Link Love: Trans* Health Care, Bisexuality, and Forced Sterilization

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New Report Shows Trans* People Experience Huge Gaps in Health Care Access (emphasis below is mine):

…the final bullet bears special mention, in light of the recent media attention on the high suicide rate for gay, lesbian, and bisexual youth that has almost entirely ignored the suicide epidemic among trans* youth. An attempted suicide rate over 25 times higher than the general population is profoundly distressing, and points rather strongly to systemic discrimination harassment, and huge gaps in health care, including mental health care.

Bisexuality, Binarism, And Why Everyone Has It Wrong:

What happens is, instead of recognizing that biphobia is actually a form of monosexism and bisexuality one simple form of polysexuality, bisexuality replaces polysexuality as the label for non monosexual orientations and biphobia is equated to polysexuality. This erasure is destructive to these other sexualities and centers bisexuality as the only polysexual option beyond pansexuality (which many bisexuals even approach in a bigoted fashion) which creates binarism within bisexuality.

So people on both of the major sides of this debate on bisexuality and binarism are both engaging in binarism, cissexism, erasure and are just flat out wrong. Bisexuality doesn’t enforce the binary and cissexism, the erasing way it is used to mean polysexual, the way essentialism is spilled into it and the way it is policed to only be about men and women does.

Report Shows HIV-positive Women in Chile Forcibly Sterilized, Denied Medical Treatment:

During the first trimester of her pregnancy, Julia began experiencing an orange-colored vaginal discharge. Concerned, she went to the hospital to have it checked out. Instead of treating her, however, hospital workers turned her away and told her to return for her regularly scheduled check-up. She was admitted to the hospital three days later, hemorrhaging and with severe abdominal pain, but she still sat untreated while the hospital staff attended all the HIV-negative patients first, including those who arrived after Julia. Her pregnancy ended in a miscarriage shortly thereafter, and a paramedic told her, “‘It is because God knows, because you were going to have a sick child.’”

Trans Women, Lactation, and Exclusion

While I have discussed the obstacles faced by cis women who wish to breastfeed many times, I have neglected to delve into the reality of trans women and their experiences with breastfeeding. This is unacceptable, and a reflection of the cis privilege that I enjoy. Contrary to popular belief, almost every person regardless of gender has the necessary equipment to nurse a child. If you have a healthy breast, you can probably breastfeed.

Now, when a cis woman wants to breastfeed, she is in for an uphill battle. She will get so much misinformation from health care professionals, well-meaning relatives, friends, and advertisements. Her decisions on when and how frequently to nurse are going to be policed by total strangers. If she nurses for “too long,” people will accuse her of being selfish (as if there were no health benefits to full-term nursing or child-led weaning); if she doesn’t nurse “long enough,” then people will accuse her of being vain or lazy (as if there were no legitimate reasons to choose not to nurse or to choose mother-led weaning), which not only is disrespectful to a woman’s bodily autonomy, but also feeds the “rabid baby-fetishing mommy-guilting breastfeeding zealout” meme and turns more women off to even considering breastfeeding in the first place. If she wants to take breaks at work to pump, she will have to deal with coworkers and superiors who may be less than understanding.

That’s just the tip of the iceberg for cis women. For a trans woman, take all of those issues and multiply them by a million.

Misinformation regarding, well, almost anything about trans women’s lives is regurgitated and unchallenged by the vast majority of the cis population (who, naturally, dominate the medical profession as well as every other discipline of our society). Trans women have to deal with discrimination from the medical community on a horrific level; things that cis women do without much thought, such as filling out medical forms, are not such a carefree task for trans folks. When I see a new doctor for the first time, I don’t have to wonder if she is going to be so bigoted against me that she will not even enter the room or touch me.

While I feel snug and protected by the laws in my state that guarantee my right to nurse publicly, trans women do not have the same luxury. They cannot take for granted that someone will not challenge them (or arrest them!) on the basis that they are “not really women.”

While many cis women can take for granted that their milk will come in without much effort on their part, there are many trans women who will not be able to afford the hormonal regimen that will allow them to simulate a pregnancy and induce lactation. Insurance companies already overwhelmingly fail to provide support and supplies for lactating cis women; trans women can expect to get exactly squat to even spur lactogenesis in the first place.

The books that I’ve been reading about breastfeeding are of course filled to the brim with cis-sexism. There is a complete black hole in regards to the needs and concerns of trans women who wish to nurse their children. This is something that needs to change. When the “pro woman” battle cry really means “pro cis woman” (and let’s be honest – it almost always certainly means just that), then we are failing. We are neglecting our duties as supporters of health care, as womanists, as decent damn people.

My silence about the needs of trans women in breastfeeding advocacy is a testament to my bigotry. I’ve been fucking up. And I need to do better.

