Time to TRANSform: Creating Transfriendly Spaces & Places
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The transgender population is increasingly becoming more visible, thereby increasing the need for gender diversity and inclusion education. Staff at institutions such as universities, places of employment, and health care settings should have a basic knowledge level regarding the transgender population, the differences between gender identity and sexual orientation, and ways to make their workplace setting more transgender friendly.
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Time to TRANSform: Creating Transfriendly Spaces & Places
- 1. Time to TRANSform Creating Transfriendly Spaces & Places Dana D. Hines, PhD, MSN, RN Marissa L. Miller Ivy Tech Community College Bloomington, IN February 26, 2016
- 2. Acknowledgements • Ivy Tech Community College • Ryan White HIV/AIDS Services Program • Marissa Miller (Howard Brown, Chicago) • No financial conflicts of interest to disclose • Views expressed in this presentation are not reflective of the Marion County Public Health Department
- 3. Objectives • General overview of transgender population • Highlight current policies threatening transgender equity in schools • Highlight promising practices for transgender equity • Describe state of transgender equity in healthcare settings • Discuss strategies for inclusivity and diversity
- 4. Transgender Population Makes up an estimated 0.5 to 1 percent (~ 700,000) of the US population. The Williams Institute, 2011
- 5. Transgender Health Care • Postponed medical care due to discrimination • Refused care due to their transgender status • Harassed in medical settings • Providers lacked knowledge
- 6. Transgender Health & Social Disparities • Drug/alcohol use • Suicide • Depression • Sex work • Homelessness • Incarceration • Violence/homicides
- 7. Senate Bills/Legislation/Laws January 7, 2016- Indiana lawmakers introduced SB 344, legislation allegedly aimed to update the state’s civil rights law to protect LGBT Hoosiers from discrimination. • But unlike SB 100, which was introduced late last year, this new bill omits any protections for transgender Hoosiers. SB 100 7-The chapter permits separate restrooms, shower facilities, dressing facilities based on sex, sexual orientation, or gender identity. 9. It imposes a burden of proof of sorts on gender identity claims. You have to have medical proof consistent with your asserted gender-identity within the past 12 months and/or a consistent and uniform assertion of the “gender-related identity” for the past 12 months. Senate Bill 35 criminalizes use of restrooms or locker rooms by transgender people as a Class A misdemeanor, On Tuesday, February 16, 2016 South Dakota state legislature passed a bill that would require public school students to use the bathroom, shower and locker room that correspond to their biological sex.
- 9. Case Study Framingham, MA • Framingham Public Schools partnered with the Mass Dept. of Elementary and Secondary Education’s grant-funded initiative – Promoting Adolescent Health and School Success • Creating safe and supportive learning environments for all students, with a special focus on transgender students.
- 10. Sarasota County, Florida February 16, 2016
- 12. Transgender Students Indiana Schools 2012 Administrators at Cathedral High School in Indianapolis have decided that Catholic beliefs require them to refuse to recognize the fact that one of their students is transgender. https://youtu.be/n3D9v6fngFQ
- 13. Challenges for Transgender Athletes School Level Guidelines/Policies Middle School No rules or guidelines for gender of any kind at the middle school level High School Indiana High School Athletic Association policy requires transgender athletes to complete gender reassignment surgery and provide proof in the form of an amended birth certificate or other government documentation. College National Collegiate Athletic Association (NCAA) only requires hormone therapy and gender acknowledgement from the school.
