Because of the importance of the issues and my respect for the people and organizations involved, I want to put up full follow-up post to my earlier request for answers and support around the New Orleans Women’s Health Clinic and whether or not trans women can access health care there. Thanks to several readers — especially tghi, who has been a champion the important complexities in this situation — for calling the updates to our attention.
So it turns out that nobody can get health care at the New Orleans Women’s Health Clinic, because they are currently lacking a medical director and have been forced to suspend their programs. I’m sure this represents a terrible drop in services for a lot of women in the area, not just trans women. Queen Emily has posted NOWHC’s response to her questions about getting health care there. The key answer seems to be that the clinic has had difficulty finding medical staff who will serve trans women (among many other oppressed and marginalized populations of women) without stigma, without pathologizing. They haven’t been able to find a medical director (and possibly other medical personnel?) who can accept NOWHC’s priorities without acting like treating all women’s bodies, regardless of age and ability and body type and trans status and a dozen other factors, creates an untenable “risk” or “liability.”
This is really unfortunate and unfortunately common — treating trans women, for instance, is often treated as “too dangerous” by health care providers, or labeled as something “they don’t have the necessary expertise in” even though the vast majority of trans women’s health care is identical to any other woman’s. This happens to many other women as well, and is a very common and often insurmountable barrier to finding health care. It’s happened to me, and probably to most trans women at some point or other. It’s happened to other trans people as well, which is part of why I still wonder why “trans people who were assigned male at birth” were a particular problem for NOWHC, but not trans men or other trans & gender non-conforming people who were female-assigned.
This can be a horribly thorny issue for any social-justice-motivated health care provider. I know that there are community clinics in many areas that keep trying to provide health care even though their staff is not as well-trained in trans-affirmative health care as they should ideally be. Heck, where I live a whole lot of trans people get health care at clinics where they are still occasionally mispronouned or where they encounter transphobia. It’s better than nothing, but it’s not necessarily the right way; it also hurts and creates barriers.
NOWHC faces tremendous challenges and overwhelming odds in trying to be fully responsible, in an economically devastated area where so many people are left without health care, and probably with resources that I can’t imagine are anywhere near sufficient. So I really admire their statement of devotion to doing it right, and providing health care for all the kinds of bodies, and women of different experiences, that they list. I also am glad that NOWHC has made it clear that the policy as worded on their website (currently down, for understandable reasons) did not accurately represent their real policy and goals, or fully explain the struggles going on.
Like I said in my earlier post, I hope that there is some way that online communities that have become aware of these dilemmas can actually help provide support and assistance to NOWHC. That’s in part because of how clear it is to me that their services are badly needed, and partly because I am personally incredibly grateful to their parent organization, INCITE! for years of hard work, analysis, and tools that have Support from the online world might be impossible at this point because of the way this issue blew up across many blogs. Given the volatile, reactive, semi-informed nature of the blogosphere, I respect NOWHC’s right not to get involved or take support from these online spaces.
After all, like I originally said, the people most affected by this particular issue are women trying to find health care “on the ground” in New Orleans, especially women who are marginalized and stigmatized to a degree where it’s hard to find respectful, affirming, sufficient health care. That includes trans women, of course, especially trans women of color and low-income trans women. And all of those people have a right to speak out, make their voices and needs heard. But the bottom line is, NOBODY is getting health care at this clinic right now. I really hope that NOWHC gets what it needs to get back up and running, and I’m willing to put out more calls for support if they do ask, or if there is a way that makes sense. It’s worth a conversation. If you want to start right now, I know that one way might be to donate to INCITE! — which in my experience is certainly a worthy cause.
Several of the bloggers involved in publicizing this story have given more thoughts or apologies:
Emily: http://questioningtransphobia.wordpress.com/2009/06/30/clarificatio/
bfp: http://flipfloppingjoy.com/2009/06/30/1412/ (and follow-up open letters 1 2 3)
belledame: http://fetchmemyaxe.blogspot.com/2009/06/i-also-want-to-apologize.html
I also want to apologize for further fanning the flames by calling more attention onto this issue — which ideally, by Emily’s account, could have been handled more productively through waiting longer for a response. I tried, in my original post, to express my hope and admiration for INCITE! and their local chapters and organizing projects at the same time as I joined the general (and ongoing, neverending) frustration and anger at the exclusion of trans women from vital services. But bringing another spotlight to shine on a complex, problematic situation doesn’t necessarily help.
I also wanted to say a few words about anger. It’s nothing new for the blogosphere — anger erupts, there are reactions to it, more anger flies back and forth. There have been regrets and apologies about how all of these feelings played out, while on the ground in New Orleans a whole lot of women are getting no health care at all. Online spaces, all mad up of ideas and words and feelings, can easily feel out of control when those mental energies swirl around — rapid, reactive, bursting up and dying down. And it’s probably true that blogs are better at dealing with and putting a stop to something like Tranny-Alert.com than with trying to improve the way a WOC organizing project provides health care to local women in a hard-hit region of the country. A lot of that has to do with anger, and how anger is and isn’t productive.
Here’s what I really want to say: all oppressed peoples have a right to anger. A right to express anger, and be heard. Sisters, your anger over oppression is justified — as women, as people of color, as trans women, as the disenfranchised, as immigrants — when you see yet another door slamming in your face as it has so many times before. I don’t ever want to label that anger as wrong. It’s important to me that this blog continue struggling to be a place where that anger can be expressed and heard. We’re not just trying to be Nice Feminists, after all, even though there’s a time and a place for niceness. Not everyone can hear it and really listen to anger, not all the time. But hearing, listening, and understanding the anger of marginalized and stomped-upon peoples can sometimes be a critically important teaching about privilege, for privileged people. Including me — I certainly enjoy plenty of privileges.
I was talking about anger last night with my girlfriend. We both have a lot of anger, about many different things — unaccountable, white, privileged faux-feminist dudes, Zionists, transphobic comedians, people who insist on “taking care of” the poor faux-feminist dudes — and we’ve both dealt with temper problems. She pointed out that whether anger is “right” or “wrong” is a very different question from the tactical question of whether anger worked well in any given situation. This may sound obvious to some of you, but it’s a very important point to me.
Anger — especially the anger that arises from having privilege denied to you, of being othered and discriminated against and excluded from basic needs — does not deserve to be invalidated. It’s often hard to recognize that when we encounter anger and have a whole host of our own feelings in response — not feeling trusted, guilt, responsibility, shock, confusion. So it can be hard to separate these things out, but it’s important. Sometimes even the most valid anger can end up being a bad idea purely for the reason that it doesn’t help us get to a better place and build real, transformative change. That doesn’t make it wrong, and that makes it all the more important that we have places to express it, hear it, share it, channel it into the next good idea.