It is Right to Rebel

"Marxism comprises many principles, but in the final analysis they can all be brought back to a single sentence: it is right to rebel against the reactionaries." - Mao Zedong

A space for resistance and insurrection. I post rants, ravings, artwork, and propaganda from a radical queer trans dyke perspective.

#hormone replacement therapy

Women's Health Should Mean All Women | The L Stop »

My access to healthcare has become somewhat of a mixed bag. I’ve been fortunate enough to receive insurance under my family for twenty-four years. Dental, check-ups, and even braces. But ever since I came out as queer and then as a trans woman, services have been hard to come by, and added to that, even more difficult now that I’m uninsured.

In the case of my local community, I am lucky. Here in Chicago we have a variety of transgender-friendly and women’s health providers: Howard Brown, Chicago Women’s Health Center (CWHC), and Northwestern come to mind as institutions that serve the LGBTQ community with respect, compassion, and care. One institution, though, the CWHC, I’ve found myself in a bit of a struggle with due to their oversight of trans women care.

The CWHC does great work for women, or at least those who were assigned female at birth. Yes, I get it—services fluctuate and non-profit health centers are constantly in need of money. It’s difficult to serve everyone with limited resources.

I mean, on a practical level it make sense, right? There’s an estimated 50.8% of the U.S. population that are cis women,¹ while only 2% (by “liberal” estimates) are transgender—and that includes trans men, of course. When comparing reproductive health between trans and cis women, it’s apples to oranges to kiwis, or something. The point is, all bodies are different, but the essential functions of cis women are the same, while, for trans women, it depends on surgery status, hormone levels, and generally how your transition has effected health risks and benefits.

However, we do not live in a practical society. And particularly feminist institutions don’t function on “provide the greatest good for the most people.” Feminists operate with a keen eye toward institutionalized oppression. That’s how feminist health centers got started in the first place, right? They saw the systemic exclusion and non-prioritization of women in a male-dominated field, medicine, and decided to change it—to make it more accessible to women, to give them agency, and to be treated (mainly) by other women.

So it may be a no-brainer that these services should be served to transgender people too. Not so much.

About a year ago, Chicago Women’s decided to provide hormone replacement therapy (HRT), testosterone, to trans men and transmasculine individuals—not to trans women and transfeminine ones. A year or longer ago than that, they began a trans gynecology program for this same gender group.

This makes sense on a couple levels. First, they provided expertise on gynecological service to cis women, so all you really need is some transgender 101 information to make sure transmasculine folks are comfortable doing this check-up. Secondly, and more interesting, is the historical tie between cisgender women, particularly queer cis women, and transgender men. There’s a whole other explanation why these communities are closer together than cisgender and transgender women.

First, there are community-based reasons. While no one knows exactly the “origins” of the queer-as-orientation-and-identity community, it mainly came from transgender folks (both trans women and men) and cis women. But mainly it grew out of and was claimed the cisgender lesbian community as more trans men / transmasculine folks came out.

Sylvia Rivera

Simply put, trans women have been so historically marginalized by lesbian, gay, bisexual, and transmasculine communities (albeit in different ways and capacities) that we were never included with “queer” in mind. Hell, Silvia Rivera, a radical trans woman and one of the leaders of Stonewall, was banished from the “LGBT” community because people yelled at her “we don’t need any more drag queens in our movement.”

Second, there’s a more specific gender and sexual orientation explanation. Frankly, I believe a vast majority of lesbian and “queer” cisgender women, even those who will stand in solidarity with trans women’s rights, stray away from us sexually, romantically, and physically because of phallocentrism and something called “gender essentialism.”² This is very much a hang up from 1970’s second wave feminism.

But honestly, what does this all have to do with a small feminist health non-profit in Chicago? I think the larger issues of exclusion—historically, communally, intimately, sexually—have everything to do with receiving basic, comprehensive healthcare. Until cisgender women truly welcome trans women as sisters, partners, lovers, and feminists, this issue will remain a sore spot in the historical wedge between us.

So, the bottom line is that CWHC decided to provide services for trans men, including hormones, over that of other women: transgender women. Our shared history in women’s and LGBT communities informs why many “feminist” communities still favor those with a biologically-assigned vulvas over women who don’t. Hence how “women’s health” still does not mean all women. Women’s reproductive health means cisgender women’s health.

I don’t expect this to change overnight. I don’t expect everyone to think of trans women when they hear “women’s health.” I don’t expect CWHC to change overnight either.

But change does not happen by itself. I’ve organized a petition to push for comprehensive trans women’s health. “Equal access and equal care” must be the slogan. That is, if trans men can get gynecology exams, then we should have prostate exams. If you’re opening up testosterone hormone services, make sure you include estrogen as well.

We’ve all made progress so far. I’m pleased to see CWHC give an apology and start focus groups for transfeminine folksthat are finally happening. I encourage anyone who is transfeminine or trans female to give input on what your needs and our needs are.

Challenge women’s health institutions. Do it for all women, not matter what their “parts” are. Who knows, maybe in a few years we’ll have Planned Parenthood providing comprehensive care for all women everywhere.

