December 17, 2014
“A divided federal appeals court in Boston on Tuesday overturned a lower court’s ruling that a transgender Massachusetts prison inmate, convicted of committing a domestic murder, was entitled to taxpayer-funded sex change surgery.
The ruling by the First US Circuit Court of Appeals came after a 2012 ruling by US District Judge Mark Wolf, who ordered the surgery after finding that the state’s failure to provide it violated the inmate’s Eighth Amendment protection against cruel and unusual punishment.
In January, a three-judge panel of the appeals court upheld Wolf’s 2012 decision, but the state of Massachusetts then asked for an en banc, or full bench, review, which led to Tuesday’s ruling.
The ruling came in the case of Michelle Kosilek, who was born Robert Kosilek. Kosilek is serving a life sentence for killing her wife, Cheryl Kosilek, in 1990.
The court ruled 3-2, with Judges O. Rogeriee Thompson and William J. Kayatta Jr. filing separate dissenting opinions..
“We are faced with the question whether the [state Department of Correction’s] choice of a particular medical treatment is constitutionally inadequate,” the court said in the majority opinion.
“After carefully considering the community standard of medical care, the adequacy of the provided treatment, and the valid security concerns articulated by the DOC, we conclude that the district court erred and that the care provided to Kosilek by the DOC does not violate the Eighth Amendment,” said the opinion, which was written by Judge Juan R. Torruella.
Kosilek and the DOC — under successive administrations, both Democratic and Republican — have battled in the courts for decades over what medical treatment, clothing, makeup should be provided to deal with Kosilek’s gender identity disorder.
Wolf ruled in 2012 that the only medically appropriate treatment for Kosiliek’s condition was the surgery, which would be paid for by the state since Kosilek is a state prison inmate.
But the appeals court ruled Tuesday that Wolf had wrongly substituted his own judgment for the medical professionals, who did not unanimously endorse the surgery as the only appropriate solution for the condition that all sides acknowledged contributed to a depressed mental state and suicide attempts by Kosilek.
Wolf also went too far by “circumvent[ing] the deference owed to prison administrators’’ under federal laws when the issue is the safety of prison inmates, Torruella wrote.
“The prison administrators in this case have decades of combined experience in the management of penological institutions, and it is they, not the court, who are best situated to determine what security concerns will arise,’’ Torruella wrote.
The ruling said the DOC made a valid argument when it expressed concern about the safety of Kosilek and women prisoners he potentially could be housed with once the surgery was done.
“The DOC’s security report reflected that significant concerns would also arise from housing a formerly male inmate — with a criminal history of extreme violence against a female domestic partner — within a female prison population containing high numbers of domestic violence survivors,’’ Torruella wrote.
In a statement, Public Safety Secretary Andrea Cabral said the DOC accepts as true that Kosilek suffers from gender identity disorder diagnosis, and added that was not the issue that the latest round of Kosilek litigation was resolved by the courts on Tuesday.
“The First Circuit Court of Appeals ruled that the medical and mental health care provided to Kosilek by the DOC did not violate the Eighth Amendment of the U.S. Constituion,’’ Cabral said in the statement.
“While we acknowledge the legitimacy of a gender identity disorder diagnosis, DOC’s appeal was based on the lower court’s significant expansion of the standard for what constitutes adequate care under the Eighth Amendment, and on substantial safety and security concerns regarding Ms. Kosilek’s post-surgery needs,’’ Cabral said in the statement.”
Read more at the link.
[Bolding by me- GM]
Read the court decision here [PDF]: http://media.ca1.uscourts.gov/pdf.opinions/12-2194P2-01A.pdf
Read more about Kosilek HERE.
November 11, 2014
We’ve all seen the television shows and news reports on “Transgender Children”. They all state that “Nothing permanent is being done to children before the age of consent! Oh gosh no!”
Here’s a typical example of this rhetoric from yesterday’s Irish Examiner:
“Young children don’t need treatment yet,” explains Lacey. “They can make a social transition at home and at school. But older children may need hormone suppressors to delay puberty for a while. This gives them and their families breathing space to decide what’s best for the future.”
Hormone suppressors ((known as anti-androgens) delay the development of breasts, facial hair and other secondary sex characteristics. Males who identify as female take anti-androgens to block testosterone while females identifying as male take anti-androgens to block oestrogen.
