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Injustice at Every Turn

The National Center for Transgender Equality (NCTE) and the National Gay and Lesbian Task Force (NGLTF) just released a report on discrimination against trans and gender-noncomforming people, and the results are (predictably) horrifying. The report is based on the largest survey of trans and gender-nonconforming people ever taken in the United States, with 6,450 participants. Among the key findings:

-Survey respondents were nearly four times more likely to live in extreme poverty (household incomes of less than $10,000 per year)
-Respondents of color were especially at risk for discrimination (although discrimination was widely reported by respondents of all backgrounds). African-American trans and gender-nonconforming people reported the most severe discrimination.
-Health care access is a major problem. One in four respondents reported being HIV positive. Nineteen percent reported being refused care because of their trans identities, or non-conforming gender presentation. African-American respondents reported even higher numbers of health care discrimination.
-Survey respondents were twice as likely to be unemployed compared to the population as a whole. Half of respondents reported workplace harassment or mistreatment, and a quarter had been fired because of their gender identity or expression.
-Nineteen percent of respondents reported being refused a home or apartment; 11% reported being evicted from their home because of their gender identity or expression. One in five survey respondents experienced homelessness.
-Twenty-two percent of respondents reported feeling uncomfortable asking law enforcement for assistance.
Forty-one percent of survey respondents reported attempting suicide. Only 1.6% of the general population has reported attempting suicide. The rate of attempted suicide among trans people and gender-nonconforming people is significantly higher even than the attempted suicide rate of people who are diagnosed with chronic depression.

As Nancy Goldstein says in the American Prospect, it’s crucial that this survey even happened in the first place:

Currently most surveys — including the census and epidemiological studies — contain zero questions about sexual orientation, never mind gender identity and expression. The consequences of not being counted, of being invisible, is that no one knows who constitutes the transgender community, what its members experience, or what their challenges or needs are. The many costs to transgender people include the fact that they are allotted little if any funding or resources on the state or federal level. That’s even true of resources spread within an LGB community that often forgets the “T.”

Much of this discrimination, it’s worth noting, is entirely legal. Trans people are routinely left of out anti-discrimination laws that protect citizens from discrimination based on age, gender, race, religion, nationality, etc. And the breadth of problems faced by trans and gender-nonconforming people all tie together: It’s awfully hard to keep a job if you can be legally fired for being trans and if your co-workers routinely harass and discriminate against you; it’s hard to stay above the poverty line if you’re not employed; it’s hard to avoid homelessness if you’re living in extreme poverty and if landlords routinely refuse to rent to you; it’s hard to enforce even existing anti-discrimination laws if you don’t trust the police (and for good reason — twenty-two percent of respondents reported being harassed by law enforcement); it’s hard to stay healthy when health care providers refuse to care for you.

This kind of discrimination, bias and hate kills. Trans and gender-nonconforming people attempt suicide at astounding rates. When health care providers refuse to help, patients die (and trans people have died because doctors and emergency workers didn’t do their jobs). When people are desperate for a place to live and for food to eat, and when above-the-board employers won’t hire them, sometimes the only option is to enter underground economies, which (especially for marginalized populations) can bring with them higher incidences of drug use, higher-risk sexual activity and incarceration — all of which may be factors in higher rates of HIV. And of course, trans and gender non-conforming people aren’t just killed by suicide, poverty, discriminatory medical workers and health issues — they are also sexually and physically assaulted, abused and murdered. Back to Nancy (trigger warning):

There’s a direct link between being able to earn an above-board living, having stable housing, and staying alive. The results of facing continual job discrimination, combined with being refused housing (19 percent) or being evicted (11 percent), and having a nearly 1-in-5 chance of being homeless at some point, are not only painful, stressful, or unhealthy but catastrophic. Those who have been fired due to anti-transgender bias are far more likely to enter the underground economy, where sex work and drug sales expose participants to a range of increased risks, including incarceration and a higher incidence of intravenous drug use and HIV (with rates in the survey at four times the national average). No wonder respondents, when asked to list their policy priorities, threw the biggest numbers (70 percent) behind protection for transgender/gender nonconforming people from discrimination in hiring and at work.

