Posts Tagged ‘ Alberta ’

On conscience-based medical exemptions

The College of Physicians and Surgeons of Ontario is currently reviewing its Human Rights Code policy on conscience-based exemptions for medical professionals, and their effect on access to medical services.

This review was sparked by a number of news reports of doctors in Ontario and Alberta refusing to prescribe birth control because of their religious beliefs. In some of those cases, patients were refused in clinics where there was only one doctor on duty.

Concurrently, south of the border, the United States Supreme Court ruled in favour of a corporation’s right to deny medical insurance to its employees when doing so would violate the owners’ religious beliefs — a case that was specifically about access to contraception. The Hobby Lobby case has been followed by several new attempts to widen the exemption, and calls to extend it to other sectors and in ways that would allow businesses to refuse service to LGBT people.

These events reflect a major shift in the way that conscience rights are being seen and applied in North America.  It is my hope that the experiences of trans* people in Alberta with conscience-based medical exemptions might provide some insights for those considering a conscience policy review in Ontario.

Alberta has had a policy for some time which allows a doctor to refuse to prescribe treatments that violate their religious beliefs in non-emergency situations. However, they are required to state that the refusal is because of their religious beliefs, and to provide a timely referral for patients to someone who will provide care, so that patients still receive service and experience a minimum of undue hardship (although to be fair, having to jump through referral hoops can be considered an undue hardship of itself, especially when one factors in the difficulties in scheduling time off from work and other real life concerns).  Ontario’s policy is similar, though not identical.

Alberta’s policy was created to protect medical professionals from having to participate in any situation that might lead to an abortion.  But in the past year, there has been an upsurge of discussion about the need for a religious or conscience-based exemption in every sector and every practice.  Access to birth control is one of the pivotal issues in play in that discussion, although it is not the only one.

As an advocate for transsexual and transgender people, I’ve needed to assist a great number of people over the years who’ve been denied medical services because they’re trans* under Alberta’s conscience exemption policy.  Sometimes people have even been denied services for things like urinary tract infections, routine checkups and cases of the flu.  To be fair, the conscience exemption is not the only factor: denials are sometimes made by doctors who say they’ve never been trained in trans* health — although this complaint is made not only in regard to trans-specific health concerns, nor does there appear to be a willingness to learn from many of those doing the refusing.

Most often, trans* people who are refused care are also not provided a referral to anyone else.  This exploits the public’s unfamiliarity with this part of the law, and that they’re entitled to a referral.  It is certainly not every medical professional who refuses to assist, but it occurs frequently enough that the trans* community has had to try to keep a list of “trans-friendly” doctors — a list that is constantly plagued by doctors no longer being able to accept new patients, or making changes in their practice or habits.  I’m always happy to add doctors to the list, with the only requirement be that they adhere to the WPATH Standards of Care (which is also the policy of Alberta Health Services).  Two years ago, someone obtained a copy of our records and stormed into the offices of several listed clinics in Calgary, raising a ruckus about doctors’ willingness to treat trans* patients, and this resulted in several requests to be removed from our list.

Although commentators sometimes note theoretical possibilities like a Jehovah’s Witness practitioner denying blood transfusions, I can say from experience that conscience policies already can and do result in people being denied access to the care they need… and are not always given “timely” alternatives.

I am sensitive to a person’s right to opt out of something because their conscience, and not just a religious-based conscience.  However, in practical experience, exemptions tend to be abused, and marginalized people pay the heaviest price.  If there is to be a conscience-based exception to medical care, a province also needs to have a much better way of coordinating timely and accessible care alternatives, and better enforce the responsibility to provide those alternatives.  In Alberta, this is difficult, since there is no centralized means of communicating with medical professionals and provide some forms of training after they’re already in the field, short of making laws — so strengthening things at a policy level proves difficult.

