DOCSLIB.ORG

The Political and Clinical Emergence of Trans Health

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Political and Clinical Emergence of Trans Health Care la Transit "The MMeai md Clinical Basejrges»c« of Trans Health: C&n$$6ph L, HatssgmarM DISSERTATION Sohffl&ted its partial satisfaction of the retpdsmtMfs for the degree of DOCTOR OF FHULOSOFHV' m W in the GRADUATE DIVISION of the 'UMVBRsSmf OF CALIFORNIA, SAM FRANCISCO Copyright 2017 by Christoph Hanssmann ii ACKNOWLEDGEMENTS Nobody writes alone. This was the unofficial motto of the writing group that played a central part in this dissertation seeing the light of day. And it remains true in a much broader sense—the reflections that follow owe to the actions, thought, and support of many people, near and far. And just as nobody writes alone, nobody thinks alone. Here I thank some of the primary supporters, mentors, collaborators, friends, and respondents who made it possible to see this project through. First and foremost, I thank the feminist scholars and activists who trained me, mentored me, and demonstrated to me that scholarship imagines new worlds into being. I owe a particular intellectual debt to my dissertation committee: Adele Clarke and Janet Shim (co-chairs), and members Mel Chen, and Lawrence Cohen. Adele took me on as a student despite being on the brink of retirement, and for this I am immeasurably grateful. Her incisive reflections, tenacious support, and ebullience kept me afloat and significantly sharpened my analysis. I also had the incredible fortune of having Janet as co-chair of my committee. Her considered and insightful readings, collaborative approach to mentorship, and unflagging encouragement not only deepened and broadened my thought—they also set the bar for the kind of mentor I hope to be. Even though they were across the bay at UC Berkeley, Mel and Lawrence were wonderfully dedicated committee members, each of whom invited me to experiment in thinking well beyond the bounds of my discipline. Through conversations about scholarship’s potential that were at once generous and critical, Mel reminded me of the stakes of the work and the importance of “thinking with”. Lawrence’s teaching and perceptive engagement pointed me towards many of the intellectual conversations in which I strove to invest. As a group, my committee’s generosity of mind and spirit has shown me what strong and supportive mentorship can mean. iii I was also fortunate to have received support and guidance from many scholars outside of my dissertation committee. Charis Thompson provided me with many of the gifts of mentorship, even without the formal title. Chandra Lekha Sriram and Amy Ross showed interest in my project in its formative stages, and their incisive support proved critical to its development. In the first few years of my graduate program, Nayan Shah, Priya Kandaswamy, and Aihwa Ong (among many others) helped me to develop analyses that proved central to my analyses. Susan Kools and Howard Pinderhuges provided important insights and guidance in the pilot stages of my project. Mauro Cabral Grinspan, Emmanuel Theumer, Nick D’Avella, Soledad Cutuli, and Mabel Bellucci generously helped me to develop a better understanding of Argentinian activism and social movements. Emily Thuma, Alisa Bierria, Aren Aizura, Dean Spade, Chandan Reddy, Janelle Taylor, Gillian Harkins, Sarah Lamble, Sharyne Shiu-Thornton, Finn Enke, and Paisley Currah initially encouraged me to pursue my seemingly somewhat late entry into graduate training. Their work, activism, and kind support have been a perpetual inspiration. Steven Epstein, Héctor Carillo, Natalie Boero, Julia McReynolds Pérez, Katie Hasson, Lezlie Frye, Emily Thuma, Kate Darling, Natali Valdez, Sonia Rab-Alam, Emily Vasquez, Aren Aizura, Dean Spade, and Melissa Creary (among others) organized panels and events in I had the opportunity to take part. These