Transgender people often suffer harm from the very systems designed to protect most citizens. Twenty-two percent report being harassed by police, but the problem extends beyond law enforcement. In 1995, D.C. resident Tyra Hunter died from entirely treatable injuries incurred in a car accident. First, the firefighters who arrived at the scene stopped emergency medical treatment once they cut away her clothes to discover male genitalia. (One witness reported hearing a firefighter say, “This bitch ain’t no girl. … It’s a nigger, he got a dick.”) Once they stopped joking around and got her to the emergency room, the doctor refused to treat her. She died there of blunt force trauma and medical negligence. Fifteen years after Hunter’s death, the survey’s numbers still stink: 19 percent of respondents reported being refused care because of their gender identity or expression, with even higher figures for respondents of color. Nearly 3 percent reported being attacked in emergency rooms.

This is despicable. Mainstream American society has created the conditions that harm and sometimes kill trans and gender non-conforming people. Federal bills protecting the most basic human rights of trans people are non-starters. Even “LGBT” groups routinely throw trans rights under the bus to accomplish other parts of their agendas.

Do read the whole report — it’s depressing and heartbreaking, but necessary.


33 thoughts on Injustice at Every Turn

  1. I understand how there is a lack of legislation to protect trans* people in many realms, but I am confused about protection when it comes to medical care. Isn’t it part of the Hippocratic Oath to treat all patients, regardless of their situation?
    “I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.”

    I understand this may not be legally binding, but all doctors swear to do this while they’re in medical school. Under what grounds is it legal to refuse to treat someone when you are an ER doctor? It doesn’t seem like there should be any justification! I hope that “doctor” lost the license to practice medicine. That person has absolutely no business treating patients.

  2. We absolutely need legislation, but we also need to clean house within the movement. Five percent of trans people have experience discrimination in rape crisis centers. Eight percent at DV clinics and shelters. How can feminism be allied with the trans community when the major sources of grassroots outreach actively discriminate against trans people seeking help to recover from physical and sexual abuse?

  3. I hope this is not considered to be derailing the thread, because I want to bring up another country. The topic is related, however.

    In Canada there is currently legislation proposed to include gender identity and gender expression in the Canadian Human Rights Act and hate crimes legislation. This bill, Bill C-389 is coming up for a final vote this Wednesday, February 9th. Opponents of the bill have been organizing a campaign to petition MPs to vote against it.

    There is currently a petition online in support of the bill, here. If any readers are from Canada and wish to support the bill, please consider sending a letter to your MP from the link above.

  4. Kristen J.: How can feminism be allied with the trans community when the major sources of grassroots outreach actively discriminate against trans people seeking help to recover from physical and sexual abuse?

    I’m not a feminist, but even I am aware of the holy war between the transphobic wing of the movement and all the others, and I didn’t have to do a lot of research to see it. This is one of several issues where the movement really has tried to monitor itself and uphold its standards and stated beliefs.

  5. Jim: I’m not a feminist, but even I am aware of the holy war between the transphobic wing of the movement and all the others, and I didn’t have to do a lot of research to see it.

    Yeah, I’m well aware of the beliefs of some assholes. I’m not sure what that has to do with my comment though…

  6. gretel[…]I am confused about protection when it comes to medical care. Isn’t it part of the Hippocratic Oath to treat all patients, regardless of their situation?

    It would be comforting if it were actually applied, but there are many who do not. Documentation of this exists for cases in the US for a long time and it clearly isn’t over yet; as Erin Vaught discovered last summer.

    This was very much on my mind after a close call I had last fall. I was on my motorcycle, driving on a city street, when a vehicle made a left-turn across my lane too close. I can still clearly picture the rear of that car as I passed just inches from it. Afterwards I realized that, had the wreck happened, it’s possible the greatest threat to me could have been from medical care providers and not the crash itself.

