that
  represent your program or publication include
  identifiably transgender persons?
• Do your transgender staff member/s, board
  member/s, and/or advisor/s adequately represent
  the full transgender community?
• Can you provide your staff with the necessary
  training, materials, and support they need to
  understand trans issues?

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Trans Community Resources

• Ct TransAdvocacy Coalition [phone]
  www.transadvocacy.org
• True Colors (Advocacy, education for Queer Youth)
  Manchester,CT www.truecolors.org
• Community Centers
• NH on Fitch St. in Westville- CT View,
  Norwalk (Triangle Community Center)- Queer AA, NA
  mtgs.
• CT Outreach Society, MA groups
• Hartford Gay Lesbian Health Center
• Transgender support group 1st Saturday
  of every month 2-330 PM lizy_at_hglhc.org, XXClub
• Pride Institute- 800-54-PRIDE (Minneapolis,
• Dallas, Ft.Lauderdale, Chicago, NYC)
• www.transadvocacy.com
• GLBT Task Force of CPA
• Affirming psychologists state-wide
  directory
• for now richard.stillson_at_po.state.ct.us