were highly generative, and helped me to sharpen my arguments and draw new connections. Nancy Burke, Irene Yen, Rina Bliss, Juana María Rodríguez, Leslie Salzinger, Susan Stryker, Kalindi Vora, Joe Hankins, Ben Singer, Leslie Dubbin, Lindsay Smith, Noah Tamarkin, Rayna Rapp, Ann Travers, Juno Salazar Parreñas, Alondra Nelson, James Pfeiffer, Zakiya Luna, Eric Plemons, Christine Kennedy, Seth Holmes, Maria Glymour, and many others provided support, guidance, and feedback at critical times over the course of my graduate training. I also remain indebted many years later to my undergraduate mentors and instructors, particularly Jill Morawski, Jennifer Tucker, Christina Crosby, Joe Rouse, Jessica Shubow, and Kate Rushin. iv My colleagues, writing partners, and interlocutors—many of whom are now also faculty members—played critical roles in the development and direction of my scholarship. While its membership shifted over time, our writing group at UCSF (including several guest stars from other institutions) included Kate Darling, Sonia Rab-Alam, Dilara Yarbrough Krista Sigurdson, Jen James, Natalie Ingraham, Jarmin Yeh, Heather Dron, Rima Praspaliauskiene, Jamie Chang, Mike Levesque, and Taylor Cruz. Kate, Sonia, and Dilara were especially generous in reading even the roughest of drafts over the course of my writing, and their insights were crucial to developing each and every chapter in this dissertation. Emily Thuma and Alisa Bierria have long been the interlocutors and co- conspirators a feminist scholar dreams about. As readers, their insights have been invaluable, and their friendship, intellectual engagement, and political commitment have been transformative. Cindy Bello’s sharp analysis, moral support, and well-timed humor rescued me from despair on more than one occasion. Her intellectual curiosity and warm encouragement helped give me the nerve to move in new directions with my thought, and helped me to develop ideas that I might have otherwise deferred. Anna Torres, at that point still a new friend, read and provided monumentally helpful comments on my dissertation proposal. Oliver Rollins, Martine Lappé, Quinn Grundy, Florencia Rojo, Katie Hasson, Anna Jobloner, Gowri Vijayakumar, Melissa Creary, Elizabeth Payne, Rosanna Dent, Priya Kandaswamy, Natali Valdez, Sara Matthiesen, Jaimie Morse, J Sebastian, Alexa Hagerty, Mark Fleming, Francisco Fernández, and Mauro Cabral Grinspan were also incisive readers and collaborators. My SSRC DPDF program cohort in “Critical Approaches to Human Rights” nurtured the earliest inklings of my project, and their feedback and support were instrumental in assuaging my doubts about it. Special thanks to cohort members Jaime Morse, Alexa Hagerty, J Sebastian, Laura Matson, Greg Hervouet-Zeiberand, Justin Pérez, and Samar Al-Bulushi and to field leaders Amy Ross and Chandra Lekha Sriram. My participation in the São Paulo Advanced School on v Biotechnologies, Biosocialities and the Governance of the Life Sciences proved immensely important for my understanding of STS in the global South, and through it I made wonderful friends and colleagues. Co-attendees of the annual California STS Retreats also workshopped early ideas and reminded me that scholarship should frequently involve beachfront chats and campfires. Members of UC Berkeley’s Reproductive Justice Working Group, under the guidance of Zakiya Luna, also provided me with vital feedback on what eventually became Chapter 3 of this dissertation. In addition, the commemorative conference honoring the life and work of UCSF Sociology alumna Susan Leigh Star, which took place just as I was beginning the program, was deeply influential. Her legacies of feminist creativity, political engagement, and fashioning unpredictable connections remained palpable in the remainder of my experience in the program. A very special thank you to my collaborators on the Speculative Visions of