  7. Re gretel: In theory yes, but unless you explicitly put in language that protects trans* people and says that refusing to give them full care is not doing their job, some people will figure this case “doesn’t really count.”

  8. Kristen J.: Yeah, I’m well aware of the beliefs of some assholes. I’m not sure what that has to do with my comment though…

    I just got the sense that you were damning feminism for the bad behavior of some adherents. You were really talking about actual services, and that’s a distinction, so yeah, my comment was a little tangential to yours. I just wanted to point out that it has been feminists more than anyone who have championed trans people*, and feminists more than anyone who have called out transphobic feminists.

    * I hope this is the repesctful term.

  9. Jim: I just wanted to point out that it has been feminists more than anyone who have championed trans people*, and feminists more than anyone who have called out transphobic feminists.

    This may be your perception, but I doubt that it is really the case. While not all feminists are aggressively and explicitly anti-trans, a lot of cis feminists are uninformed and/or apathetic to trans issues and perpetuate oppression through inaction and quiet complicity. I would argue that trans people, be they feminist or otherwise, have more than anyone, including cis feminists, championed trans people and called out transphobic feminists.

  10. Jadey: This may be your perception, but I doubt that it is really the case. While not all feminists are aggressively and explicitly anti-trans, a lot of cis feminists are uninformed and/or apathetic to trans issues and perpetuate oppression through inaction and quiet complicity.

    Exactly. Uniformed and apathetic is the also phrase I would use. There are absolutely some feminists who are actively hateful, and I don’t think anything can be done about those assholes. (Although many have tried and those who continue…I wish you luck.) But if this many people are being denied what I consider vital care from rape crisis and DV centers, it seems the movement as a whole is failing miserably to provide necessary services to the most vulnerable population.

  11. Gods, that suicide attempt rate is alarming. Especially given that it only accounts for unsuccessful suicides, so its probably significantly underestimating the actual suicide rate in the trans* community. I can’t think of another demographic thats anywhere near there without going to clinical populations. I’d be curious to know if the LGB community had numbers like this in the 70s or 80s (i.e. could this be a closet/complex trauma effect?). I wish my colleagues served transfolk better…

  12. But if this many people are being denied what I consider vital care from rape crisis and DV centers, it seems the movement as a whole is failing miserably to provide necessary services to the most vulnerable population.

    Its not just the feminist movement. The clinicians who serve in those settings have failed transfolk, too. I was trained at a program that was very serious about diversity competency (one of the major washout points in our program was a course designed to, sometime traumatically, force you to unpack your backpack of privilege and face up to it) and we didn’t even start incorporating trans issues into our curriculum until a few years ago despite having an expert on our faculty. Even then, unless you’re in the psychoanalytic or humanistic concentrations theres a good chance you could still go through an entire doctoral program there without ever having to think about transfolk. Hell, as a profession we still haven’t cast out people like Zucker.

    Theres a lot of failure going around and we aren’t going to do much to fix it unless we start educating and holding one another accountable. One house cleaning isn’t close to enough.

  13. William:
    Theres a lot of failure going around and we aren’t going to do much to fix it unless we start educating and holding one another accountable. One house cleaning isn’t close to enough.  

    Agreed.

  14. Jim: I just wanted to point out that it has been feminists more than anyone who have championed trans people*, and feminists more than anyone who have called out transphobic feminists.

    So says the cis man who knows the experience of trans people better than we do ourselves.

    Look: In the US, there are a *few* feminist blogs and web sites that take this shit seriously (and thank g-d that Feministe is one of them), but IRL, this ain’t the case.

    When the #mooreandme shit went down and it was suggested that people donate to RAINN, it took us trans folk to point out to Sady that RAINN funds rape and DV shelters that refuse services to trans women. RAINN is one of the largest anti-rape/DV orgs out there, and they don’t give a shit about us. And I’ve seen little to no support for trans folk from SAFER or from various Take Back The Night organizations.

    Rape and DV shelters regularly deny services to trans folk (or sometimes offer services to trans men on the belief that their special magical unicorn super-butch women while denying services specifically to trans women because we’re packing heat, dontcha know).

