I can't help but get frustrated over these whole "x trans person has it worse than y trans person" discussions. Over in my city its manifested itself in some circles as transwomen constantly hating on transguys acting as though there is only one kind of transguy with one experience. One prominent transwomen activist here even ranted on about transmen as part of her speech at Slut Walk. Meanwhile, there's quite a number of homeless or incarcerated transguys out there with few places to turn for support because most the orgs focus on transwomen. So you end up with situations where transguys are placed into women's shelters because someone decided to designate a woman's shelter as "the trans shelter," yet fail to recognise the issues that transguys face in those shelters (being denied access to health care facilities because they are "women only" and no effort by the shelter to organise something for transmen staying at the shelter, being harassed, people trying to get them kicked out of the shelter etc), to the point where what little statistics exist (thanks to one transguy activist in the city, who sadly recently committed suicide) point to the fact that the majority of homeless transmen prefer to sleep outside than in shelters. These are things both transmen and transwomen face. And yet, neither can transguys (just as transwomen as well) go to male shelters safely because of the violence and harassment they face there.

So why can't there be more inclusive resources? I feel the idea that transwomen face more issues than transmen can create this imbalance where there aren't really inclusive resources, so that transmen "can stay here too" but there's not the same level of organisation to provide them with support, health care etc.

I don't mean to always bring it back to shelters, streets and prisons, but that is where a huge amount of the abuse of trans people occurs...so we shouldn't really be looking at as much at the experiences of trans people in office jobs or something as the way of saying "oh such and such has it so easy."

It becomes frustrating. I think all trans people should be equally considered, and there just seems to be so many barriers wedged between transmen and transwomen right now.

And it feels like no one ever thinks of people's experiences depending on their choices or situations as far as hormones/surgery etc. A lot of trans people who are low income, suffer from depression, have a history of substance abuse or incarceration are denied hormones or surgery because therapists decide they aren't "stable enough"...and the more they deny them what they need, the more "unstable" they appear to the therapist or health care professional. That happens equally with all trans people in those situations.

And what are those people having to go through? How many transguys have had people abuse them to try to "make them acknowledge" their "femaleness," especially when they're not on T...but that's one thing I've noticed talking to friends and such is that there seems like there's little space to talk about that, and partially because some people feel it will detract from their identities as men. So how to get over that... And I also feel that because a lot of transguys who are not on T are frequently mistaken for female, when it happens there's just zero visibility statistically.

Everything that happens to vulnerable transwomen, there's a flip side for transguys in similar situations, whether its visible or not...and especially since there are very few statistics that include transguys who are in more vulnerable living situations.

But then there's this fucked up feeling that every time these discussions occur, someone is being left out. Like transguys feeling left out when a lot of the resources out there are for transwomen, but then you also get transwomen feeling left out when things focus on transguys. How do you strike a balance?

Edit: and I think it stems too from the fact that everyone is struggling for space. Because society in general doesn't leave much space for trans people, especially certain trans people, its like we struggle among each other to create more safe space for ourselves or to get our struggles across...but again how to strike a balance?

Blah...

Hi, Ender. I enjoyed your whole post. Very thought provoking.

That is really refreshing. Kinda been waiting on what the outcome would be and been out of the loop. It is what i wanted. It is nice to hear this, in a concise manner, from someone whom is knowledgeable about the issue. This way, i don't feel the need to go foraging through the DSM now.
Thanks.

Wow, how to come together without excluding others or slowing progress for all people? Or the other trans sex. Tearing down barriers that already exist in the x, y, world to open up doors for trans x,y....without stepping on trans y, so that trans x can get help too. Or vice versa. Very interesting. Cool post.
Thanks.

From the Prop 8 Blog
 

American Psychiatric Association issues new position on transgender care
By Jacob Combs

ThinkProgress reports that the American Psychiatric Association has published a new official position regarding care for transgender and gender non-conforming men and women. In this year’s edition of the Diagnostic and Statistical Manual of Mental Disorders (the DSM-V), transgender status will no longer be classified as “Gender Identity Disorder,” but rather as “Gender Dysphoria.” The APA’s new position reads as follows:

The American Psychiatric Association:

1. Recognizes that appropriately evaluated transgender and gender variant individuals can benefit greatly from medical and surgical gender transition treatments.

2. Advocates for removal of barriers to care and supports both public and private health insurance coverage for gender transition treatment.

3. Opposes categorical exclusions of coverage for such medically necessary treatment when prescribed by a physician.

The American Psychiatric Association:

1. Supports laws that protect the civil rights of transgender and gender variant individuals.

2. Urges the repeal of laws and policies that discriminate against transgender and gender variant people.

3. Opposes all public and private discrimination against transgender and gender variant individuals in such areas as health care, employment, housing, public accommodation, education, and licensing.

