{"id":13636,"date":"2024-09-05T00:00:46","date_gmt":"2024-09-05T04:00:46","guid":{"rendered":"https:\/\/munciepostdemocrat.com\/?p=13636"},"modified":"2025-08-30T14:12:41","modified_gmt":"2025-08-30T18:12:41","slug":"answers-to-trans-healthcare-are-universal","status":"publish","type":"post","link":"https:\/\/munciepostdemocrat.com\/index.php\/2024\/09\/05\/answers-to-trans-healthcare-are-universal\/","title":{"rendered":"Trans Healthcare Impacts All Healthcare\u200b"},"content":{"rendered":"\t\t
\n\t\t\t\t
\n\t\t
\n\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t

Trans Healthcare Impacts All Healthcare<\/span><\/font><\/span><\/h2><\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

9.5.2024 \/ Essay \/ Daisy Dale<\/u><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

One way or another, most of us live with a strong compulsion not to seek help in our healthcare system. We are discouraged from seeking treatment unless it falls under what we deem the most urgent of problems, and that only limits what we consider to even be urgent.\u00a0<\/span><\/span>That happens whether it be for shame over our conditions or fear of learning what we don\u2019t already know, and god forbid how to even handle the financial burden.\u00a0<\/span>When any one of us has to deal with a serious health scare, we don\u2019t get to ask our providers how we can feel great or better than before, but instead we\u2019re only compelled to ask for the bare minimum to survive.\u00a0<\/span>Without being able to even think about the idea of asking for more, we aren’t able to collectively make serious healthcare demands because of it.<\/span><\/p>

I sat with this idea almost without question before transitioning. I don’t remember ever having regular check ups<\/span><\/span>, which I now have at least quarterly if not monthly<\/span>. With how it’s working for me today thanks mainly to hormone therapy, it’s not only to tweak and make add-ons but for the sake of knowing that my changing hormones are sufficient enough to prevent a heart condition.\u00a0<\/span><\/span>I started this process at 22, and it was the first time I realized navigating healthcare would no longer be just for the most rare occasion that I deem an emergency, but something in my life that I would have to take charge of in order to use to my advantage.<\/span><\/p>

Last week I was tasked with preparing an introduction to our trans healthcare panel hosted at Kennedy Library, and of course the major topics we knew we needed to cover had to do with the GOP’s moral panic. That panic manifests into “religious freedom” to allow doctors not to treat us, or the genocidal claims that transness is a social contagion, and of course the myths surrounding care for trans youth. And while I covered this to the best of my ability, I’m downright exhausted from having to even consider refuting the latest talking points. I just want free healthcare! I don’t feel like I should have to feel any shame if I get diagnosed with cancer and can’t afford it. C<\/span><\/span>hances are most of our readership has already come to the conclusion that our system outright sucks despite better alternatives, but I’ll just tag here a quote from single-payer advocate Timothy Faust in 2019:<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

“There is a school of thought that lays the blame for healthcare costs at the feet of the people who need healthcare. (They seek it “irresponsibly,” we’re told.) This is a callous argument advanced by smart people whose livelihoods depend on them pretending not to know better.<\/p>

To the patient–even to the overly prepared patient, with PDFs of insurance plans and WebMD printouts at hand–American healthcare is a vast and incomprehensible maze, obscene in design and fatal in consequence. Its every navigation–will there be an open clinic? Will my insurance cover this? For the services for which my insurance will inevitably skimp, can I afford the cost?–requires a small mystery of faith.”1<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

When I try making this connection, I don’t mean for this as a plea to our cisgender counterparts for permitting rights to a marginalized group.\u00a0<\/span><\/span>It’s about opening people to a new way of understanding trans politics, and those whom we’re persuading in this case matters for a broader landscape of long overdue change.\u00a0<\/span>And so what many of us in the trans community are calling for isn\u2019t just for rights over our own autonomy, justifiably, but to rethink how healthcare in general is thought of.<\/span><\/p>

