Transgender Health and the Political-Sociocultural Framework

Medical prescriptions
Close-up of physician writing down prescription in medical card by Storyblocks 

The stakes are high, and the morale is low. There was a time kids were hospitalized to have their tonsils removed at astonishing rates. A British journalist at the Daily Express in 1927 wrote that tonsillectomies were routinely performed on at least 80,000 schoolchildren annually. In the 1970s, public discourse claimed it was a practice that did not have the child’s best interest at heart. (Dwyer-Hemmings, 2018).

In 2019, a study focused on improvements in care delivery and recommended education for clinicians and patients with actionable goals to optimize the tonsillectomy management of children pre and post-operatively, emphasizing reducing inappropriate or unnecessary operative procedures or variations in care (Mitchell, Archer, Ishman, et al. 2019).

Take the eustachian tube debate among scholars and physicians. Once again, affecting the pediatric population, any child with frequent ear infections who does not respond to traditional treatment might be a candidate for eustachian tube dilation. A child who responds to traditional treatment most likely is not a candidate. Eustachian tube dilation procedure is guaranteed to minimize the risk of hearing loss caused by ear infections (Tisch, Maier, Sudhoff, 2017).

What about cesarean sections? Most commonly performed worldwide, mainly in the United States. Can we say C-sections are classified as major surgery and a risk to the birthing parent and the infant?

A Harvard Chan podcast at the School for Public Health held by two OB gynecologists agree that risks correlate to hospital labor and delivery units’ management. (Shah & Leavitt, 2017).

The trends are not just about tonsillectomy, eustachian tube dilations, or C-section narratives; puberty blockers for prepubescent children allow a child time to decide.

Prepubescent children are not receiving gender-affirming surgeries. Prepubescent children are receiving plastic surgery who present with rare diseases or are born with cleft palates, and congenital anomalies.

Debates about prepubescent blockers will probably continue for decades, turning the discussions into a political platform and a public health concern.  In an interview with pediatrician, Dr. Raoul Sanchez, M.D., puberty blockers have been well-studied for years, given that the intersex population consists of individuals who don’t reach puberty until much later. Some present with Androgen Insensitivity, Congenital Adrenal Hyperplasia, and Kleinfelter’s, but not all are the same. Still, unlike the other examples, gender-affirming care does not receive the same consideration.

For the tonsillectomies, Dwyer-Hemming’s arguments point to the shifts concerning social determinants that have lasted over a century and remain in discourse among medical providers. To date, tonsillectomies continue.

Reducing risks for birthers and infants hinges on how hospital labor and delivery units manage care (Shah & Leavitt, 2017).

Despite reported deaths in tonsillectomies and C-sections,  the clinics weren’t cut off or shut down. Funds weren’t slashed. Doctors weren’t threatened with felonies, and people weren’t left without any care. There might have been some malpractice suits, but overall, the government did not step in and shut down access to care.

We could improve pediatric medical and mental health practices addressing gender-affirming care by tracking public health trends and studies focusing on three areas; the number of individuals receiving informed consent and counseling unhurriedly and competent medical care compared to those rushed through all three modalities. 

A study was done on the reasons why individuals chose to reverse their transition.

Fenway Institute and Massachusetts General Hospital (Harvard Medical School) published one of the first rigorous studies that showed 82.5% of people who reversed their transition did so because of family pressure, lack of affirming environments, sexual assault, and violence. (LGBT Health  2021).

We must be open to all conversations, including detransitioners who detransitioned for various reasons. Not everyone detransitions because of regret. We have a public health crisis identified in the Fenway and Harvard study.

Some who have braved coming forward to talk about having detransitioned did so at a risk only to end up blamed by the trans community, who fear that these stories will end gender-affirming care. The fear is displaced, however. The rise in political sociocultural blind spotting originates from economics, religion, and political interests as opposed to the small percentage of detransitioners who have come forward to report alongside medical providers and parents concerned with a lack of medical and mental health due diligence.

We are responsible for improving the informed consent process as a continuum instead of a rushed one. We also must remember that what makes a pediatrician good at their job is when they take the time to address the child, the parents, and the family in an unrushed fashion. The fashion of medical delivery has turned shabby because it is primarily rushed in a standardized way throughout most clinical settings. The hospital industry, by design, is all about money, time, and reputation. This is a bad combination because when time is money, the usual outcome will affect reputation at the end of the day. Someone will not feel adequately cared for or pleased with their care or how they were treated.

