Suicide Prevention and Intervention: Supporting Transgender Communities
Articles,  Blog

Suicide Prevention and Intervention: Supporting Transgender Communities

Good afternoon and welcome to the Suicide
Prevention and Intervention Supporting Transgender Communities Webinar. My name is Brandy Brooks,
and aside from being the moderator this afternoon, I am a contract manager for the Massachusetts
Department of Public Health Suicide Prevention Program, the sponsors of this Webinar. Before I introduce our presenter, Gunner Scott,
I would like to go over a few housekeeping issues. First, should anyone experience any
technical difficulties with either the audio or video for this Webinar, please dial 1-800-843-9166.
Again, that’s 1-800-843-9166, and a
ReadyTalk representative will be more than happy to help. Second, all telephone lines are muted except
for mine and Gunner’s, so please use the Chat function located in the bottom left corner
to type any questions you may have. Again, all lines are muted except mine and Gunner’s,
so use the Chat function if you have any questions or are experiencing any technical difficulties. Now that I’ve gotten that out of the way,
let me introduce our presenter, Gunner Scott. Gunner Scott is the Executive Director of
the Massachusetts Transgender Political Coalition and a nationally recognized activist, educator,
and community organizer on transgender rights, LGBT health issues, and LGBT partner abuse.
He has written articles for What’s Up magazine, Sojourner Women’s Forum, and “Agitate and
Activate,” the introduction to Pinned Down by Pronouns, a 2003 Lambda Literary nominee
anthology published by Conviction Books. He is on the Board of Directors for the Equality
Federation, on the National Board of Advisors for the National Center for Transgender Equality,
a Commissioner on the Massachusetts Commission for GLBT Youth, and a founding steering committee
member of the Transgender Advocacy Network, a national coalition of state-level transgender
political groups. He holds a B.A. in Liberal Arts from Goddard
College, where he completed an oral history project titled, “Boston Area Transgender Community
Leaders and the ENDA Crisis.” In 2008, MTPC partnered with DPH, the Samaritans, and Fenway
Health to produce transgender-specific suicide prevention education materials, the first
of this kind in the United States. So without further ado, I will now turn it
over to Gunner. Thank you, Brandy, and thank you, everyone,
for taking the time out to be on this Webinar with us today. It’s pretty exciting. This
is my first Webinar, so please forgive any technical glitches that may happen as I move
forward with this. And I look forward to folks’ questions and conversation over the Chat. So I’m just going to start with outlining
a little bit about some guidelines and a little bit about my organization and how we came
into doing this work, because it may seem a little interesting to see a political organization
taking on suicide prevention work. But we do see this as part of our mission as well. Just some guidelines. First, whenever I do
these types of trainings, I just like to let folks know is wherever you are is okay, that
I have no expectations that we’re all coming in with the same information, and we probably
all won’t leave with the same level of information. I work with a number of different organizations
and groups and, really, the issues, particularly around transgender folks, and also I would
say lesbian and gay/ bisexual communities, is that folks have different levels of comfort,
information, and things like that. And wherever you are is okay. Please participate and ask questions. And,
as Brandy said, we’re going to take those through Chat. And if there isn’t time to answer
questions, I will be available through email to answer any further questions, and we’re
going to provide some more resources as well as a follow-up. Please speak from your own experiences, and
we’re going to all attempt to be non-judgmental. I believe, particularly for transgender folks,
there is a diagnosis that is sometimes associated with being transgender. But our organization’s
stance is that being transgender is a healthy way of being, and that it’s inherently not
a mental illness. But, unfortunately, as we’re going to find out through this training, that
stigma, and social stigma in particular, can exacerbate issues around depression and other
things like that. And with that being said, we’re not here to
diagnose or stigmatize folks any further. So the Massachusetts Transgender Political
Coalition is dedicated to ending discrimination on the basis of gender identity and gender
expression, and we do this through the lens of state-level work. We are an organization
that does public policy work, lobbying on behalf of statewide and local legislation
as well as identifying gaps in services and resources and things of that nature. The reason that we got involved in particularly
providing and identifying and pulling together materials and resources around transgender
suicide prevention and intervention was that our organization was contacted a few years
ago by a number of community organizations and community members when we had had three
suicides of transgender individuals across the state. And the interesting thing that
we saw was that many of these individuals were what we call “post-transition,” meaning
that they had already transitioned and they were living their lives as the gender they
see themselves as, yet were feeling extremely suicidal and, unfortunately, had taken their
own lives. The community members were looking for resources
to (1) support themselves in dealing with losing someone in their community, and (2)
they wanted to begin to educate folks in their own peer support groups. And so I started
doing some research and tried to find any materials and recognized that there was nothing
specific to transgender people. And so I approached the Department of Public
Health about this, and we came up with a working group to work on those materials and produced
two brochures. We are in the process of producing some further materials. One will be a video
on how to support somebody who’s dealing with feeling suicidal, and that will be a peer-level
video. And hopefully, that will be out in the next couple of months. And we’ve been
spreading these materials and information around the country as well as worldwide. So I wanted to open this with talking about
some of the experiences of transgender youth and adults, and just to help folks get an
understanding of what is happening in our community from the research that’s been done
as well as looking at specifically the issue of suicide in the community. So I would ask folks to take this poll. And
the question is, “What is the approximate rate for suicide ideation in the transgender
community that you believe?” And to make sure that you hit Submit so we can record those
responses. So we’ve gotten a good number of folks who
have responded to the poll. And from the poll answers, we’re seeing that, “E – more than
30%,” we had the majority of folks clicking on that. And that’s actually correct, that
we do see more than 30% of folks in our community having experienced suicide ideation and also
suicide attempts. As I said earlier, there has not been a lot
of research on the transgender community. There is some specific research, particularly
on HIV prevention and some on substance abuse. And then in 2009, the Massachusetts Department
of Public Health did do a survey looking at the health outcomes of lesbian, gay, bisexual,
and transgender persons in Massachusetts, and they did some comparisons to heterosexual
folks in the community as well. And the major finding they found in that was that transgender
persons had worse outcomes with respect to self-reported health, disability status, depression,
anxiety, suicide ideation, and lifetime violence victimization. The question that was asked specifically around
suicide or attempting suicide, was respondents were asked if, in the past 12 months, they
had seriously considered attempting suicide. And 30.8% of transgender people reporting
on that survey did respond that they had seriously considered attempting suicide as compared
to 2.3% of heterosexual men and women, 4.4% for gay men and lesbians, and 7.4% for bisexual
men and women. The survey did not break down the difference
between what we call transgender women or male-to-female transgender folks or female-to-male,
or transgender men. Since that survey was done, there has been
a national survey done by the National Center for Transgender Equality and National Gay
and Lesbian Task Force. And the survey results were released–there were preliminary survey
results released last year specifically on unemployment, but they just recently released
the full 300-page report, and Massachusetts was given a breakdown of our numbers. And
we found that 35% of transgender men and women have reported attempting suicide at some point
in their lives. So that’s slightly higher than what we saw in that report with the Department
of Public Health. And then nationally, they found that 41% of respondents had reported
attempting suicide as compared to 1.6% of the general population. We saw rate increases for those who had also
lost a job due to bias, so 55%; were harassed or bullied in school to 51%; and had low household
income or were the victim of physical assault at 61%; and were the victim of a sexual assault
at 64%. So the coupling of being transgender as well as experiencing what we call social
discrimination, harassment, and violence, then therefore exacerbated that suicide ideation,
and those numbers did increase. I’m going to stop for just a few minutes and
see if there’s any questions specifically about the data before I move on to the next
section. Yes, someone has their hand raised. Then we’ll take a question from Julie Evan. The question is, “Can you distinguish between
suicide ideation
and suicide attempts?” Those have not been distinguished in those surveys. The question
asks specifically around attempting suicide in the national survey as opposed to the local
survey, which just talked about people thinking about that. I do think the number of other
surveys that have looked at this that are much smaller. The numbers were ranging between
16% and 32%, and the questions were both–some questions were around suicide ideation and
some were around suicide attempts. All right. So we’re going to move to the next
slide, and this is actually–and I will come back to the question that was just asked in
just a few minutes. We’re going to move to the next slide, and this is actually for you
all to think about, which is how do you know what your gender is? And this is a question
that’s specifically asked a lot of times for transgender people or people who are questioning
their gender identity, that often people first go to is, “How do you know what your gender
is?” We see this particularly with young people, with questioning, the people don’t know who
they are. And I’d like to turn that on its head and ask people whose gender matches up
with how they present and what they were labeled at birth and say, “How do you know what your
gender is?” And most people, when I ask that question,
have said, “I just know. This is just how I feel inside.” And that is the same thing
for transgender people, is that we know what our gender is. It’s the world that sometimes
is confused by us, and that for some of us, we are in the process of figuring that out.