    Planned Parenthood is almost universally transphobic. I know a *cis* woman who got fired from the Philadelphia, PA PP because she was too butch.

    As far as NOW (Nat’l Org of Women) is concerned, we still don’t exist.

    I was very lucky that after I was raped, I was able to get counseling from the Philadelphia Women Organized Against Rape, but even then they would not permit me to be part of a women’s support group; they only offered me individual counseling. This only happened because our local LGBT health clinic actually gives a shit about the ‘T’, including trans *women*, and referred survivors of rape/SA to other, more accepting agencies, until WOAR got it through their head that they had to do something.

    Oh, and Bitch Mag once carried an article by Julia Serrano. OOOooooh.

  15. gretel: I understand how there is a lack of legislation to protect trans* people in many realms, but I am confused about protection when it comes to medical care. Isn’t it part of the Hippocratic Oath to treat all patients, regardless of their situation?
    “I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.”I understand this may not be legally binding, but all doctors swear to do this while they’re in medical school. Under what grounds is it legal to refuse to treat someone when you are an ER doctor? It doesn’t seem like there should be any justification! I hope that “doctor” lost the license to practice medicine. That person has absolutely no business treating patients.  

    See William@12. The problem is systematic, not a case of bad apples.

  16. I was very lucky that after I was raped, I was able to get counseling from the Philadelphia Women Organized Against Rape, but even then they would not permit me to be part of a women’s support group; they only offered me individual counseling.

    There could (not saying there is) be a good clinical reason behind that decision. Groups can get unsafe very quickly, especially when theres trauma involved and someone gets tagged as “other.” One of the big reasons I don’t like group therapy is that for it to work it has to have some element of exclusion, especially once you begin to drill down on the goals and scope of the group. Groups also tend to be run by students or lower-level professionals which reduces the chance that a facilitator is going to be able to recognize when things are getting unsafe or be able to manage it.

    Or…they could be staffed by assholes who didn’t think about any of that.

  17. William: There could (not saying there is) be a good clinical reason behind that decision. Groups can get unsafe very quickly, especially when theres trauma involved and someone gets tagged as “other.”

    I believe this was their rationale, and I didn’t challenge it, because I did not want to become a target of other women’s fears and if that had happened, it would have interfered with their treatment as well as mine. So even though the situation sucked, it was more important to me that it did not become a source for further trauma for *everybody* involved; hence, I did not push the issue.

    William: Groups also tend to be run by students or lower-level professionals which reduces the chance that a facilitator is going to be able to recognize when things are getting unsafe or be able to manage it.

    The groups were run by women with MSWs, the same ones that did individual counseling.

    You’re probably right about the dynamics of group therapy being difficult to manage; my experiences with group therapy were less than stellar.

  18. William: Or…they could be staffed by assholes who didn’t think about any of that.

    No, I don’t think they were staffed by assholes. A new ED had come on board shortly before I started going there; the previous ED had been very hostile to trans folk (as in, Mary Daly-level of hostility), but the new ED seems to be trying to set a new tone / policy, and they were still finding their sea legs, so to speak.

  19. I keep writing and rewriting my comments. In short, I want to punch every douchebag who others or discriminates against trans* people in the face. This entire post is heart breaking.

  20. GallingGalla: Look: In the US, there are a *few* feminist blogs and web sites that take this shit seriously (and thank g-d that Feministe is one of them), but IRL, this ain’t the case.

    Point taken. But I stiill ask – who has done more than the little feminists have done? Gay and lesbian groups have not exactly been eager advocates. So says the gay man. I’m glad that your local LGBT group was decent when you needed help; it’s not universal.

    GallingGalla: So says the cis man who knows the experience of trans people better than we do ourselves.

    Not only that, but a cis guy who has a lot less experience with feminist organizations than you have!

    I appreciate the whole comment. I am now not quite as uninformed as I was. Thanks for taking the trouble.