Race, Technology, Science, and Survival conference at UC Berkeley in 2013 through the Center for Race and Gender. Planning and co-hosting this event with Alisa Bierria, Mel Chen, Jakeya Caruthers, and Elisa Huerta was a highlight of my graduate school career, and the dialogue that transpired there strongly resonated with and shaped my intellectual and political commitments. From the beginning, Elizabeth Payne nurtured and encouraged my slightly irrational decision to move away from my home in the Northwest to start a new career, and patiently helped me to hone in on what would become my research focus. Her moral support, unflagging encouragement, intellectual engagement, and confidence in my path have been an essential component of my completing this project. Many other friends and colleagues have also been indispensable interlocutors and inspirations, in manners both direct and less so. These include Kathleen Frederickson, Sonia Rab-Alam, Kate Darling, Raphaëlle Rabanes, Pierre Minn, Jason Alley, Jake Pyne, Andrea Parra, Jin Haritaworn, Sean Arayasirikul, Aaron Norton, Amanda Armstrong, Munira Lokhandwala, Emi Kane, Pascal Emmer, Jakeya Caruthers, Adele Carpenter, Ren-yo Hwang, Natalie vi Valdez, Hale Thompson, Chris Roebuck, Pooja Gehi, Florencia Rojo, Anna Torres, Joss Taylor, Paige Johnson, Adrienne Skye-Roberts, Lauren Berliner, Calvin Burnap, Canelli, Leah Jacobs, Toby Beauchamp, Cristina Visperas, D. Adams, Liat Ben-Moshe, Stephanie Cruz, Alexandria Wright, Francisco Fernández, Michelle Potts, Mimi Kim, Sakinah Suttiratana, Susan Miller, Sonny Nordmarken, and many others. I was privileged to have many people support my fieldwork in both New York and Buenos Aires. People put me up, helped me connect with respondents, and asked seemingly casual questions that led to important reevaluations of my assumptions. During my fieldwork in New York, I made many fortuitous connections
Load more

Recommended publications
  • Transgender Health Care Exclusions from CWRU’S Health Care Plans (2013)
    Health Insurance Coverage for Transgender Related Healthcare: Introduction, Impact and Recommendations for CWRU Prepared by: Liz Roccoforte, Director, CWRU LGBT Center Definitions: Transgender: An umbrella term that refers to a broad range of gender identities and gender expressions. Basically, the term transgender refers to many identities and expressions that fall outside the “traditional” norms of gender. This is not a diagnostic term, and does not imply a medical or psychological condition. (adapted from http://transhealth.ucsf.edu) Transsexual : Transsexual is one of the gender identities that falls underneath the broader category of “transgender.” This term most often applies to individuals who seek hormonal (and often, but not always) surgical treatment to modify their bodies so they may live full time as members of the sex category opposite to their birth-assigned sex. (adapted from http://transhealth.ucsf.edu ) Introduction: “Transgender Related Health Care” refers to medical benefits relating to transgender individuals. Generally, this care refers to the coverage of procedures, surgeries and hormones associated with medical gender transition. Often, individuals seeking this kind of healthcare identify as transsexual. However, not all people seeking this care identify specifically as transsexual, but still meet the criteria for transition related care, therefore the broader term “transgender” is often used instead of “transsexual.” This health care coverage also refers to the coverage of healthcare needs that are not directly related to medical gender transition, but impacted by it. Currently, all CWRU employee health care plans explicitly exclude transgender related health care as a covered benefit. • Specifically, current employees seeking coverage for medical procedures, visits and pharmaceuticals, required for medical gender transition, are denied coverage by insurance.