Budget slashes usually come at the cost of training, employing less-skilled individuals, and rushed consent processes and procedures to save time and money at the risk of medical errors.

Addressing social determinants in healthcare that potentially could result in delays in treatment requires changing the dynamics of social, cultural and economic policies at the political level.

Transgender Care is Needed

Apartheid in South Africa was racial segregation and politically driven, with consequences for anyone who opposed segregation. Apartheid existed in the U.S. as well, but we avoided using this term. 

We do not learn from our past mistakes. We continue to placate political agendas to spare our institutions.

Robert Otto Valdez, Ph.D., M.H.S.A., at the Agency for Healthcare Research and Quality, reported that we have “troubling trends” in healthcare quality and delivery. The report addresses intersections and social determinants that affect healthcare.

H.R.C., in October of 2022, in a press release, addressed the consequences of denying youth transition-related care. In youths aged 13 to 20 years enrolled in gender-affirming care, including puberty blockers and gender-affirming hormones, suicidality rates dropped over a 12-month follow-up by 73%.

We enhanced the mental health of kids and adults everywhere until Governor DeSantis’s latest Parental Rights in Education bill otherwise known as the anti-gay bill. Institutions, schools, and medical and mental health care face the consequences if they do not comply. The bill is anti-gay, shamefully dismissing the value of all the hard work of activists, healthcare and mental health providers, and organizations serving children and young adults.

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Many of us are deeply concerned with the changes imposed on Floridians. Others seem to have ignored the experts. Experts are usually the people who live as the person who is the least understood by mainstream communities. While DeSantis’s latest ruling is not necessarily racially driven, it segregates LGBTQIA2S people. His agenda will continue infiltrating every grant and state-funded educational program, including universities. When institutions and programs comply, the erasure of this population will take effect, and we will shut down narratives and history.

We already have whitewashing eliminating parts of truth in history in predominantly most schools. However, even in some tourist sectors, the names of slave markets have changed to avoid having conversations that these markets once housed and sold enslaved people. During the AIDS crisis, we refused to acknowledge people in grief, instead reinforcing stigma. Partners, families, friends, and communities grieved in silence as the world looked on in judgment criticizing and blaming gay men for the crises neglecting to recognize that AIDS did not discriminate, and children, Ryan White, for one, and his family endured hateful speech. Ryan White contracted AIDS because of a blood transfusion, and many others lived in isolation and silence. 

We have separation within Florida, driven by misinformation and misguided intentions to scare parents, teachers, mental health, and medical providers into complying with threats to criminalize anyone opposed. The anti-gay bill is damaging to children, and their families may be trans or sexual minorities will be unable to talk openly and honestly. How does a six-year-old share a story about his two dads?

Once again, Florida is at the helm of fueling biases within groups opposed to transgender care. The rhetoric that hormone blockers are irreversible is to intentionally misstate, misinform, and instill public fear. Parents whose transgender children are now adults are some of these experts who dispel the incited lies. However, despite over 7,000 people from all across the U.S. joining forces with HRC in condemning the attacks on transgender and non-binary youth and President Biden promising to have their backs cascading effect is in full force. Attempts to shut down conversations are another example of erasure. 

World Professional Association for Transgender Health (WPATH) and the United States Professional Association for Transgender Health (USPATH), in November of 2022, made a public statement opposing the Florida Draft Rule Banning Gender Affirming Care for Adolescents. 

Just as in South Africa during Apartheid, political agendas dismissed the consequences to POC. The radical curtailing of access to mental health and medical care and its toll on the Black community led to an economic crisis. It increased suicidal behavior in Black South Africans. Another example of political agendas harming people is in Kabul, Afghanistan; since the Taliban have taken control, measures to erase women and girls have been a long-standing practice.

What will the consequences be to the trans population of adolescents? We already have the data. We know there will be an increase in suicidal ideation and deaths by suicide. We know that individuals will suffer health and socioeconomic disparities. What about lower grades and the Parental Rights in Education bill? Is this really about parental rights or enforcing existing bias against sexual minorities and gender non-conforming and transgender youth and families? Will we see an increase in deaths by suicide, a rise in mental health illnesses, medical crises, family violence, and homelessness? Who will we hold accountable?

