Tag: healthcare

Dr. Oz is trying to take gender-affirming care coverage away from trans Medicaid recipients

*This is being reported by LGBTQNation.

Mehmet Oz, the newly confirmed administrator of the Centers for Medicare & Medicaid Services (CMS), is telling state Medicaid officials to stop covering gender-affirming care for transgender youth. Medicaid is the joint state-federal program that covers health care for people with low incomes, including 40% of minors in the U.S.

A letter sent from the CMS to state Medicaid directors said that the program should stop reimbursing gender-affirming care for minors, including puberty blockers, hormone therapy, and surgical interventions. The letter says that there is an “underdeveloped body of evidence” supporting gender-affirming care despite the research showing that it’s a safe and effective treatment for gender dysphoria, which is supported by all major medical organizations in the U.S. The letter also cites the U.K.’s “Cass review,” a report on gender-affirming care that has been criticized for its bias against transgender people.

In a statement, Oz – who was confirmed by the Senate earlier this month – said that gender-affirming care can lead to sterilization, and that’s why the CMS is cracking down on it.

“Medicaid dollars are not to be used for gender reassignment surgeries or hormone treatments in minors – procedures that can cause permanent, irreversible harm, including sterilization. CMS will not support services that violate this standard or place vulnerable children at risk.”

Republicans in the Senate at first balked at Oz’s nomination, not due to his lack of qualifications for leading the agency but because he had, on television, expressed more liberal views when it came to acknowledging that trans kids exist and supporting reproductive freedom. The White House assured Senate Republicans that Oz is now transphobic.

Taking away health care from trans minors in low-income families just a week into his tenure at the CMS may reassure Republicans of Oz’s conservative credentials.

In January, the president signed an executive order targeting gender-affirming care for trans minors and some young adults. The order told the Department of Health and Human Services (HHS) – under which the CMS is organized – to “take all appropriate actions to end the chemical and surgical mutilation of children,” including by changing “Medicare or Medicaid conditions of participation or conditions for coverage.” Referring to gender-affirming care as “mutilation” is a tactic used by anti-transgender activists to sway public opinion against the care that has been shown to save lives.

Former HHS official Adrian Shanker, who worked at the department under former President Joe Biden, said that the CMS letter misuses regulations to limit gender-affirming care coverage.

“I don’t think this letter is using those regulations in good faith,” Shanker told Advocate. “This letter is using highly politicized language that is not grounded in the mountain of evidence that supports the underlying health and well-being of trans youth.”

“It frankly looks like a campaign document,” he continued. “It looks like a document written by anti-trans activists rather than by public health professionals and health care leaders.”

Shanker pointed out that the letter itself is not legally binding but that it will lead states to cut off coverage for gender-affirming care.

“The significant fear here is that this ‘Dear State Medicaid Director’ letter will be utilized to preclude access to care even further in some states,” he said. “And the risk of that is actually very significant because we have incredible amounts of data that confirms the health impacts of denying access to care for trans youth.”

In 2015, trans reality TV personality and author Jazz Jennings appeared on Oz’s talk show, and he complimented her mother for being supportive.

“I love the support you’ve given your daughter,” Oz said. “It’s wonderful. And you can see the beautiful young woman she’s becoming because of it.”

This was before Oz entered the political realm. The exchange, though, led to Sen. Josh Hawley (R-MO) sending a letter demanding the administration explain the ten-year-old episode.

“Have your views on this issue changed since you hosted your television show?” Hawley’s letter demanded, asking if Oz supports the administration’s position that “gender transition procedures for minors should be banned.”

In a statement, a spokesperson for the White House said that Oz would follow the president’s views on the matter, saying that everyone in the administration will follow his “playbook.”

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A 50-state look at the well-being of LGBTQ+ young people

*This is being reported by University Business.

The well-being of LGBTQ+ young people suffers not because of who they are but due to mistreatment and stigmatization, a leading suicide-prevention organization contends.

