WTF Missouri, Gender Affirming Care is Vital For Everyone!!!

 

As I was catching up on email I read one of my news emails from earlier this week that made me go WTF, WTF, WTF. Currently a Missouri judge has temporarily halted the first-of-its-kind rule restricting access to gender-affirming health care just hours before it was set to take effect but that is no guarantee that the law will be stopped. 

The proposed emergency regulation clearly misses the point on several levels:

• There is NO transgender emergency/epidemic
• Correlation does NOT mean Causation
• While transgender individuals especially transgender youth have much higher rates of suicide and suicidal thoughts, those thoughts are not why they are transgender. 
• Being suicidal has not made anyone transgender, while not being able to access gender affirming care has led to suicidal thoughts
• Many of the other health issues that are to be screened for are important but it is not an either/or situation. 
• For example "Ensuring that any existing mental health comorbidities of the patient have been treated and resolved" is confusing since in many cases not being able to transition or get gender affirming care is the reason for the mental health issue in the first place. 

Among all the proposed regulations (see next section) honestly the one that personally stood out to me was the one about "Ensuring that the patient has received a comprehensive screening to determine whether the patient has autism."***

I think this highlights the difference between what makes sense on paper and what makes sense in term of people's lived experience. 

• Should more people be screened to see if they are autistic? Yes. 
• Does being autistic mean you can't be transgender too? No. 
• Does either being autistic or being transgender make you the other? No

Personally having who I am (autistic) used against another community (my transgender siblings) as a way to prevent them from getting the gender affirming care they need and deserve, or at least making the process much longer and more complicated really hurts. 

We should not be put in competition, everyone deserves to get the supports they deserve and the care they need. 

*** Also it is important to note that getting an autism diagnoses or lack of diagnoses is a very long and involved and costly process. This is one of the reasons I doubt I will ever be formally fully diagnosed (I did have one therapist say it fit but they did not do any formal process) as an adult. So I have an understanding how this requirement is simply putting up barriers to individuals getting the care they need. 

The proposed emergency regulations (note this is not even a law it is one individual dramatically reducing the rights of trans individuals to get gender affirming care) include:

• Prohibiting gender transition interventions when the provider fails to ensure that the patient has received a full psychological or psychiatric assessment, consisting of not fewer than 15 separate, hourly sessions (at least 10 of which must be with the same therapist) over the course of not fewer than 18 months to explore the developmental influences on the patient’s current gender identity and to determine, among other things, whether the person has any mental health comorbidities
• Ensure that any existing mental health comorbidities of the patient have been treated and resolved
• Ensure that, for at least the 3 most recent consecutive years, the patient has exhibited a medically documented, long-lasting, persistent and intense pattern of gender dysphoria
• With respect to a patient who is a minor, ensure that the patient has received a comprehensive screening (at least annually) for social media addiction or compulsion and has not, for at least the six months prior to beginning any intervention, suffered from social media addiction or compulsion
• Maintain data about adverse effects in a form that can be accessed readily for systematic study
• Adopt and follow a procedure to track all adverse effects that arise from any course of covered gender transition intervention for all patients beginning the first day of intervention and continuing for a period of not fewer than 15 years
• Obtain and keep on file informed written consent
• Ensure that the patient has received a comprehensive screening to determine whether the patient has autism
• Ensure (at least annually) that the patient is not experiencing social contagion with respect to the patient’s gender identity