And what I mean by that is figuring out if we’re going to live as the gender we believe
ourselves to be, and that’s really what it comes down to, is that for some of us, that
process can be very short. For other folks, it can take years. I work with families who have children as
young as six or seven who are very clearly saying to their parents, “Stop calling me
a boy. I know I’m a girl,” and I work with other folks who have struggled with this all
their lives. And then when they meet other transgender people or start to get information,
it’s kind of like a light bulb goes off and explains those questions that they’ve had. So the next question I’d like to ask folks
to take a moment and answer is, “Do you think sex and gender mean the same thing?” And while folks are just answering that, one
of the other questions that came in was, “Is there any other state-level data available
that you’re aware of?” I am not aware of any state-level data specific to suicide ideation
or attempts other than the data pulled from the NGLTF survey and the Mass Department of
Public Health survey. There are a few smaller community or regional
surveys that do have some data. Most of those now are pretty old. There was done in 2003
through an organization in Cambridge and there were some others done in the early 2000s and
late 1990s. Great. So most folks have responded to that
question. And the response was no, 92.5%. And it’s interesting when I ask that question,
that when we think about forms that we’re asked to fill out or check boxes, whether
that’s going to reapply for your driver’s license or other things like that, a lot of
times, forms will either say “Sex – Male or Female,” and sometimes they’ll say, “Gender
– Male or Female.” and that sometimes the forms are not distinguishing about those. Recently, in the last couple of years, the
Department of Transportation, through the Registry of Motor Vehicles, changed the way
that they ask the question about people’s sex and/or gender. For a long time they asked
for “Sex – Check Male or Female,” and then they changed it to “Gender – Check Male or
Female.” And for many people, they may not even have noticed that. But when they did do that, we here at MTPC
started to get some calls from transgender people, saying, “Does this mean I get to put
down the gender of who I am?” And at that time, the registry wasn’t ready for that,
but I don’t think that they understood that for transgender people, we often see that
difference. So I just want to talk a little bit about
sex versus gender, just to kind of talk about the culture and community of transgender folks
and to think about it through that lens. So when we talk about sex here at the Mass Transgender
Political Coalition, we’re talking about the assignment at birth of male or female based
on anatomy. And that really is looking at the child and saying, “This child is a boy,”
or, “This child is a girl,” based on their anatomy. There are a small percentage of folks who,
for some doctors, they may not be able to label that right away because they may have
a medical condition called intersex. And intersex is different than being transgender. Intersex
is also its own training. There are 27 different medical conditions that make up intersex.
For some, they are labeled intersex right at birth because based on their physical being.
And for other folks, they may get labeled intersex when they get closer to puberty. So intersex is different than transgender.
There are some intersex folks that have a gender picked for them and it doesn’t match
up with who they are, and they may transition. And that’s one of the places that it kind
of gets confusing. But intersex is about your physiology as opposed to transgender, which
is about people’s kind of like their mind not matching up with their brain. Gender is, itself, the culturally defined
codes of behavior, presentation, social rules, based on men and women. And this is specific
to different communities, different areas, sometimes different religions have different
codes of behavior for men or women, different ethnicities, races, things like that. There’s
a US kind of predominant culture about gender and what that should look like, but it really
is different around the country. And when I travel around the country, there is different
ways that men and women express themselves. And those gender codes and those gender behaviors
shift over time. If we think back around women trying to win women’s rights, that women were,
a lot of times, wearing skirts and dresses and were made to feel like they couldn’t wear
pants, and that has shifted over time. And so we do see the way that people express their
gender change with time as well. Gender identity is how someone identifies
their own gender. We all have a gender identity. Many of us, that matches up with what our
assigned sex is what the gender is that we use to describe that. But we all have a gender
identity. And for transgender people, our gender identity doesn’t necessarily match
up with what the assigned sex was at birth. We express our gender identity through gender
expression, and that’s how someone expresses that. It’s also the keys that other people
use to identify another person’s gender. For some folks, the inability, not to clearly
define someone’s gender, can make people very uncomfortable. And for some people, they relate that uncomfortability
with being unsafe by not being able to figure out, “Is this person a man or a woman.” And
that inherently doesn’t mean that someone is unsafe. If someone’s walking down the street
and they can’t tell if it’s a man or a woman, they’re just walking by somebody, that doesn’t
make that an unsafe situation. For most of us, when someone is walking down
the street towards us, that’s the first thing we’re trying to figure out, “Is that person
a man or a woman?” because that tells us how we’re going to act or not act, how we’re going
to react to this person or we’re not going to react. And for some folks, they’re socialized
to act a certain way around certain genders. Women are socialized to act a certain away;
men are socialized to act another way. For transgender folks, sometimes the social
cues is what throws people off. If you were not raised a certain way, then you may not
have all those social cues yet, and that can throw people off as well, and that’s when
people, again, become uncomfortable. But for many folks, they learn those social cues,
and they become part of who they are. So the term “gender identity” or “expression”
is also embedded in some of our local laws and policies. Here in Massachusetts, we have
four cities and towns that do protect on the basis of gender identity and gender expression
in non-discrimination laws. There are some states, there are 13 states that also have
this, and Massachusetts is working on their own state law. But states around us like Maine,
Vermont, Connecticut, Rhode Island, also have these protections in place on the state level.
There’s approximately 142 other cities and towns that do protect on the basis of gender
identity or gender expression. The typical definition within a law or policy
currently is “a gender-related identity, appearance, or expression or behavior of an individual
regardless of that individual’s assigned sex at birth.” And what that means is that people
get to be treated as the gender they’re expressing themselves to be and they generally see themselves
as. So we live in a very gender-binary society,
which basically says there are only men and women. And I will say that historically, there
have been accounts of people who have been outside that gender binary. There are accounts
in different cultural communities and ethnic communities that have shown more than two
genders. But here in the US, we predominantly see male or female. There are people also who gender expression
doesn’t conform to traditional gender stereotypes of what men or women should act or look like,
and they don’t identify as transgender. I work with a lot of youth and young people,
and young people, oftentimes it’s gender expression was what they used to kind of push people’s
buttons and express their individuality, and it doesn’t necessarily make them transgender
unless they identify that way. There are some folks that have a gender expression
that isn’t considered the norm, and that might just be for one day, or that could be just
how they express themselves in certain parts of their lives. A lot of entertainers use
gender expression as a way, as a part of their entertainment, you know, all the way through
folks such as Madonna, who’s definitely pushed the gender boundaries. Lady Gaga today is
one of those folks who pushes gender boundaries and things like that. Gender identity and gender expression is different
than sexual orientation, and I think sometimes this can be confused, because oftentimes we
see the GLBT, or Gay, Lesbian, Bisexual, Transgender together. So we see sexual orientation describing
a person’s physical, romantic, emotional attraction to another person. So that is folks, who they’re
attracted to. Transgender people also have sexual orientation
as well as straight folks, gay, lesbian, and bisexual folks, but they are not the same.