The Trevor Project has released a state-by-state analysis of the mental health of LGBTQ+ teens and young adults. The survey of 18,000 LGBTQ+ young people ages 13 to 24 examines suicide risk, access to care, discrimination, bullying and the impact of anti-LGBTQ+ policies, among other factors.

The Trump administration has impacted support and awareness for LGBTQ+ students across colleges and universities. A recent Dear Colleague letter has demanded institutions to dismantle diversity, equity and inclusion programs, which usually house support for LGBTQ students. GOP lawmakers across Florida, Texas and Iowa have also targeted academic programs related to gender studies.

Young people made the following statements about where they live:

I live in a community that is accepting of LGBTQ+ young people.

  • Arkansas: 36%
  • Hawaii: 88%
  • Idaho: 31%
  • Puerto Rico: 60%
  • Washington, D.C.: 97%

I or my family have considered leaving for another state because of LGBTQ-related topics politics and laws.

  • Connecticut: 19%
  • Kentucky: 56%
  • Montana: 53%
  • Texas: 58%
  • West Virginia: 46%

Percentage of LGBTQ+ youth who have seriously considered suicide in the past year:

  • Arizona: 39%
  • Colorado: 41%
  • Louisiana: 32%
  • Michigan: 37%
  • Vermont: 44%

LGBTQ+ young people were physically threatened or harmed:

  • Alaska: 16%
  • New York: 22%
  • Rhode Island: 17%
  • South Carolina: 25%
  • Wyoming: 29%

LGBTQ+ youth who reported experiencing symptoms of depression:

  • Alabama: 56%
  • Kansas: 49%
  • Maryland: 48%
  • Tennessee: 57%
  • Utah: 53%

LGBTQ+ young people who wanted and received mental health care:

  • Florida: 44%
  • Massachusetts: 58%
  • Mississippi: 41%
  • New Jersey: 55%
  • Wisconsin: 53%
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I was misgendered for having “female breasts” as a kid. Here’s why it hurt.

*This commentary by Matt Keeley was originally published by LGBTNation.

Some cisgender people think the recent Republican fad of banning of transgender people from sports and bathrooms won’t affect them, and that if people just conform closely to gender stereotypes, they won’t have trouble. But these don’t realize that random nuts have confronted cis women in the ladies’ room just for wearing pants and having short hair.

Gender policing goes from controlling how we look to controlling how we behave. And cis people who have never been misgendered may not realize just how much it can hurt… but as a cis man who has been misgendered, I do.

As a kid, I had gynecomastia, a condition where prominent breasts develop on a boy or man. And my breasts were indeed prominent — probably a C- or D-cup in bra size. It started around when I was 10 or so. While we never figured out the reason, it doesn’t really matter when you’re in middle school and kids confront you in the bathroom, calling you “titty boy.” 

Even friends would make the occasional crack to my chagrin. I remember once talking about how my uncle’s internal organs were backwards; one of my friends immediately joked, “And you’ve got two hearts: here and here,” gesturing at each breast. It didn’t feel great!

I hated my breasts. I often fantasized about chopping them off. It was never gory or gross in my mind — it usually was more like picking off a scab — a little bit of pain at first, but then perfectly fine with a normal chest just like every other boy.

The teasing changed my relationship with my body. My nipples usually inverted into my areolas by nature. But whenever they weren’t, I’d push them back in because, in my weird kid mind, women’s breasts had outward-facing nipples for babies to feed. If mine pointed inward, then that meant they weren’t breasts like what women had, and were…. something different.

I didn’t know the word “dysmorphia” at the time, but looking back, it seems like a manifestation of that. Most of all, I wanted to ignore that my breasts even existed. I hated even using the word “breast” in any context. While taking swimming lessons, I’d refer to the breaststroke as the “whip-kick stroke” based on the leg movements. When I wore collared shirts, they had chest pockets — men had chests, women had breasts.

While the teasing and bullying was bad, unintentional cruelty was somehow even worse. One expects bullies to be mean and to focus on one’s flaws. But if someone unintentionally misgendered me, it felt like they couldn’t help but hurt me, based solely on my appearance, infringing on my misguided attempts to ignore and feel indifferent to my own body.

