Lights in the Increasing Darkness
As I write this tonight news emerges (I ain’t saying “Breaking”) that the Trump Administration is again drawing back an Obama-era policy which had been enacted to protect the most vulnerable of trans people in our country. Word is that guidance which had required Federal Prisons to respect the gender identity decelerations of trans prisoners is going away, thanks (for icing on this particularly nauseating cake) to a complaint raised by four evangelical women imprisoned in Texas.
But I’m not here to state the obvious – again – about this rank bigotry. You already know who he is, who he answers to, and what it means for us . . . and about my utter contempt for the reprehensible quisling sycophant transwomen (as far as I know, they are pretty much all women) who supported him and who as far as I can tell still do in the considerable majority of cases.
Rather I write to share with you good news about the contained appearance of hopeful beams of light penetrating the odious gloom which emanates from the GOP and the White House.
A week ago, NPR reported about the advent of a Telemedicine service which stands to be a revolutionary breakthrough for trans people in the southern U.S. I have some personal experience with what that burden has been like until now and find it impossible to overstate what a game changer this is. I live in a rural town in Mississippi. I’m over 70 miles from the closest (known) provider of HRT for transition and that doctor, one of two or three in that city who see trans patients for transition, is in a different state (which for patients using private insurance can often create a network provider problem). The next closest resources is also out of state, and beyond that is the state capital, a full 250 miles one way (and a provider with mixed reviews on reliability). Literally every trans person I have interacted with in this state testifies that their primary care provider, if they have one at all, declines to involve themselves in transition related care. Often, the person wears their religiosity so prominently that it’s very apparent that there’s no point in even asking. We are far from alone in this. Look at the last election results on a map – if the state is red, with the possible exception of Florida, many many trans people would be looking at hours of driving, with all the attendant burdens that brings, to arrive at a provider who is knowledgeable and willing to participate in transition related care.
The article profiles one such patient, who was a three hour drive away from the closet such provider, Dr. Izzy Lowell, until that doctor changed the paradigm completely. To quote from the relevant passage:
After all the effort to get to her first visit, she was initially taken aback when Lowell informed her she would soon be scaling back her brick-and-mortar practice to focus on telemedicine. Williams came around to the advantages fairly quickly. “I know lots of people in rural areas, like me, where they don’t have any doctor who remotely knows anything about transgender care,” she said.
It’s those patients Lowell had in mind when she opened QMed in the late summer of 2017. The practice offers care exclusively to transgender and gender nonconforming patients in the southeastern United States.
For those unfamiliar with the term, a telemedicine practice consults with patients via Skype, or phone, and that helps eliminate many of the associate anxieties with seeking treatment in the first place. For example, he article reports that patients in a telemedicine session with the doctor encounter and speak with only the doctor. While trans-serving providers generally have more respectful staffs than might generally be found, it’s still true that some staff can be loose with a “mister” or a “he” at the wrong moment, and anxiety about such inadvertent (or deliberate) misgendering is one f the burdens trans people suffer in persuit of care in a physical business location. likewise, if a doctor is known to provide such care often nearby onlookers make the assumption that’s what a patron is there for effectively outing them against their will.
While there is still work to be done – the article notes difficulty with broadband internet access (necessary for video conferencing) in many rural areas, and uneven rules and policies regarding insurance coverage for the practice, this is nevertheless a harbinger of much needed progress and a step towards integrating broader transition care resources into the broader health care system. In spite of the ongoing bigotry from our rulers.
Image by: Javier Linares