    [Show full text]
  • Unconscionable and Unconstitutional: Bill C-8'S Attempt to Dictate Choices Concerning Sexuality and Gender
    Unconscionable and Unconstitutional Bill C-8’s Attempt to Dictate Choices Concerning Sexuality and Gender May 12, 2020 Marty Moore, JD, and Jocelyn Gerke, BComm, MPP, JD (Student-at-Law) Mail: #253, 7620 Elbow Drive SW, Calgary, AB • T2V 1K2 Web: www.jccf.ca • Email: [email protected] • Phone: (403) 475-3622 CRA registered charity number 81717 4865 RR0001 CONTENTS Executive Summary ...................................................................................................................... 1 I. Bill C-8: An Act to Amend the Criminal Code (conversion therapy) .................................. 2 A. An overly broad definition of “conversion therapy” .............................................................. 2 B. Bill C-8 restricts children’s and adults’ access to care.......................................................... 3 C. Bill C-8 imposes an ideological view of sexuality and gender ............................................... 5 II. Bill C-8 Restricts Health Professionals’ Ability to Treat Children’s Gender Distress without Transition and Medicalization ....................................................................................... 7 A. Bill C-8’s imposition of a single treatment path for children ................................................. 7 B. Violation of practitioners’ and patients’ freedom of thought, opinion, belief and expression 9 C. Political interference with medical and scientific debate limits healthcare options .............. 9 III. Bill C-8’s Violation of the Charter Rights of Children and Parents
    [Show full text]
  • 10 Tips for Working with Transgender Patients
    Introduction to the transgender community MEDICAL PROTOCOLS The World Professional Association for Gender identity is our internal understanding of Transgender Health (WPATH) publishes our own gender. We all have a gender identity. Standards of Care for the treatment of The term “transgender” is used to describe people gender identity disorders, available at whose gender identity does not correspond to their www.wpath.org. These internationally rec- birth-assigned sex and/or the stereotypes asso- ognized protocols are flexible guidelines ciated with that sex. A transgender woman is a designed to help providers develop individ- woman who was assigned male at birth and has ualized treatment plans with their patients. 10 Tips for Working a female gender identity. A transgender man is a man who was assigned female at birth and has a Another resource is the Primary Care Proto- with Transgender male gender identity. col for Transgender Patient Care produced by Center of Excellence for Transgender Patients For many transgender individuals, the lack of con- Health at the University of California, San An information and resource publication gruity between their gender identity and their Francisco. You can view the treatment birth sex creates stress and anxiety that can lead protocols at www.transhealth.ucsf.edu/ for health care providers to severe depression, suicidal tendencies, and/or protocols. These protocols provide accu- increased risk for alcohol and drug dependency. rate, peer-reviewed medical guidance on Transitioning - the process that many transgen- transgender health care and are a resource der people undergo to bring their outward gender for providers and support staff to improve expression into alignment with their gender iden- treatment capabilities and access to care tity - is for many medically necessary treatment for transgender patients.
    [Show full text]
  • 13 Las Elecciones Subnacionales De 2015 En
    Revista Uruguaya de Ciencia Política - Vol. 25 N°1 - ICP - Montevideo 13 LAS ELECCIONES SUBNACIONALES DE 2015 EN ARGENTINA: ESTABILIDAD CON CAMBIO* 2015 Subnational Elections in Argentina: Stability with Change Natalia Del Cogliano** y Carlos Varetto*** Resumen: El presente artículo explora las principales características del extenso año electoral que vivió Ar- gentina a lo largo de 2015 para demostrar que la excepcionalidad del proceso no estuvo tanto en la magnitud del cambio en el orden subnacional, sino en la significancia para la política nacional de unos pocos hechos en ciertas provincias. Se analizan las elecciones de orden subnacional, buscando realizar una lectura dinámica que incorpore el plano de la carrera por la Presidencia de la Nación, sin el cual el análisis electoral subnacio- nal resultaría insuficiente. A tal fin, en primer lugar se presentan las características del complejo federalismo electoral, y la dinámica de desdoblamiento del calendario electoral, los cuales constituyen importantes retos para la coordinación de las élites y del electorado. Seguidamente, se realiza una sintética descripción del desarrollo de los sistemas políticos provinciales argentinos utilizando una serie de indicadores de sistemas de partidos. Finalmente, se hace una lectura del año electoral en su dimensión fundamentalmente subnacional a partir de cuatro hitos centrales, y se concluye subrayando la centralidad en la definición de la política nacio- nal de las provincias que constituyen la zona núcleo de producción agropecuaria del país. Palabras clave: elecciones, Argentina, política subnacional, calendario electoral Abstract: The paper explores the main features of the long electoral year that took place in Argentina during 2015. It aims to demonstrate that the main feature of the electoral process was not so much the magnitude of the political change in the subnational level, but the relevance of the electoral outcomes in a few districts for national politics.