This shouldn’t even really be a surprise, but it unfortunately is when the things we want aren’t even accurately told to begin with. It is true that we definitely have a strong focus on respect, dignity, and affirmation when it comes to how our providers communicate with us, but this is only a baseline. Training in the healthcare industry along the lines of preferred pronouns and gender identity can vary greatly and isn’t as widespread as what’s propagated by conservative advocacy groups.\u00a0I’ve mentioned before<\/a><\/span>\u00a0that I first received hormone treatment in Bloomington, always touted as a progressive city home to a lucrative IU campus. But many would be surprised to hear that o<\/span><\/span>ne in six trans individual in the U.S. live in rural areas<\/span>,<\/span><\/span>2<\/span>\u00a0where providers with LGBTQ+ training are few and far.\u00a0<\/span><\/span>Too often, family doctors avoid prescribing hormone treatment if they lack knowledge or experience on gender-affirming care. To combat this, there needs to be widespread, mandatory education for healthcare providers on how to treat individuals seeking gender-affirming care.<\/span><\/p>

By that same ethos, we want to be listened to both as individual patients at our appointments and by medical researchers publishing desperately needed work. When this isn’t done, many trans individuals are led to taking the Do-It-Yourself approach.\u00a0<\/span>It’s not as if we like playing doctor with our hormones or want to fall for misinformation, but often times we seek insight from within the community, and this means what we find is largely online. With so little research in transgender medicine, it can feel as if even anecdotal experiences can beat the outdated journal articles from ten years ago or what’s not been published. A benefit to this at least is that it can mean achieving grassroots knowledge.<\/span><\/p>

As of now for instance, it’s common for doctors to prescribe Spironolactone as a way to suppress androgens, which for transfemmes specifically can mean testosterone. Some of the concerns over Spiro are exaggerated, for instance the chances of it causing blood clots that so many are worried about is the same chance a cis woman would get from using birth control, but there are still other valid concerns: not only do the side effects include your usual brain fog, anxiety, and tiredness that many prescription drugs have, but surprisingly it can mean inadequate suppression of testosterone and poor breast development<\/span>,<\/span><\/span>3<\/span>\u00a0<\/span><\/span>the last side effects\u00a0<\/span><\/span>a trans woman\u00a0<\/span>would expect from their hormone regimen.<\/span><\/p>

Providers have caught onto this, and I know my current provider brought this up at least once, but in the case that a trans individual might bring this up it’s not always guaranteed they’ll be taken seriously. That can happen to any individual with any chronic issues, who despite having lived experience with\u00a0a given condition might have fear over seeking treatment, fueling mistrust among patients. This in part comes down to the fact that providers are stretched thin and pushed to have the shortest appointments they can to get as many patients in as possible, brought to you by an overwhelmed system that could be fixed if it didn’t have such an obscene profit motive.<\/span><\/p>

Brief appointments, months apart and nearly impossible to schedule for any sooner, discourage us from desiring more out of healthcare. “Bare minimum” will be said a few times in this article,\u00a0<\/span>but it’s important to emphasize that treatment should go far past this. I briefly touched on this in my essay “Trans Rights As Class Struggle<\/a><\/span>,” and since then I’ve had the chance to read the Zena Sharman book “The Care We Dream Of: Liberatory and Transformative Approaches to LGBTQ+ Health” that raises the question not only of what it would be like if healthcare was not deeply overwhelmed, but if the prospect of seeking healthcare was an enjoyable or pleasurable process. One of Sharman’s interviewees in the book Dawn Serra had this to say about inviting this idea into the industry:<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

“I’m also interested in how we can bring pleasure into places that have historically been painful. For so many people, especially trans, nonbinary, and queer folks, and other people who experience marginalization, asking for help has led to policing, institutionalization, rejection of resources, loss of access, and harm. When I think about pleasure and health, I think about more opportunities for vitality and arriving exactly as we are, regardless of what we’re going through and how our body looks, and also being able to experience more support and validation when we do ask for help.<\/span><\/p>

So often the bar in health care is to eliminate pain. I understand the importance of this–pain is debilitating for many people, and our health system isn’t well equipped to care for people who experience chronic pain. At the same time, I’m interested in growing our capacity to ask questions that position pleasure as the baseline. Pleasure is often treated as a nice-to-have when, really, it’s essential. It’s crucial. It’s what makes this life something we want to continue showing up for.”<\/span>4<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

“I’m also interested in how we can bring pleasure into places that have historically been painful. For so many people, especially trans, nonbinary, and queer folks, and other people who experience marginalization, asking for help has led to policing, institutionalization, rejection of resources, loss of access, and harm. When I think about pleasure and health, I think about more opportunities for vitality and arriving exactly as we are, regardless of what we’re going through and how our body looks, and also being able to experience more support and validation when we do ask for help.<\/span><\/p>

