Transgender Rights are Human Rights

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

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

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

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

Ban Ki-moon

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

Nelson Mandela Human Rights

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

 

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TRANS PROFILE – FJ (Part 2)

This is the final part of the series on FJ. Part 2 features a discussion on his identity as a transgender man, some of the challenges he faces and some of the changes he wishes to see. (First part of profile.)

What is it like to identify as a transgender man, living and working in Jamaica? What are some of the challenges you face?

I was fortunate enough to be in the minority of college graduates who acquired a job within a year of completing their studies. That doesn’t mean however, that I landed a job as soon as I began looking. In fact, that’s quite far from the truth. I had been interviewed countless times for jobs I was qualified for and more than competent to perform, but had been denied because of my gender expression.

In Jamaica, being gender non-conformist in your gender expression automatically brands you as gay or lesbian. As such you are discriminated against in the slightest or most egregious of ways. So given that I was designated female at birth, my masculine presentation worked against me in some of these instances.

You can identify such occurrences because from the moment you step into the establishment you see the reactions on their faces. You feel the stares and become aware of the faint whispers and hushed tones amongst members of staff. The interview commences. Questions are asked and you respond, but they’re not listening; not really.  I have only been on one interview during which I felt that the interviewer was genuinely interested in getting to know me and actually listening, not just hearing, to my responses. Not surprisingly, I currently work for him.

My work environment is special. The culture at the company is familial. Everyone supports each other, not only career-wise, but in their personal lives as well. They attend family gatherings such as funerals, weddings and even christenings. But despite such a congenial atmosphere, there are times when I experience homophobia. I would call it transphobia, but their motivations lie in their perception of my sexual orientation and not my gender identity.

When I first began, it was worse than it is now; especially from other persons who worked in the building that my company shares. To be fair, they were rather “polite” about it, as very few were bold enough to question my choice in attire or my perceived sexual orientation. Now they have more or less gotten used to me, but I still get the occasional quip or inappropriate look.

I’m eternally grateful for the existence of a gender neutral bathroom. You can only imagine the reactions I received from the women while attempting to conform to convention and use the bathroom that coincided with my body parts. The discomfort was too much for me to bear. I gave up on trying to appear normal, which in turn resulted in a more comfortable situation for everyone else. I always go to the men’s room in other public spaces though.

Being constantly misgendered is something I’m building my tolerance to; just as I am with the crude street harassment to which I am constantly being subjected. Some of my coworkers are aware of my identity as a transgender man, others are not. My office consists of quite a few Christians and other individuals with strong beliefs regarding gender identity and human sexuality. So while I don’t appreciate the language used, I’d rather not stir the pot if you catch my drift.

Do you have a support network? What are some of the resources that help you navigate life in Jamaica as a transgender man?

Hmm. A support network. Yes I am very fortunate to have made a family out of supportive friends and of course I can’t leave out my Twitter peeps lol. When I began owning my identity and coming out, I thought that it was only my friends that would have been accepting and supportive of me. However, I was, as I usually am when I make these assumptions in my head, so very wrong. Yes my friends accepted me with open arms, but gradually, over time, some of my biological family came around as well. I’m tempted to call her my little cousin, but she isn’t so little anymore, so I shall refer to her as my younger cousin. She is a living testament to the fact that regardless of my gender identity or sexual orientation, there will always be at least one family member (apart from my mom) who loves me unconditionally.

Growing up I learned to be self-reliant. I don’t possess strong familial ties with the exception of those I share with a few of my family members. Even so, during my turbulent teenage years, there wasn’t really anyone I could confide in that would help me to successfully navigate those stressful and trying times. Subsequently, I internalized everything and developed my own coping mechanisms; though how well they work is another story entirely. So I don’t use resources as much as I utilize exercise, work and my hobbies to keep me occupied and my friends and meditation to aid in keeping me grounded.

A group of gender non-conformists are in the process of establishing a more formal support group for persons who don’t conform to society’s gender binary. It’s an initiative I’m looking forward to being a part of and I hope tremendously that it will prove to be beneficial to those involved. Mental health is of the utmost import to trans and queer persons; especially those who experience gender dysphoria. Having a support system is just as crucial as accessing the appropriate health care that will enable queer and transgender persons to lead healthy, balanced and productive lives.

 

What are some of the changes you wish to see regarding the accessibility to healthcare for transgender men and women in Jamaica and the wider Caribbean?

Tackling the issue of providing adequate health care services for transgender individuals in Jamaica will be an arduous task. Ideally, our framework would include comprehensive policies and procedures for providing health care to transgender persons; complete with legislation to ensure that the rules implemented receive the strictest adherence and failure to comply is met with equal retribution. Sadly injustices against LGBT persons still run rampant in our society. We have to ensure that when trans persons attempt to access these services, they are not met with the same discrimination that is already all too commonplace in their everyday lives.

I know that expanding our health care sector to cater to the transgender community might be novel and exciting to health care professionals, but we are not guinea pigs and I would hate for us to be treated as such. I believe that a concerted effort between all parties involved – medical institutions, medical professionals from various segments, insurance companies, legislators and the trans community is the only way to successfully achieve a suitable and sustainable outcome. Our services should not be the result of a doctor “trying a ting”.

I am an advocate for sensitization and training sessions for current medical personnel, as well as the inclusion of transgender specific issues in the curriculum for persons aspiring to enter the medical profession. All too often are our doctors and nurses ill-equipped to handle the nuances of delivering services to transgender people. They often misgender their patients and use offensive language, albeit sometimes unknowingly. Still, this can result in members of the trans community refraining from accessing healthcare services in the future. Refusing to use their preferred name may also be distressing, as is the inability to use a gender-neutral restroom, or at the very least the one patients prefer to use.

Usually, as soon as persons hear the word “transgender” they automatically think “surgery” and “transitioning”; but there is so much more to trans people than transitioning and their surgeries. As such, the approach to healthcare for the transgender community should be holistic and not centered solely around hormone therapy or surgical procedures.

On top of all of this, the healthcare services being offered need to be affordable. Unemployment rates for those belonging to marginalized populations tend to be significantly greater and this affects their ability to afford healthcare. Subsequently, healthcare is not usually one of the top priorities of said population. We need to work in conjunction with healthcare providers and insurance companies to ensure that this vulnerable group is able to access these services which are especially crucial to their overall wellbeing without said access adversely affecting their pockets.

Do you face any other challenges you wish to discuss further?

Retaining my sanity? Lol. I kid. On a serious note, living in an environment that can be quite hostile to LGBTQ individuals demands a magnitude of resolve that is unbelievably and undeniably hard to maintain consistently; day in, day out. Some days are better than others, but we are humans after all, not machines.

 

What advice would you give to transgender men and women living Jamaica and the wider Caribbean?

You are not alone in your strife. There are many others like you who face similar struggles. Find or build a support system if you can, even if it consists only of online interaction. Isolation is dangerous and having a support system will vastly improve your mental and emotional health. Also, in whatever you do, stay safe. We all desire full self-expression but be mindful of your social context. Visibility is important but please remain as safe as you possibly can.

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

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

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

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

What’s the situation in Jamaica?

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

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

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

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

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

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

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

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

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

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

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

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

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

Sources

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

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

(iii) Resources and Publications – JASL

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

Transgender Mental Health

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

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

Source: World Health Organization

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

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

Gender Dysphoria

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

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

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

Transtition Process

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

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