4. Declares that no burden of proof of such judgment, capacity, or reliability shall be placed upon these individuals greater than that imposed on any other persons.

The APA’s move is an extremely important one, since it represents the scientific consensus of one of America’s most important mental health groups, and as such is taken seriously by the courts when cited in litigation. In the face of so many who continue to smear LGBT individuals with untrue arguments about the dangers of homosexuality and gender non-conformity, having scientific organizations like the APA on our side gives the lie to those falsehoods. And, as we’ve written about on this site, language matters, so moving away from the negatively tinged “Gender Identity Disorder” is a positive development for transgender Americans

It's not conscious in the sense that anyone is "conspiring" or something to not grant transguys services...but I think it should be recognised that transguys are often not seen as legitimate by institutions. Transguys are usually not what pops into people's heads when they think of "trans." I think there are definitely far more transwomen who advocate for disadvantaged transwomen or for themselves than transguys who do the same. Some services are set up by well off middle/upper class transwomen for low income/homeless transwomen or transfemale sex workers. But often, especially in the case of sex workers, these services are started by organisations trying to work with transwomen in these situations to provide those services. However, because they are organisations (often lgbtq) doing the funding and service creation, they have a very set view of what they think trans people need. Transguys are often not on their radars because even in the lgbtq community we're often forgotten.

I think a lot of it has to do with competing life experience and the assumptions people make about "what it means to be a man." Transguys were coercively assigned female at birth and wrongly perceived as female for a good chunk of our lives. When we are the victims of harassment or assault and especially sexualisation we often remain silent of it both because of the way we were brought up to think that we should remain silent about it and also because of insecurities about maleness/masculinity and the idea we shouldn't talk about it also silences us. As such, any statistic that might have existed, our experiences are often recorded in the "woman" category. No accurate statistics for us exist and its not because of a lack of experience, but because of silence. We don't often end up trying to advocate for ourselves or represent ourselves the way many transwomen do, and especially low income, homeless or incarcerated...or even transmale sex workers who are frequently forgotten or deemed non-existent because of stereotypes around sex work. Slowly transguys are starting to advocate more for each other and creating visibility, but there is still a long way to go. Organisations won't start paying more attention until we break the silence and start helping each other out and reaching out to others for help.

I really don't care much about what a "majority" is or isn't. It's a moot argument, imo, because there are no accurate statistics about trans people. It's pretty hard to gather any accurate statistic about any queer or trans identity because certain people will always be more likely to respond than others. Trans people with class privilege already have too much attention to begin with. A massive chunk of trans people are in low income situations or worse and that's what I care about.

As far as more of this "transwomen have it worse than transmen" generalisations...that's the kind of divisive thing I really think the trans community needs to move beyond. Ultimately this hierarchy competition doesn't mean shit to a homeless transman or transwoman being denied their basic rights.

A friend posted this on Facebook.

http://votingwhiletrans.org/download.html

Excerpt: "Transgender people, the majority of whom have never had problems voting in the past, may now lose their right to vote due to dozens of new voter suppression laws. Over 25,000 transgender people could have their voting rights taken away. In response to these dubious new laws, we have released two resources to help transgender people reclaim their voting rights."

So.. Buck Angel has started a dating site for FTMs: http://buckangeldating.com/ You can read more about the thought process of why at this article http://www.huffingtonpost.com/buck-a...ef=transgender

So I am at the SF VA Medical Center thursday morning. All over the VA are these flat screens that have announcements of stuff on them. It's a variety of things going on at the VA for veterans and staff members. One of the announcements was the following:

Transgender Awareness Day
Oct 3 8:00am-12:00noon

Featured speaker is Marci Bowers, MD

there are other speakers also.......

and yes I think I will go just to hear what is being said..........



please ohhh please vote, vote often and vote Democratic........

I promise if Romney wins none of this kind of stuff will be happening at any VA....we can count on a reduction in services and an attempt to privatize veterans health care.........just like they want to do with Medicare/Medicaid and Social Security.......it will be voucher-VA, voucher-care, voucher-caid and voucher-security
__________________

I don't know about SRS at SFVA (in the past) but I'll see what I can find out cuz I am now curious........I know they are not doing it now. I know transwomen are getting their healthcare in the Women's Clinic......a friend of mine gets her care there....and trust me she would be vocal if she was not happy....laughin.... I'm not sure about transmen.

I'm not sure what the format will be for the program, but I am sure there will be a Q&A after the lectures....it is a teaching hospital.....so it should be very interesting.

I'll come back and give y'all my impressions if you like.........

I'd have loved to hear Marci Bower's lecture. It should prove very interesting. I would love to hear your impressions of the lecture.

I'm doing it for me too Theo......I like to keep up.......so here it is:

It was a great mini-conference. I would say about 50 folks were there with large majority social workers and they got CME/CEU credit for it.