One moment that’s seared in my brain (and will be for the rest of my life) happened around age 11 one afternoon at an office supply store. I needed a new graphing calculator for math class. I approached a worker kneeling on the floor, re-stocking the bottom shelf. 

“Pardon me, do you know where the graphing calculators are?” I asked.

“Oh, sure, sir,” he said, turning and seeing my shoes. 

His eyes raised to my chest and said, “…ma’am…”

His eyes then hit my face and he quickly went back to “sir,” before telling me where they were located.

I could tell he wasn’t being mean, he was just processing the visual stimuli in the order presented. I could tell he was embarrassed and neither of us wanted to call attention to his error, so I thanked him, and went to pick up the TI-85 calculator I needed. 

I have no idea if he remembers that day at all. Probably not. But it’s a moment I relive over and over. I was wearing my standard uniform of jeans and a loose-fitting green/yellow Hypercolor T-shirt — it was the early ‘90s after all.

It’s hard to explain why it hurt so much to be mistaken for a woman. It wasn’t merely that it proved I was “different” from other boys. It wasn’t shame at being seen as a woman or less than “manly” — in fact, I don’t think real-or-perceived misogyny played a part in what happened or how I felt. I’ve always had various “feminine”-coded interests even as a kid: In first grade, I loved The Baby-Sitter’s Club book series (which features mostly girl characters) and I’d often pretend to be the magical Mrs. Piggle-Wiggle from the classic children’s novels.

The misgendering bothered me more so because it just wasn’t me — I wasn’t being perceived correctly. I couldn’t put it into words; I wasn’t necessarily “manly” and had no real desire to be seen as such, but I was a man (or at least, I would be one day when I grew up).

I was lucky; I was able to get a breast reduction — top surgery in trans masc parlance — the summer I turned 13. My surgeon, Dr. Kropp — whose name somewhat matched his surgical specialty — was excellent, and confirmed that I had excess breast tissue, not just fat. 

That fall, I came into a new school as a high school freshman, and no one ever commented on my chest again; I was thankfully average. Friends even seemingly forgot about it, and no one asked about the change.

It took me a very long time to get over it — my chest was the one thing I was sensitive about. I’m pushing 45 now; it’s been 30 years, and the wounds have finally scabbed over. (The figurative ones, I mean. As for the actual surgical scars, those healed very nicely and relatively quickly after the procedure.)

But it took decades for me to get over the misgendering. And I immediately “passed as male” otherwise, if you wanted to call it that. It was just: one day boobs, one day none. So I can only imagine the pain that accumulates over when a trans person gets misidentified for so long, sometimes even after transitioning. 

Misgendering can lead to depression and psychological distress. (It certainly did for me.) It can also create a sense of emotional exhaustion. I know that when I came home from a particularly bad day at school, I just wanted to shove everything out of my mind, and just veg in front of the TV. But the teasing made me think about self-obliteration. I never attempted suicide — but the idea of just not existing for a while definitely appealed to me.

Truthfully, these days, when I start feeling very anxious, stressed, or depressed, the idea of not existing for a while still appeals to me. And I can’t help but think that this desire to disappear first began when people mocked and mistook me for having “female” body parts.

I have just a glimpse of how cruel Trump and his transphobic followers have been in their constant crusade to demonize and misgender trans people. I can’t imagine feeling the full force from a lifetime of this meanness — the years I endured it was enough for me.

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US health agencies scrub HIV, other data to remove ‘gender ideology’

*This first appeared on Reuters

Jan 31 (Reuters) – The U.S. Centers for Disease Control and Prevention and other federal health agencies on Friday took down webpages with information on HIV statistics and other data to comply with Trump administration orders on gender identity and diversity, raising concerns among physicians and patient advocates.

CDC webpages that appear to have been removed include statistics on HIV,among transgender people and data on health disparities, among gay, lesbian, bisexual and transgender youth. A database tracking behaviors,that increase health risks for youth was offline.

