First Event Conference (A Review)

Our co-founder, Neish McLean, attended the First Event Conference recently held in Waltham, Massachusetts from January 20-24, 2016 at the Westin Hotel. The event was attended by over 700 persons within the transgender community and featured a plethora of workshops as well as social activities. The workshops offered participants an extensive array of gender specific topic options to choose from and catered to therapists, youth, family, transmasculine persons, transgender women and cross-dressers. In addition, there were general-focused workshops ranging from professional development to meditation.

First Event1

Each day kicked off with a new-comers orientation session. This was  a great way to start the day as it afforded the opportunity to meet other new-comers and explore what brought each person to the conference. After the orientation session, persons dispersed to their different workshops of interest.

Of particular interest was the  transmasculine track of the programme which had workshops such as ‘Masculinity and the Trans Masculine Person’, ‘Show Me Your Package’,  ‘FtM Chest Surgery Show and Tell’, and ‘New Directions in Surgical Gender Confirmation for FtMs’. One of the more impactful sessions was the FtM Chest Surgery Show and Tell as it gave a live and personal exchange between the volunteers and the audience. The volunteers were able to stand up, bare-chested and explain their procedures and experience.

Some of the general workshops included topics such as ‘Preparing a Successful Transition’, ‘Building a Support Team’, ‘Professional Workplace Transition’ and ‘The Power of Voice’. The Building a Support Team workshop highlighted the importance of creating a safe space that supports the transgender individual through their journey.

In addition to the workshops, the conference also featured a vendors’ area displaying products and services being offered by businesses and professionals for the community. In addition, Tiffany’s Closet was a budget-friendly, high quality offering of clothing and accessories for the shoppers to take advantage of.

In the evenings, there were scheduled social activities to attend. Thursday evening featured event was a Black Tie/Red Carpet Community Service Award event. Friday night featured the John Warrener Memorial Fashion Show and Saturday night’s main event was the banquet with keynote speaker – Dr. Renee McLaughlin.

First Event Conference provided a wonderful opportunity for attendees to learn, explore and challenge the restrictions that often prevent the freedom to express and live an authentic life. It afforded a safe space, especially for those who didn’t have a supportive environment, to embrace all that they are, all that they deny and to let themselves out; let themselves be. Many lives were changed over the course of the conference. Many mental barriers were broken and many lives were set free.

The Way Forward for the Jamaican Transgender Community

After interacting with individuals in the transgender community and participating in the workshops, TransWave is charged with thinking about a way forward given our local context. Jamaica has a far way to go when it comes to equality for the transgender community. However, 2015 reflected greater visibility and increased engagement with civil society and government agencies. For 2016, further collaboration with our partners such as J-FLAG, We-Change, Colour Pink Group and Aphrodite’s Pride is integral to paving the way for increased access to services for transgender Jamaicans. The work continues.

 

Transgender Rights are Human Rights

Today, December 10, 2015, we celebrate Human Rights Day under the theme “Our Rights. Our Freedom. Always”. Human Rights Day commemorates the day on which, in 1948, the Universal Declaration of Human Rights, was adopted by the United Nations General Assembly.

Jamaica has since incorporated the principles set forth into Chapter III of our Constitution at the time, and now have adopted and amended the principles to make our own Charter of Fundamental Rights and Freedom.  As set out in the Charter of Rights, all Jamaicans have several rights afforded to them by law.

However, the right to freedom in Section 2(i) which makes specific reference to the right to freedom from discrimination on the grounds of – (i) being male or female; (ii) race, place of origin, social class, colour, religion or political opinions does not adequately protect transgender persons from discrimination.

The Charter of Fundamental Rights and Freedom neglects to fully protect all Jamaicans regardless of gender identity or sexual orientation. This failure to protect all Jamaicans makes the following outlined in section 3 debatable with regards to their coverage and protection of transgender and gender non-conforming Jamaicans. Section 3 states – (a) the right to life, liberty and security of the person (c) the right to freedom of expression.

Ban Ki-moon

One cannot have the right to life, liberty, security or freedom of expression when the right of freedom from discrimination does not adequately cover transgender persons. Transgender rights are human rights. The amendment of the Charter of Fundamental Rights and Freedom to include the right to freedom from discrimination regardless of gender identity or sexual orientation would be a step in the right direction to securing the rights and freedom for transgender and gender non-conforming Jamaicans. Our rights, our freedom, matters.

Nelson Mandela Human Rights

The video below highlights the reality of the lives of transgender people across Asia-Pacific. It’s quite a similar reality that many transgender Jamaicans face. Our hopes for the future are the same. Have a watch.