“These suppressors are 100% reversible,” says Lacey. “Young people resume puberty if they stop taking them.”
The article continues:
“Prescribing cross-sex hormones is taken more seriously than hormone blockers. Teenagers must have socially transitioned and be aged over 16 to qualify.
“We have to be sure it’s the right thing to do,” explains Dr Brinkmann. “Cross-sex hormones have irreversible effects on fertility. There’s no going back.”
Guidelines from various pro-gender lobbying and medical groups back up this claim. The Endocrine Society states that no child under the age of sixteen should ever be administered cross-sex hormones by physicians under “parental consent” for the purpose of physically disguising the reproductive sex of the child to promote gender conformity. Even WPATH, the powerful pharmaceutical-industry funded transgender lobbying group acknowledges that decades of research show the majority of children who claim a “cross-sex identity” do not mature into transgender adults if left untreated, and in fact many grow up to be well-adjusted lesbian and gay adults. WPATH also states that children under sixteen should not be given cross-sex hormones which cause permanent changes (including sterilization). None of the “transgender children” clinics in the Netherlands, which pioneered the practice, have ever administered cross-sex hormones to children under sixteen. In the UK, parents who desire to have their children placed on puberty blockers (which paralyze the pituitary gland) must meet strict guidelines and be entered into a government research protocol. Cross-sex hormones are not administered prior to the age of sixteen. In Australia, a court order is required to provide “blockers” in an attempt to formalize oversight of these practices and protect children from abuse.
In the United States, however, it is coming to light that “transgender children” physicians, (that is, the doctors who have been championing and pioneering this practice without oversight), have been “going rogue” since the very start, ignoring all research and guidelines and pushing the limits of what the human bodies of these gender-nonconforming children are medically able to endure.
Last month, in a program specifically addressed to medical students, Dr. Johanna Olson, director of the LA Children’s Hospital transgender children clinic, admitted that she has been “skipping the blockers” and placing children as young as twelve directly on cross-sex hormones, starting with her very first patient. Read the rest of this entry »
November 1, 2014
Insurers struggle to justify the sex discrimination of legally mandated “transgender care” while surgical providers continue to decline
October 30, 2014
Less than 50 physicians worldwide are willing to provide transgender surgical “sex reassignment” or “sex change” procedures, and as the few existing practitioners retire, no one is replacing them. Modern cosmetic and reconstructive surgeons at large are opting not to do these procedures, even when they are state mandated and funded.
Now, insurers are struggling to fulfill state mandates covering transgender surgical procedures for men that are excluded for women based on sex discrimination. Transgender state medical mandates pushed by lobbyists insist that procedures such as breast implants and “face lifts” are medically necessary for men who wish to look more like women, while denying coverage for those same procedures to actual women. Transgender advocates have successfully lobbied for such government provided “care” on the grounds that without such procedures men may become depressed or abuse alcohol or other substances, and that such men have a state-protected right to avoid being mocked or socially ostracized for their appearance. Males must declare a “transgender identity” to receive coverage.
From the Boston Herald:
Four months after the state Division of Insurance put health plans on notice that denying medically necessary treatment to transgender people is prohibited sex discrimination, insurers are still grappling with what constitutes medical necessity, and patients are struggling to find doctors who’ll treat them.
“We were concerned people were having to go all over the country for this surgery,” Dr. Joel Rubenstein of Harvard Pilgrim Health Care said yesterday at a Division of Insurance informational session. “We’re hopeful somebody would step up to put together the surgical piece so it could all be in one place.”
On the other hand, he said, Harvard Pilgrim does not want to approve procedures such as facial feminization for transgender people if those procedures would be considered merely cosmetic for other people.
But Ruben Hopwood of Fenway Health said facial feminization is not about wanting a “cuter nose.” A transgender person’s appearance is more likely to be the difference between getting a job or not getting one, and walking down the street unafraid or being attacked, Hopwood said.
Getting the proper treatment also can save money that might otherwise be spent on treatment for alcohol or substance abuse or depression, said Pam Klein, a nurse at Boston Health Care for the Homeless.
