Trans News/ Issues

[tiggs]

Thank you for posting this weatherboi. I read this tonight and was so disappointed and embarrased to find this coming from my country. I think sometimes I just don't want to believe this non-sense can come from the same government that allows us to marry.

[Nadeest]

I finally found out a bit more about that transwoman in Tennessee that was arrested outside the DMV for taking her top off. Here is the link to it: http://http://manicsquirrel.com/2011...-days-in-jail/
Apparently, she served 21 days in jail so far, and went to court on Dec. 20th. I couldn't find any more information then that, though. Has anyone heard anything about it, since then?

[christie]

In this month's issue of Employee Benefit News:

Large companies push progressive benefits forward

By Lisa V. Gillespie

February 1, 2012

Thirty-three percent of major employers offer transgender-inclusive benefits. This is five times more companies than last year, and a big part of the push came from the Corporate Equality Index, a series of guidelines from the Human Rights Campaign that measured employers on five criteria regarding benefits for transgendered workers: short-term leave, counseling by a mental health professional, hormone therapy, medical visits to monitor hormone therapy and surgical procedures, without any exclusions.


Eliminating exclusions

The "without exclusions" part is significant, because for years, transgendered employees were denied medical benefits because they were in the process of transitioning or had previously undergone gender reassignment surgery. So, say a transgendered employee was injured in a fall, went to the emergency room and disclosed to the hospital he had undergone gender reassignment years before. Because of these "exclusions," the employee would be denied treatment because of language like, "Services for, or leading to, sex transformation surgery," or "Gender Transformation: treatment or surgery to change gender including any direct or indirect complications or aftereffects thereof." The same denials pertained to mental health services because of "Transsexual surgery including medical or psychological counseling and hormonal therapy in preparation for, or subsequent to, any such surgery."

"There was a lot of moral judgment of people changing their sex, but we have a much more nuanced experience with it now because more and more people have been talking about it rather than sweeping it under the rug," says Andre Wilson, a policy consultant and educator on gender issues for 20 years. On top of the basic medical care that was frequently denied, employers were also not paying for the sex reassignment surgery. The average cost for a male-to-female surgery is about $17,000, plus $1,000 for therapy, $1500 for hormones and $500 for doctors visits and lab tests. Though the cost for care is relatively the same if an individual or an insurance company picks up the tab, the cost to a plan is relatively small in comparison to the out-of-pocket cost to an individual.

Though no claims data has been made available by the private industry, one city has, and it has seen better results than originally anticipated. In 2001, the City of San Francisco made available transgender benefits, and their claims cost much less than they had anticipated. In 2004 and 2005, there had been 11 claims for surgery, totaling $183,000, or $46,000 per year, not including costs for therapy or hormones. The city lowered its charge to $10.20 per year-per employee - or 85 cents per month - raised its lifetime cap to $75,000, removed the one year employment requirement and offered the benefit on every health plan offered to its 30,000 employees.

"This is why we have insurance in the first place, to spread the risk of high-cost treatments across a pool of people, and that's true for everything," Wilson says. One of the main reasons health plans and self-insured employers didn't offer the benefits is because people simply didn't know.

Wilson explains it this way: "For executives, maybe they can afford it, so they don't ask for the changes in the policy because they don't want to make waves, and the low-wage workers don't want to ask because they don't want to make waves. They have a well-documented history of trying to fit in."


'Leveling the playing field'

Benefits aren't the only arena transgendered employees must grapple with: 97% of transgendered people surveyed by the National Center for Transgender Equality and the National Gay and Lesbian Task Force in 2009 reported experiencing harassment or mistreatment on the job, while 47% had experienced an adverse job outcome, such as being fired, not hired or denied a promotion. But with providing benefits, "you're essentially leveling the playing field," says Victoria Fulkerson, vice president of corporate relations and supplier diversity at the National Lesbian and Gay Chamber of Commerce. "You waste less time on how you're different and spend more time on how you can do your job."

The majority of the 636 companies cited by HRC are self-insured, but companies under group plans can also get coverage, although it is sometimes an "add-on" for an extra free. Aetna offers it as such, but would not specify how much it costs a company. Scot Roskelley, communications director for Mid-America region, also wouldn't say if they have plans to make it part of their basic medical coverage.