  21. Jim: But I stiill ask – who has done more than the little feminists have done?

    Jadey: I would argue that trans people, be they feminist or otherwise, have more than anyone, including cis feminists, championed trans people and called out transphobic feminists.

  22. Point taken. But I stiill ask – who has done more than the little feminists have done? Gay and lesbian groups have not exactly been eager advocates. So says the gay man. I’m glad that your local LGBT group was decent when you needed help; it’s not universal.

    Some feminists and feminist groups have done good work on trans issues. But that’s largely been because of the work of trans feminist activists. And trans rights activists have also done amazing work outside of feminist activism. So yes, some feminist work has been done, but that’s because of trans folks (“feminist” and “trans” are not totally totally separate identities for lots of people, after all).

    Or, what Jadey said.

  23. Thanks all of you. Especially that last bit groggette, where you quote Jadey. And here you caught a failure to communicate clearly – I meant who other than the people directly affected has done more, and I should have said that if I meant that. Of course gay people to fight most for our own rights, and the same is probably going to be true for every other group. That’s the supposition I was working from, and it fouled me up. Never mind; the point is that GG and you both have given me a lot of information. Thanks again

  24. Honestly I feel vindicated by this report. I’ve been fortunate in some ways and not so much in others, but finding medical care is an ongoing battle, especially since I’ve had a lot of bad reactions to the hormones and not even my endo who’s treated a lot of transpeople knows what’s going on. I’ve been sent to a lot of secondary doctors to check out various symptoms, and it’s the same conversation each time; I get asked what medication I’m on, then confusion as to why I’d be taking estrogen, and then a question as to whether the side effects I’m experiencing are typical. I don’t expect doctors to have any knowledge about trans issues, and so far not a single doctor has surprised me.

    I finally found a full time job. Soon I’ll be able to move out of an abusive situation. Things are looking up but I keep having the same nightmares; what if I get fired? I’m a highschool dropout (long story involving abusive parents). What if I can’t find someone who will rent to me? What if I get evicted? What if I end up with a neighbor who doesn’t like how effeminate I look? What if I get injured and have to gamble that the ER staff are enlightened? I have no sense of security at all even though my actual position isn’t terrible, it’s like I’m just one catastrophe away from hell.

    Sorry for dumping all this here. I just get no sympathy in real life when I tell people about what transpeople have to go through. Even the people who accept me as trans either think I’m being paranoid (because they’re clueless why other people might have an issue with transpeople when they don’t) or just shake their head and ask me why I’m putting myself in this position!

    I’m going to print out this report and shake it in the face of everyone who ever said that to me.

  25. Jim: But I stiill ask – who has done more than the little feminists have done?

    Dude.

    Look, I’ve got plenty of critique for mainstream feminism, but this snide little phrasing here? Is just fucking not on. And if you meant to imply that this is what I think of feminism, you’re wrong. I’m angry with mainstream feminism because I think that mainstream feminists are thinking, intelligent people who are capable of taking criticism and critique into consideration and making a better movement. I’ve seen that process happening here, so you can just quit it with the misogynist “little feminist” characterizations.

  26. @ GG

    The phrasing was unclear, but I think Jim might have meant the “little amount that feminists have done”, and not an epithet of feminists being little.

    (Unless I have totally misinterpreted your comment, in which case I’m sorry.)

  27. GallingGalla:
    So says the cis man who knows the experience of trans people better than we do ourselves.Look: In the US, there are a *few* feminist blogs and web sites that take this shit seriously (and thank g-d that Feministe is one of them), but IRL, this ain’t the case.When the #mooreandme shit went down and it was suggested that people donate to RAINN, it took us trans folk to point out to Sady that RAINN funds rape and DV shelters that refuse services to trans women.RAINN is one of the largest anti-rape/DV orgs out there, and they don’t give a shit about us.And I’ve seen little to no support for trans folk from SAFER or from various Take Back The Night organizations.Rape and DV shelters regularly deny services to trans folk (or sometimes offer services to trans men on the belief that their special magical unicorn super-butch women while denying services specifically to trans women because we’re packing heat, dontcha know).Planned Parenthood is almost universally transphobic.I know a *cis* woman who got fired from the Philadelphia, PA PP because she was too butch.As far as NOW (Nat’l Org of Women) is concerned, we still don’t exist.I was very lucky that after I was raped, I was able to get counseling from the Philadelphia Women Organized Against Rape, but even then they would not permit me to be part of a women’s support group; they only offered me individual counseling.This only happened because our local LGBT health clinic actually gives a shit about the ‘T’, including trans *women*, and referred survivors of rape/SA to other, more accepting agencies, until WOAR got it through their head that they had to do something.Oh, and Bitch Mag once carried an article by Julia Serrano.OOOooooh.  