[bolding by me-GM]
September 8, 2014
In the UK, Children as young as three years of age are now being admitted to state medical clinics for “corrective treatment” of sex-role noncompliance, with the aim of upholding social norms of gender and to prevent the development of “visibly transgendered” adults. Such treatments involve administration of drugs which halt normal child development (“Puberty Blockers”) followed by the lifetime administration of cross-sex hormones, resulting in sterilization. In the US, the first federally-funded state eugenics program in over thirty years will be launched in Oregon on October 1, 2014, specifically targeting pre-pubertal children deemed by parents and providers to be “transgender”. Surgeons now routinely perform complete “Sexual Reassignment Surgeries”: removing the genitals and reproductive systems of children as young as sixteen.
The following are excerpts from an interview featured in this month’s issue of LGBT Health Journal, discussing the “Current Practice and Future Possibilities” of sterilized transgender children:
“Dr. Eyler: So there are treatments for trans adults who want to become parents. Would the two of you like to discuss the needs of transgender youth, particularly children who may not complete pubertal development in the natal sex, and possibilities for future fertility for them?
Dr. Pang: My experience has been only with postpubertal individuals. The youngest transgender person whom I have treated was 22 years old, so I do not have any experience with children who are either early postpubertal or prepubertal. I think that more transgender young people are becoming interested in potentially being parents. Last year, I was contacted by the mother of a transgender teenager, a 15-year-old transgender son. Her son is interested in fertility preservation; they had questions so I explained to them what it would involve. The technologies that I have to offer are useful only for postpubertal youth, such as someone his age, but I am sure that you, Anderson, might have ideas about how to help prepubertal children.
Dr. Clark: In the trans community, more and more trans youth are being treated at younger ages, such as at Dr. Norman Spack’s clinic at Children’s Hospital in Boston. Some gender variant children are treated with puberty suspending medications, GnRH analogs, similar to the treatment of children who are experiencing precocious puberty. This keeps them from going through the full puberty of the birth sex, spares them from developing secondary sex characteristics that are misaligned with their psychological gender, and gives them some time to mature.
Dr. Eyler: Cognitively and emotionally.
Dr. Clark: Yes, to be able to decide, when they get older, whether they want to medically transition. Some gender variant children are not actually transsexual or transgender as such, and will eventually decide to stop treatment and experience the puberty of the birth sex. Others, with the support of their parents and clinical team, find that they need cross-sex hormone treatments to proceed with the puberty that is aligned with their gender.
The Endocrine Society Guidelines1 support puberty-suppressing treatment beginning as early as Tanner (sexual maturity rating) stage 2, so this can precede significant hormonal and sexual development. Some adolescents, therefore, don’t develop the ability to produce viable gametes (eggs and sperm). Adolescent trans girls may lose fertility from estrogen treatment, even if they developed the ability to produce sperm before this was started. When they reach the age of majority, trans youth may also proceed with gender-affirming surgery that includes removal of the gonads.
For children and young adolescents, it is often the parents who are thinking about future reproductive capacity, because they would like the possibility of grandchildren, and because they are looking after the future interests of their children. When I speak at community conferences, they often come to ask about reproductive options for their children.
Dr. Eyler: Yes, and as a biologist, you are prepared to discuss the significance of the gametes not maturing and what future reproduction might involve.
Dr. Clark: Yes. The most applicable research has been performed on behalf of children who are treated for cancer and are rendered infertile. The Society for the Preservation of Fertility focuses on the needs of both postpubertal and prepubertal youth who may experience sterility from cancer treatments.
Organization Intersex International: Transgender people using “brain sex” theories damage the Intersex community’s ability to organize
July 26, 2014
By Morgan Carpenter, new Director of Organization Intersex International Australia:
Intersex, brain differences, and the transgender tipping point
5 June 2014.
Over a decade ago, intersex and trans activist Raven Kaldera wrote that trans people seeking classification as intersex might be seeking legitimisation, as if a physical cause is necessary to obtain social or familial validation. He said that trans people using brain sex theories to claim intersex status were basing a political stance on unproven science and damaging the intersex community’s ability to organise.
We might hope that times have changed, with the amazing Laverne Cox appearing on the cover of Time magazine, as it declares The Transgender Tipping Point. This is great news (also, we can’t wait for the next series of Orange is the New Black) but, sadly, a high proportion of enquiries that we get at OII Australia, a national intersex organisation, are still from trans folk seeking biological validation for their identity.