The experiences sometimes of transgender people and lesbian/gay/bisexual folks are similar
in some experiences, particularly around discrimination and sometimes violence, which is why the community
is put together, as well as we have people who are transgender and also identifying as
gay, lesbian, or bisexual. So sexual orientation is separate, and the
sexual orientation laws and policies don’t often protect transgender folks, because it
is seen separately in the law as well. So I have a question. It’s, “How are you defining?”
And I guess I would ask, with defining which term? So we’re getting to how we’re defining
transgender. So we define transgender as a term that refers to people live as the opposite
sex from what they were born as. It has also been described as an umbrella term to cover
a lot of different folks. But the easiest one is to refer to people who live as the
opposite sex or gender from what they were born as. At some point, transgender people decide to
live as the gender they are, and that is to transition to that gender. We would suggest
to people that use the term “transgendered” with the “ed” on the end, so if you’re thinking
about creating materials or things like that, “transgendered” is an older term that’s not
used anymore. I often say it’s like we don’t say the word, “gayed.” So we do ask folks
not to put out materials that way. There are some folks in the community who may describe
that term for themselves that way, but when we think about materials and things like that,
to be universal. Okay. We do include a number of folks under
that umbrella, the trans community. There are folks who identify as transgender, transsexual,
cross-dressers also may identify under the umbrella, gender-queer, which is a newer term.
Drag. There are some drag performers, such as drag queens or drag kings, who consider
themselves under the transgender umbrella. There are also some performers that do also
consider themselves under the gay and lesbian umbrella. We also include partners and family,
because they sometimes experience secondary discrimination, and they also have to also
come out in some ways as well The question I’m getting now is, ‘Can you
give an example of would a person who is transgender that is also identified as gay?” So I will
give this example when we get to talking about male-to-female and female-to-male in just
a moment. So gender transition–that’s the term that
we use–is the personal process in which a person begins to openly identify and live
as the gender they see themselves as. Medical transition is just a small part of that; it’s
not the whole process. For many folks, it starts with what we call the social transition
process, which means for some people changing their name, changing their gender presentation,
changing the pronoun that they are asking people to use for them. And then for some
transgender folks, they may or may not use medical transition as well. And I’ll talk
a little bit about that in just a moment. So for some folks, the name change, some folks
go on and do a legal name change. For some people, they may not have the monetary means
to do that, depending on the cost. There are some places that it’s been difficult for people
to get a legal name change through the courts because of transphobia. There have been some
cases with judges who feel like, that people shouldn’t be able to change their gender and
therefore won’t allow name changes. We’ve seen that happen. So not all transgender people
are going to have that legal name change, which means that some people are going to
have IDs and things like that where they have one name, their legal name on a piece of ID,
but the name they go by is something different. And so we often suggest, particularly if people
are making forms, to put down what is the legal name, especially if they have to use
health insurance, something like that, and then, “What’s your preferred name?” I think
for folks to think about is there are plenty people that are alive that have nicknames,
and that that’s the name they go by. And not to say that the name someone uses for themselves
that is transgender is considered the same weight as a nickname, but we think about forms
and things like that, there are a lot of folks who use a different name for themselves and
may not legally change that name. Changing someone’s gender presentation, for
some people, it may be very drastic, and for other folks, it might be more subtle. You
know, particularly society here in the US, and particularly in the Northeast, where gender
transition is–I’m sorry, gender expression–can sometimes be kind of gender-neutral in some
ways. So I’m getting a question asking about a Massachusetts
law, the harassment, the Massachusetts Prevention Order, harassment. And it’s asking if transgender
folks are covered. Transgender people are not covered in the harassment law. That’s
actually one of the laws that we’re trying to change here. We’re trying to change the
nondiscrimination laws as well as the hate crimes laws, so transgender people are currently
not covered in that law. And I just want to talk a little bit about
the process of people coming out and transitioning, and it’s somewhat similar to people who are
identifying as gay, lesbian, or bisexual, but it is significantly different for folks.
It’s about a personal evaluation, and that’s the place where people are questioning, “This
gender that I was assigned at birth, does this really fit who I am? And what would it
mean for me to move forward and live as the gender I see myself as?” For some people,
the next step is preparing for that transition. And for many folks, that’s finding a therapist,
a peer support group, folks in their community that can help support them through that process
and figure that out. For many people, they then move on to what
we call the real-life experience, so living as the gender they see themselves as. And
at this point, for some folks, they may start medical transition, and that could be hormone
replacement therapy so that folks can present and get the secondary sex characteristics
of how their gender is for them that they’re going to be living as. This is the place where
people start coming out to family, friends. Often the workplace is the last place that
most people come out because of the fear of losing their job or being discriminated on
at the job. And so that is often the last place that people start their transition or
come out in their transition. For some folks, they may lose family and friends
and community support as they start to do their transition. Sometimes people do get
those folks back in their lives, but it could be a long process as well. Transition doesn’t
just affect the person who’s transitioning; it affects all the people around them, and
that can go in different ways. And so for some people, they may lose a lot of their
support systems they had before. At some point, people start, people are living
and presenting and not being seen as their former gender and they go into what we call
“post-transition.” And that is that people are, for some people, they’re no longer even
using the word “transgender” to describe themselves and that the people are just living as who
they see themselves to be. And that, for some folks, they may not disclose that they’re
transgender, and there’s no law that says that people have to disclose that. It is personal
information, just like anything else. For some people, they do live openly as transgender,
and for other folks, they do not. And that, as I say, with many things is to think about
confidentiality and that someone may disclose that they’re transgender to the person they’re
working with. But the question to ask is, “Should I be putting this on your chart? Do
you want me to let other people know? Do you want to just keep this between you and I as
the counselor?” or whatever your role might be. And so to think about that as well. Another question I have just received is,
“How do you define transsexual versus transgender?” The term “transsexual” historically has meant
people who are medically transitioning and changing their sex medically. Today, we don’t,
not all folks who use the term “transsexual” to describe themselves are going through medical
transition or are going to have gender reassignment surgery. There are some people who identify
as non-medical transsexuals. “Transsexual” is an older term that was given
to us in the community by the medical establishment. And for some people, the word “transgender”
fits better because it doesn’t have the word “sex” in it, which can be kind of highly loaded.
And for some people, they see themselves is that they’re changing the way their gender
and the way they present their gender. So terminology, particularly in communities
that are oppressed, oftentimes is given by folks that are from that community. And as
time moves on and people feel more empowered in the community because they’re more empowered,
people start to develop their own words and own language in that. Another question I’m receiving is, “Is transgender
common among all the races?” and the answer is yes. Although the term “transgender” may
not be used in different ethnic and cultural communities, that we do see other terms being
used, and that other ways to describe that. There are some folks that may, some cultures
that see transgender people as the third sex. We see this particularly in Southeast Asia.