Breastfeeding Success Is A Collective Responsibility

During class last week, the professor had us do an exercise in which we paired off with one another and had to learn about each other. We then had to address the class and tell them what we’d learned about our partner (if you’re wondering what exactly the point of the exercise was, I can assure you that it was indeed a waste of time). One of the things that I told my partner, a super shy 16-year-old who was literally quaking in her seat next to me (I know my afro has been kind of unruly, but am I really that scary?), was that I want to become a lactation consultant.

When it was our turn to share what we’d learned about each other, this is how it went:

Classmate: “She’s twenty-seven.”

Class: *eyes glaze over*

Classmate: “She’s a mother.”

Class: *eyes start to close sleepily*

Classmate: “And she wants to be a lactation consultant.”

Class: *GASP* SHOCK! HORROR!!

Honestly, you’d have thought that she’d just told them that I want to fly to the moon and open up a fucking Starbucks. The class erupted in confusion, and my professor just looked at me with her mouth hanging open and asked, “Is that what it sounds like?” I assured her that yes, it is exactly what it sounds like. Cue more confused murmuring. One of my classmates piped up and said, “It’s true! I work with someone who saw a lactation consultant in the hospital.”

I started to say something about how breastfeeding is not always as straightforward as people assume it to be, and how the presence of an expert can help ensure a healthy nursing relationship, but another classmate interrupted me, saying, “Well, I guess you need someone to make sure that they don’t nurse the baby for too long.”

I looked at him and mother help me, I was about to start quite the lecture of my own, but Professor G decided that we’d wasted enough time and moved on to the next pair of students.

The whole encounter only reaffirmed the reasons that I want to go into lactation consultation in the first place: the myths surrounding the breastfeeding relationship between parent* and infant are harmful to that relationship and are by extension harmful to the communities that would benefit the most from higher rates of breastfeeding. I’m sure that my classmate – we’ll call him E – who expressed concern about parents “nursing too long” is the same guy who shames parents for nursing in public and breeds insecurity in new parents by telling them “your baby needs some ‘real’ food and you are selfish for not giving it to him.”

I wonder how long E thinks is ‘too long.’ Three months? Six months? What would he say if he knew that my 11-month-old daughter still nurses happily several times a day and once or twice overnight? The fact is that the nursing rates are entirely too short: while the World Health Organization recommends that infants be breastfed for at least two years, in 2003 only 5.7% of parents were nursing their children at 18 months old in the US.

I want to clarify that I do not believe that it is any one person’s obligation to breastfeed their child. Rather, it is our collective responsibility as a society, for the health of our children, to provide an environment in which breastfeeding is normalized, encouraged, and accommodated. We can’t keep saying “Breast is best!” and then nix legal protections for nursing in public, spread misinformation even in medical settings, fail to provide for parents who need help during the postpartum period, refuse to offer paid parental leave, deny medical coverage for pumping equipment, etc.

And we cannot shame parents who do not choose to breastfeed, whatever their reason – especially since we have set them up to fail. Even if parents were well-supported in deciding to nurse, there will always be those who choose not to or are unable to, and that is okay. Choosing to nurse or not to nurse does not make any parent better or worse than any other. We must be compassionate, supportive, and address the needs of those who will or can not nurse as well. The goal of breastfeeding advocacy is to ensure healthy nutrition for all infants, not to shame parents and tell them what to do with their bodies, when, where, and for how long.

The fact that I have been able to nurse Eve for this long is not an accomplishment on my part – it is a privilege. I was lucky to birth a baby with a good latch, lucky to have nipples and breasts that do not impede our nursing relationship, lucky to not need any medications that would have negatively affected my supply, lucky to have found the resources that I have in order to sort myth from truth, lucky to have a husband that supports my decision to breastfeed (the single most important factor in whether a parent chooses to nurse is whether they have the support of their partner), lucky to afford to take 3 full months off work in order to fully establish a nursing relationship, lucky to have a friend who was willing to give me her old breast pump… The list goes on.

My success in breastfeeding was a collective effort. I could not have done it on my own! It was the support I received from others and the privileges that I have that allowed me and Eve to start and continue our nursing relationship, in spite of the obstacles that society has placed in front of us. Our society cannot blithely say that parents have the right to choose to nurse when we have literally stacked the game against them socially, financially, and logistically. I want every parent to have the same support that I had – and more! – so that breastfeeding can be a proper choice.

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*There are trans men who choose to birth and nurse a child, so it would be cis-sexist for me to assume that every breastfeeding dyad consists of a woman and child.

Saving Lives the Hard Way

Today I’m thinking about Catholic hospitals.

Eve was born in one such hospital. For the most part, it was a very positive experience. All of the staff were friendly and the granola from the cafeteria was amazing (except for the raisins, which I picked out). My birth plan was respected without question and the only time that anyone mentioned pain meds during my labor was when I first arrived and they verified with me that they would not offer me any meds. (After she was born was a different story, but it was no big deal at that point.)