So often the bar in health care is to eliminate pain. I understand the importance of this–pain is debilitating for many people, and our health system isn’t well equipped to care for people who experience chronic pain. At the same time, I’m interested in growing our capacity to ask questions that position pleasure as the baseline. Pleasure is often treated as a nice-to-have when, really, it’s essential. It’s crucial. It’s what makes this life something we want to continue showing up for.”<\/span>4<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

“Elimination” or “cure” don’t always apply where management and treatment do. Whether it be chronic pain or gender dysphoria,\u00a0<\/span>it’s more holistic than any cure for us that many doctors picture<\/span>. In my transition I’ve almost never thought of the idea of what “fully” transitioning means, and I think that’s allowed me to think of my foreseeable treatment not as what’s been propagated to me (“damage” to my biology) but as a valid part of me.\u00a0<\/span>For us in the trans community, we see the care system as something that should go beyond that bare minimum solution or that often arbitrary idea of a cure, and instead have more potential for exploring identity in our case, or putting pleasure at the baseline. Pleasure, defined here not as sexual or erotic but broadly speaking as joy, should be a default in our care system or else we can’t think past that massive profit motive. Sharman writes:<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

“Many people live, suffer, and sometimes die inside the harm and violence of ‘it’s just the way things are.’ This taken-for-grantedness can also limit our ability to imagine what kinds of change might be necessary or desirable to create a health system capable of meeting LGBTQ+ people’s needs. To change a system, we need to be able to perceive it.”<\/span>5<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

“Many people live, suffer, and sometimes die inside the harm and violence of ‘it’s just the way things are.’ This taken-for-grantedness can also limit our ability to imagine what kinds of change might be necessary or desirable to create a health system capable of meeting LGBTQ+ people’s needs. To change a system, we need to be able to perceive it.”<\/span>5<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

Being able to perceive change, I like to think, explains why we advocate for the recognition of our identities by our doctors, because…well, why not honestly? But also, as one activist wrote: “if you don’t have words for something, it’s hard to do or imagine it’s possible,”<\/span>6<\/span>\u00a0so why shouldn’t we be able to talk to providers who are educated on gender and sexuality? There shouldn’t be stigma around such topics, especially sexuality with regards to trans individuals (particularly trans women).\u00a0<\/span>Advocacy for better knowledge and treatment of LGBTQ+ issues in the care industry fundamentally rethinks what a broader working class can get out of an unpredictable and insanely hard to navigate system.\u00a0<\/span>Often because of this label that the trans community receives as being overprivileged, or “coddled, bourgeoisie, and anti-working class” as trans writer Shon Faye wrote<\/span>,<\/span>7<\/span>\u00a0trans politics gets dismissed from having anything to do with long overdue economic reforms that would apply universally.<\/span><\/p>

Treatment that is affirming and comfortable is compromised thanks to the monstrosities affecting the care industry that are privatization, austerity, and neoliberalism. When the industry is as\u00a0<\/span><\/span>squeezed thin and\u00a0<\/span>commodified as it’s become, there’s no ability to guarantee that the experience will at the very least be worthwhile for the costs, or that your safety and autonomy won’t be at risk.\u00a0<\/span>For cultivating curiosity of what care can mean for you, it’s not only what providers can do for comfort or safety, but what a system without such a dreadful profit motive can accomplish. We\u00a0<\/span>don’t want anyone to have to feel limited with medical care or to have to prove their conditions through the most rigorous, hyperrational diagnostic approaches.<\/span><\/p>

This is also why privatization should be the real enemy to trans care. Let’s say, for instance, that the moral panic we’re in today, one that’s desperately shifting its focus between bathrooms, sports, and healthcare for trans youth (which we addressed in our recent panel last weekend<\/a><\/span>), is done away with. That means nothing if the care we receive doesn’t fall under a gender dysphoria diagnosis and is instead all considered cosmetic. A big part of why this isn’t the case today is thanks to a 2014 ruling by the Obama administration, removing a decades long ban on Medicare coverage of transgender surgery<\/span><\/span>,<\/span>7<\/span>\u00a0<\/span>which wouldn’t take much to be reversed by a new administration.\u00a0<\/span><\/span>While there are mixed feelings within the community on how gender dysphoria should be defined and whether a diagnosis is necessary, the reality is we currently need this for the sake of having affirming surgeries at least in the public option of Medicare.<\/span><\/p>