____________________

  1. Cisgender, or “cis,” means “same gender,” is the opposite of transgender. It means that you agree with the assigned gender you were given at birth. Cissexual means “same sex,” and is opposite of transsexual.
  2. Gender essentialism is the belief that men are a certain way because of their biological and hormonal conditioning, and the same goes for women. This includes defining a person by the shape and/or history of their genitals. This erases transgender people’s experience and (re)definition of our parts.

Please Sign! We Need Comprehensive Transgender Health at CWHC »

To the Chicago Women’s Health Center:

We demand the following things:

1. A statement of apology taking responsibility and accountability for the historical exclusion of transgender women, transfeminine, and trans female people from your health services. This statement should explain why this “women’s” health center chose to prioritize services to transgender men, transmasculine, and trans male people over transfeminine-identified people. This statement should be readily accessed from the CWHC website.

2. Rewriting each line of “women’s” to be “cisgender women’s” where intended and/or applicable on the CWHC website.

3. A comprehensive plan to include services for transgender women that includes public and transparent benchmarks that may be easily accessed from the CWHC website. Those services include:

a. Feminizing Hormone Replacement Therapy

b. Trans prostate examination

c. Fertility awareness and/or options for trans female people

d. Continual education on the particularities of trans female-spectrum health issues

Failure to comply with and/or address such a comprehensive plan will result in the changing of the name of Trans Greater Health Project into Transmasculine Greater Health Project.

Furthermore, we encourage more community development and ties among the transgender women’s, transfeminine, and trans female community. Employing transfeminine-spectrum people to your staff would be encouraged.

Lastly, we encourage anyone supporting the CWHC and/or the Trans Greater Health Project to unabashedly, critically, and courageously point out the disparities between their transgender health services at the current state it is in.

women's health and trans health | trans grrrl riot »

i find myself becoming nauseous. again. i’m tired and nauseous with those in my local women’s and transgender communities who gloss over, disregard, and/or intentionally exclude trans women and transfeminine issues. and for pathetic reasons at that.

i really like the chicago women’s health center (CWHC). i like the staff. i like the atmosphere. i like what they do. and yeah - i’m actually a client. but, really, i’m not a client for their Trans Greater Access Project (TGAP), and i’ll tell you why. 

chicago women’s does not provide medical services, besides counseling, to trans women / transfeminine folks. i want to spell this out c-l-e-a-r-l-y so no one get’s frustrated that i’ve misinformed anyone.

TGAP provides the following things according to their website:

- Masculinizing hormone replacement therapy

- Trans gynecology

…and then the ones that they’ve had in place that can be like “well yeah this includes trans people”

- Counseling and Therapy

- Artificial Insemination (AI)

they do not provide feminizing hormone replacement therapy. they intend to start a pilot program for this “soon.”

they’ve done the masculinizing hormone replacement therapy for one year now. AI and trans gynecology for transmasculine folks have existed longer at CWHC - so we can see that transfeminine exclusion isn’t entirely new.

but going to hormone replacement therapy, which is very important to many transgender people. why would they make such a decision to include transmasculine before transfeminine folks? the answer given to me from TGAP was, “they didn’t see a need for it [feminizing hormone replacement therapy] in the community.” really? like. really?

the specifics are: apparently (i have not confirmed this) transmasculine folks stopped being able to get hormone replacement therapy (HRT) for those without insurance before transfeminine folks at another local chicago clinic, howard brown. chicago women’s decided to step in and say there is a need for uninsured transmasculine folks who desire HRT. apparently there was a group of transgender (female / feminine and male / masculine) folks who got together with CWHC to assess the needs of the trans community.

chicago women’s, i call bullshit. there’s ALWAYS a need for HRT accessibility, and y’all know that. if this was an honest error of trying to assess needs then i call complicity in forgetting the deep wedge between cis women and trans women and the ugly legacy of transphobic “feminism.” how would you expect transfeminine people at-large to agree with serving transmasculine people and simply nodding at our exclusion (however temporary) at a women’s health center.

let’s just call it what it is, shall we? TGAP is female-assigned at birth health. trans health in the context of feminist health has meant transmasculine health. so why am i getting in a tussle about this right now? because i’m so dreadfully torn between supporting transmasculine friends and the services that i DO enjoy at chicago women’s.

there’s a benefit coming up at the burlington (one of my fave bars when i used to live in logan square) for TGAP and, you’d never guess, all of the hosts for this fundraiser are masculine-identified (or at the very least have masculine privilege)! i’m expecting a low low low turnout from transfeminine people.

not only is it seriously tearing at my nerves that this fundraiser exists, but these organizers that i like and respect are brushing aside transfeminine folks just like CWHC softly covers up their exclusion of trans women from their trans services. the event has even been billed by one of the organizers as “a program promoting trans-affirming health care for everyone on the transgender spectrum.” THAT’S MESSED.

the burden of changing this b.s. is on women’s health centers, including the CWHC.

so far they haven’t taken any action besides my private call outs. maybe this will help.