For self-insured plans, it's easier to offer because it assumes the risk. However, according to Deena Fidas, deputy director at HRC, most insurance companies have had guidelines around the coverage for a decade or more.

"Some companies will charge because they're still trying dissuade people from adding it because, I suspect secretly - and they wouldn't acknowledge it - they have a moral objection," Wilson says.

But just like depression, having gender identity disorder is diagnosed by doctors, and the American Medical Association asserts that when discriminatory financial barriers are placed between the transgender community and proper health care by dismissing treatments as "cosmetic" or "experimental" - even when covered for other patients with other recognized medical conditions - more expensive problems can develop as a result, such as depression, substance abuse problems and stress-related illness. And, Wilson says, those companies don't "understand how vital these services are."

Staples, a self-insured employer, offers two plans that went into effect Jan. 1. Craig Hazenfield, vice president of human resources at Staples, says a main reason they hadn't included the benefits in previous years was simple education.

"This is new territory for many companies. Making advances in this area requires understanding, education and, in some cases, exposure to transgender individuals," he says, relating it to domestic partner benfits. "More companies will recognize the value these benefits provide to valuable associates who just happen to be transgender."

The business case for offering the benefits appeals to a price tag that can run lower than some expensive surgeries, and to employee morale and productivity. "Our associates can't be expected to be at their best if they are burdened with something that prevents them from being who they are in the workplace or burdens them with medical expenses," Hazenfield says.

MGM Grand International is another employer who offers benefits, but it did not qualify under the Corporate Equality Index because it only offers prescription medication and counseling related to transgender care. Jeff Ellis, vice president of benefits, said that the company had been offering these for a little over five years, and that he envisions it will start offering additional benefits in the upcoming year.

Fields expects the number of companies they qualify as transgender-inclusive to increase again next year, because though the term "transgender" was taboo or simply unknown in the past, it is gaining recognition, along with the benefits that go with it.

[sanee66]

Transgender children getting more drug, hormone treatments

The Associated Press Posted: Feb 20, 2012 11:39 AM ET Last Updated: Feb 20, 2012 3:10 PM ET

The Passionate Eye: Transgender kids
Switching gender roles and occasionally pretending to be the opposite sex is common in young children. But about 1 in 10,000 children actually feel they were born with the wrong bodies, some doctors say. (iStock)A small but growing number of teens and even younger children who think they were born the wrong sex are getting support from parents and from doctors who give them sex-changing treatments, according to reports in the medical journal Pediatrics.

It's an issue that raises ethical questions, and some experts urge caution in treating children with puberty-blocking drugs and hormones.

An 8-year-old second-grader in Los Angeles is a typical patient. Born a girl, the child announced at 18 months, "I a boy" and has stuck with that belief. The family was shocked but now refers to the child as a boy and is watching for the first signs of puberty to begin treatment, his mother told The Associated Press.

Pediatricians need to know these kids exist and deserve treatment, said Dr. Norman Spack, author of one of three reports published Monday and director of one of the nation's first gender identity medical clinics, at Children's Hospital Boston.

"If you open the doors, these are the kids who come. They're out there. They're in your practices," Spack said in an interview.

Switching gender roles and occasionally pretending to be the opposite sex is common in young children. But these kids are different. They feel certain they were born with the wrong bodies.

Some are labeled with "gender identity disorder," a psychiatric diagnosis. But Spack is among doctors who think that's a misnomer. Emerging research suggests they may have brain differences more similar to the opposite sex.

1 in 10,000
Spack said by some estimates, 1 in 10,000 children have the condition.

Transgender kids face psychiatric risks: study
A new study shows that nearly half of 97 children and adolescents diagnosed with gender identity disorder at a Boston hospital between 1998 and 2010 suffered from other psychiatric problems.

The study, led by Children's Hospital Boston endocrinologist Norman Spack, found that 44 per cent of the patients had a history of psychiatric symptoms, 37 per cent were on medication for such symptoms, 21 per cent had a history of self-mutilation and nine per cent had attempted suicide.

Fifty-eight per cent of the children, who had an average age of 14.8 years, were treated with either hormones or puberty-suppressing drugs.