With the recent shift of thinking among the religious right toward making provinces “abortion-free” and denying access to previously uncontroversial things like birth control, this issue will worsen in coming years.  If there is to be a conscience-based exemption to medical care, provinces need to seek a solution to the policy quandaries this creates now.  For example, if a walk-in clinic’s only physician on duty  will not prescribe contraception, then it’s worth investigating what responsibility the clinic should have in providing a doctor who will, and in a manner that suits the patient’s needs, rather than the doctor’s.

Or what responsibility the province is taking upon itself by sanctioning health care exemptions.

(Crossposted to Rabble.ca)

MP’s trans predator fearmongering escalates.

On Friday, Sun News commentator Brian Lilley interviewed Rob Anders, the Member of Parliament who has drawn condemnation for conflating transsexual and transgender people with sexual predators in a petition he has been circulating on his website, and to at least one church in his riding. In “Children’s bathroom bill reaches Parliament Hill,” both doubled down on conflating trans people with sexual predators, and suggested that granting human rights inclusion will somehow enable and legally absolve predatory acts.  Anders claims there is “all sorts of examples of this going on.”  Which is news to anybody else.

Lilley introduced the interview by once again calling for the defunding and privatization of CBC, the network which first broke the Anders story, and which Lilley has tried to portray as ludicrous for taking note of the petition.  During this time, though, Lilley has also been taking note of a Toronto District School Board (TDSB) policy that accommodates trans kids.  Like fellow Sun News Network commentators Michael Coren and Faith Goldy, he’s made that all about washrooms.  While discussing the TDSB policy with Anders, they arrive at this exchange:

LILLEY: We are going and changing all kinds of things that… I agree with you, could put people at risk of being exposed to perverts to fix something that is, what, one percent of one percent of one percent of a subset of a subset?

ANDERS: Yeah.  You know, why would we lower peoples’ natural defenses of a man going into a woman’s bathroom in order to “accommodate” [scare quotes added because at this, Anders appears to grin mockingly or suggestively]  this very very small, you know, part of the population.  In order to expose all sorts of women and girls to this…?

At that point, Rob Anders relates a phone call that told an anecdotal story of a crossdressed peeping tom who allegedly peered over stalls in the Canterra building in downtown Calgary four years ago.  Searching various media online, there appears to be no corroboration that it even occurred, let alone that it happened as related.  The network sensationalistically underscores this story with staged photos that are supposed to be representative of trans people in restrooms, including one featuring a urinal covered in police tape, and another showing someone with a long wig and a dress standing at a urinal.  Or at least I’m assuming they’re staged, because it would be concerning if someone is snapping candids in washrooms.

At an earlier point in this interview, Brian Lilley also points to one of the men accused of chaining and abusing a Nova Scotia teen — the attacker was said to have occasionally dressed in womens’ clothing.

Most Canadians either don’t know someone who is transsexual or transgender, or else aren’t aware that an acquaintance is trans (and given my experience as a community advocate, I suspect it’s more often the latter).  For this reason, Anders and Lilley float these examples as being representative of all trans people, and as justification for excluding those entire characteristic classes from basic human rights protections.

LILLEY: “Then he’s free and clear.”

Enter Bill C-279, An Act to Amend the Canadian Human Rights Act and the Criminal Code (Gender Identity and Gender Expression), which is a human rights bill addressing employment, housing, access to services and discrimination.

The bill says nothing about washrooms, which Lilley briefly acknowledges before calling washrooms a side effect of the bill, and then continuing to focus on them at the expense of all else.  C-279 also wouldn’t change the fact that trans people have already been using washrooms appropriate to their gender identity for decades.  But it’s at this point that Lilley and Anders claim that the bill would somehow essentially absolve the people in their examples of any culpability for their actions.

ANDERS: “Then he’s free and clear, that’s right.”