    [Show full text]
  • Affirmative Care for Transgender and Gender Non-Conforming People
    Affirmative Care for Transgender and Gender Non-Conforming People: Best Practices for Front-line Health Care Staff Updated Fall 2016 NATIONAL LGBT HEALTH EDUCATION CENTER A PROGRAM OF THE FENWAY INSTITUTE INTRODUCTION Front-line staff play a key role in creating a health care environment that responds to the needs of trans- gender and gender non-conforming (TGNC) people. Everyone, no matter their gender identity or expres- sion, appreciates friendly and courteous service. In addition, TGNC people have unique needs when in- teracting with the health care system. First and fore- most, many TGNC people experience stigma and dis- crimination in their daily lives, including when seeking health care. In light of past adverse experiences in health care settings, many fear being treated disre- spectfully by health care staff, which can lead them to delay necessary health care services. Additionally, the names that TGNC people use may not match those listed on their health insurance or medical records. Mistakes can easily be made when talking with pa- tients as well as when coding and billing for insurance. Issues and concerns from TGNC patients often arise at the front desk and in waiting areas because those are the first points of contact for most patients. These issues, however, are almost always unintentional and can be prevented by training all staff in some basic principles and strategies. This document was devel- oped as a starting point to help train front-line health care employees to provide affirming services to TGNC patients (and all patients) at their organization. What’s Inside Part 1 Provides background information on TGNC people and their health needs.
    [Show full text]
  • The Paradox of Authenticity: the Depoliticization of Trans Identity
    The Paradox of Authenticity: The Depoliticization of Trans Identity THESIS Presented in Partial Fulfillment of the Requirements for the Degree Master of Arts in the Graduate School of The Ohio State University By Meredith Cecilia Lee Graduate Program in Women's Studies The Ohio State University 2012 Master's Examination Committee: Professor Shannon Winnubst, Advisor Professor Mary Thomas Professor Jian Chen Copyright by Meredith Cecilia Lee 2012 Abstract The language of authenticity that valorizes the mind over the body is embedded in Cartesian dualism, which thereby inspires an entirely personal understanding of self- fulfillment. Within the trans community, this language depoliticizes trans issues by framing nonnormative gender presentation as a personal issue. This paper examines the relationship of Cartesian dualism to the paradoxes of authenticity in trans medico- scientific discourse. For example, to express authenticity and gain social recognition within the medical model of trans identity, an individual must articulate her/his desire within the normative language of the medical establishment; therefore, the quest for authenticity is already foreclosed through the structures of normalization. This paper argues that, while medical procedures typically normalize one’s body to “pass” as the other sex, these procedures are also necessary for many trans individuals to gain social recognition and live a bearable life. The notion that trans individuals are “trapped” in the wrong body has been the dominant paradigm since at least the 1950s. This paper argues that centering gender in the body constructs gender as ahistorical and thereby erases the political, economic, and cultural significance of trans oppression and struggle. This paper concludes that the systematic pathologization of nonnormative sex/gender identification has historically constituted the notion that gender trouble is indeed a personal problem that should be cured through medical science.
    [Show full text]
  • Debating DSM 5 Zowie Davy Phd, Senior Lecturer in C
    Commentary on the construction of Gender Dysphoria at Classifying Sex: Debating DSM 5 Zowie Davy PhD, Senior Lecturer in Community Care, University of Lincoln, UK. Context to the commentary On the American Psychiatric Association’s (APA) website the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5), is promoted as the “most comprehensive, current, and critical resource for clinical practice available to today's mental health clinicians and researchers of all orientations” (American Psychiatric Association, 2012a). The manual is ‘comprehensive,’ indeed; it has grown in size since its first edition to over 900 pages in its current DSM 5 incarnation. We could argue as Farley, the former president of the American Psychological Association, does that the DSM authors are contributing to an increase in “the relentless production of disorders and pathologizing of normal extremes” (Gornall, 2013: no page no.) and the facilitating of mental illnesses. In response to the publication of the DSM‐5, a two‐day conference at the University of Cambridge took place: Classifying Sex: Debating DSM‐5, at which discussants debated the potential impact of the manual’s criteria for pathological, paraphilic and by default ‘normal’ sexualities, gender identities, and psychiatric practice. The delegates considered amongst many other topics the role of power and evidence, at least that is how I understood many of the contributions to the debate. The panel that I was invited to contribute to featured Kenneth Zucker (Chair of the Sexual and Gender Identity Disorders workgroup of DSM‐5) to whom I was to critically respond. In this reflective commentary I would like to focus on power and evidence because Zucker has previously described the DSM’s international influence as spreading from clinical care, clinical training to clinical research (Zucker, 2010b).