    GallingGalla:
    So says the cis man who knows the experience of trans people better than we do ourselves.Look: In the US, there are a *few* feminist blogs and web sites that take this shit seriously (and thank g-d that Feministe is one of them), but IRL, this ain’t the case.When the #mooreandme shit went down and it was suggested that people donate to RAINN, it took us trans folk to point out to Sady that RAINN funds rape and DV shelters that refuse services to trans women.RAINN is one of the largest anti-rape/DV orgs out there, and they don’t give a shit about us.And I’ve seen little to no support for trans folk from SAFER or from various Take Back The Night organizations.Rape and DV shelters regularly deny services to trans folk (or sometimes offer services to trans men on the belief that their special magical unicorn super-butch women while denying services specifically to trans women because we’re packing heat, dontcha know).Planned Parenthood is almost universally transphobic.I know a *cis* woman who got fired from the Philadelphia, PA PP because she was too butch.As far as NOW (Nat’l Org of Women) is concerned, we still don’t exist.I was very lucky that after I was raped, I was able to get counseling from the Philadelphia Women Organized Against Rape, but even then they would not permit me to be part of a women’s support group; they only offered me individual counseling.This only happened because our local LGBT health clinic actually gives a shit about the ‘T’, including trans *women*, and referred survivors of rape/SA to other, more accepting agencies, until WOAR got it through their head that they had to do something.Oh, and Bitch Mag once carried an article by Julia Serrano.OOOooooh.  

    GallingGalla:
    When the #mooreandme shit went down and it was suggested that people donate to RAINN, it took us trans folk to point out to Sady that RAINN funds rape and DV shelters that refuse services to trans women.

    Is that because the alternative is not funding those shelters at all? Are there other, more trans-friendly shelters which exist, but get ignored by RAINN? Is the problem really with RAINN, or the fact that we live in a society where is acceptable to set up services which exclude trans* people?

  28. I understand how there is a lack of legislation to protect trans* people in many realms, but I am confused about protection when it comes to medical care. Isn’t it part of the Hippocratic Oath to treat all patients, regardless of their situation?

    Aww, that’s touching.

    It is impressive how many doctors will say, “I don’t treat people like you.” Honestly, my hormone replacement is a cakewalk. If I was legal to prescribe for myself and could order the blood tests, I could oversee my own testosterone therapy, it’s fourth grade math and a little guesswork. Any internist or GP can do it. But trans people get sent to specialists, endocrinologists, who, being specialists, cost more than the family doctor who’s perfectly content to handle diabetes, or hypothyroidism, which are a little more complicated than HRT for me. Or hormone replacement for cis people who’ve lost their gonads, which is the same.

    When I changed doctors it took me about four months to find one who would treat people like me, with the exception of the one who specializes in treating trans people and who’s staff treated me like shit on the phone and demanded that I give them a letter from my psychotherapist, in spite of the fact that I had already completed my transition and just needed a prescriber for maintainence. I needed a letter from my shrink for this doctor to be willing to continue a stable, proven regimen that allowed me, for the first time in my life to be well, and my previous doctor’s records of that fact would not do.

    I now go to the clinic for the very poor. My doc is a GP. He does fine. I like him. He treats me like a human being. Most of his other patients are homeless. I go there because the clinic’s mission statement doesn’t say it’s “for the poor” but for “people who experience barriers in accessing health care” and I sure as hell qualify.

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