The Native American culture, they have actually identified five genders, and so people fit
within, folks are in those different five genders outside of male and female. Historically,
we have seen examples of people changing their gender. And in some religions, it’s actually
seen as a great thing, and that for some, particularly the Buddhist religion, it’s been
said that it’s not unusual for someone to change their gender during their lifetime.
So there’s different texts and different historical documentation of what we would label as transgender
people. Today the language has shifted since even
the 1970s. In the 1970s, particularly around Stonewall, which was kind of the birthplace
of the gay rights movement, folks that participated and were part of that movement, some described
themselves as “street queens,” and the way that they described who they were would be
what we might identify as transgender or transsexual today. I’m getting another question. Do I have any
information on the prevalence in the military? Here in the United States, recently Don’t
Ask/Don’t Tell was repealed, and that does not actually apply to transgender communities.
It only applies to sexual orientation, because transgender is still listed in the Diagnostic
Statistical Manual, and so that’s one of the ways that people are not able to serve in
the military. There are countries that do allow transgender
people or transsexual folks to serve. Australia recently has allowed this. Britain is another
one. There’s actually five, but I can’t remember off the top of my head. But we do not have
any knowledge of folks who are currently serving in the military, because if they did come
out, they would be discharged. There is actually a significant population
of transgender women and men who are veterans, who have served before they came out. And
there’s a Transgender American Veterans Association. So if folks are interested, I can make sure
that information gets out. So I just wanted to talk a little bit about
some terminology and ways that people describe themselves. Folks who were born male to transition
to female, M-to-F, or male-to-female. “Transgender woman” is another way to describe that. And
these are folks who live and identify and present as female or as women and use female
pronouns. Next is female-to-male, or F-to-M, transgender
men. A transgender man, someone who is born female, transitions to live and identify as
male and uses male pronouns. And these are, again, are just two of the
identities, but these are more common ones that most folks see. Some public health forms
now are including male-female, M-to-F and F-to-M, on their check-off boxes, and that’s
one way to do that. We often say that the best thing to do, if you really want to capture
people’s gender identities, is to put gender with a line and letting folks fill that in,
but I do recognize that the Scantron machines don’t like that. And so one way we do say
is for people to add M-to-F and F-to-M to their forms. Another way is a two-part question,
which is, “What sex were you born as?” and “What gender do you live as?” That’s another
way to do that. As I mentioned before, transsexualism is listed
in the Diagnostic Statistical Manual. There is an organization called the World Professional
Association of Transgender Health, or WPATH, which used to be known as the Harry Benjamin
Association. And there are standards of care for people who are transitioning, specifically
to people who are medically transitioning. But oftentimes gender therapists and other
folks who work with transgender folks do follow these guidelines in some ways. They are guidelines,
and oftentimes they’re personalized to the person that they’re working with, and that
the guidelines urge folks who are gender questioning to see a mental health professional for at
least three months to a year before starting, particularly, hormone therapy, and that for
folks who do need to access sex reassignment or gender reassignment surgery, they would
be required to see a mental health professional at least a year, and they also have a signoff
from a psychiatrist as well as a mental health counselor. And I had one person who raised their hand
with a question. And the question is, “What about individuals who feel that they are neither
gender?” There are folks that do feel like they are somewhere between genders or that
they are neither gender. For some folks, they use they use the term “gender queer” to describe
themselves. I know the term that was also used is androgynous. We do still see some
people using those types of terms, and that’s, unfortunately, because they do live in such
a binary gender system or society, that it forces people to pick one or the other, so
that the majority of people do end up presenting, at least on the spectrum, masculine or feminine
spectrum, in some way, and are pretty much forced into picking a box. That, I think, one of the stereotypes and
misconceptions about transgender folks is that the people want to flip-flop from one
day to another. And that’s not necessarily true. One community that’s often talked about is
the cross-dressing community. And typically, cross-dressers cross-dress as the gender they,
that many times cross-dressers are talking about embodying both genders, but when they’re
cross-dressing, they’re usually doing that away from their kind of normal, day-to-day
work life, and that they’re often out with other cross-dressers, that cross-dressers
do not come to work dressed one way and then dress differently another way. What we do see happening, particularly for
folks that are accessing low-income services, such as homeless shelters, is that because
folks don’t always have access or it’s not safe to present a certain way, that for some
of our folks who are male-to-female, they may be presenting a little bit more gender
neutral when they’re out in the street, so to speak. And that when they do come into
a shelter and they’re able to be in a safer place, that they present more feminine. And
this is around safety issues and also access issues. For some folks who are low-income, they do
not necessarily have access to medical transition, even if they do want to have that. And so
to remember that folks who don’t have particularly financial access is that they may be doing
the best they can with what they have. But it does not make them any less transgender
or the gender they see themselves as. Another question I received is, “Are the guidelines
different in other countries?” And the answer is yes. The medical transition guidelines
can be different in other countries, that most gender therapists do follow the standards
of care, so to speak, but the access to medical transition may be different in other countries. For instance, in some of the European countries,
they do require people who are transgender and want to change their gender identity documents
to have had certain medical procedures done. And they actually still require folks to identify
as heterosexual and not be gay or lesbian. And we did see this here in the US about 15
to 20 years, but we don’t anymore. We do see that in some of the European countries, and
there is a push to remove that, because that’s forcing people to be a sexual orientation
they’re not. Just to talk a little bit more about the medical,
the barriers to medical transition, that it does require a mental health diagnosis. And
for some folks, they may feel like that is an extra stigma upon them. And so for some
people, they may not want to go through a medical transition because they don’t want
to be labeled with a diagnosis. And the diagnosis currently is gender identity disorder, although
it is going to be changing in the DSM-5. But for some folks, they don’t see it as a disorder.
They see it as who they are, and this, again, is a healthy way of being. For many people, it’s financial ability. The
cost to medically transition is pretty expensive. And it’s typically not covered by health insurance.
Any, even, sometimes therapy is not covered by health insurance as well. And so for many
folks, they may not have the financial access to do that. And then talk a little bit about
what the poverty levels are in the community in just a few minutes. Another issue is access, that not all states,
cities, or towns have good primary care doctors, therapists, or other medical health professionals
that are familiar with transgender folks and are welcoming of transgender people. Here
in Massachusetts, we do have the Fenway Community Health Center, which has a transgender health
program. But for many of my folks out in western Mass or even central Mass or the south coast,
as we call it, there is not identified primary care physicians or other specialty physicians.