 

HIV/AIDS & Human Rights in Jamaica: Reality or Rhetoric?

HIV/AIDS is a communicable disease that we’ve heard about for decades. It used to be considered a death sentence until better research, education and advances in treatment improved quality of life for persons living with HIV (PLHIV). Coordinated efforts among international donors, the government via the National HIV/STI programme, and civil society groups, make HIV/AIDS one of the most supported public health issues. Does the LGBTQIA community, and specifically trans persons, benefit from this bounty?

First, here’s a 7 minute video that explains in simple terms what HIV/AIDS is and the treatment involved.

If you can’t see the vid here’s an alternative resource: HIV Basics.

What’s the situation in Jamaica?

International aid as it relates to disease control and reduction has shifted towards more partnership with local government and civil society groups to implement programmes. In (i) July 2015, the Ministry of Health recently announced that The Global Fund–an international financial institution created to combat HIV/AIDS, TB and malaria–will invest in Jamaica’s National HIV/STI programme for the next three years. PEPFAR (United States President Emergency Plan for AIDS Relief) will also fund the programme. At that press briefing, and recently at the World Learning Caribbean Grant Solicitation Management (CGSM) Programme, Ferguson placed the government’s mission within the framework of human rights — he was committed to reducing stigma and discrimination. In naming vulnerable groups, it’s important to note that he acknowledged the transgender community specifically:

“In addition, men who have sex with men and their female partners accounted for almost 40 per cent of new infections in 2012. I want to further note that MSM who reported being involved in sex work reported an HIV prevalence of 41 per cent, transgender women 45 per cent, and transgender populations in sex work reaching as high as 56 per cent.”

In the (ii) JIS report, JFLAG, along with the National AIDS Committee, and Eve for Life, are listed as groups in partnership with Nat HIV/STI programme.

These are important steps — for far too long there has been no targeted research of the trans community. Trans women, especially, were grouped under MSM, leaving the problem obscured. However, prejudicial laws against sexual orientation and gender identity remain in such critical documents as the constitution; the Sexual Offences Act; the Offences against the Persons Act; and, in relation to (iii) sex work, the Constabulary Act and the Towns and Communities Act. This prevents the government from creating and implementing a truly comprehensive policy that would enable all Jamaicans to access the best healthcare possible. As we are stigmatised or invisible in the eyes of the law, it follows elsewhere.

Released in 2014, the (iv) National HIV/STI annual 2013 HIV epidemiological profile conflated sexual orientation with sexual practices. Risk behavioral factors are described as “heterosexual practice” versus homosexual or bisexual. This limits the usefulness of the data. If persons felt comfortable enough to provide more accurate personal data, government and civil society groups could create better profiles of the various sub-groups in the population and modify plans to better address and target their needs. Indeed, “44% of men reported with HIV (and 41% of men reported with AIDS)” did not disclose their sexual practices, which was partly attributed to such a reluctance.

There is no data provided on female “homosexual practice”.

As it relates to gender, the situation is worse. TransWave is still trying to find the source of Minister Ferguson’s statistics as it relates to transgender persons, for only “male” and “female” are covered in the MoH 2013 profile. (Is it local or international data?) There is a strange column in the sexual practices data table for “Unknown Gender” but the term is not defined. Without reliable data we cannot expect to get the best value from the millions donated.

Groups like J-FLAG, Colour Pink, and Jamaica AIDS Support for Life (JASL) work to identify key population groups like the transgender community and collect data which can help to fill in the gaps.The Health Policy Project (funded by PEPFAR & USAID) run training workshops in the Caribbean to equip medical professionals to best serve transgender health care needs. However, the reality is that the government is the major provider for health care in the island. Civil society groups — who progress in an environment which hinders rather than enhances their efforts — can only work in complement to and not act as a sufficient substitute. Our regional medical universities, partly-funded by CARICOM, ought to be at the forefront of research in this area.

While TransWave applauds the government’s support of civil society organisations who address such marginalised groups as LGBTQIA and sex workers, its tendency to only address such groups within a HIV/AIDS narrative only helps to “other” the community as victims and creates associations with issues perceived as “societal problems”. It promotes  stigmatisation. (It’s a common complaint among trans activists groups in the region that they can only get funding for HIV/AIDS projects.)

The government should take its human rights agenda to heart. Once Jamaica commits to respecting and honouring the inherent dignity in all citizens, everyone can be empowered to do the best work for it and each other.