Readers are invited to find any example in which rape, molestation and other illegal and inappropriate behaviours were suddenly excused because the perpetrator was a member of a class listed in human rights legislation.  As equal human beings, we are all still responsible for behaving ethically and respectfully toward our fellow human beings, and to face the legal consequences if we don’t.

We also don’t exclude entire groups of people from public washrooms (let alone human rights) on the off-chance that one of them might be a sexual predator.

When I wrote about the history of the “Bathroom Bill” meme, one thing I didn’t mention is how opponents of trans rights initiatives tended to conflate trans people with predators, and then when called on it, would habitually backtrack to say it wasn’t trans people they were worried about, but that they thought trans-inclusive legislation could provide cover for actual predators to commit acts of sexual predation.  And then they’d go on talking about “transgenders” with hairy legs and skirts stalking children and doing unmentionable things in washroom stalls, as a reason to block human rights legislation.

But with the way Lilley’s interview is presented, there’s visibly no effort at all to make any kind of distinction.

And all of this, of course, completely overlooks the dangers to safety of going the opposite direction and forcing transsexual women to use a men’s room.  Or whether women would be happy having trans men in theirs.

Which brings us to Brian Lilley’s bottom line:

LILLEY: “Why do we have all these groups mentioned to get special treatment in the Human Rights Act, in the Criminal Code?  I thought we believed in treat all people equally and fairly in this country.  And why don’t we just get rid of all this nonsense and say all people are equal above and beyond [sic] before the law?”

Overlooking the fact that you just referred to equality as “special treatment,” Mr. Lilley, it is most likely because there is ample evidence that there are clearly bigoted attitudes and beliefs about entire groups of people, conflating them with abhorrent actions and behaviours — even to the point of circulating petitions, making comments on the floor of the House of Commons, and reporting them on television as fact — in ways that make discrimination against those groups likely or even inevitable.

Sun Media’s Brian Lilley interviews Rob Anders

(Crossposted to Rabble.ca)

Rob Anders, the transsexual bogeyman, and the weird phenomenon of MPs petitioning their constituents.

Rob Anders is on a mission.  Hot on the heels of having to halfway apologize for alleging that NDP leader Thomas Mulcair drove former NDP leader Jack Layton to his grave, Anders is now sending at least one church (possibly more) a letter asking them to petition MPs to oppose Bill C-279, which would (in its current form) extend human rights protections to transsexual and transgender people.  You’d almost think he needs an easy deflection, and trans people are the punching bag du jour.

It must be important, too.  For a Member of Parliament who has gained a reputation for falling asleep during Question Period in the House of Commons, allegedly napping through presentations about homeless veterans, and about whom fellow MPs have stated that “It’s a regular occurrence… I sit across from him when we meet in Ottawa and I’ve seen his neighbours poke him awake sometimes,” this must be pretty urgent, attention-getting stuff. After all, he’s staying focused on this one.

In his original letter, he raises the alarm:

“That Bill C-279, also known as the “Bathroom Bill”, is a Private Members Bill sponsored by B.C. NDP MP Randall Garrison and its goal is to give transgendered men access to women’s public washroom facilities.

“And that it is the duty of the House of Commons to protect and safeguard our children from any exposure and harm that will come from giving a man access to women’s public washroom facilities.”

Ah, he wants to protect women.  Hence his vote in support of M-312, which hoped to make government an arbiter of what reproductive health decisions women are allowed to make.  How chivalrous.

The Calgary West MP has stirred up controversy before, sending Canadian troops a Christmas message which read, “when in doubt, pull the trigger.”  He also made international news when he called Nelson Mandela a terrorist.  In 2010, 19 members of Anders’ riding association quit citing interference from the Conservative Party, with another 5 of the 32-member board following in the days afterward.