    [Show full text]
  • Serving the Health Care Needs of Transgender Students
    From GLBT Campus Matters 1 (October 2005): 7-8. Serving the Health Care Needs of Transgender Students By Brett Genny Beemyn For many transgender students, the three most pressing campus concerns are access to safe and appropriate housing, bathrooms, and health care. While a number of colleges and universities are beginning to address the first two issues, few have considered the physical and mental health concerns of transgender students. The staff members of campus health clinics and counseling centers are often unaware of the needs of transgender students and rarely provide even basic transgender-specific health services. As a result, transgender students frequently report having negative heath care experiences and are forced to turn to off-campus providers (generally at a greater cost) or forgo health care altogether. Counseling Centers For students who are transitioning, college health care services are especially inadequate. The accepted standards of care for transsexual adults require that they receive an initial psychological examination and see a therapist for a period of time before they are prescribed hormones. But at most institutions, including many large universities, campus counseling staff typically lack sufficient training on transgender issues to be able to provide a proper evaluation or short-term, supportive counseling (Beemyn, in press). For example, a 2004 study (McKinney, in press) involving 75 trans-identified students from 61 different colleges and universities found that few of the schools met the mental health needs of transgender students. Only four of the survey respondents felt that the therapists on their campuses were helpful, affirming, and knowledgeable in regard to transgender issues.
    [Show full text]
  • The Patient-Centered Transgender Health Toolkit
    National Organization of Nurse Practitioner Faculties Patient- Centered Transgender Health A Toolkit for Nurse Practitioner Faculty and Clinicians A Work Product from the Sexual and Reproductive Health Special Interest Group 1 Table of Contents Introduction ......................................................................................................................................................... 3 Cultural Humility................................................................................................................................................. 4 Sexual Health History ........................................................................................................................................ 4 Ethical Issues ........................................................................................................................................................ 5 Alignment with NONPF Core Competencies ........................................................................................... 6 Definitions of Terms Used in Caring for Transgender Individuals ...................................................12 Videos on Transgender Care .........................................................................................................................14 Website Resources ...........................................................................................................................................14 Appendix Appendix 1: Resource List ........................................................................................................................16
    [Show full text]
  • Revista-07.Pdf
    AUTORIDADES Dra. Cristina Fernández de Kirchner Presidenta de la Nación Lic. Amado Boudou Vicepresidente de la Nación Cdor. Jorge Milton Capitanich Jefe de Gabinete de Ministros Dra. María Matilde Morales Secretaria Ejecutiva Consejo Nacional de Coordinación de Políticas Sociales Arq. D. Julio De Vido Ministro de Planificación Federal, Inversión Pública y Servicios Dr. Alberto Sileoni Ministro de Educación Dr. Carlos Tomada Ministro de Trabajo, Empleo y Seguridad Social Juan Luis Manzur Ministro de Salud Dra. Da. Alicia Kirchner Ministra de Desarrollo Social Ing. Agr. Carlos Casamiquela Ministro de Agricultura, Ganadería y Pesca Dr. Daniel Reposo Síndico General de la Nación Dr. Eduardo Omar Gallo Síndico General Adjunto Dr. Agustín Carlos A. Tarelli Síndico General Adjunto Revista SIGEN SUMARIO Año 5 / Nº 7 / Noviembre 2014 Staff 02. Editorial Director Dr. Daniel G. Reposo 04. ¿Qué es la Red Federal de Control Público? Subdirectores Dr. Agustín A. Tarelli Dr. Eduardo O. Gallo 09. Breve historia Comité Editorial 13. Fortalezas, Objetivos y Resultados Cr. Marcelo Cainzos Cr. Alejandro Díaz Dra. María Isabel Fimognare 15. Decreto 38 / 2014 Cra. Miriam Lariguet Ing. Fernando Mollo Ing. Arturo Papazián 2014, el año en que el Gobierno Nacional destacó la labor de la Dra. María E. Rodríguez Greno 20. Dr. Agustín Tarelli Red Federal de Control Público Cr. Arturo Zaera 26. El Secretariado Permanente de Tribunales de Cuentas en la Coordinación Periodística Red Federal de Control Público Lic. Jorge Laprovitta Paola Busti 29. El Tribunal de Cuentas de Tucumán en la Red Federal de Paola Abatto Valsamakis Control Público Coordinación de Diseño y 33. Red Federal de Control Público a diez años de su creación Producción Gráfica Roberto Cappa 35.