And, this is a reason why Medicare needs to be at the forefront when we connect gender-affirming care with economic change. People working in the care industry can be of the same mindset, and encourage patients to think more broadly about what they want, but this means very little for patients and providers alike if everyone is seen as a medical price tag. Single-payer is absolutely needed for this, and\u00a0<\/span>that’s not “pie in the sky” as many critics in their infinite wisdom suggest. The same amount of federal dollars that could be spent on the financial mechanism is already being spent moreover on national healthcare expenditures that subsidize corporations<\/span>.<\/span>9<\/span>\u00a0It’s also the same legacy of New Deal liberalism from the ’30s that advocated for security, opportunity, and industrial democracy in the United States.<\/span>9<\/span>\u00a0There is at the same time a learning lesson from that timeframe, and that is to envision workers’ rights more broadly to the care economy. It has grown significantly in recent decades, practically replacing manufacturing jobs lost from deindustrialization, but also presents an inability for union organizing and collective bargaining in the same period. Gender has a role in this, because whatever could be accomplished in the blue-collar, male dominated manufacturing sector could not be in this pink-collar, largely considered “<\/span>effeminate”<\/span><\/span>\u00a0industry that was degraded in such a way that upheld a social hierarchy.<\/span>11<\/span>\u00a0<\/span>This shouldn’t lead to a dismissal of New Deal liberalism, but it’s another example of how social and economic issues are tied together.<\/span><\/p>

We know we need federal dollars, fewer barriers preventing medical access, and to finally put people over profits in our system. Another solution until then, as Alex Geiger mentioned at our panel, is community care: reaching out to your local community organizations and to each other. As well as mutual aid, both of which tie into that grassroots knowledge we have historically held onto. We do need to stay in the mindset of expanding care to push against the Right’s moral panic over our existence, a panic closely tied to their obsession to privatize all healthcare, but in the case that these demands are years away, I want us to be tight-knit. I want us to share resources when all else fails. Yes it’s best to have a plan for when the time’s right to move out of your hometown when it isn’t safe, but we also know we shouldn’t have to get pushed out to begin with.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t
\n\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
\n\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tFacebook<\/span>\n\t\t\t\t\t\t<\/path><\/svg>\t\t\t\t\t<\/a>\n\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tInstagram<\/span>\n\t\t\t\t\t\t<\/path><\/svg>\t\t\t\t\t<\/a>\n\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tYoutube<\/span>\n\t\t\t\t\t\t<\/path><\/svg>\t\t\t\t\t<\/a>\n\t\t\t\t<\/span>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
\n\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t

Notes:<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

1.\u00a0Faust, Timothy.\u00a0Health Justice Now: Single-payer and What Comes Next<\/em>. (Melville House Publishing, 2019)\u00a0<\/span>pg. 38.<\/span><\/p>

2.\u00a0<\/span>https:\/\/www.lgbtmap.org\/file\/Rural-Trans-Report-Nov2019.pdf<\/span><\/p>

3.\u00a0<\/span>https:\/\/moderntranshormones.com\/2018\/01\/01\/whats-wrong-with-spironolactone\/;\u00a0<\/span>https:\/\/drzphd.com\/trans-feminine-blog-1\/spiro<\/span><\/p>

4. Sharman, Zena.\u00a0<\/span>The\u00a0<\/i><\/span>Care We Dream Of: Liberatory and Transformative Approaches to LGBTQ+ Health<\/i>\u00a0(Arsenal Pulp Press. 2021) pg. 61.<\/span><\/p>

5. Sharman,<\/span>\u00a0pg. 95.<\/span><\/p>

6. Sharman, pg. 81.<\/span><\/p>

7.\u00a0<\/span>Faye, Shon.<\/span>\u00a0<\/span>The Transgender Issue<\/i>. (Penguin Books. 2021) pg.\u00a0119.<\/span><\/span><\/p>

8.\u00a0<\/span>https:\/\/www.washingtonpost.com\/national\/health-science\/ban-lifted-on-medicare-coverage-for-sex-change-surgery\/2014\/05\/30\/28bcd122-e818-11e3-a86b-362fd5443d19_story.html<\/span><\/p>