An Interview with an Adolescent Gamer

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In the past year, I have attended symposiums and webinars addressing the dangers of social media. I am also aware of the nuance of continuing to fight for girls’ rights and how we turn a blind eye to boys. Both camps of gender are at risk for different reasons. These reasons have to do with societal pressures to conform to gender rules. In fact, we know without even having to look for this information that boys are discouraged from expressing emotions while girls are told to be “nice.” Despite these differences, the gaming industry calls for vigilance.

Gaming is a risky business, and according to The Spokesman-Review, a 21-year-old Washington man received a 15-year sentence in federal prison after pleading guilty to child sexual abuse material he sought from exploiting two boys ages nine and eleven. The children’s mother alerted federal authorities.

A few weeks ago, I interviewed an adolescent gamer whose parent’s granted me permission to sit down with him to ask about his experience playing online gaming for a class I teach. He was very gracious and eager to talk with me because I mentioned to him a while back that I thought it would be cool to interview him about the dangers of gaming.

He had to stand to talk to me since he needed to move around and not feel confined to a chair. I think it is essential when we interview kids or adults who deviate from traditional interviewing styles to respect their needs. I was thankful that I had the space so he could move about freely to tell me his story. We had some laughs between this moment of me recording him amidst dogs barking, humans calling out, and a distant cawing sound.

He told me that he reports incidences as instructed on Fortnite’s website, but he cautioned me that it takes Fortnite 48 hours to respond. He said this was a bit of a problem, leading him to block anyone who is inappropriate with him or bullies him. I immediately had to check out what protocol Fortnite practices. Their website does have a category for community rules.

I spoke with the parents about what he shared with me. His parents informed me that he plays in the living room in their presence, and when he wears his headset, it is plugged into the controller and plays through the television speakers so that it is audible throughout the living room, and they can hear what is said. I asked them what they recommended parents could do. They emphasized always keeping an eye on your child. Do not allow your child to wear a headset when playing this game unless you are tech-savvy and know how to plug into the controller, so the dialogue plays through speakers. They also said that on PlayStation, you could set time limits. His parents told me he is swift to report and block “offenders.” They did confirm that once a gamer plays Fortnite, the rules are clear and stipulate to report any bullying or inappropriate behavior.

Okay. Well, the 48-hour range is troubling.

Fortnite has a platform referred to as Playground. Reading this section will probably bring back, for those of us who are way older than the hills, memories; some good and others not so good. The years of playing at playgrounds were fun; these were in real-time, unlike gaming playgrounds, but could also be terrifying for those of us who endured bullying by the meanest brutes in the area. Unlike gamers, we had no way to block the meanies in the neighborhood. Instead, the lessons with which our parents armed us were rolled into one sentence, “Walk away when you see them.” We had to learn shortcuts to our streets to get home via back alleys, and thinking back to those years, some of these shortcuts weren’t the safest routes.

Bullying has been “a thing” for years, and as kids, we formed friendships with others equipping us to stand up to the bullies. Power isn’t always in the numbers but in the supportive efforts kids show one another, even if only in twos. It is this message we could teach gamers. When you see someone bullied, please stand up for them.

This adolescent gamer said the same thing. Please stand up for one another, but sometimes the gangs have already formed a league of their own, and he said there is no standing up to them. He told me kids could report issues like cyberbullying to the game moderator. He hopes to be a game moderator someday, as he is for the game Roblox.

Our moderators, for those of us dinosaurs, happened to be our parents, neighbors, or friend’s parent. Usually, our moderators had the same mundane responses. “Walk away.”

Child safety experts at The National Center for Missing Children (NCMEC) provide a free online safety presentation, NetSmartz, that parents, educators, or anyone interested in using NetSmartz may use for presentations.

NCMEC also has a section titled, KidSmartz, which educates families about preventative measures to reduce the chances of abduction, and kids, K-5 can receive lessons at home. This whole notion of Stranger Danger is misleading according to NCMEC because most reports of kidnapping, solicitation, and assault, occur because the child or youth is familiar with the person. So, what does this have to do with gaming? Well, first of all, let’s face it, friends isn’t a word that refers to a camaraderie earned through building trust or in person. Hinging on your age group, today’s interpretation of “friendship” is based on how many “likes” someone gains, and anyone can be your “friend” without ever meeting the person or knowing anything about them. Offenders groom kids and adolescents, which can take place over months via social media and gaming.