    [Show full text]
  • Agency of Human Services Medicaid Policy Unit 280 State Drive, Center Building Waterbury, Vermont 05671-1000 July 12, 2019
    State of Vermont For consumer assistance: Department of Financial Regulation [Banking] 888-568-4547 89 Main Street [Insurance] 800-964- 1784 Montpelier, VT 05620-3101 [Securities] 877-550-3907 www.dfr.vermont.gov Agency of Human Services Medicaid Policy Unit 280 State Drive, Center Building Waterbury, Vermont 05671-1000 July 12, 2019 Dear members of the Medicaid Policy Unit: The Vermont Department of Financial Regulation supports proposed rule HCAR 4.238, regarding gender affirmation surgery for the treatment of gender dysphoria. The proposed rule contains important updates to Medicaid coverage requirements for gender affirmation surgery that would help prevent discrimination on the basis of gender identity, increase access to medically necessary services for lower income Vermonters, and protect Vermont’s LGBTQ+ youth. Vermont law prohibits discrimination based on “an individual’s actual or perceived gender identity, or gender-related characteristics intrinsically related to an individual’s gender or gender identity, regardless of the individual’s assigned sex at birth.”1 Proposed rule HCAR 4.238 would update clinical criteria and expand Medicaid coverage of gender affirmation surgery for the treatment of gender dysphoria when medically necessary and developmentally appropriate, including by allowing individuals under age 21 to access to such services. These changes better align not only with Vermont’s anti-discrimination statute, but with DFR’s recent guidance for private insurers regarding medically necessary gender affirmation surgery. On June 12, the Department issued Insurance Bulletin #174, which clarifies that, under existing law, insurance companies, nonprofit hospital and medical services corporations, non-ERISA employer group plans, and managed care organizations shall not exclude coverage for medically necessary gender affirmation surgery for gender dysphoria or deny such coverage on the basis of age.
    [Show full text]
  • Defending the Human Right to Life in Latin America
    Defending the Human Right to Life in Latin America Translated from the Spanish Americans United for Life, Washington, DC 20005 Copyright © 2012 by Americans United for Life All rights reserved First edition published 2012 Published in the United States of America ISBN 978-0-9777204-8-4 Defending the Human Right to Life in Latin America Dr. Charmaine Yoest, President & CEO Editors M. Laura Farfán Bertrán, Lawyer & Project Coordinator William L. Saunders, Senior Vice President & Senior Counsel Jeanneane Maxon, Vice President of External Affairs & Corporate Counsel Translator Noelia Estefanía Marchetti Translated from the Spanish Copyright 2012 by Americans United for Life. All rights reserved under International and Pan-American Copyright Conventions. No part of Defending the Human Right to Life in Latin América may be reproduced or transmitted in any form, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system now known or to be invented, without permission in writing from the publisher, except by a reviewer who wishes to quote brief passages in an article or a review written for inclusion in a magazine, newspaper, or broadcast. For information, please contact: Americans United for Life 655 15th Street NW, Suite 410, Washington, DC 20005, United States of America; 202-289-1478 www.aul.org Table of Contents Introduction – Human Rights and the Right to Life William L. Saunders 11 Overview – Latin America Reaffirms its Commitment to Life M. Laura Farfán Bertrán 15 Legislation Guidelines for Latin America 21 I. General Guidelines to a Constitutional Amendment 21 II. Prohibition of Hormonal “Emergency Contraception” 22 III. Rights Acknowledgement 23 A.
    [Show full text]