And so for many folks, they do have to come all the way into Boston, and if people don’t
have the transportation means, that can be very difficult. There are also health issues for some people
which may preclude them from particularly hormone therapy, people who have liver disease
or liver problems, as well as high blood pressure, heart conditions, things like that. So for
some people, they may not be able to be on hormone therapy. For some, we’ve also found
some folks who have been allergic to some of the oils that, particularly testosterone
is suspended in, and so for some people, they’ve had a difficult time finding hormone replacement
therapy that they’re not allergic to. For other folks, it’s personal reasons. For
some people, when they start presenting as the gender they see themselves as, they start
to pass–and what we mean by that is that people don’t see them as the gender they see
themselves–you know, see them as their old birth sex–and then for some people, that
is when they become more comfortable in their body. And when we talk about transition, it’s really
about transgender people finding a place that we’re comfortable in our bodies, and that
is different for each person. And then for some folks, they may belong to a religion
or have religious reasons on why they don’t medically transition. Another question I’ve received is, “Do you
know what countries subscribe to the WPATH?” I don’t know exactly which countries do, but
the WPATH website may have that type of information listed. So for transgender folks, the reality is that
many of us live and present the gender we see ourselves as without medical transition,
and for some without hormones and for many without gender affirmation surgery. For many
folks, they do want to go through a full, what we call medical transition, but may not
have the financial means or the support to do so. And for many folks, they may be saving
to do that, and it could take them anywhere from five to ten, sometimes 20 years for people
to be able to save up and to pay for those types of surgeries and transition care. So I’m going to move into talking specifically
about suicidality in the community and just some of the things that we’ve learned and
things that we’ve seen in the community. Just thinking about stressors contributing to suicidality,
discrimination and violence in particular. It’s one of the main sources that we see that
can contribute to suicidality, so discrimination or victimization by parents or family of origin,
by significant other people in their lives, and then thirdly, by strangers. And the same survey that I cited earlier,
the national survey, found that family acceptance was a protective factor, but it still, that
the rates were still high, but were even higher for folks who experienced family rejection,
that we are seeing a shift in family acceptance over the last 15 years. I work, again, with
many young people and their parents, and we’re seeing more and more parents participating
in coming to parent support groups and things like that specific around transgender folks
in their lives. And part of the issue is that there hasn’t
been specific support for families in the last 15 to 20 years as there have been for
gay and lesbian family members, and that’s only started to build in the last few years,
as well as more information and resources available, and just generally more kind of
exposure to who transgender people are, particularly in the mainstream media. That having family acceptance is a protective
factor, but unfortunately, we do see a high rate of suicide attempts, at 32%, whereas
with family rejection, we’re seeing 51%. Other stresses that contribute to suicidality–low
self-esteem due to coping with being transgender. And what I mean by this is not that–I think
another stereotype is that transgender people are inherently going to be sad and depressed
because of who they are, and that’s not necessarily the truth to it. It’s really about the external
experiences of discrimination and living in a world that’s not supportive and is actually
stigmatizing that can exacerbate depression or other things like that. Many folks talk about coming out and being
able to be who they are and feeling just exhilarated to finally figure it out. And it’s kind of
like a roller coaster, and so people are going up, and they’re like, you know, finally happy
to be kind of free in their minds, say like, “Oh, this is who I am and now I can live as
who I am,” and then it just kind of flips down when they start to go out into the world
and maybe their job has not been supportive and they’ve been fired or they’re trying to
find a job, or people who were close to them in their lives leave them, those types of
things. And then secondly is internal, mostly around
body image and body satisfaction, and really about struggling with having a body that doesn’t
match who you see, you inherently know yourself to be. This can also be exacerbated by a history
of depression as well as substance abuse, drug and alcohol abuse. Some of the external things that we have seen
and we have found, 47% of transgender people have either been fired or lost their jobs
for being transgender; 97% have suffered harassment on the job. And that in the community, we
have doubled the rate of unemployment, at 13%. And I just wanted folks to know this
study was done before the economic crash. So when things were actually going pretty
well economically, that we still saw double the rates of unemployment. Fifteen percent of our community live on less
than $10,000 per year, which is double the rate of the general population. And so if
we think about folks, the impact of poverty on people and their ability to access resources
and support and things like that. And that 19% of our community members have been homeless
or are currently homeless at this time. And I actually think that number is probably lower,
because the survey did do some in-person participants, but a lot of this was done online, and so
for the folks who don’t necessarily have access online, they’re not necessarily going to be
contributing to a survey. And then the majority of our folks are not
accessing homeless shelters or places like that, because they’re often discriminated
against or treated poorly or made to stay on the side of the shelter that doesn’t represent
who they are, and therefore experience violence and victimization because of that. For young people, this is pretty troubling
for us to see this. Anecdotally, we kind of knew some of this information, but Massachusetts
specifically, we found that transgender and gender non-conforming youth in the K-through-12
setting had a rate of harassment at 79%, physical assault at 31% and sexual assault at 11%. And this was not just from their peers, but
this included staff as well as teachers and administrators in the schools, and this, I
would say, unfortunately, is also along with some of the calls that we get here at our
organization. And oftentimes it’s parents who are supportive of the young person who
is experiencing harassment or violence in the school system, and either that’s from
the peer or the teacher, and the administrators are not doing anything to deal with it. For some of our young people, the harassment
is so bad that they do have to leave school. And we saw 11% of students leaving school,
both in K-through-12 as well as higher education. The Southern Poverty Law Center, which does
a lot of work around looking at hate violence, found that transgender women of color were
particularly often viewed by criminals as “disposable people.” And what is meant by
that is that the police aren’t necessarily going to do anything to investigate crimes
against transgender women of color particularly, and that by targeting those folks, that they’re
probably not, they’re not necessarily going to be considered as a viable community. And unfortunately, we do see hate crimes against
transgender women and transgender folks at a rate of about one a month. I think it’s
actually a little bit higher than that. And we recently had three here in Massachusetts
in the last month. And they range from being harassed by neighbors in their homes, as well
as family members, as well as strangers. And as I said, the documented murders of transgender
people annually, the majority of them have been transgender women of color, particularly
young transgender women of color, and that in some years they’ve been every documented
murder. I think a major difference between our community
and other communities is that we don’t get the same media attention. The murder of Matthew
Shepherd occurred in 2000, and here in Massachusetts we had a transgender woman murdered two weeks
after his murder and we could barely get the same kind of media coverage for her murder.
And her murder is still unsolved. And then medical transition. So there are
some mood effects to hormone therapy which may change how people are coping or reacting
to things. Transgender women who are on estrogen therapy may have increased or activate depression.