Intersex is a term for innate physical differences in sex characteristics, known controversially to medicine as “Disorders of Sex Development” and historically as hermaphroditism. At least 30 or 40 genetic differences causing intersex traits are known to science. Intersex is not defined as a gender identity. Intersex people have all sorts of gender identities, just like trans and other people. Some intersex people have non-binary gender identities, just like some trans people, but most intersex people are men or women.
Correlations between brain sex differences and same sex attraction in men, and trans gender identities in women, have been widely reported over a long period of time – yet there’s still controversy even regarding the notion that men and women have different brains. Given the known biological basis of many intersex variations, much of the research on causes of homosexuality has been carried out on live foetuses and infants with intersex traits.
Late last year, a neuroscience study inspired headlines proclaiming, “hardwired difference between male and female brains could explain why men are “better at map reading” (And why women are “better at remembering a conversation”)”. Cordelia Fine writing at The Conversation shows how the reporting and the study itself, of nearly 1,000 people, inflated very modest differences into something “tediously predictable“. In reality:
In an larger earlier study … the same research team compellingly demonstrated that the sex differences in the psychological skills they measured – executive control, memory, reasoning, spatial processing, sensorimotor skills, and social cognition – are almost all trivially small…
the social phenomenon of gender means that a person’s biological sex has a significant impact on the experiences (including social, material, physical, and mental) she or he encounters which will, in turn, leave neurological traces.
The more research that is conducted, the more clear is the evidence that brains are plastic. Differences are often over-stated, especially where results fit social preconceptions, but brain structures change according to circumstance and repeated activities.
Studies in recent years have found that a short eight-week mindfulness meditation program changed the brain structures of 16 participants, while other studies have found brain differences in active longer-term meditators. Scientific American has collected some good links.
More recently, a study in Israel has found that parenting rewires the male brain, particularly those of gay men: “the experience of hands-on parenting, with no female mother anywhere in the picture, can configure a caregiver’s brain in the same way that pregnancy and childbirth do“. In heterosexual men, brain differences were “proportional to the amount of time they spent with the baby“.
Laverne Cox said in that Time interview (via The Guardian):
If someone needs to express their gender in a way that is different, that is OK, and they should not be denied healthcare. They should not be bullied. They don’t deserve to be victims of violence … That’s what people need to understand, that it’s okay and that if you are uncomfortable with it, then you need to look at yourself.
It’s time for a bit more pride, and time for phone calls seeking validation based on brain sex to stop.
Biological validation doesn’t improve access or quality of healthcare. Testing for biological differences creates its own risks. Basing a human rights campaign on being “born that way“, or not being able to help being different is undeniably seductive, but we all deserve human rights whether we’re born a particular way or not. It shouldn’t depend on your genetics or your brain structure any more than your gender expression or what you choose to wear.
- Raven Kaldera (c.2000-2004) Dangerous Intersections
- Katy Steinmetz (29 May 2014) The Transgender Tipping Point in Time Magazine
- Simon LeVay (30 August 1991) A difference in hypothalamic structure between heterosexual and homosexual men in Science 30 August 1991: Vol. 253 no. 5023 pp. 1034-1037. DOI: 10.1126/science.1887219
- OII Australia (29 April 2014) Submission on the ethics of genetic selection against intersex traits, includes material on research on the causes of homosexuality using foetuses and infants with intersex traits.
- Christie Nicholson (22 January 2011) Meditation Correlated with Structural Changes in the Brain in Scientific American
- Eileen Luders, Arthur W. Toga, Natasha Lepore and Christian Gaser (15 April 2009) The underlying anatomical correlates of long-term meditation: Larger hippocampal and frontal volumes of gray matter in Neuroimage, 15 April 2009; 45(3): 672–678. PMCID: PMC3184843, NIHMSID: NIHMS90659
- Scientific American (31 October 2013) Taking a Closer Look at How Meditation Improves Our Brains [Video], collected research on meditation and brain structure.
- Cordelia Fine (4 December 2013) New insights into gendered brain wiring, or a perfect case study in neurosexism? at The Conversation
- Elizabeth Norton (27 May 2014) Parenting Rewires the Male Brain, American Association for the Advancement of Science.
- Amanda Holpuch (30 May 2014) Laverne Cox heralds ‘transgender tipping point’ on cover of Time in The Guardian.
[Bolding by me. Images added by me.-GM]