Arming children early on is similar to teaching our children what to do when they smell fire. It is essential to differentiate between reporting and tattle. I remember the days when teachers would tell us to stop ratting out students. These teachers did not want to hear about the student who, on the surface, seemed like a good kid but was slicker than sly. Many of us ended up having to do battle on our own.

Parents pay attention here because while kids talk away about an upsetting experience, you may be caught up in your day-to-day stuff. Stop and listen.

NCMEC offers helpful tips, one of which is setting up a safety plan for kids. Walk the paths your kids walk daily and look around to areas where your kids can quickly go for help.

The adolescent’s feedback was eye-opening. He informed me that he has endured gamers telling him to kill himself and that he is fat and ugly. One gamer asked him his age and if he was a girl. The offender told the gamer he sounded like a girl. The adolescent played along. The offender built him a house and a bedroom. He instructed him to get on top of the bed, to which the gamer responded, “I said, ‘Heck, no!’ and I blocked him!” He also reported him, so he never knew the outcome because once anyone blocks offenders, they do not know what happens after that.

What if curiosity took over and this adolescent gamer continued to follow the offender’s instructions? Where would this have led him?

The adolescent gamer said he has friends who will share their faces on facetime when they play using their phones and that Fortnite is one of the games that can track an IP Address.

Now back to the parents of the adolescent. They did not know whom to report incidences outside of Fortnite and felt comfortable relying on Fortnite’s reporting structure. They are not the only ones, so this was troubling but easily circumvented since I could provide them with some of the links I have included. Here is a link to everything parents need to know about Fortnite.

Consternations of Trafficking in the Adoption World; The Elephant in the Room

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Adoptees have sent clear messages that warrant those of us who are anti-trafficking advocates to sit up and pay attention.

Discussing trafficking is a distant thought—a subject for another industry. In the foster system, 60 percent of child sex trafficking victims have been in foster care. Neurodivergent children, disabilities, sexual violence, intimate partner violence, rape, exploitation, sex trafficking, incest, and domestic servitude, are some reported incidences involving foster care. You can select this link and listen to the information about runaways. This same link has a report to Congress: The Child Welfare Response to Sex Trafficking of Children.

Every school district, public and private schools, could use continual training on trauma-informed care, not just for gun violence and deadly school shootings but also for the reasons described throughout this essay. What are school systems doing to address these areas directly involving adoptees and foster children?

What about adoption agencies turning a blind eye when red flags are noted, potentially engaging in what may be perceived as child trafficking or adoptions rushed to meet adoptive parents’ requests?

Organizations become complacent when these values are overdriven and misguided by competitive practices. Opportunities are missed when assuming that addressing the un-populace would mean a loss of funding.

Years ago, I sat and spoke with one of the EDs in a nonprofit organization who lost sight of why they did their work. It all filtered back into the fear of losing funding. This fear is real, but at what point do we step away to serve as leaders setting examples for others to follow?

Complacency is one of those descriptive words that pull forth comfort, satisfaction, and feelings of familiarity – trusting the good, the bad, and the ugly because it is predictable. However, it is also a state of mind that disconnects from the rest of the world. Complacency takes care of the “ego” and “self” and is familiar with the “issues” but ignores what falls outside of this perimeter, dismissing what others face because of harboring a false sense of security that settles into permanence, ignoring the social issues fought and overcame. It also means that complacent people could potentially miss the danger that harms them and others. Read more about the definition of complacency.

Complacency discards any nuance that might get in the way of feeling comfortable, satisfied, and safe. The minute classism infiltrates these boundaries, marginalized communities face obstacles that the privileged do not. Complacent communities may have fought for rights but disregarded equality because they reconstructed their narratives and are tired. They are tired of the so-called allies who were nothing but pomp and circumstance, capitalizing on their rights to seek a right to passage, rights to healthcare, housing, adoption, education, workforce, and a place to belong. Unfortunately, their tiredness stops short of helping others attain equal rights. Not all alleys are pomp and circumstance. Many have helped us get where we are today. However, in the adoption industry, might there be a concern for pomp and circumstance? Who benefits from transactions between buyer and seller? Have some adoptees been fortunate and ended up with wonderful adoptive parents? Of course. There are those stories as well. However, why are adoptions ranging in costs from $70,000 to $150,000?