In fact, my worst complaint had nothing to do with the birthing ward but with pediatrics, where Eve was transferred at 3 days old for her jaundice; they had a policy of only allowing one parent to stay overnight with their children – even newborns – which meant that Marcus had to go home and I was left to care for the baby by myself at 3 days postpartum and with no energy, food, or rest. It was hell, especially since I still was learning how to deal with latching correctly and soothing my newly engorged breasts. But I couldn’t blame the staff for that.

After Eve was born, I decided that my new form of birth control would be Paragard, a hormone-free IUD. I knew that I could get one placed by my midwives at 3 months postpartum. Unfortunately, by the time I made the call for my appointment, I was told that the hospital that Eve was born in had decided that my midwives’ office – which operates outside of the hospital but is partnered with them – could no longer purchase and offer IUDs per Catholic doctrine. So they were no longer buying the devices. Fortunately for me, they had one more in stock that they had already paid for, which they were willing to give to me.

That worked out for me now, but what about after the next child? I’m going to have to go to Planned Parenthood to get any future IUDs placed. It’s not that I dislike PP – to the contrary, they’ve always been very good to me and I am more than happy to give them the support – but one of the reasons I continue to see my midwife practice after the birth rather than seeing a gynecologist is because I like to receive all of my reproductive health care in one place, by the same people. I want the women who know what my body does while it’s gestating to be the same women who give me my yearly PAP, who help me manage my birth control, who examine my breasts, who advise me on managing my chronic anemia. I hate that I’m going to have to partition my care between two practices and two groups of people.

It was at that point that I realized – or remembered – that even though I am not a Catholic or a Christian or even a theist, I am subject to the whim of Catholic doctrine whenever I seek care from a Catholic establishment. My care can and will be determined partially by the Catholic belief system. I attended Catholic school from kindergarten through the end of high school, so I am pretty familiar with the sect, and I am definitely not one of its biggest fans.

Eve’s birth went wonderfully – but what if what happened to this patient had happened to me? And what if I had no compassionate and realistic woman like Margaret McBride in a place of power to save my life? Would the hospital that I chose for Eve’s birth intervene as I lay dying if it meant violating church doctrine? As this article asks, are Catholic hospitals safe for pregnant women?

I just can’t imagine being 11 weeks pregnant and dying, and being told that I cannot be moved to another hospital or I will die, and that I cannot carry this pregnancy or I will die. And then being told that they will force me to carry this pregnancy and let me die.

Abortion saves lives. Not all of the time, not most of the time, but sometimes. A hospital with a policy that does not recognize that women’s lives are worth saving is not one that I can risk giving birth in. I’ll be calling the hospital soon to talk to them about their policies and what they would do if I needed an abortion to live while in their care, after which I’ll have to do some thinking on whether or not I want to continue birthing my babies there.

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YES, Oklahoma Legislature Fucked Up, BUT That Is No Excuse For Ableism

By now, I’m sure many of you have heard about the two laws that were passed in Oklahoma by overturning the governor’s vetoes. The first requires that before having an abortion, a woman be required to view and listen to a description of the fetus’ organs and limbs, even for survivors of rape or incest. From what I understand, that means for very early pregnancies which cannot be viewed with an external ultrasound, those women will have to submit to the vaginal penetration required for internal ultrasound; while terrible for all women, that could be especially traumatizing for rape survivors.  The intended result is to guilt women by making them realize “Oh hey, I didn’t know a fetus has limbs and if it has limbs that makes it MURDER” as if women didn’t understand what pregnancy is or what ending a pregnancy means. The law is paternalistic, invasive, and yet another ridiculous barrier to women’s agency in pregnancy.

The second law is much, much worse. It protects doctors from being sued by their patients if they decide to lie or mislead (either outright or by omission) pregnant women about the health of their fetuses if they think that this information may cause the woman to choose to abort. In essence, doctors are now allowed to lie to women about their pregnancies, keeping them from being able to make an informed decision regarding those pregnancies. Not only will these women [those with dishonest doctors] no longer have the option to abort, they will also no longer have the option and ability to prepare financially, emotionally, and mentally for the outcome of their pregnancies, whether that be for caring for a child with disabilities or for the birth of a child whose life may be exceptionally painful or short. This benefits neither woman nor child.

Now, this IS enraging. This IS terrible. What this is NOT is an excuse to exercise all of your able-bodied privilege to devalue the lives and worth of people with disabilities, lives which are devalued every day (many times for “laughs”) in our society. Some of the comments that I’ve been reading in reaction to this law pretty much boil down to “This law is disgusting because more ‘defective’ people will be born and we don’t want that!”

That is unacceptable. That is wrong. When you devalue the lives of people with disabilities, you are also devaluing the lives of women with disabilities – and if you do this as a supposed pro-choicer and supporter of women, well…I don’t know what else to say except that you’re fucking up.

Keep in mind that many of the people fighting to protect the right to abortion are themselves disabled. We are all in this together, so check your privilege. Defending the right to choose means defending ALL women – not just the temporarily abled.