Earlier this month, President Donald Trump ordered the federal government to solely recognize male and female sex and eliminate diversity, equity and inclusion programs.

The Office of Personnel Management gave agencies more specific guidance on how to comply with the orders in a Jan. 29 memo,saying they were to be completed by 5 p.m. ET (2200 GMT) on Jan. 31.

It specified that agencies must end all programs that promote or reflect “gender ideology extremism” by recognizing a self-determined gender identity rather than biological sex. The measures include removing references to gender identity online.

A spokesperson for the Health and Human Services Department, which oversees the CDC, said any changes to websites follow this guidance.

“There’s a lot of work going on at the agency to comply,” said a source who was not authorized to speak publicly, adding that the CDC is “taking down anything on the website that doesn’t support this executive order.”

Deletions from the CDC’s site include pages with data on HIV in the United States in general, as well as pages with statistics on HIV in Hispanic/Latino people, women, by age, and by race and ethnicity.

The elimination of such data “creates a dangerous gap in scientific information and data to monitor and respond to disease outbreaks,” the Infectious Diseases Society of America and the HIV Medicine Association said in a joint statement.

For example, a page with information about how people can get HIV tests was offline on Friday, according to the Internet Archive, as was a page for doctors with information about testing for HIV and treating patients.

“This is very alarming,” said John Peller, head of the AIDS Foundation Chicago. “In many cases, basic health information is going dark.”

Timothy Jackson, senior director of policy and advocacy at the group, said they are going through the CDC website and printing out information used to educate people about HIV that may not be accessible after Friday.

Also missing from the CDC’s website was the Youth Risk Behavior Surveillance System, which tracks trends in tobacco use, teen pregnancy, unsafe sexual behavior and other aspects of teen health.

At the National Institutes of Health, a senior employee this week urged agency leaders to refuse to implement the Trump administration’s guidance in an email to acting NIH Director Matthew Memoli and other top officials that was seen by Reuters.

The employee, Nate Brought, director of the NIH executive office, said Trump’s orders ran contrary to years of NIH research and findings about sexuality and gender.

“By complying with these orders, we will be denigrating the contributions made to the NIH mission by trans and intersex members of our staff, and the contributions of trans and intersex citizens to our society,” he wrote.

“These policies will lead to mental health crises or worse for tens of thousands of Americans who contribute productively to our communities.”

Reporting by Julie Steenhuysen in Chicago and Ted Hesson in Washington; Additional reporting by Jaimi Dowdell in Los Angeles and Brad Heath in Washington; Editing by Leslie Adler and Bill Berkrot.

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Trump Bans Gender-Affirming Care for Minors 

*This was first published by The Hill

President Trump on Tuesday signed a sweeping executive order meant to broadly restrict access to gender-affirming care for transgender children and teenagers younger than 19, inching closer to fulfilling a key campaign promise to ban treatments that he and his administration have cast as experimental and dangerous, in conflict with major medical associations and transgender health experts. 

“Across the country today, medical professionals are maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child’s sex through a series of irreversible medical interventions,” Tuesday’s order states. “This dangerous trend will be a stain on our Nation’s history, and it must end.” 

“Accordingly, it is the policy of the United States that it will not fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures,” the order states. 

Every major medical organization supports gender-affirming care for transgender adults and minors, although not every trans person chooses to medically transition or has access to care. 

Trump’s executive order, titled “Protecting Children from Chemical and Surgical Mutilation,” tasks federal agencies with rescinding or amending policies that rely on guidance from the World Professional Association for Transgender Health (WPATH), including the organization’s latest standards of care, released in 2022. 

WPATH, a nonprofit professional organization devoted to transgender health care, did not immediately return a request for comment. 

Trump’s order tasks the incoming Secretary of Health and Human Services (HHS) with publishing a review of existing literature on best practices “for promoting the health of children who assert gender dysphoria, rapid-onset gender dysphoria, or other identity-based confusion.”  

