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Read Ebook {PDF EPUB} Diagnosing Identities Wounding-Bodies Read Ebook {PDF EPUB} Diagnosing Identities Wounding-Bodies Medical Abuses and Other Human Rights Violations Against Lesbi JFI brief and recommendations on LGBT rights in Iran. Background Information Under Iran’s Islamic Penal Code, consensual same-sex sexual relations between adults carry flogging and the death penalty while transgender expressions including cross-dressing may attract a punishment of 74 lashes and a fine. Transsexuality is, however, recognised as a Gender Identity Disorder (GID) curable through sex reassignment surgeries, which were made legal in Iran after a 1986 fatwa by Ayatollah Khomeini, Iran’s previous Supreme Leader. As a result of this legal framework, lesbian, gay, bisexual and transgender (LGBT) individuals who do not conform to culturally approved models of femininity and masculinity have to choose between risking harassment, persecution, and arbitrary arrest and detention by police and paramilitary basij forces because of their actual or perceived homosexual orientation on the one hand, and seeking a diagnosis of GID with a view to undergoing sex reassignment procedures on the other. Medical professionals frequently lead LGBT individuals to choose the latter course, which accounts for Iran having one of the highest numbers of sex reassignment surgeries in the world. Lacking access to information about sexual orientation and gender identity and fearing laws criminalising any positive speech about homosexuality, medical professionals frequently assign a diagnosis of GID to LGBT individuals merely on account of their same-sex desires and gender non- conformity. They then nudge LGBT individuals to either receive reparative therapies (including electroshock therapy and psychoactive medications) aimed at “curing” them of homosexuality or undergo sterilisation and genital reassignment surgeries (GRS) aimed at turning them into “normally gendered” men or women. These abusive practices are taking place at the instigation of or with the consent or acquiescence of Iranian officials. In March 2013, Mohamamd Javad Ardeshir Larijani, the head of Iran’s Human Rights Commission, for example called homosexuality “an illness” for which “people must be put under psychiatric care and sometime even biological and physical care.” JFI & 6Rang have documented the accounts of dozens of LGBT individuals who have been prescribed reparative treatments without being given accurate and complete information whether about the risks, benefits, efficacy and scientific validity of such procedures or about issues relating to sexuality and gender diversity. JFI & 6Rang have further documented the plight of transgender individuals who are unable to obtain identity documents reflecting their gender and therefore enjoy their civil, political, economic and social rights until they complete mandatory sterilisation and GRS. For more information, please refer 6Rang & JFI’s report Diagnosing Identities Wounding Bodies: Human Rights Violations against Lesbian, Gay and Transgender People in the Islamic Republic of Iran available at: https://justice4iran.org/wp-content/uploads/2014/06/Pathologizing-Identities- Paralyzing-Bodies.pdf. RECOMMENDATIONS During its first UPR, Iran refused all three recommendations concerning the human rights of LGBT individuals, including their right to life. JFI is keen to see the following recommendations being made to the Iranian delegation: Diagnosing Identities Wounding-Bodies: Medical Abuses and Other Human Rights Violations Against Lesbian Gay and Transgender People in Iran by Justice for Iran. Laws and regulations pertaining to substance abuse and mental health services, SAMHSA programs, and related topics. Federal Laws Related to SAMHSA. H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018, was made law to address the nation’s opioid overdose epidemic. The legislation includes provisions to strengthen the behavioral health workforce through increasing addiction medicine education; standardize the delivery of addiction medicine; expand access to high-quality, evidence-based care; and cover addiction medicine in a way that facilitates the delivery of coordinated and comprehensive treatment. The Support Act followed the passage of the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act in the previous Congress. The Support Act has many important provisions, a few of which are: State Targeted Response Grants (STR): Reauthorizes and modifies the State Targeted Response grants from the 21st Century Cures Act to provide funding to Tribes and to improve flexibility for states in using the grants. First Responder Training: Continues a program that trains first responders to administer drugs for an opioid overdose and expands the program to include training on safety around fentanyl. Comprehensive Opioid Recovery Centers: Authorizes a grant program to establish comprehensive opioid recovery centers that will provide individuals with opioid use disorder (OUD) holistic care, including all FDA-approved MAT, counseling, recovery housing, job training, etc. Requires HHS to issue best practices for recovery housing. Also requires HHS to identify or facilitate the development of common indicators that could be used to identify potentially fraudulent recovery housing operators. In December 2016, the 21st Century Cures Act was signed into law. The Cures Act addresses many critical issues including leadership and accountability for behavioral health disorders at the federal level, the importance of evidence-based programs and prevention of mental and substance use disorders, and the imperative to coordinate efforts across government. The Cures Act established the position of Assistant Secretary for Mental Health and Substance Use. The Cures Act codified the role of the Chief Medical Officer, which provides a clinical perspective at the national level that is imperative to sound stewardship and implementation of high quality, effective services. The Act also codified the Center for Behavioral Health Statistics and Quality (CBHSQ), which serves as the federal government’s lead agency for behavioral health statistics. CBHSQ conducts national surveys tracking population-level behavioral health issues, including the National Survey on Drug Use and Health. The Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) was created by the Cures Act to ensure better coordination across the entire Federal Government related to addressing the needs of individuals with serious mental illness or serious emotional disorders and their families. The Committee represents collaboration across multiple Departments and fourteen non-federal members representing treatment providers, researchers, patients, families, criminal justice systems, and others also participate in the ISMICC. The Cures Act created the National Mental Health and Substance Use Policy Laboratory (Policy Lab). The Policy Lab is working to promote evidence-based practices and service delivery models, and evaluating models that would benefit from further development and expansion. In particular, the Policy Lab is focusing on schizophrenia and schizoaffective disorder, as well as other serious mental illnesses. It is also focusing on evidence-based practices and services for substance use disorders with an emphasis on opioids. The Comprehensive Addiction and Recovery Act (CARA) of 2016 authorizes over $181 million each year (must be appropriated each year) to respond to the epidemic of opioid abuse, and is intended to greatly increase both prevention programs and the availability of treatment programs. CARA launched an evidence-based opioid and heroin treatment and interventions program; strengthened prescription drug monitoring programs to help states monitor and track prescription drug diversion and to help at-risk individuals access services; expanded prevention and educational efforts—particularly aimed at teens, parents and other caretakers, and aging populations—to prevent the abuse of opioids and heroin and to promote treatment and recovery; expanded recovery support for students in high school or enrolled in institutions of higher learning; and expanded resources to identify and treat incarcerated individuals suffering from addiction disorders promptly by collaborating with criminal justice stakeholders and by providing evidence-based treatment. CARA also expanded the availability of naloxone to law enforcement agencies and other first responders to help in the reversal of overdoses to save lives. CARA also reauthorizes a grant program for residential opioid addiction treatment of pregnant and postpartum women and their children and creates a pilot program for state substance abuse agencies to address identified gaps in the continuum of care, including non-residential treatment services. The Affordable Care Act of 2010 is one aspect of a broader movement toward reforming the health care system. The Affordable Care Act makes health insurance more affordable for individuals, families, and small business owners. People living with mental health challenges or substance use disorders often have problems getting private health insurance. Now there are special insurance protections to help. The purpose of the TLOA (PDF | 210 KB) of 2010 is to institutionalize reforms within the federal government so that justice, safety, education, youth, and alcohol and substance abuse prevention and treatment issues relevant to Indian country remain the subject
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