I’ve written before about washroom panic, and the historic use of this non-existent epidemic (considering that we’ve used public restrooms for as long as we’ve existed, and not seen any statistically notable number of instances of predation) to oppose all basic human rights inclusion for trans people, and have to admit that Anders’ comments pale in comparison (probably only because of brevity) to the rant that Niagara West-Glanbrook MP Dean Allison delivered right on the floor of the House of Commons this past April:

I find this potentially legitimized access for men in girls’ bathrooms to be very disconcerting. As sexual predators are statistically almost always men, imagine the trauma that a young girl would face, going into a washroom or a change room at a public pool and finding a man there. It is unconscionable for any legislator, purposefully or just neglectfully, to place her in such a compromising position.

Still, Anders is careful to make his talking points look original, although they are really not that different from Allison’s, the panic letters previously sent from LifeSiteNews, rants by Charles McVety, or the letter sent by MP Maurice Vellacott to his fellow MPs when the predecessor of this bill, Bill C-389, trekked through the previous session of Parliament, forwarding comments from a “constituent” who turned out to be Jim Hughes of the Campaign Life Coalition.  Or the editorial written by MP Blake Richards in the Rocky View Weekly as C-389 proceeded to Third Reading.  That bill passed, but died awaiting ratification by the Senate, when the election was called.

Rise and shine, SunTV

Anders’ comments also come as Sun News Network commentators Michael Coren and Faith Goldy are reacting negatively to the Toronto District School Board’s introduction of a policy that will allow trans students to use washrooms that are appropriate to their gender identity — even the Toronto Sun implies that trans identity is whim by phrasing it as using “whichever washroom they wish.”  The TDSB ruling is in response to a 2011 ruling by the Ontario Human Rights Commission, and addresses accommodating trans kids (something badly needed), but like Anders, Coren and Goldy fixate on potty panic.  Transcribed by the Huffington Post:

“Goldy was quick to make the issue personal. ‘I cannot but help but bring this story back to my 5-year-old god-daughter and the fact that when she goes to the bathroom by herself who knows what kind of creepo is now fully permitted, he has the right now, to be standing in that bathroom and doing God knows what,’ the reporter said.”

“Who knows what” is probably peeing, and trans people value their privacy during that as much as any other Canadian, thank you very much.

Goldy, like Anders, deliberately misgenders female-identified trans people.  We know that Anders isn’t referring to anyone else when he is petitioning about “transgendered [sic] men” because the trans men I know would generally not be wanting to use the womens’ room anyway.  Granted, womens’ restrooms tend to be cleaner, but those beards might raise questions.

I’ve seen that kind of deliberate misgendering a lot, and typically the objective is to portray trans people as being deluded at best or else outright fraudulent.  But when this kind of intentional disrespect comes from politicians and media figures, it especially needs to be challenged.

“I’m petitioning you to petition me…”

Although Anders’ comments are obviously not new, it signals a growing trend when Conservative MPs start actively lobbying their constituents to lobby them for petition signatures.  This is reminiscent of Jason Kenney’s recent letter to congratulate himself on his efforts as a champion of LGBT human rights, and his previous petition to petition his constituents to petition him to thank him for petitioning them to thank him (or something) on his valiant initiative to deny health care to immigrants.  With Anders, Vellacott, Allison et al actively stirring up fears of an imaginary transsexual bogeymonster in order to defeat human rights legislation, it signals a disturbing trend among legislators — in these cases, Conservatives — by attempting to manipulate the public conversation and skew public input in a way that would appear to support their personal agendas.

Which brings me back to a point I’ve made before, and made often:

Human rights protections are necessary exactly because this irrational fear persists.  It’s necessary exactly because trans people still get conflated with sex predators and child predators, or labeled as “sick,” “perverse,” and “freaks.”  It’s necessary exactly because people become so clouded with assumptions and myths that they argue for our deliberate exclusion from human rights under the pretext that granting them would be “dangerous” or “scary.” It’s necessary exactly because this bias is so entrenched that people think nothing about broadcasting it openly as though fact.  It’s necessary exactly because this “ick factor” response is seen as justification for not allowing an entire group of people to share the same space, to terminate their employment or to evict them.  It’s necessary exactly because it is so pervasive that discrimination becomes not only likely but inevitable — especially if there is no explicit direction in law to the contrary on the matter.

