PERSPECTIVE: Transgender Awareness Week
Addressing Trans Health Respectfully, Holistically BY COREY JOHNSON & DOUG WIRTH
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magine surviving childhood trauma, sexual assault, homelessness, an HIV-positive diagnosis, and multiple suicide attempts. That’s a snapshot of the life of one Amida Care member, a transgender woman of color living in Brooklyn. Unfortunately, her story is all too common for people of transgender experience and gender-nonconforming individuals. Transgender individuals experience higher risk for violence, murder, and suicide, and triple the rate of unemployment compared to the general population. They also face overwhelming barriers to accessing quality, culturally competent health care, including stigma, discrimination, and a lack of knowledge about the community’s health needs. A symptom of these socioeconomic and health disparities, the HIV epidemic disproportionately affects the transgender community — transgender women are 49 times more likely to be living with HIV than the general population. New York City and State are working to find solutions to these issues, which must also be addressed by health care professionals and government leaders across the country. With Transgender Awareness Week having concluded this past Monday, it is particularly timely to emphasize the need for advocacy for the rights of the trans community. Health care is a right, not a
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MEDIA CIRCUS, from p.17
for which Franken had already abjectly apologized. Team Moore, including his wife, has been generating more than enough fake news to go around, Vice’s Mike Pearl reports: “‘Second Roy Moore Accuser Works For Michelle Obama Right NOW,’ the headline says, and gosh, I know some Facebook uncles who are eager to hit the share button on a story like that. Indeed, according to the counter on the site that published it, Lastlineofdefense.online, 20,000 people did share it online.” They’ve got to be kidding, right?
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privilege. It’s critical to ensure that trans individuals are able to receive respectful, high-quality, culturally competent health care, including gender-affirming services, access to HIV prevention methods, HIV testing, and linkage to treatment. Being engaged in treatment and care is essential for people living with HIV to become virally suppressed, which means they have the chance to live longer, healthier lives and cannot transmit the virus to others. More than one third of New York City’s trans women living with HIV were not retained in care in 2014, and negative experiences with health care providers are a contributing factor to that fall-off. If trans individuals feel uncomfortable and unsafe visiting their health care provider, they are unlikely to return. Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are highly effective in preventing HIV-negative people from contracting HIV, but access still remains a significant issue, often due to lack of insurance. As of November 1, New York State Medicaid Special Needs Health Plans (SNPs) expanded to accept transgender HIV-negative New Yorkers. Previously, New York SNPs only enrolled eligible individuals who are HIVpositive or people who are experiencing homelessness. The expansion enables Amida Care, the largest of the three Medicaid SNPs in New York, to help HIV-negative transgender individuals stay negative. Amida Care
has a long history of helping the transgender community — which comprises seven percent of its total membership — access high-quality, culturally competent health care. It also works with community-based organizations to help members access support for housing, employment, and legal issues. Amida Care recently partnered with Community Healthcare Network to devote a day of the seventh annual Transgender Health Conference to educating health care professionals about culturally competent transgender care. Community-based health organizations have been working with New York City and State to push for smarter and better policies to help make the end of AIDS a reality for the trans community and all New Yorkers. Funding to end the AIDS epidemic has brought the number of new HIV infections down incrementally in New York State, from 2,509 in 2013 to 2,436 in 2015, but much more work needs to be done to reach the goal of fewer than 750 new HIV infections by the year 2020. By investing in the comprehensive care needed to keep people living with HIV healthy, the government can save millions in costly hospitalizations and in-patient care. Preventing one new HIV infection can save as much as $500,000 in lifetime medical costs. Attention to transgender health care must go beyond HIV treatment and prevention. Health care must take a holistic approach that empowers individuals to access the
full spectrum of care and services that are needed to live authentic lives. We also need policy reforms that break down barriers to gender affirmation so that transgender individuals can live authentically. In 2015, a New York City Council bill took effect allowing transgender individuals to more easily change their gender on their birth certificates by eliminating the surgery requirement. Since then, more than 730 change applications have been approved, a dramatic increase from the approximately 20 change applications approved annually prior to the bill’s implementation. Accurate identification for transgender individuals is critically important to access employment, housing, and health care. New York City and State are at the forefront of a national conversation around transgender health, but broader progress depends on others stepping up. New York’s initiatives can serve as a model for the nation and can be adapted to meet the distinct needs of specific cities and states. Efforts to provide competent care and improve health outcomes for trans individuals are essential not only to end the HIV epidemic but also to ensure that they can live their best, healthiest, and most authentic lives.
Well, as a matter of fact they are. “But hold the phone!” Pearl continues. “This isn’t real news, and we can be sure of that because according to a disclaimer at the bottom of every page, Lastlineofdefense.online is ‘satire.’ So those thousands of people who shared this fake post about a fake accuser working for the former first lady? Don’t worry, they just enjoyed the article for its sidesplitting humor!” But that’s not all. As Pearl goes on to report, “Then, like a bolt from the blue around November 15, a robo-call claiming to be from the Washington Post started ringing phones in Alabama. Initially re-
ported by a pastor named Al Moore (no relation), the calls to the homes of potential voters seem to be coming from a reporter named ‘Bernie Bernstein,’ a name that doesn’t match the name of anyone on staff at the Post. ‘Bernstein’ claims to be paying sources enormous sums of money for information that he ‘will not be fully investigating.’ Before hanging up, he gives the email address of someone named Al Bernstein instead of his own. Oh, and he has a Jewish name, and the exact speech pattern of my Jewish grandmother, so I think it’s safe to say his name is meant to be spelled ‘(((Bernie Bernstein))).’” [The triple
parentheses are the alt-right’s cute way of designating that the person is a dirty Jew.] This whole story is bound to get even uglier as the weeks and months go by. And I promise you that I’ll enjoy every grotesque moment of it. I’ll close with a hilariously sick joke a friend posted on Facebook: “Why did Elon Musk call his Mars lander mission SpaceX? Because if he called it SpaceY he would have had to land on 14-yearold boys.” Come on! It’s a joke!
Corey Johnson, the City Council Health Committee chair, just won reelection to a second term representing District 3 on Manhattan’s West Side. Doug Wirth is president and CEO of Amida Care.
Follow @EdSikov (no triple parentheticals) on Twitter and Fracebook.
November 23 – November 29, 2017 | GayCityNews.nyc