For counselling, support or info on how to get tested:

J-FLAG Social Services: (876) 754-2130

JASL: (876) 925-0021/2; email: info@jasforlife.org

Sources

(i)”Jamaica Gets Millions in HIV Funding” – Ministry of Health

(ii) Health Minister Commits to Reducing HIV/AIDS Stigma and Discrimination – JIS News

(iii) Resources and Publications – JASL

(iv) HIV Epidemiological Profile 2013, Facts and Figures (PDF) – National HIV/STI Programme

Transgender Mental Health

There is no doubt that mental health is important for everyone. Furthermore, there are additional considerations for transgender persons as they navigate their internal struggles along with the external stigma from friends, neighbours, co-workers and strangers. Transgender individuals face additional burdens that remain unresolved for an extended period of time due to the unavailability of mental health providers who have the capacity to address these issues.

Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

Source: World Health Organization

There are two major issues that are specific to the transgender community when it comes to mental health – gender dysphoria and the transitioning experience. Let us first discuss gender dysphoria.

Gender dysphoria is the significant discomfort and dissatisfaction with the biological sex one is born with. For transgender persons, this is normally the root cause of depression, anxiety and other symptoms of mental illness.

Gender Dysphoria

Imagine looking in the mirror and hating what you see. The image reflecting back at you does not match up with the way you see yourself. There are many people who face this problem with regards to insecurities but gender dysphoria is different in that a transgender person hates their body so much that they want parts of it removed permanently. They desire a drastic change that goes beyond biological and physical. The inability to align one’s biological sex with their gender identity and gender expression is a cause for great despair for many transgender persons and is something some transgender individuals deal with throughout their childhood into adulthood. Many transgender individuals experience suicidal thoughts or attempts at suicide.

In order to alleviate and eventually eliminate gender dysphoria, many transgender persons proceed with transitioning as the solution. The transitioning experience is another major cause of mental discomfort within the transgender community. While this process might be something that a transgender person has been looking forward to for their entire lifetime, it is still a scary, anxiety causing process that can result in disappointment for the individual.

While the decision to transition can be exhilarating, there are some issues that can cause great concern for the transgender person – such as anxiety about hormone therapy and surgery. There are additional frustrations such as attempting to update one’s legal documents to reflect your new gender assignment or even fears that one can be identified as transgender and hence face discrimination. After the transitioning is completed, the transsexual is faced with coming to terms with their new bodies and the realigning what they thought they would look like with their actual physical reality. Sometimes, there is disappointment with the transitioning as the changes seen might not reflect the image the transgender person had prior to their transition.

Transtition Process

The process or decision to transition, ideally starts when the individual gets counselling from a mental health provider. This is key so that the transgender individual can receive therapy to navigate their feelings and to receive information and guidance that will help them through the transitioning process. Therapy is an integral part of the process, regardless of the transgender person’s ultimate decision to transition or not.  Many health care providers in Jamaica are not equipped with enough knowledge about the issues affecting transgender persons and thus might not know best how to support or treat the transgender person. Also significant is the fact that trans-sexual health is not a part of the medical curriculum in Jamaica and as such medical professionals are not equipped with the tools or skills to provide treatment specific to the transgender community.

These hurdles are significant to the transgender community and are cause for concern as they try to navigate their own feelings while attempting to improve their quality of life. Certainly there is much need for change to the healthcare policy in Jamaica so that it is more inclusive and supportive of the transgender community. A policy change is needed so that transgender Jamaicans can update their legal documents such as their driver’s license and/or passport. In addition, healthcare providers need more training in order to address the needs of their patients who are transgender so that the mental health support needed can be met.

Trans Profile – Jessica, Part II

(This is the final of a two part series. Part one focused on Jessica’s personal journey to becoming the “ultimate” her. Part two focuses on health care issues facing transgender persons in Jamaica and how she plans to change it. This interview was edited for length and clarity.)

First part of interview

Do you plan to remain in Jamaica?

I’ve thought about it. One of the things I look at is the treatment cascade. The treatment cascade is services provided by the government in the public health system. You have an entry level which is when you get tested (for everything: diabetes, HIV, STIs etc), then you move from treatment to medication. You may need to be referred to a psychologist by a social worker.

Is this in relation to HIV treatment or transitioning?

No, just in general. The health system is supposed to provide you with a minimum package. There are some issues. Accessing the treatment cascade is a problem. For some persons even walking to a health centre can be a problem. If you don’t look as feminine as society requires you to look you might fraid seh somebody run yuh down. This means you have to take a taxi instead which is expensive. [To fund that] you need to work and you may lose your job if you go to work dressed as how you are. You may then have to start a business, likely supported by the LGBT community. All of this depends on money! That’s why I say that when you face the question on whether or not to transition you need to take a lot of things into consideration. You need family and friends. If you don’t have a family, try to mek one.