Rapid-onset gender dysphoria, which claims that adolescents identify as transgender because of influence from friends or social media, is not recognized as a valid medical diagnosis by major professional medical organizations. In 2021, 61 professional health care organizations, including the American Psychological Association, signed a letter stating the condition lacks “rigorous empirical support for its existence.” 

According to Tuesday’s order, heads of executive departments and agencies that provide research and education grants to medical institutions, including medical schools and hospitals, should take immediate steps to block funding for institutions that continue providing gender-affirming care to minors. 

Meredithe McNamara, an assistant professor of pediatrics at Yale University specializing in adolescent medicine, said the provision amounts to “an immediate de facto ban on medical care” for trans youth who receive care at academic medical centers. 

“It basically defunds those medical centers if they continue to provide that care,” McNamara said of the order. 

“This is a stunning example of how all health care is tied together, and how the most effective way to attack gender-affirming care is to attack the entire health care apparatus as a whole,” she added in an interview. “They’re holding everyone hostage and saying, ‘We’re going to take away everyone’s healthcare unless you systematically deprive just these people.’” 

Trump’s executive order additionally directs the HHS Secretary — a position he wants for Robert F. Kennedy, Jr. — to bar access to gender-affirming care for transgender minors through federal programs like Medicaid and Medicare and withdraw the department’s 2022 guidance supporting gender-affirming care. The secretary should issue new guidance, in consultation with the incoming attorney general, “protecting whistleblowers who take action related to ensuring compliance with this order,” according to Tuesday’s order. 

The executive order also directs Defense Secretary Pete Hegseth to draft a rule to exclude coverage for gender-affirming care for minors from TRICARE, the military’s health program. Former President Biden in December signed a $895 billion defense policy bill barring TRICARE from covering transition-related care for transgender children of active-duty service members, a provision that military families with transgender kids called a “slap in the face.” 

Tuesday’s order similarly tasks the director of the Office of Personnel Management with taking steps to remove coverage for gender-affirming care for trans youth from federal health plans. 

It also asks the attorney general to prioritize enforcement of existing federal laws against female genital mutilation, which carry a penalty of up to 10 years in prison. The attorney general should also “prioritize investigations and take appropriate action to end deception of consumers, fraud, and violations of the Food, Drug, and Cosmetic Act” by entities that may be “misleading the public” about the long-term side effects of transition-related care. 

Republican state attorneys general have, in recent years, used consumer protection laws to investigate individuals and organizations that provide gender-affirming care to minors. A Senate Finance Committee report released in April claimed that at least four GOP attorneys general — Ken Paxton of Texas, Todd Rokita of Indiana, Jonathan Skrmetti of Tennessee and Andrew Bailey of Missouri — abused their oversight authorities to “further ideological and political goals.” 

Trump’s executive order additionally directs the attorney general to work with Congress to “draft, propose, and promote legislation” to enact a private right of action for children, as well as their parents, “whose healthy body parts have been damaged” by medical professionals practicing transgender health care. 

The attorney general should also take “appropriate action,” the order states, “to end child-abusive practices by so-called sanctuary States,” including through the potential application of the Parental Kidnapping Prevention Act, a federal law preventing one parent from interfering with another parent’s custody rights. 

Conservative organizations celebrated Trump’s executive order Tuesday evening. In a joint statement, Independent Women’s Forum and Independent Women’s Voice said the move restores the “true meaning of ‘care’ for America’s youngest generation.” 

Kristina Rasmussen, executive director of Do No Harm, a health policy group that opposes gender-affirming care for minors, said Trump’s order prioritizes “safety, scientific integrity, and family autonomy.” 

Omar Gonzalez-Pagan, senior counsel and health care strategist at the LGBTQ civil rights organization Lambda Legal, called the order “morally reprehensible and patently unlawful” and said the group would sue. 

“The federal government — particularly, this administration — has no right to insert itself into conversations and decision-making that rightly belongs only to parents, their adolescent children, and their medical providers,” he said. 

The executive order comes after Trump signed separate orders declaring that the federal government recognizes only two sexes, male and female, and barring transgender people from serving openly in the military. 

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