And then for transgender men who are on testosterone therapy, that may increase the risk of acting
on suicidal thoughts. But they’ve shown in some studies that testosterone therapy over
time has the decrease of depression, and that for many folks, if they’re not able to stand
their hormones, they have that hormone imbalance happen. That can also exacerbate things. This
is particularly troubling–we work with folks who are in prison settings and have gone into
prison on hormones and then are abruptly taken off of them. Or, particularly for people who
are not able to financially pay for them, and that can be also an issue. Denying hormones and/or gender affirmation
procedures or gender transition can really exacerbate suicidality or initiate suicide
ideation. And so even though there is some risk to hormones, we do not see the risk as
being exceptionally high, that the risks are higher if people are not allowed to be who
they are and to be able to medically transition if they need to. I just want to touch on some resiliency factors
in the community because, unfortunately, there’s not a lot of research done on that. But from
the things that we’ve seen and the things that we know about the community, for folks
who are not involved heavily with the transgender community, just to have some understanding
of some things that we’re doing to take care of ourselves and our friends and family. For many people, gender transition allows
someone to really live in a well-adjusted life in the gender consistent with their gender
identity. And then, for many folks, they talk about being able to finally be who they are. For folks going through gender transition,
there are peer support systems in place. One of the things that we have historically done
is have support groups made up of peers, of other transgender folks. Many of these support
groups are in person, and there are many online support groups now, particularly for people
who are in rural areas or places where there are not as many transgender folks available. I was in Texas last year, and I met another
transgender man, and I actually was the first transgender man he had met in person. He had
done all his support online and had not personally met another transgender man but had reached
out and had a support group online and participated that way because of where he was living. He
was too far away from a large enough city that had a peer support group in person. For some people, they may have current or
previous connections with therapists. Again, if someone is going through a medical transition,
they’re often in therapy or have been in therapy at some point, and so there are some connections
that way. A question I’m being asked is, “What can schools
do to be more supportive?” I think one thing is to really take into account policies and
procedures for transgender students and their families. For some students, they don’t want
to be out in schools, and so to really keep that information confidential. And even if
someone has not legally changed their name yet, to make the name they use for themselves
in the records and things like that so teachers know to call that student by the name, provide
appropriate access to bathrooms and locker rooms and things of that nature. I think also
having in place specific anti-bullying policies and teacher trainings and administrator trainings
on how to support transgender and gender non-conforming youth is one way to do that. And then another question I’m receiving is,
“Can you give an address of an online support group?” And I will be providing materials
and links to Brandy after this and will include some links to some online support groups. So I did get some kind of startling statistics
around employment for transgender community members, but what the national survey also
found was that over 78% of the transgender adults surveyed reported feeling more comfortable
at work and had improved work performance after transitioning despite the same levels
of harassment. And so people really being able to be who they are in the workplace and
live their life as who they are. And it can also help them get through some of that workplace
harassment. Another question I’m getting is if I can explain
the relationship between testosterone therapy and suicidal tendencies. I wouldn’t have time
to do that at this point, but what I can do is I know there’s been some studies on that,
and I can also include that in the materials that will go back out to the group on that
particular study. The other thing to note about the community
is that even though the mistreatment in school is considerably high, the transgender community
itself has considerably higher rates of educational achievement than the general population. Forty-seven
percent of the community surveyed had received a college or graduate degree compared to only
27% of the general population. And then we saw many people returning to school later
in life. And anecdotally, this was not surprising to us, that for many folks, they talk about
finally dealing with their gender stuff, so to speak, and being able to really, then,
focus on where do they want to be in their lives and who do they want to be as far as
their careers go and things like that. The other thing that happens is that people
who are looking for work, college settings have actually done a really god job, for the
most part, supporting transgender students and have actually been way ahead in policy
changes and things like that than many of the state and local laws. And so many colleges
are more supportive of transgender students and have those policies in place. And so we
see a number of folks going back to school because they feel like, “Well, I can’t get
a job right now, but what I can do is I can go back to school full-time, use this time
wisely, and I’ll be able to apply for student loans and get some money to live on so I can
eat and have a place to live.” And so we do see that happening quite a bit. So I work with a number of folks who have
exceptional resumes, exceptional degrees, engineers and software designers and actually
work with someone who is a cancer research and things like that. And a lot of this is
because they haven’t been able to work in the field that they want to work in or have
been pushed out of the job market because of who they are, and so people go back for
higher degrees and things like that. So I want to spend the rest of our time together
just talking about ways that you can work with the transgender community and some tips
and things like that. And one of the brochures that we have that’s specific for providers
does have some of that information as well. And we have a brochure specifically for the
community, and the pictures of the brochures are at the beginning of this Webinar. And
those can be ordered through the Department of Public Health, and that will be in the
information that Brandy will provide at the end of this. There was a study done with some folks in
our aging community, and I put some quotes from that study. And this would also anecdotally
speak to some of the folks in the community that I’ve talked with about what service providers
should know about transgender people. And Bea, she would say, “We need to be respected
for what we are. We need to be accommodated for what we are. And don’t treat us like the
sex that they perceive us to be, but treat as the gender that we are.” In other words,
allow people to be the gender they present and live and identify as, and not to place
somebody inappropriately in service provision. One of the cases that kind of brought us to
this work around suicide prevention was a young transgender man who was attempting to
get mental health inpatient services. And because he had not changed all his identity
documents, the inpatient unit wanted to place him on the women’s side, even though he lived
and presented as a male and had a male name. And he felt that that was just going to be,
that just exacerbated the issues for him, and so he did not go into inpatient treatment.
And so those are some of the reasons we really push for people to be treated as the gender
they live and present as, and not based on what someone’s birth certificate or what they
think their ID should say and things like that. Another participant in that study said that,
for John, he said that, “We need to be honored and respected and provided for our continuing
needs to be able to live physically and socially in our true gender.” And again, the same thing
is to honor people as who they are and not what people think they should be because that’s
what their birth certificate says. So here’s a question I would like to ask the
group. “Do transgender participants experience service access differently from non-transgender
participants?” So thinking about your own organization or places that you’ve worked,
do you think that those participants experience access to services differently? So if folks
want to take a moment and just answer that question, and remember to hit Submit. Thank you. And so a good majority of folks
said “certainly agree” or “agree.” And you would also say the same thing, that transgender
participants do often experience that service access differently. And part of that is some of the access barriers
for transgender participants, that for many folks, the fear of being turned away and/or
having been turned away, that for many folks trying to access even basic types of things
as a doctor or an emergency room, people have experienced discrimination in that or have
been treated so poorly that they don’t stay for the services that they need. The fear of being judged for who they are,
and oftentimes that fear, for some people, they, unfortunately, hear that judgment from
service providers. So whether that’s directly to their face or under their breath or, as
we say, around the water cooler. I worked with a state agency that was supposed to be
providing help for people facing discrimination and violence complaints. And that many of
our transgender folks who had gone over to file a complaint about discrimination somewhere
else said that when they were sitting in the waiting room, that some of the staff would
come out and look at people, and they would hear them talking about, “Oh, did you see
that man in a dress sitting in the waiting room?” and that was a transgender woman. And
so saying really judgmental or discriminatory comments about people. Disrespect of a person’s need, their pronoun,
or their gender identity. You know, I talked a little bit earlier about why someone’s identity
documents might not match up, and so providing places for people to use the name they use
for themselves. And if you don’t have that or if it’s a type of place you don’t have
an intake form, to ask the question, you know, say, “I want to call you by the name that
you use for yourself. What would that be?” and so being able to give space for people
to name who they are and also asking about pronouns. And, particularly for folks who
do telephone work or support on the phone, it can be difficult to determine someone’s
gender based on their voice. And so to make sure that we’re conscious about that and to
ask questions when needed. Using homophobic or transphobic or biphobic
language by participants or staff. And so not addressing that when it comes up, and
having a harassment policy in place is also really helpful. For some people, they’ve actually been specifically
targeted, ridiculed, or experienced physical or sexual violence by staff and administrators
in places they’re supposed to be getting service from. So a question I’m receiving is do we see kids
that transition sooner have less suicidal thoughts? I don’t know if there’s been any
studies on that. Children’s Hospital here in Boston does have a Gender Management Clinic,
as it’s called, through Doctor Norman Spack, and he may be able to answer that question
better than I would. I would also have to go back and see if we do have any research
around that. We do know that folks who are able to transition
younger tend to pass better, meaning that they’re not identified as their former sex
or gender, and that does make people’s lives easier. And so for some young people, when
they’re able to present and live in the identity they see themselves as and not have to go
into, say, college, with an old name or an old gender marker, it does make things a lot
easier for folks. And they’re also starting their work history with the name that they
use for themselves. For many of our folks who are older, not only
are you changing identity documents, but you also have to explain why you can’t contact
an old employer because they’re not going to know you by a name that you used back then.