9.\u00a0<\/span>Gerstle, Gary. \u201cThe Protean Character of American Liberalism.\u201d\u00a0<\/span>The American Historical Review<\/i>\u00a099, no. 4 (1994): 1043\u201373. https:\/\/doi.org\/10.2307\/2168769.\u00a0<\/span>Gerstle, pg. 1044.<\/span><\/p>

10. Faust,\u00a0<\/span>pg. 83.<\/span><\/p>

11. Winart, Gabriel.\u00a0The Next Shift<\/em>. (Harvard University Press, 2023) pg. 16-19.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

One way or another, most of us live with a strong compulsion not to seek help in our healthcare system. We are discouraged from seeking treatment unless it falls under what we deem the most urgent of problems, and that only limits what we consider to even be urgent.\u00a0<\/span><\/span>That happens whether it be for shame over our conditions or fear of learning what we don\u2019t already know, and god forbid how to even handle the financial burden.\u00a0<\/span>When any one of us has to deal with a serious health scare, we don\u2019t get to ask our providers how we can feel great or better than before, but instead we\u2019re only compelled to ask for the bare minimum to survive.\u00a0<\/span>Without being able to even think about the idea of asking for more, we aren’t able to collectively make serious healthcare demands because of it.<\/span><\/p>

I sat with this idea almost without question before transitioning. I don’t remember ever having regular check ups<\/span><\/span>, which I now have at least quarterly if not monthly<\/span>. With how it’s working for me today thanks mainly to hormone therapy, it’s not only to tweak and make add-ons but for the sake of knowing that my changing hormones are sufficient enough to prevent a heart condition.\u00a0<\/span><\/span>I started this process at 22, and it was the first time I realized navigating healthcare would no longer be just for the most rare occasion that I deem an emergency, but something in my life that I would have to take charge of in order to use to my advantage.<\/span><\/p>

Last week I was tasked with preparing an introduction to our trans healthcare panel hosted at Kennedy Library, and of course the major topics we knew we needed to cover had to do with the GOP’s moral panic. That panic manifests into “religious freedom” to allow doctors not to treat us, or the genocidal claims that transness is a social contagion, and of course the myths surrounding care for trans youth. And while I covered this to the best of my ability, I’m downright exhausted from having to even consider refuting the latest talking points. I just want free healthcare! I don’t feel like I should have to feel any shame if I get diagnosed with cancer and can’t afford it. C<\/span><\/span>hances are most of our readership has already come to the conclusion that our system outright sucks despite better alternatives, but I’ll just tag here a quote from single-payer advocate Timothy Faust in 2019:<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t\t
\n\t\t
\n\t\t\t\t<\/div>\n\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

“There is a school of thought that lays the blame for healthcare costs at the feet of the people who need healthcare. (They seek it “irresponsibly,” we’re told.) This is a callous argument advanced by smart people whose livelihoods depend on them pretending not to know better.<\/p>

To the patient–even to the overly prepared patient, with PDFs of insurance plans and WebMD printouts at hand–American healthcare is a vast and incomprehensible maze, obscene in design and fatal in consequence. Its every navigation–will there be an open clinic? Will my insurance cover this? For the services for which my insurance will inevitably skimp, can I afford the cost?–requires a small mystery of faith.”1<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
\n\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

When I try making this connection, I don’t mean for this as a plea to our cisgender counterparts for permitting rights to a marginalized group.\u00a0<\/span><\/span>It’s about opening people to a new way of understanding trans politics, and those whom we’re persuading in this case matters for a broader landscape of long overdue change.\u00a0<\/span>And so what many of us in the trans community are calling for isn\u2019t just for rights over our own autonomy, justifiably, but to rethink how healthcare in general is thought of.<\/span><\/p>

This shouldn’t even really be a surprise, but it unfortunately is when the things we want aren’t even accurately told to begin with. It is true that we definitely have a strong focus on respect, dignity, and affirmation when it comes to how our providers communicate with us, but this is only a baseline. Training in the healthcare industry along the lines of preferred pronouns and gender identity can vary greatly and isn’t as widespread as what’s propagated by conservative advocacy groups. I’ve mentioned before<\/a><\/span> that I first received hormone treatment in Bloomington, always touted as a progressive city home to a lucrative IU campus. But many would be surprised to hear that o<\/span><\/span>ne in six trans individual in the U.S. live in rural areas<\/span>,<\/span><\/span>2<\/span>\u00a0where providers with LGBTQ+ training are few and far.\u00a0<\/span><\/span>Too often, family doctors avoid prescribing hormone treatment if they lack knowledge or experience on gender-affirming care. To combat this, there needs to be widespread, mandatory education for healthcare providers on how to treat individuals seeking gender-affirming care.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