The study was published online in the March issue of the journal Pediatrics on Monday.
Offering sex-changing treatment to kids younger than 18 raises ethical concerns, and their parents' motives need to be closely examined, said Dr. Margaret Moon, a member of the American Academy of Pediatrics' bioethics committee. She was not involved in any of the reports.

Some kids may get a psychiatric diagnosis when they are just hugely uncomfortable with narrowly defined gender roles; or some may be gay and are coerced into treatment by parents more comfortable with a sex change than having a homosexual child, said Moon, who teaches at the Johns Hopkins Berman Institute of Bioethics.

It's harmful "to have an irreversible treatment too early," Moon said.

Doctors who provide the treatment say withholding it would be more harmful.

These children sometimes resort to self-mutilation to try to change their anatomy; the other two journal reports note that some face verbal and physical abuse and are prone to stress, depression and suicide attempts. Spack said those problems typically disappearin kids who've had treatment and are allowed to live as the opposite sex.

Guidelines from the Endocrine Society endorse transgender hormone treatment but say it should not be given before puberty begins. At that point, the guidelines recommend puberty-blocking drugs until age 16, then lifelong sex-changing hormones with monitoring for potential health risks. Mental health professionals should be involved in the process, the guidelines say.

The group's members are doctors who treat hormonal conditions.

Those guidelines, along with YouTube videos by sex-changing teens and other media attention, have helped raise awareness about treatment and led more families to seek help, Spack said.

His report details a fourfold increase in patients at the Boston hospital. His Gender Management Service clinic, which opened at the hospital in 2007, averages about 19 patients each year, compared with about four per year treated for gender issues at the hospital in the late 1990s.

The report details 97 girls and boys treated between 1998 and 2010; the youngest was four years old. Kids that young and their families get psychological counselling and are monitored until the first signs of puberty emerge, usually around age 11 or 12. Then children are given puberty-blocking drugs, in monthly $1,000 injections or implants imbedded in the arm.

In another Pediatrics report, a Texas doctor says he's also provided sex-changing treatment to an increasing number of children; so has a clinic at Children's Hospital Los Angeles where the 8-year-old is a patient.

The drugs used by the clinics are approved for delaying puberty in kids who start maturing too soon. The drugs' effects are reversible, and Spack said they've caused no complications in his patients. The idea is to give these children time to mature emotionally and make sure they want to proceed with a permanent sex change. Only 1 of the 97 opted out of permanent treatment, Spack said.

Early treatment has advantages
Kids will more easily pass as the opposite gender, and require less drastic treatment later, if drug treatment starts early, Spack said. For example, boys switching to girls will develop breasts and girls transitioning to boys will be flat-chested if puberty is blocked and sex-hormones started soon enough, Spack said.

Sex hormones, especially in high doses when used long-term, can have serious side effects, including blood clots and cancer. Spack said he uses low, safer doses but that patients should be monitored.

Gender-reassignment surgery, which may include removing or creating penises, is only done by a handful of U.S. doctors, on patients at least 18 years old, Spack said. His clinic has worked with local surgeons who've done breast removal surgery on girls at age 16, but that surgery can be relatively minor, or avoided, if puberty is halted in time, he said.

The mother of the Los Angeles 8-year-old says he's eager to begin treatment.

When the child was told he could get shots to block breast development, "he was so excited," the mother said.

He also knows he'll eventually be taking testosterone shots for life but surgery right now is uncertain.

The child attends a public school where classmates don't know he is biologically a girl. For that reason, his mother requested anonymity.

She said she explained about having a girl's anatomy but he rejected that, refused to wear dresses, and has insisted on using a boy's name since preschool.

The mother first thought it was a phase, then that her child might be a lesbian, and sought a therapist's help to confirm her suspicion. That's when she first heard the term "gender identity disorder" and learned it's often not something kids outgrow.

Accepting his identity has been difficult for both parents, the woman said. Private schools refused to enrol him as a boy, and the family's pediatrician refused to go along with their request to treat him like a boy. They found a physician who would, Dr. Jo Olson, medical director of a transgender clinic at Children's Hospital Los Angeles.

Olson said the journal reports should help persuade more doctors to offer these kids sex-changing treatment or refer them to specialists who will.

"It would be so nice to move this out of the world of mental health, and into the medical world," Olson said.