And so for some people, it really does, for transgender people, we almost always have
to come out, particularly if we have a long work history. And so for younger people, if
they’re able to live and present and have the names they use for themselves, they don’t
have to worry so much about those types of things. So some tips, again. Reflecting back the language
the participant uses for themselves. And this is kind of universal in some ways, but the
way that someone may talk about themselves and to reflect that back, using the person’s
preferred name and pronoun and providing relevant, inclusive materials and resources. That’s
really–again, when we started this project, it was because there was a need in the community,
and materials I was finding were not relevant or inclusive of transgender people. And so,
for many folks in the community, they may see a brochure around suicide prevention or
a suicide hot line, and they didn’t see themselves reflected in that, whether that was the language
or the photo. And so people didn’t think that the place was going to be welcoming and that
they would understand who they were and be supportive. And so it’s really important to name the communities
that we’re reaching out to. Because for many folks, because of the history of discrimination
and being turned away, unless we’re specifically named, we don’t think we’re going to be welcome. So that, and we also, unfortunately, have
a long memory and don’t always easily forgive. And so if an organization has made a mistake
in the past, that for some community members, they might hold onto that and not provide
space for people to grow. And part of our work is to help build that bridge and hopefully
help service providers move forward and acknowledge past mistakes and move forward around that
and grow to be more inclusive. Front line staff, if you’re an organization
that has such a thing, really need to address transphobic attitudes and behaviors of the
other participants and to really speak up, in that even if there isn’t a transgender
person people have identified sitting in the waiting room, but a comment is made and that
receptionist says, “That’s not acceptable here,” people hear that, and so they also
feel more safe and comfortable in the service that’s being provided, because they’re recognizing
that this organization takes very seriously equality, inclusion, those types of things.
And that also does get around to the community, that, “You know what? This organization deals
with people who are transphobic, and so this is going to be a safe place for me to go.” The other thing, by not doing so, also just
reinforces the participants’ attitudes that it’s acceptable to insult or harass transgender
folks. And so to really call those types of behaviors out. So some specific tips. If you’re working on
a support line or a listening line, asking the question, “Do you have a name that you
prefer?” not making an assumption about someone’s voice over the phone, and really trying to
degender language, so not using, try not to use pronouns right away or “ma’am” or “sir.”
I think that, you know, I know we come from a culture that does, particularly some places,
“ma’am” and “sir” are a sign of respect, but that can really trip people up. And so trying
not to use those types of things and using more gender-neutral kind of greetings and
things like that. Not making assumptions about people’s partners
or family structures, that for some of us, because we may not have traditional or family
of origin support, we have made our own families. And so for some folks, to really ask the question
about, “Who do you consider your family or support system?” And to let people know that
when you’re inviting family into support systems or into support counseling or things like
that, the people get to choose who their families are, and it doesn’t have to be the family
of origin. Asking if people are connected to the transgender
support system in general, whether that’s through peer support groups, they’ve had a
therapist in the past, folks in their community. Because for some of us, being in a space that’s
all transgender people can be really empowering. And also, we can be, I don’t want to say more
honest, but more open about who we are. We do get calls from folks who have experienced
discrimination or violence or just feel sad and will say, “I’m calling you because you’re
the transgender organization, and I don’t have to explain who I am. You’re going to
get that right off the bat, and I can just dive into what the problem is.” And so for
mainstream organizations, to get to that point as well, so that people who do call or access
service support don’t have to feel like they have to go through this whole Trans 101 before
they get to really being able to talk about who they are. You know, as a transgender person myself,
if I go to a doctor’s appointment, I expect the doctor to have some knowledge and not
to ask me a whole bunch of questions about what I did to be transgender, because then
I don’t feel like he’s actually listening or she’s listening to the actual problem,
which could be that I fell and broke my arm. And so making sure that we educate ourselves
first is really important. Some tips about being an ally to transgender
people. I think the one that, if anything, if you remember from this, is need-to-know
versus want-to-know, that there are things that counselors and support groups, things
like that, service professionals do need to know, whether that’s for billing insurance
and things like that. But if you do need to know what someone’s legal name is, explaining
why is really important. It really does help people feel like they’re in control of their
information. And so if you don’t need to know what someone’s
legal name is, then don’t ask for it. And then to really think about, “If I’m going
to ask this question of a transgender person, do I need to know this, or do I just want
to know this?” And if it’s a want-to-know thing, to really look outside and look for
other ways to educate yourselves. And to really, to think about those two places before asking
questions, whether that’s on forms or in person. Not asking for former name or for pictures.
So if someone’s legally changed their name, then you don’t need to know what their name
was before. I know this can be different if someone’s applying for a job and you have
to do a CORI form, but for the most part, people don’t need to know what people’s former
names are. And I know it may sound obvious not to ask
for pictures, but that’s one of the questions that often gets asked to transgender people,
is, “Well, I want to see a picture of you when you lived as, when you born a girl, or
you were born a boy.” And it’s really offensive. It’s also offensive to ask for people’s former
name, because it sends a signal that you don’t believe who I am. Not asking about medical procedures, not basing
policies on that, so not basing policies on that transgender women can be in a women’s
support as long as they’ve had sex reassignment surgery. It’s really inappropriate. It’s private
medical information. And if the person’s living and presenting as the gender they see themselves
as, then they should be allowed to access that type of space. Not making assumptions, which is an easy thing
to say but a hard thing to do. You know, when we do our own groups here, we do ask people
to go around and give their name and the pronoun they use for themselves. That’s one way for
us to not make an assumption about someone’s gender identity. Not outing somebody, so disclosing that they’re
transgender to other folks. And again, asking the question of how you can share that information
or not. Speaking up when people are being homophobic or transphobic, as I talked about
before. Correcting mis-pronouning. And what I mean
by that is that if you know the person uses a certain pronoun and someone, your colleague
or somebody, uses the wrong one, whether they’re there or not, to correct that person. When
somebody does that for a transgender person, you’ve kind of given them the day off where
they don’t always have to educate people. And then if you know one transgender person,
you know one transgender person, that all of us are unique and different and have different
needs and experiences. Even the way we talk about language can be different. One thing,
if you’re building a relationship with somebody, is to ask how someone defines transgender
for themselves. I’ve given you a general definition, but that’s not how all transgender people
would define the term, so asking those types of questions might be helpful in building
that kind of relationship. So I’ll just take a few minutes, and if folks
could just let me know what they think they might be able to do to reach out to transgender
communities through your organization or the work that you do. So maybe just a point or
two of ways you might be able to think about doing that, and to hit Submit. I’m seeing some great responses. And I’ll
just submit those for other folks to see. Or actually, it didn’t allow that. So I’ll
just read a few of them off. Put up transgender-friendly materials as a
way to share information providers. To add inclusive language to your documents
and trans-specific, update information. To increase awareness in the mental health
clinic where the person works. To have a department participate in the Safe
Zone Training, which is GLBT training on supporting GLBT young people. Find out what transgender organizations exist
in your state and contact them to meet and discuss how they can educate their community
members and their communities. Building more collaborations with community
resources and providing outreach materials that reach the transgender communities. Participate in (inaudible) activities. Welcome young adults who are transgender to
join and be a part of the Young Adult Advisory Council. That’s a great idea. Change language and photos in brochures and
include them in focus groups and conduct presentations on risk and protective factors in schools. Have a more inclusive website and outreach
materials and a better screening process to ensure people are receiving our services,
are survivors and feel comfortable and safe knowing they’re living among other survivors. So these are great. Marketing materials and
provide unisex bathrooms. Those are some excellent suggestions, and all are really great ways
to be welcoming to the transgender community and to be advertising that your organization
is welcoming there as well. And many folks hit a lot of the things that
we also suggest on being a welcoming institution, and one of those ways is creating visible
support. And so, again, putting up posters, brochures out, materials, things like that. Understanding trans folks’ experiences and
letting trans people be the expert on their own experiences. And so we all need to analyze
in the work that we do, but to remember that those who are living as transgender and that
we are experiencing that. And I often say that we need our allies to speak with us and
not speak for us. Full integration at every level. So not only
providing services for transgender people, but thinking about how do you advertise job
opportunities, volunteer opportunities out to the transgender community. As I said before,
we have a number of highly educated folks who don’t have a lot of jobs and job opportunities.