By that same ethos, we want to be listened to both as individual patients at our appointments and by medical researchers publishing desperately needed work. When this isn’t done, many trans individuals are led to taking the Do-It-Yourself approach.\u00a0<\/span>It’s not as if we like playing doctor with our hormones or want to fall for misinformation, but often times we seek insight from within the community, and this means what we find is largely online. With so little research in transgender medicine, it can feel as if even anecdotal experiences can beat the outdated journal articles from ten years ago or what’s not been published. A benefit to this at least is that it can mean achieving grassroots knowledge.<\/span><\/p>

As of now for instance, it’s common for doctors to prescribe Spironolactone as a way to suppress androgens, which for transfemmes specifically can mean testosterone. Some of the concerns over Spiro are exaggerated, for instance the chances of it causing blood clots that so many are worried about is the same chance a cis woman would get from using birth control, but there are still other valid concerns: not only do the side effects include your usual brain fog, anxiety, and tiredness that many prescription drugs have, but surprisingly it can mean inadequate suppression of testosterone and poor breast development<\/span>,<\/span><\/span>3<\/span>\u00a0<\/span><\/span>the last side effects\u00a0<\/span><\/span>a trans woman\u00a0<\/span>would expect from their hormone regimen.<\/span><\/p>

Providers have caught onto this, and I know my current provider brought this up at least once, but in the case that a trans individual might bring this up it’s not always guaranteed they’ll be taken seriously. That can happen to any individual with any chronic issues, who despite having lived experience with\u00a0a given condition might have fear over seeking treatment, fueling mistrust among patients. This in part comes down to the fact that providers are stretched thin and pushed to have the shortest appointments they can to get as many patients in as possible, brought to you by an overwhelmed system that could be fixed if it didn’t have such an obscene profit motive.<\/span><\/p>

Brief appointments, months apart and nearly impossible to schedule for any sooner, discourage us from desiring more out of healthcare. “Bare minimum” will be said a few times in this article,\u00a0<\/span>but it’s important to emphasize that treatment should go far past this. I briefly touched on this in my essay “Trans Rights As Class Struggle<\/a><\/span>,” and since then I’ve had the chance to read the Zena Sharman book “The Care We Dream Of: Liberatory and Transformative Approaches to LGBTQ+ Health” that raises the question not only of what it would be like if healthcare was not deeply overwhelmed, but if the prospect of seeking healthcare was an enjoyable or pleasurable process. One of Sharman’s interviewees in the book Dawn Serra had this to say about inviting this idea into the industry:<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t\t
\n\t\t
\n\t\t\t\t<\/div>\n\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

“I’m also interested in how we can bring pleasure into places that have historically been painful. For so many people, especially trans, nonbinary, and queer folks, and other people who experience marginalization, asking for help has led to policing, institutionalization, rejection of resources, loss of access, and harm. When I think about pleasure and health, I think about more opportunities for vitality and arriving exactly as we are, regardless of what we’re going through and how our body looks, and also being able to experience more support and validation when we do ask for help.<\/span><\/p>\n

So often the bar in health care is to eliminate pain. I understand the importance of this–pain is debilitating for many people, and our health system isn’t well equipped to care for people who experience chronic pain. At the same time, I’m interested in growing our capacity to ask questions that position pleasure as the baseline. Pleasure is often treated as a nice-to-have when, really, it’s essential. It’s crucial. It’s what makes this life something we want to continue showing up for.”<\/span>4<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
\n\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

“Elimination” or “cure” don’t always apply where management and treatment do. Whether it be chronic pain or gender dysphoria,\u00a0<\/span>it’s more holistic than any cure for us that many doctors picture<\/span>. In my transition I’ve almost never thought of the idea of what “fully” transitioning means, and I think that’s allowed me to think of my foreseeable treatment not as what’s been propagated to me (“damage” to my biology) but as a valid part of me.\u00a0<\/span>For us in the trans community, we see the care system as something that should go beyond that bare minimum solution or that often arbitrary idea of a cure, and instead have more potential for exploring identity in our case, or putting pleasure at the baseline. Pleasure, defined here not as sexual or erotic but broadly speaking as joy, should be a default in our care system or else we can’t think past that massive profit motive. Sharman writes:<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t\t
\n\t\t
\n\t\t\t\t<\/div>\n\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