Embracing diversity and addressing transracial issues, including disability, sexual violence, incest, and trauma, are necessary discussions since infants grow up, form identities, and eventually attend school. How are adoptees and foster children treated in school systems? Several adoptees will attest that they came from trauma. Some experienced trauma due to separation at birth or negative statements about the birth parent, rejection, secrecy, alcoholism, and drug use in the family.

Stories about kidnapping and transnational adoption involve parents coerced into giving up their infant and finding out later in life that their child was rehomed. They never were contacted to be given the option to reunite with their birth child.

United Nations’ definition of human trafficking balances the following words: Prevent, Suppress, and Punish, Trafficking in Persons. Adoptions without the biological parent’s consent have been a global problem. Also, a problem in the US. Human Trafficking Adoption Scheme

Another area of adoption practice that needs ethical reconsideration is placing a child with adoptive parents prior to all birth parents’ full consent. Here is an article whose authors, Daniel Pollack and Steven M. Baranowski, discuss this issue. Ethical Challenges Remain in the World of Private Adoptions

Rehoming is a buzzword for trafficking. Stories of adopted parents using social media to advertise rehoming a child using grooming language, such as describing the child as “Willing to wash dishes,” “Enjoys housework,” and “Loves to garden,” need to be investigated. How do we get the attention of Homeland Security or Internet Crimes Against Children to recognize that these types of advertisements place a child at risk? One advertisement read the State pays $2,000 a day.

Unfortunately, no one wants to address the elephant in the room because of the political issues. Such as the organization risking the loss of votes, rights, funding, or reputation when taking a position. What about companies taking a stand against human rights violations? Ten brand campaigns that took a stand on social issues

Is there any reason why adoption agencies should not take an oath against human trafficking?

Other organizations Globally and in the US receive score cards.

Is it time to regulate private adoption agencies and stipulate the need to score agencies for performance and committing to take a stand against human trafficking?

An estimated 24.9 million people worldwide are victims of forced labor, generating $150 billion in illegal profits in the private economy.

So, how do we talk about the elephant in the room?

State why you are exposing the elephant in favorable terms. “I am concerned …” statement. When the ostrich sticks its head in the sand, it does not see any more than we would if we ignored these uncomfortable discussions. The conversation is predictable when people turn a blind eye or when the elephant stays hidden. Predictable because the message is “Turn off this conversation!” Instead, try forming committees of interest whose members can work together to address changes and challenges. Invite people with experience in these subjects, and even more importantly, either serve as experts or have lived experiences.

Lift the veil and put complacency into action. Take the leap of faith. Embrace differences no one else wants to address.

©An Goldbauer

It is time to recognize another part of history, June as National Pride Month

It is time to recognize another part of history, June as National Pride Month

Indian-born Canadian Rupi Kaur quote, “How you love yourself is how you teach others to love you.” Many of us can relate to this quote and especially in the upcoming month of June. The decision of the Saint John’s County Board of Commissioners to decline to recognize June as Pride month is a massive disappointment to many of us in the community.

There are many reasons individuals visit or relocate to Saint Augustine. Some of these reasons are not just because of the beach. Ponte Vedra, Neptune, Jacksonville, and Atlantic Beach exist among many of the other beautiful coastal beaches that run North in one direction and South in the other along A1A. Most people would agree they experience a shift in their metabolism as they draw nearer to the coastal line.

We live such busy and hurried lives that we avoid connecting most of the time, and we forget how to connect when we have the time. Saint Augustine is about connecting people to its’ city’s rich history, dating back 800 years or so ago. The city holds series of special events that locals, visitors, and tourists look forward to attending.

Saint John’s County Board of Commissioners has taken a pledge to keep the city’s history alive, interactive, and engaging. In their own words, “to provide memorable experiences for visitors, foster international economic development, and enrich the quality of life in our community.” Proceeds from the festivals and events go to charitable organizations; one of these is Flagler College’s Hospitality and Tourism Management Program.

Michael Gonchara, deputy editor and journalist for the New York Times Learning Network in a 2018 article, invited students to participate in a contest linking a topic they learned in class to a current news event. Gonchar wrote about the influential role connecting to history has in bringing current events into the classroom. In much of the same way, Saint Augustine connects people to its’ history.

It is difficult for anyone to appreciate or understand why we recognize Black Lives Matter or Constitution Day and Citizenship Day without learning about the history that led up to these events. Gonchar supports the study of history. He writes that it promotes critical thinking and connects people to share about their culture with others. He refers to this as a shared cultural literacy.