So how does the transgender community gain access?

They’re not going out to the health centres. One or two of us may be at a workshop. Where transgender persons do come out is at the big gay parties. But when they’re there they don’t want to be tested. [It’s uncomfortable to face] in that environment. I am one of the lucky ones who got tested.

If you manage to enter the treatment cascade, as a transgender person wanting to transition, there is nothing there. Just a doctor, if you have one, to do regular check ups, and maybe a psychologist who doesn’t really know how to deal with transgender issues. The doctors are reluctant to prescribe the hormone medication because of the country’s prohibitive environment. They don’t know anything about the treatment, they don’t know if it’s against the law, if it’s against their practice. They have to consult with others before they treat you.

The treatment cascade here is also not designed in a way to make transgender persons feel comfortable. I may want some linguistic skills to make my voice more feminine, and transgender men (female to male) may want techniques to help lower the voice etc. If you look at women like Caitlyn, they look beautiful, but they still have that male voice. There’s nothing in the treatment cascade for that.

You have to go abroad.

Yes. However, I did apply for a grant to help me develop a treatment cascade for the Jamaica health system — to create a treatment cascade for transgender persons. It will not be the best, but I want to at least allow for access to hormones and linguistic skills development. And we need to get psychologists on board because going through all of this is a big process. Even [as a transgender woman] to move from the male to the female bathroom….

I spoke to someone about that and it was a big issue for them. Regardless of which one they chose it was uncomfortable.

Moving from one to another is like a whole new world. When I went into a female bathroom for the first time I gasped because there were no urinals. [laughter]

Yeah, we don’t necessarily need those.

And then you start to look within yourself and think, Am I looking at the women in any way…? Do I fit in with them? For me, now, it’s not a problem. Others may not look as feminine and so other women using the bathroom get uncomfortable. Why dis man come in the bathroom dressing like a woman? Many don’t mean anything by it, they just have security concerns. Is this person an impostor who intends to rob me? So a lot of trans persons think twice. I know a lot who wait until they reach home to use the bathroom.

Doing that may cause health problems, though, like UTIs and kidney infections.

Yes. So the referral manual I want to create for the treatment cascade will be Colour Pink’s first TransHealth project that targets the transgender community. It will also involve educational plans for sexual reproductive health plus gender and sexuality to learn about the terminology. When transgenders are out they should be able to firmly articulate who they are.

We are grateful for the time spent with Jessica and look forward to working with her on future initiatives. Please like the Colour Pink Facebook page to keep current with its activities and learn how you can help.

Transgender Health Myths

The health and well-being of a transgender person, though quite important, has many aspects that are very private and personal. In addition, there are also a few misconceptions within and outside the transgender community. So here we go busting up some myths.

Myth #1: Surgery is a Top Priority for All Transgender People

Surgery is not a top priority for all transgender people but it is impolite to invade the transgender person’s privacy by seeking to find out if they have had any surgeries. As we explore and promote transgender health and well-being, it’s important to keep in mind that though there is boundless curiousity, there are some things that are not open for conversation, unless the transgender person chooses to discuss it. The anatomical makeup and genital configuration is one such topic that is very personal.

Myth #2: Providing Transgender-Inclusive Benefits is Prohibitively Expensive for Companies. 

Jamaica is not at the stage yet where trans-inclusive healthcare is available from employers. However, it’s important to state here that providing such coverage is not expensive to companies. Trans-inclusive healthcare should be covered under the basic healthcare coverage afforded to all employees. Transgender health benefits are critical to well-being and productiveness of the transgender person, and therefore beneficial to the success of the workforce.

Myth #3 – My Child is Too Young to Know They’re Transgender

As parents and guardians, it’s important to listen to your child in all matters that concern them. The exploration of gender identity is no different. Children are by nature curious: they seek to know more about themselves and the world they live in. If a child has questions about their gender identity or gender expression, then caregivers need to be open to discussing these topics. The child’s emotional health and well-being should be what’s most important and a non-judgmental, loving and open conversation can go a long way towards the long-term success of the child.

Myth#4: Transgender Healthcare is ‘Special Care’

Transgender healthcare is NOT ‘Special Care. The transgender community is no different from the larger community that they exist in. Transgender people are a subset of the population and need healthcare just as all other persons do. Everyone’s medical needs are not the same. It is very important within our Jamaican context that healthcare coverage includes the needs of the transgender population so that the community can access services specific to their needs. Everyone has healthcare needs that are specific to their own needs, and the transgender community is no different. The mandate of the medical profession is to provide ‘special care’ to all. The acknowledgement of the transgender community and their needs is important in order to provide services for ALL Jamaicans.