“Many people live, suffer, and sometimes die inside the harm and violence of ‘it’s just the way things are.’ This taken-for-grantedness can also limit our ability to imagine what kinds of change might be necessary or desirable to create a health system capable of meeting LGBTQ+ people’s needs. To change a system, we need to be able to perceive it.”<\/span>5<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
\n\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

Being able to perceive change, I like to think, explains why we advocate for the recognition of our identities by our doctors, because…well, why not honestly? But also, as one activist wrote: “if you don’t have words for something, it’s hard to do or imagine it’s possible,”<\/span>6<\/span> so why shouldn’t we be able to talk to providers who are educated on gender and sexuality? There shouldn’t be stigma around such topics, especially sexuality with regards to trans individuals (particularly trans women). <\/span>Advocacy for better knowledge and treatment of LGBTQ+ issues in the care industry fundamentally rethinks what a broader working class can get out of an unpredictable and insanely hard to navigate system. <\/span>Often because of this label that the trans community receives as being overprivileged, or “coddled, bourgeoisie, and anti-working class” as trans writer Shon Faye wrote<\/span>,<\/span>7<\/span> trans politics gets dismissed from having anything to do with long overdue economic reforms that would apply universally.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

Treatment that is affirming and comfortable is compromised thanks to the monstrosities affecting the care industry that are privatization, austerity, and neoliberalism. When the industry is as <\/span><\/span>squeezed thin and <\/span>commodified as it’s become, there’s no ability to guarantee that the experience will at the very least be worthwhile for the costs, or that your safety and autonomy won’t be at risk. <\/span>For cultivating curiosity of what care can mean for you, it’s not only what providers can do for comfort or safety, but what a system without such a dreadful profit motive can accomplish. We <\/span>don’t want anyone to have to feel limited with medical care or to have to prove their conditions through the most rigorous, hyperrational diagnostic approaches.<\/span><\/p>\n

This is also why privatization should be the real enemy to trans care. Let’s say, for instance, that the moral panic we’re in today, one that’s desperately shifting its focus between bathrooms, sports, and healthcare for trans youth (which we addressed in our recent panel last weekend<\/a><\/span>), is done away with. That means nothing if the care we receive doesn’t fall under a gender dysphoria diagnosis and is instead all considered cosmetic. A big part of why this isn’t the case today is thanks to a 2014 ruling by the Obama administration, removing a decades long ban on Medicare coverage of transgender surgery<\/span><\/span>,<\/span>7<\/span> <\/span>which wouldn’t take much to be reversed by a new administration. <\/span><\/span>While there are mixed feelings within the community on how gender dysphoria should be defined and whether a diagnosis is necessary, the reality is we currently need this for the sake of having affirming surgeries at least in the public option of Medicare.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

And, this is a reason why Medicare needs to be at the forefront when we connect gender-affirming care with economic change. People working in the care industry can be of the same mindset, and encourage patients to think more broadly about what they want, but this means very little for patients and providers alike if everyone is seen as a medical price tag. Single-payer is absolutely needed for this, and\u00a0<\/span>that’s not “pie in the sky” as many critics in their infinite wisdom suggest. The same amount of federal dollars that could be spent on the financial mechanism is already being spent moreover on national healthcare expenditures that subsidize corporations<\/span>.<\/span>9<\/span>\u00a0It’s also the same legacy of New Deal liberalism from the ’30s that advocated for security, opportunity, and industrial democracy in the United States.<\/span>9<\/span>\u00a0There is at the same time a learning lesson from that timeframe, and that is to envision workers’ rights more broadly to the care economy. It has grown significantly in recent decades, practically replacing manufacturing jobs lost from deindustrialization, but also presents an inability for union organizing and collective bargaining in the same period. Gender has a role in this, because whatever could be accomplished in the blue-collar, male dominated manufacturing sector could not be in this pink-collar, largely considered “<\/span>effeminate”<\/span><\/span>\u00a0industry that was degraded in such a way that upheld a social hierarchy.<\/span>11<\/span>\u00a0<\/span>This shouldn’t lead to a dismissal of New Deal liberalism, but it’s another example of how social and economic issues are tied together.<\/span><\/p>