June is National Pride month, an essential part of Gay history and culture. What does this have to do with St. John’s county history? Lesbian, Gay, Transgender, Queer/Questioning, Intersex, Asexual, Ally, and others (LGBTQIA+) from this community didn’t just come about recently. We have been around for centuries. Learning about National Pride month connects us to the narratives of others, the history and issues affecting people today, and most importantly, sends a strong positive message showing support to the children, youth, families, and friends of the LGBTQIA+ community who live in and visit Saint Augustine.

Family and community acceptance builds healthy children, and families feel supported; ambivalent inter-generational biases burden children and youth. Worse yet, the inter-generational biases keep feeding the pipeline of negative messages and only amplify history repeating itself. It is time to revisit another part of history, recognizing June as Pride month.

Check out Marcelo Chagas photography

Check out Rupi Kaur

To read more about Michael Gonchar check out

City Ordinances

two persons standing on the street
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Last year the HRO passed LGBT rights in Jacksonville. Last month I was invited to the Women’s Center’s Open Door celebration and given a personal tour of the facilities by one of the board members, who pointed out to me that they were supportive and all-inclusive of both LGBTQIA men and women despite the gendered bathrooms. She showed me two identical single-stall restrooms. One was for men, and the other was for women. To meet the city’s code, the single-stall New Human Rights Ordinance bathrooms could not be gender-neutral. It seemed odd given the fact that the HRO had passed. I took note to think about this at a later time. This afternoon, I went and reviewed the ordinances online which, by the way, was an incredibly tedious process. It seems some businesses including one I visited in downtown Jacksonville, Chamblin Bookmine, have gender-neutral single stall bathrooms. I decided to search the web instead. I came across this article.

“The law does not have any new requirements regarding bathroom usage.”

New Human Rights Ordinance
“Earlier this month, the Occupational Safety and Health Administration released a set of guidelines regarding bathroom access for transgender workers. The guidelines recommend providing better access to options for transgender individuals with gender-neutral facilities.”
Gender Neutral Signs
I’m not sure why the Women’s Center could not have single stall restrooms, but maybe this is one of those situations where the inspector was misinformed? I don’t know, but it all seems ridiculous to me. Can you imagine if we were required to have gendered single stall bathrooms at home? What about the campgrounds or art’s market? We seem to accept these gender-neutral bathrooms just fine, but we can’t or won’t allow the ones inside a building.

©An Goldbauer



architect composition data demonstration
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Data collected on LGBT homicides will significantly alter how we react to news about killings or, maybe more appropriately, homicides and transcides, a term applied to murders of trans people.

Some international trans activists even started to introduce the term ‘transcide’ to reflect the continuously elevated level of deadly violence against trans people on a global scale.

–Transgender Europe

Gender Prison transcides

When we look at what other cities report throughout the U.S.A., we will see a disparity with data for LGBT murders – if it is disclosed at all.

LGBT people are often targets of organized abuse from religious extremists, paramilitary groups, neo-Nazis, extreme nationalists, and others, as well as family and community violence, with lesbians and transgender women at particular risk (United Nations, 2011, December 15).

The United Nations first began collecting data – Worldwide – on trans and homicides in 2011. The United Nations gets involved when death rates of a class and subclass of people meet the definition of genocide.

In 2013, the FBI began recording hate crimes motivated by gender and gender identification biases — such as attacks on transgender people. Crimes motivated by gender identification rose from 31 in 2013 to 114 in 2015, according to FBI reports (, 2017, January 12).

Genocide: the deliberate killing of a large group of people, especially those of a particular ethnic group or nation. New Oxford American Dictionary.

“the discrepancies of de jure versus de facto practices underline the need for systematic training, especially of police, correctional personnel, teachers, healthcare workers, and the judiciary, to understand the rights and the situation of transgender people.”

So far, we have a current count of 27 trans females of color reported murdered in 2016. This number does not account for all the other transcides. We have barriers that skew the data. (1) The media misgendering trans-identified victims (2) Misgendering by police in homicide, coroners , and health care professionals when names on the birth certificates and or driver’s licenses do not match the outer appearances of the victim (3) Family request that the person is not identified by their preferred identity.” Dani Castro, M.A., M.F.T., Project Director, Center of Excellence for Transgender Health, UCSF. 

The way we use language matters a great deal when discussing the transgender and gender variant population. More importantly, the LGBT community does not exist on the JSO site, while many classes do, these demographics do not include same-sex households or LGBT standing in socioeconomics.