And especially if that irrational meme is so prevalent that it’s being loudly and embarrassingly parroted by legislators.

The sponsor of Bill C-279, Randall Garrison, has responded to Anders’ petition, saying that “what’s most offensive about his petition is that he equates transgendered people with sex offenders and pedophiles.  This petition is obviously based on ignorance, misinformation and fear, but that’s unfortunately what we’ve come to expect from Mr. Anders.”

Rob Anders, however, has been not responding to requests for comment.  Maybe he’s nodding off, after all.

(Crossposted to Rabble.ca)

Alberta reinstates funding for Sex Reassignment Surgery

The Alberta Government has announced that it will be reinstating health care funding for sex reassignment surgery (often called gender reassignment surgery, and abbreviated as GRS by the province and its clinicians), effective June 15th.

In the recent provincial election, Premier Alison Redford was returned to power by an electorate that appears to have been hoping her government would track back toward progressive politics.  Albertans have been watching to see if her government would indeed follow through, and in what manner.  An Angus Reid poll placed Ms. Redford as the second most popular Premier currently in power.

The province had cut funding in 2009 as a “cost savings measure” — however, the $700,000 savings (provided for approximately 16 people per year) wasn’t even a sliver of the provincial health budget.  Since then, the Province has been on shaky legal ground with the funding cut, since human rights tribunals have typically recognized the procedure as being medically necessary.  It was for this reason that the Province of Ontario ultimately reinstated funding, and B.C. abandoned an attempt to defund the surgery.  Judicial court rulings (eg.) in Canadian case law also indicated a likelihood that the medical necessity of GRS would be upheld.

The Trans Equality Society of Alberta responded to the announcement with a media release:

We are pleased that the current administration sees value in caring for all Albertan’s needs, enabling them to live happy, fulfilled lives.  The return of this coverage, who’s removal only saved Albertan’s $0.18 each annually, will give hope to those for whom GRS was previously out of reach.  While there are many other issues facing Trans-identified Albertans, this is a huge step in the direction of respect and dignity for the Trans Community by the Alberta Government. Thank you for taking this important first step.

The American Psychiatric Association and American Medical Association both stress that sex reassignment surgery is a medical necessity, and a 2008 resolution by the AMA emphasized that insurance companies should cover the procedure.

Most Canadian provinces have some form of coverage for GRS, although some have problematic quirks of process or costs that can create barriers to obtaining the procedure, and some still do not fund sex reassignment procedures for trans men.  In 2008, Nova Scotia’s Liberal Party added working toward GRS funding inclusion to their political platform, although it has not yet been accomplished in that province.

Internationally, several nations have also added coverage to their public health insurance programs over the past couple of years, including Cuba, Brazil, and Chile.  Argentina recently passed the most comprehensive policies on trans enfranchisement, which included GRS funding, new name change guidelines, anti-discrimination inclusion in their human rights code, and legal protections from hate crimes.  A number of Australian provinces are under renewed pressure to provide funding after an incident of attempted self-performed surgery in an act of desperation.  There have been (trigger warning) at least three other major self-mutilation incidents reported in international media in the past year, including one person in China who self-castrated and then jumped to their death because they couldn’t deal with the pain.  Although not all trans people decide that they require surgery, for those who do, it can be an absolute necessity.

Corporations have also been rapidly adding health plan coverage to their benefits programs, including Apple, Chevron, General Mills, Dow Chemical, Chubb, American Airlines, Kellogg, Sprint, Levi Strauss, Eli Lilly, Best Buy, Nordstrom, Volkswagen’s U.S. division, the University of Pennsylvania, Whirlpool, Xerox, Raytheon and Office Depot (note: some of these may not apply in Canada).  According to the Human Rights Campaign’s Corporate Equality Index (CEI), over 200 major U.S. businesses now include trans-inclusive health care coverage featuring surgical transition-related care, including 50% of Fortune 500 companies — an increase of over 1500% in that group since 2002.