- 14. North Central High School Promising/Best Practices • Published special issue on transgender students • Highlighted transgender students in the article • School-wide support for Equality Alliance Club
- 15. Creating Transfriendly Spaces and Places • Adopt name change policies • Provide gender neutral bathrooms and locker rooms • Adopt policies that allow transgender people to use the bathroom or locker room that aligns with their preferred gender identity • Provide regional-wide education and training for staff, administrators, and parents
- 16. Creating Transfriendly Spaces and Places • Collect data/conduct surveys to identify the needs of transgender students across all educational levels. • Review legal issues surrounding transgender students equal access to facilities. • Review policies and rules regulating building facilities/bathrooms – Evaluate them for inclusivity, safety, and affirmation
- 17. Key Partners • American Civil Liberties Union • School Board • Student Government Association • Local Pride Organizations • Parent Teacher Organization/Association • LGBT Alliances
- 18. Healthcare Equality Index Patient non-discrimination policies Equal visitation Employment non-discrimination Training in LGBT-centered care
- 19. Healthcare Equality Index Leaders VA Roudebush Medical Center Eskenazi Health IU Health Ball Memorial Hospital- Muncie
- 20. Transgender Population in Indiana
- 21. Healthcare Equality Index Met all criteria except training in LGBT patient-centered care • Parkview Whitley Hospital, Columbia City • Columbus Regional Hospital • Parkview Health, Fort Wayne Repeatedly failed in equal visitation and employment non-discrimination • Indiana University Health
- 22. LGBT Healthcare in Indiana • Health care providers inexperienced in LGBT health care – Least knowledgeable about transgender health care • LGBT health curriculum lacking in nursing and medical schools
- 23. Nursing School Curriculum in Indiana School Outcome/Results University of Indianapolis (Sara Germann, Asst. Professor of Nursing) Two courses starting sophomore year that focus on LGBTQ issues and the importance of asking questions about sexual and gender preferences. Ball State University Did not return multiple phone calls Ivy Tech (Calvin Thomas, VP for Health Sciences Division) No concrete LGBTQ health issue integration • “Students taught to be cognizant of biological, psychosocial, culture, and spiritual components of patient needs…” Marion University (Dean of Leighton School of Nursing) Nothing in the curriculum that addresses LGBTQ health issues • Professors do train students to ask questions about sexual and gender health
- 24. Moving Towards Healthcare Equality • Eskenazi transgender health clinic • IU School of Medicine revamping curriculum to be more inclusive of LGBTQ health needs • OutCare a comprehensive list of LGBTQ friendly health care providers
Editor's Notes
- Accurate numbers difficult to obtain because census data only captures male or female, but not transgender identity Since 2011, greater efforts have been made to capture transgender-specific data in medical records and in cases of HIV, which is a reportable communicable disease
- >6,000 participants (6450) 28% postponed medical care due to discrimination (28%) 19% reported being refused care due to their transgender or gender non-conforming status Results worse among those people of color 28% of respondents were subjected to harassment or reported discrimination in medical settings 50% of the sample reported having to teach their medical providers about transgender care. Recommendations • The medical establishment should fully integrate transgender-sensitive care into its professional standards, and this must be part of a broader commitment to cultural competency around race, class, and age; Transgender-sensitive health education, health care, and recovery programs; • Transgender-specific prevention programs. • Information about health risks, outcomes and needs must be sought specifically about transgender populations;
- Over a quarter of the respondents misused drugs or alcohol specifically to cope with the mistreatment they faced due to their gender identity or expression. A staggering 41% of respondents reported attempting suicide compared to 1.6% of the general population According to the National Coalition of Anti-Violence Programs, there have been 22 killings so far this year of transgender or gender-nonconforming people. This toll compares with 12 homicides in 2014 and 13 in 2013. And does anyone want to guess what other health conditions disproportionately affect the transgender population?
- On Tuesday, February 16, 2016 The South Dakota state legislature passed a bill that would require public school students to use the bathroom, shower and locker room that correspond to their biological sex. If Gov. Dennis Daugaard (R) signs the bill, as expected, South Dakota would become the first state to enact such a law. This and other bills and have invoked outrage among transgender people, allies, and advocates The issue of transgender people and bathrooms has become particularly charged issue in schools. Across the country, districts have adopted varying policies for allowing transgender students the use of sex-segregated locker rooms and bathrooms and membership on sports teams. But guess what, some transgender people do not view sex-segregated or unisex bathrooms as inclusive.
