How Canada and the U.S. Can Improve Transgender Health Care Rights
viewing list of my medications, Dr. asks why I’m on estrogen. I tell him I’m transgender. He asks “which direction?” WTF? #TransHealthFail
— Julia Serano (@JuliaSerano) July 30, 2015
It’s political season both in the USA and here in Canada. The US has an election on November 8th 2016; here in Canada we have an election on October 19th 2015 (a 78-day election campaign; it’s our longest election campaign ever.) In celebration of politics running rampant like two frisky rabbits in springtime, let’s get political and talk about health care!
With a title that runs right off the tongue, USC 18116 is an amendment (RIN 0945-AA02) to the Affordable Care Act (ACA) which was first entered law back in 2011. That’s the most complex sentence in this, so it’s an easier ride from here in. This change to ACA has been described as a ‘no-frills non-discrimination health care amendment‘. Sounds worthwhile and simple, right? It’s waiting for Obama to enact it and it’s been there a lot longer than the expected 90 days. It’s been almost five years; the amendment was proposed back in 2011.
This change would mean that US health care providers cannot discriminate on basis of race, color, national origin, sex, age, and disability. It’s damned important and great in so many ways; I’m choosing to focus on how this would impact transgender healthcare. Thanks to the recent Twitter hashtag, #transhealthfail, transgender medical care is currently getting talked about widely for probably the first time.
Women’s health includes transgender women’s health. I hope other feminist public figures will stand with me on that. #transhealthfail
— Brianna Wu (@Spacekatgal) July 30, 2015
The term ‘Sex’ in the ACA has been defined in law to include gender identity, and this has been upheld in the case of Rumble Vs Fairview Health Services. This was a case where Fairview Health Services wanted to say that trans people weren’t included under the ACA law, which they thought made it OK to provide transgender people with substandard healthcare, mocking them, misgendering them and causing them to eventually be admitted into emergency medical care. The law disagreed with Fairview’s opinion in the same way that the Aang disagreed with the Fire Nation.
Went to ER with heart issue, told them I’m trans + take T, accused me of ‘roiding’, had to explain what #trans means #TransHealthFail
— Leo Caldwell (@Leo_Caldwell) July 30, 2015
While this interpretation of the law is great and shows that there is hope for medical non-discrimination for transgender patients, it sadly hasn’t set a legal precedent. This is interpretation in a single case in local law, which allows for challenges and differing interpretations in other cases. So other medical firms in the future may try this all over again in a more sympathetic courtroom; possibly one recently furnished new luxury leather via health care business expenditure.
“I don’t know how to treat a transgender.” “… I’m here about joint pain I’ve had since before starting HRT?” #transhealthfail
— literal bag of ducks (@duckinator) July 30, 2015
Not having laws that explicitly cover transgender people is an ongoing problem, as politicians and lawmakers don’t want to spend the time and effort to create laws that specifically cover transgender people. They are in the habit of citing existing laws that might-just-possibly-maybe cover transgender rights. Laws that can only be applied after long and expensive court cases have sided with a transgender plaintiff, which doesn’t exactly happen often. We have the same issue here in Canada as in the USA.
I am #VanProud. So great to see my city embrace equality and trans human rights! pic.twitter.com/LqcAM3AQHA
— S Chandra Herbert (@SChandraHerbert) July 27, 2015
In Vancouver Pride this year the focus was on transgender rights, and everyone taking part in the parade had to sign a transgender rights pledge. The political parties had to pledge that they were going to introduce changes to the Canadian Human Rights Code to include transgender Canadians. Both the Conservatives, the right wing party of hopefully outgoing vampire Prime Minister Harper and The Liberals, who are slightly left of the Conservatives by a cats whisker, were barred from taking part in the parade. The NDP are left of Liberals politically and the shadow party here in BC and currently highest in polls overall in Canada and the Green Party both had representatives in the Vancouver pride parade.
Nurse:”When was your last period?” Me:”Never. I’m Transgender.” Nurse:”You really fooled me! I thought you were a woman.” #transhealthfail
— Julie Rei Goldstein (@JulieRei) July 30, 2015
I’m not specifically covered by the Human Rights Code of Canada unlike other Canadian citizens; politicians have claimed I am, but a court case would need to prove it. In Canada we’re left with a patchwork system where it has been left to the Provinces and Territories (think US states, or UK counties) to recognise the problem and act individually: Saskatchewan, Manitoba, Ontario, Prince Edward Island, Nova Scotia, Newfoundland & Labrador all created local laws to cover trans citizens. Where I live, British Columbia, has refused to do so.
Seeking urgent help from my GP at St. Jude Medical Center only to be told she couldn’t. Pointing to cross over doorway. #transhealthfail
— Ms. Anne Edwardz (@AnneEdwardz) August 7, 2015
The Liberals, who are currently in office here in British Columbia, claim I’m covered by the BC Human Rights Code, they went as far to say that they don’t believe transgender protections need to be entrenched in law. I’m not sure what they think they should be entrenched in. I think they are hoping for clouds or perhaps sand on a beach just before high tide. Personally I’d like to see it branded on the Tyrannosaurus and Velociraptor from the end of Jurassic World. Then they could high five and argue together for trans rights.
My first counselor said I should enjoy my own pre-op chest if I “enjoy playing with women’s breasts in sex.” #transhealthfail
— Ira D. Sanchez (@IraSanchezLGBT) August 6, 2015
Instead of letting transgender people suffer and have to fight in court over and over again, how about enacting non-discrimination laws like the ones that have languished in the USA for nearly five years? Why do transgender people need to prove that we deserve to be treated with dignity and respect in court? Why do we need to fight to receive health care without getting mocked, derided, dismissed and mistreated to the point where we then require emergency treatment? This whole situation needs fixing.
Not telling any medical professional that I’m trans because their attitude instantly changes for the worst when I do. #transhealthfail
— Spookyline (@marcyjcook) July 30, 2015
It’s the political season, please don’t forget equal rights as the politicians try and tell you the only things that matter are taxes and military security.
This piece is from an idea by Emily Prince, you can follow her on Twitter.
Marcy (@marcyjcook) is an immigrant trans woman and writer. This includes Transcanuck.com, a website dedicated to informing and helping trans Canadians. She also has a nerd job, too many cats, is a part time volunteer sex educator and has an ongoing sordid love affair with Lego. Those last two are not related… probably.
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