There were 3 presentations from 4 presenters.

Sira Maguen, PhD and Angela Waldrop, PhD MD Working with Transgender Individuals: Mental Health Highlights

Covered definitions (transgender, transexual, sexual orientation) along with issues of violence, barriers to care, HIV, substance abuse risks and what the VA does. Only 29% used VA hospitals and then all the abysmal civilian care issues we all know about such as denial of care, discrimination. I did not know this, but there is a "Transgender American Veterans Association" and they did a study that is the first empirical data on trans vets with 827 trans vets answering questions. link to their website: http://www.tavausa.org/

They then talked about VA Care and the directive of June 2011. They covered pronouns, WPATH Standards of Care, issues with GID diagnosis (they don't like it), and the VA will provide pre-op and post-op care, HRT, mental health counseling (if needed and not everyone needs it), etc. The VA will not provide SRS surgery. The interesting thing pointed out by a later presenter is this exact quote from the directive which is titled 'Providing Health Care for Transgender and Intersex Veterans'. The Directive number is 2011-024 June 9,2011

Section 2b VA does not provide sex reassignment surgery or plastic reconstructive surgery for strictly cosmetic purposes.

That presenter felt this was a very smart little statement since no SRS including chest reconstruction is 'strictly cosmetic'. He thought this was a way to actually get the VA to do the surgeries. It will take time but it certainly could be an advocacy path......

I thought it was interesting that intersex folks are recognized by the VA.

Next Presenter was Marci Bowers, MD.

She is a warm, dynamic, funny as hell woman who has a tendency to ramble when she talks. The best and most interesting thing I heard from her had to do with female genital mutilation/female circumcision. It seems the damage can be repaired with a normal looking and functioning female genitalia as the result. Yes it can be fixed with what she called 'a simple surgery'. She is the only surgeon (she knows about) in the US that is doing this surgery and she does every one of them pro bono. There are surgeons who Europe who do it and she went to Paris and trained. I was stunned and so were the rest of the audience.

She talked about intersex folks as well MtF and FtM. She was clear that more work needs to be done to stop any surgery being done on an intersex persons until they decide what their gender is.

She does metoidioplasty and will create a scrotum with implants if individual wants it. She does not do chest reconstruction, but will also do hysterectomy. She is a board certified OB/GYN. She is not too impressed with available phalloplasty options.

She talked a bit about the history of trans folks and I mean way back history. She seems to think all those eunchs in the Bible were probably MtF folks who were castrated. It seems there was an FtM Pope....Pope John VIII 855AD was the reason that there is now a genital check for all those who are elected Pope. The Pope sits in a chair with a hole in it and one of the Bishops goes below the chair and looks for the necessary dangling bits....this is done in a special room and the Pope does not know who does it......

Another interesting thing she said was this idea of trans folks having 'regret' later is entirely un-supported by data (and in her practice) and is most likely transference on the part of the provider who may or may not have experience with trans folks.

Nick Gorton, MD (and an FtM) was the last presenter. He covered all the HRT stuff as well as some of the legal issues around documents and Medicaid/Medicare/Social Security issues. He does some work with the Transgender Law Center.

He pointed out the very large majority of health care for a trans person has nothing to do with the 'trans' part and everything to do with the human part. He says you already know 90% of what you need to know. 100% of the medical treatments and most of the surgeries are used in cisgender patients. He also does not do much in the way of labs for MTF/FtM.....at baseline, 2 months, 6 months and then yearly.

There is no data to suggest FtM on T will have more heart trouble, more bone fracture problems, and for MtF the big issue when on E is Embolism (blood clots).

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I have a handout with all the slides from the 3 presentations. I figure we can work something out if anyone wants a copy of them. PM if you are interested.

If you have questions you can ask me and I will see if I can answer it based on what I heard today.


edited to add: Dr Bowers showed a 6 minute video (at high speed because the operation is about 3 hours long) of the MtF vaginoplasty...damn is all I will say....

The MtF surgery is easier because we all start life as a female.......in the second trimester sex differentiation occurs and in males there is room in the pelvic cavity for a vagina. The other thing is because you are using viable sex organ tissue (the penis) most if not all MtF are capable of orgasm of the clitoral and vaginal varieties. She also said transwomen have a G-spot....

Dr Bowers seemed to think the awful skin grafts needed to make a penis is a HUGE drawback and that yes there are intact nerves in the new phallus, however they are not nerves of the sexual stimulation variety. So no orgasm and you need a rod in the new phallus for penetration.

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The two women in the first presentation are at the SFVA and are more than happy to talk to any and all VA folks around the country about trans issues. They really are dedicated to quality service delivered in a respectful way.

not "news"... but, WOW!!!

That poem definitely expresses things, in a way that helps people to understand, I think and hope.