- The student, who was born male and has received a diagnosis of gender dysphoria, had legally changed her name and undergone hormone treatments at the time of the complaint. She kept her identity private and was allowed to use the girls' bathroom and join female sports teams but was barred from changing clothes in the school's three female locker rooms. The district initially required her to use a separate bathroom to change clothes, the complaint noted, and later provided her with a curtained-off area within the locker room. The U.S. Department of Education's Office of Civil Rights said Township High School District 211 in Palatine, Illinois, violated federal law when it denied a transgender student unrestricted access to a girls' locker room. The agreement, approved in December, required the school system to install five privacy stalls in the locker room that the transgender student must use and any other girl can choose to use as well.
- This case is an example of promising or best practices for transgender equality in schools For the past three years, Framingham Public Schools, with assistance from the Massachusetts Department of Elementary and Secondary Education’s grant-funded initiative, Promoting Adolescent Health and School Success, has worked to create safe and supportive learning environments for all students, with a special focus on transgender students. We developed a name-change policy, gender-neutral bathrooms, and two gender-neutral locker rooms available for students and staff at our high school. We provided districtwide trainings for all staff and administrators regarding legal rights of and support for transgender students. We included, in our biennial MetroWest Adolescent Health Survey, questions to identify transgender middle and high school youth. This allowed us to illuminate the stressors transgender youth experience and to plan supportive strategies to promote a positive school climate.
- What’s happening in Sarasota County, FL is an example of a school system being proactive by taking steps to examine their current policies, or lack thereof, regarding transgender equity in schools. A Sarasota County student says he wants to pave the way for change in schools across the district, but the topic of transgender bathrooms is a dilemma school board members said they never expected to face The board is trying to figure out bathroom policies for transgender students and may be the first district in Florida to confront the issue The district does not have a policy on which bathroom a transgender student should use and schools are free to handle it on a case-by-case basis. But policies are needed to address these issues.
- What are some other stories that you all have heard? I had trouble finding stories published about challenges of transgender students in Indiana. Please share what you’ve heard?
- Still need to designate gender neutral bathrooms
- So what can Ivy Tech and the Bloomington community do? Adopt name change policies Provide gender neutral bathrooms and locker rooms Adopt policies that allow transgender people to use the bathroom or locker room that aligns with their preferred gender Provide regional-wide education and training for staff, administrators, and parents regarding the legal rights and support of transgender individuals
- Collecting data will provide insight into the stressors and needs of transgender students and allow schools to plan supportive strategies that will to promote a positive, inclusive, welcoming, and safe space in the school setting Review legal issues surrounding transgender students equal access to facilities, use those issues as a marker for evaluating what’s happening at Ivy Tech and other schools in the Bloomington community. Review policies and rules regulating building facilities/bathrooms and evaluate them for inclusivity.
- National LGBT benchmarking tool that evaluates healthcare facilities’ policies and practices related to the equity and inclusion of their LGBT patients, visitors and employees Evaluates more than 1500 healthcare facilities nationwide Help LGBT identified patients make more informed decisions about where and from who they seek care
- This article appeared in the February 3rd issue of NUVO magazine Health care facilities are evaluated in four core areas In 2014, 28 facilities were evaluated in Indiana The health care facilities on the right met all four criteria
- If you put all the people who are Transgender in one room in Indiana, the first picture is what it would look like. The second is how many of them are Veterans.
- The February 3rd issue of NUVO featured an article on LGBT health care in Indiana Dr. Janine Fogel, a family medicine practitioner at Eskenazi Health said that, “Almost all transgender patients have experienced discrimination. Many don’t seek healthcare because of past negative experiences.” Of course this problem is not unique to Indiana.
- It has been well documented in the literature that medical schools are lacking when it comes to LGBT curriculum and when issues surrounding LGBT health are discussed it is typically in relationship to HIV or simply being gay. NUVO examined nursing school curriculum in Indiana and here were the results
- Eskenazi transgender health clinic scheduled to open this spring and will provide comprehensive primary health care, including hormones, speech pathology, surgical referrals, and preventive care to transgender people OutCare a comprehensive list of LGBTQ friendly health care providers