We know we need federal dollars, fewer barriers preventing medical access, and to finally put people over profits in our system. Another solution until then, as Alex Geiger mentioned at our panel, is community care: reaching out to your local community organizations and to each other. As well as mutual aid, both of which tie into that grassroots knowledge we have historically held onto. We do need to stay in the mindset of expanding care to push against the Right’s moral panic over our existence, a panic closely tied to their obsession to privatize all healthcare, but in the case that these demands are years away, I want us to be tight-knit. I want us to share resources when all else fails. Yes it’s best to have a plan for when the time’s right to move out of your hometown when it isn’t safe, but we also know we shouldn’t have to get pushed out to begin with.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t\t
\n\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t

Notes:<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

1.\u00a0Faust, Timothy.\u00a0Health Justice Now: Single-payer and What Comes Next<\/em>. (Melville House Publishing, 2019)\u00a0<\/span>pg. 38.<\/span><\/p>

2.\u00a0<\/span>https:\/\/www.lgbtmap.org\/file\/Rural-Trans-Report-Nov2019.pdf<\/span><\/p>

3.\u00a0<\/span>https:\/\/moderntranshormones.com\/2018\/01\/01\/whats-wrong-with-spironolactone\/;\u00a0<\/span>https:\/\/drzphd.com\/trans-feminine-blog-1\/spiro<\/span><\/p>

4. Sharman, Zena. <\/span>The\u00a0<\/i><\/span>Care We Dream Of: Liberatory and Transformative Approaches to LGBTQ+ Health<\/i>\u00a0(Arsenal Pulp Press. 2021) pg. 61.<\/span><\/p>

5. Sharman,<\/span>\u00a0pg. 95.<\/span><\/p>

6. Sharman, pg. 81.<\/span><\/p>

7. <\/span>Faye, Shon.<\/span>\u00a0<\/span>The Transgender Issue<\/i>. (Penguin Books. 2021) pg. 119.<\/span><\/span><\/p>

8.\u00a0<\/span>https:\/\/www.washingtonpost.com\/national\/health-science\/ban-lifted-on-medicare-coverage-for-sex-change-surgery\/2014\/05\/30\/28bcd122-e818-11e3-a86b-362fd5443d19_story.html<\/span><\/p>

9.\u00a0<\/span>Gerstle, Gary. \u201cThe Protean Character of American Liberalism.\u201d\u00a0<\/span>The American Historical Review<\/i>\u00a099, no. 4 (1994): 1043\u201373. https:\/\/doi.org\/10.2307\/2168769.\u00a0<\/span>Gerstle, pg. 1044.<\/span><\/p>

10. Faust, <\/span>pg. 83.<\/span><\/p>

11. Winart, Gabriel. The Next Shift<\/em>. (Harvard University Press, 2023) pg. 16-19.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Trans Healthcare Impacts All Healthcare 9.5.2024 \/ Essay \/ Daisy Dale One way or another, most of us live with a strong compulsion not to seek help in our healthcare […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"elementor_header_footer","format":"standard","meta":{"_eb_attr":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[20],"tags":[],"class_list":["post-13636","post","type-post","status-publish","format-standard","hentry","category-opinion"],"_links":{"self":[{"href":"https:\/\/munciepostdemocrat.com\/index.php\/wp-json\/wp\/v2\/posts\/13636","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/munciepostdemocrat.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/munciepostdemocrat.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/munciepostdemocrat.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/munciepostdemocrat.com\/index.php\/wp-json\/wp\/v2\/comments?post=13636"}],"version-history":[{"count":860,"href":"https:\/\/munciepostdemocrat.com\/index.php\/wp-json\/wp\/v2\/posts\/13636\/revisions"}],"predecessor-version":[{"id":26787,"href":"https:\/\/munciepostdemocrat.com\/index.php\/wp-json\/wp\/v2\/posts\/13636\/revisions\/26787"}],"wp:attachment":[{"href":"https:\/\/munciepostdemocrat.com\/index.php\/wp-json\/wp\/v2\/media?parent=13636"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/munciepostdemocrat.com\/index.php\/wp-json\/wp\/v2\/categories?post=13636"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/munciepostdemocrat.com\/index.php\/wp-json\/wp\/v2\/tags?post=13636"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}