And so to think about not only providing services, but also being a welcoming institution for
potential new staff and volunteers to your organization who are transgender. Creating that welcoming physical environment,
so providing posters and things like that, but also thinking about bathrooms and not
only having unisex bathrooms, because that is helpful to lots of different kinds of folks,
particularly folks with disabilities or small children, but also just making it culturally
known that transgender women use the women’s room and transgender men use the men’s room,
and then nobody needs to be the “bathroom police,” as we call it. Creating a critical mass of transgender people
in the organization. And so, again, advisory boards, staffing, things like that. And so
reaching out to folks to be a part of those different parts of the organization. Dealing with prejudice. And not everybody
in an organization is necessarily going to be as welcoming and inviting to transgender
participants and/or staff and/or volunteers. And so to really take that on head-on and
deal with that. If you are an organization that made a past
mistake with the community, to acknowledge those past mistakes and to see it as a way
to learn and move forward. And like all work, this is all growing and we’re all going to
make mistakes, and we’re going to move forward and hope we learn from them. To have–maybe you’re an organization that
could have transgender-inclusive programming, so something specifically for the community. Particularly, if you’re in a place where there
isn’t a lot of other GLBT stuff, and so creating that kind of hub might be a good thing to
do. Or you may be partnering up with another organization that specifically works with
the community. So understanding your role as an ally and
having fair employment practices. And so also looking to see, do you have a non-discrimination
policy that includes gender identity and gender expression? You don’t have to wait for a state
law to pass or a local ordinance, but organizations and employers can also add that to their non-discrimination
policies, both for the employees and volunteers as well as the people they serve. And some homework, which some of you have
already done, is thinking about one policy issue or problem to be addressed, or something
that would need to change in the organization that you might want to think about doing.
And when I say this, I always say to think about it in terms of like what could you do
in the next six months? And just to pick one or two. And one could be just creating visible
support and making sure you’re having conversations with the other folks in your organization
before you go and do that so that people are, you know, if you do put up that poster and
people start coming in, then all folks are going to be onboard and welcoming. Ensuring name and gender marker policies on
documents and forms if you’re an organization that has those types of things. And ensuring
bathroom access, which I talked about, and acting and enforcing nondiscrimination and
anti-harassment policies that include gender identity and expression as well as race and
other personal characteristics. And if you don’t have an anti-harassment policy, then
really think about what would that look like and what would happen, both for folks who
are going to be accessing services or currently access services as well as employees and volunteers. One of the questions I’m getting is, “We don’t
have an option for remodeling our bathrooms. Is there a sign we can use to welcome people
to use whichever one they feel comfortable with?” There is some language that I can also
include in the materials that go back out that Brandy will send out about just basically
saying that people get to use the restroom that they identify and present as, and that
we all know which restroom we’re supposed to be in, so to speak. There is no need to
create a third bathroom. Transgender men and women already use, oftentimes,
already use the bathroom they identify with. It actually causes more confusion when people
are forced into the wrong restrooms. I’m a female-to-male transgender person myself.
I present male, I look male, and if I was forced into the women’s room, women would
ask why I was there. And so to really remember that we have already been using the bathrooms
of the gender we identify with. Just some resources for yourselves. We actually
started a new project called, “I Am–Trans People Speak,” and it is a public education
campaign. It’s a website, And it is videos, written stories. There will
be some audio stories up of the experiences of transgender folks. So these are really
great learning tools. You know, asking colleagues to take a look at a couple of the videos.
We have transgender youth, adults, as well as family members. All the videos are anywhere
from two minutes to, I think the longest one is five minutes long. And people are talking
about various experiences in their lives, whether that’s with employment discrimination
or housing or family acceptance and things like that. So I do encourage folks to take
a look at that campaign. And at this point, where I’m going to open
up the rest of the time for any other further questions that folks might have. One question
that’s if the slides–the slides will not be available. I will be providing links to
materials, but the slides themselves without narration doesn’t really necessarily offer
enough. The question I’m getting is if that’s my cat.
Yes, that is my cat, Fred. I like to end the presentations on a fun note, and he’s somebody
who, you know, for many of us, we may have pets or children, people in our lives that
keep us sane, as I like to say. And if you have a question, you can just type
that into the Chat section, and we will try to take all of that. So one question I’m getting right now is,
“What age is appropriate for a teacher to discuss transgender issues with a student
or a student’s parents?” So I think, if students are exhibiting cross-gender behavior or cross-gender
expression, I think there is a–I guess the story to tell is when I did domestic violence
work, I would do presentations and I would have, I had a woman come up to me and she
thought her son was transgender because he liked to vacuum. And I said, “Well, maybe
he just likes to vacuum.” So we often look at cross-gender behavior
or expression and think of it in terms of “persistent and consistent.” So if this is
something you’re seeing with a young person, and if they’re persistently and consistently
cross-gendering their presentation or their behavior, it may be appropriate to bring up
that conversation. I do have some families who have known since
the child was three or four. That’s not typical. More often or not, it’s a little bit older.
I think it becomes more apparent with folks, with people who have young children who are
labeled male or born male at birth and they’re exhibiting feminine behaviors. Whereas sometimes
with folks who have children who were born female and exhibit more masculine behaviors,
it’s also often described as tomboyish. So again, that is something to look at “persistent
and consistent.” And again, I would also offer Dr. Spack and the Gender Identity Management
Clinic as a resource, particularly around children. My expertise is more in adults,
just to let folks know, and teenagers, so to speak. Is there a place to get a poster for “Every
Girl There Is” and “For Every Boy There Is”? There is a place that does have some gender,
what we call gender subversion posters, and we have one up here in our office. The Every
Girl or the Boy one, it’s through (sic – see, and it’s,
and I’ll include that with the materials that Brandy’s going to send out afterwards. So just to be conscious of folks’ time, it
is 2:30, and I do appreciate everyone’s support as my launch of my first Webinar, and I hope
it was helpful and useful to folks. And we’ll take some of the questions and make sure that
we get some resources and materials out there to folks. There’s quite a bit of information
also on the GLBT Youth Support Project website, as well as other young-people-serving organizations,
such as BAGLEY. And you can order the brochures through the Department of Public Health here
in Massachusetts through Alison Brill, and Brandy will provide that information as well. So thank you all so much, and I look forward
to, hopefully, meeting some of you in the future. Before we go, I’d just like to thank you again,
Gunner, for presenting, and all of you for participating. Just to reiterate what Gunner
stated, I will be emailing all participants some of the materials that Gunner mentioned,
including the links to the posters, links to online support groups, and some of the
citations for articles on the association between depression and hormone therapy. I’ll
be emailing all of that to you, either later today or tomorrow. Again, thank you all for participating. After
you log off, please take a few moments to complete the evaluation that we have for this
Webinar. I hope that you’ve gained some more knowledge about the experiences and needs
of transgender people with regards to suicidality, suicide prevention, and intervention. So thank you all for participating. Have a
wonderful day. Thank you again, Gunner. Thank you.

One Comment

  • underloved1

    Great seminar.Though i live in Canada the subjects you discussed are very informative to me.Its reasuring to me that there is a movement to enlighten others to who know or care about who i am & that i have equal rights to live as others do.thank you for taking the time & making the effort to help people like me.Thanks soo much.

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