Alberta’s 2009 announcement was followed by a mass filing of human rights complaints.  Due to changes in grandfather-through decisions, some of those complaints were negated when funding was given, and others are still in process.  Due to the backlash at the time of the announcement, the province had eventually conceded to provide funding for people already in transition prior to the cut, to a maximum of 20 per year.  A number of others who had not qualified for the “Phase Out” program (usually because of the timing of their first medical appointment after starting transition) had been typically offered GRS funding as part of a settlement during negotiation stages of their human rights complaints, but have not spoken to media due to confidentiality requirements.

Although this victory is huge, some concerns about medical access remain.  It can be difficult or near impossible to find trans-friendly (let alone trans-aware) medical practitioners in several regions of the province. This can make it hard to even find general practitioners willing to treat people for medical issues that are not trans-related.  For transition care, there is one clinic in Edmonton (therapy only, currently with an 18+ month waiting list) — in Calgary, there is also a once-a-month trans health clinic operated by a psychologist and a family doctor who’ve teamed up to try to help, but the need is one that is difficult to fill with a once-a-month model.  The previous Stelmach government had shut out attempts by the trans community to speak about these matters, and advocates are hopeful that this can now change.

On Wednesday, the Federal government voted to allow a human rights bill proposing protections for transsexual and transgender Canadians to committee for review and possible changes, toward a final vote.  The bill had passed in the previous Parliament, but died in the Senate upon the election call.

(Here is a full backgrounder on why GRS is medically necessary.  It is also available as a trifold brochure)

(Crossposted to The Bilerico Project Dented Blue Mercedes and Rabble.ca)

What to Expect from a Harper Government (In The Bedrooms of the Nation III)

Previously:

I: A Brief Canadian History of Political Forces

II: The Opponents of Social Progress: Roadmap to the Far Right

As Stephen Harper and the Conservative Party seek a majority mandate, there is no shortage of speculation on either side of the map as to what a non-progressive Conservative majority would look like in Canada.  By some accounts, we’d see a new capitalist utopia of crime fighting and McJob creation.  By others, we’d see a social agenda unleashed which, now completely unbridled, would rewrite Canada into a Christian Nationalist dictatorship.

But we’ve seen already how Harper is completely cognizant of Canada’s inclination for social progress, and having to tightrope in order to maintain the far-right extreme and the centrist support he needs to maintain power.  Stephen Harper is gaming, and he is not going to seek only a 4-year majority.  He is in it for the long haul, and that means tightroping for as long as he can. Continue reading

In The Bedrooms of the Nation I: A Brief Canadian History and Political Forces

Social consciousness was in a state of flux.  Oral contraceptives had been available in the U.S. for several years but were banned in Canada.  Sodomy had been decriminalized in the U.K. in 1967.  Medical professionals and activists called for the legalization of abortion in circumstances where the pregnancy caused immediate danger to the mother.  And George Klippert was convicted of “gross indecency” for having consensual gay sex — and because he was determined to be “incurably homosexual,” he was sentenced to indefinite “preventive” detention (essentially a life sentence, which the Supreme Court of Canada later upheld).

On Dec. 21, 1967, Justice Minister and future Canadian Prime Minister Pierre Elliot Trudeau responded by introducing Omnibus Bill C-150, which amended the Criminal Code of Canada.  It decriminalized homosexuality, made abortion possible, legalized contraception, tweaked gambling and gun laws, and more.  It passed on May 14, 1969, coming into force on the eve of the Stonewall riots in New York City.  When introducing the bill, he famously told CBC,

there’s no place for the state in the bedrooms of the nation.

42 years later, it keeps trying.

Continue reading

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