In a 2013 report,  put out by the National Coalition of Anti Violence Programs, 72% of homicide victims in LGBT related hate crimes were transgender women of color. This risk increases with intersectionalities; race, religion, and gender. People of color, especially those, who are trans female, run the highest risk for homicide.

Remarks made by some allies that we do not include the LGBT population because they do not fall under the umbrella for hate crimes is misleading. Since when does a demographic, such as some single households, need the subordinate class to qualify for protection against hate crimes before including this class in demographics?

The focus of courts remains on isolating individual racists, determining their racist intent and punishing them, while disregarding mani-festations of systemic racial subordination such as substandard housing, education, and employment and the widespread incarceration of people of color. Chicano – Latino Law Review page 46 Volume 21:38

Dean Spade points out that Mathew Shepherd’s murder in Wyoming drew media and national attention “while historical specificities of geography, nationality, race and class were obscured.” Chicano – Latino Law Review page 48 Volume 21:38

Spade reminds us that months before Shepard’s murder, a black trans woman who was murdered in Baltimore never “garnered” the attention of media or nationally. Spade writes “The newsworthiness of “Matthew Shepherd” is testament to value placed on white life-even gay white life-and the disposability of people of color in the United States.” Chicano – Latino Law Review page 49 Volume 21:38


One of the reasons some of us have struggled with the ally campaigns is because as a class we are left in the shadows and listen to the erasure and silencing of the subordinate class censored when seeking protection. The reasons range from Not looking presentable and convincingly enough to pass as male or female. Insisting on forcing the binary presentations as a standing rule. Those in privileged classes are more likely to persuade the political agendas of those who serve our communities. The disparities affecting the intersectionalities of the LGBT class won’t disappear when institutions fail to discuss the issues within their own contexts.

In “A Critique of ‘Our Constitution is Color-Blind’ Neil Gotanda” Spade includes much of Gotanda’s writings. When women do not have access to birth control or abortion, their autonomy is erased, especially when they are women of color. The systemic regulations of gender, race, and sexuality determine social constructs and protections of various classes.

We are dealing with differences in classism. Historically we have failed to see it unfold when we have privilege as white people, but even more so, we fail to recognize this privilege as cisgender heterosexual or gay and lesbian people.

Classism determines who gets to use the bathroom.

The bathroom is a huge issue for anyone who perceives transgender people as threats.

We must change the way society immediately wants to “fix” what they perceive as a “problem” by voting against our better interests.

We are not looking for a fix. We are looking for protection. Worldwide, the trans community is most at risk for homicides and in particularly with trans females of color. What does this mean for the way society views male roles?  Does society punish those who are fluid in their maleness? Do we punish the male child for being effeminate? Do we blame the parent? What do we do with blame? Where do we put the blame? Do we displace the blame back on society? Can we say that classism is at the root of these issues? What about Colonialism? Before Colonialism, indigenous groups expressed and lived with gender fluid identities in peace and harmony.

We saw we heard, we felt every word cast against us in the form of accusations at the 2012 hearings on the HRO. Pedophilia …, bestiality … 

The bathroom issue has included these horrific accusations and has caused harm to people. Our fate hinges on writing public policy to include language critical to human rights, or we give up our rights to gender identity, expression, and sexual orientation. We need to stand by and address hate spewed speeches and practices or they go unfettered: and call for consequences. But, even if these rights go into law, we still have much work ahead. We will continue to receive incoming reports on trans suicides and homicides.

We heard from the Florida Family Policy Council at the hearings during the 2012 HRO. 

They are against the Florida Competitive Workforce Act which would offer protections.

We must stand in solidarity and continue to educate on cultural competency and talk openly about classism and colonialism. We look at efforts put forth by others as an improvement, which can give us a false sense of security, such as, failing to recognize pinkwashing at the cost of our community. Where were these entities yesterday when we needed them? As soon as there is an opportunity to make money, there is an opportunity to get in on the action. Is it then really about our rights?  Politicians and anyone with business acumen would be hard pressed to pass up bills that could potentially increase profits; hinging on through whose lens we are looking. Some would say that it is a start in the direction towards inclusivity. How inclusive is it when some of these not-for-profit organizations taut they care about LGBT people fail to put into practice what they preach?

In Jacksonville, FL  downtown’s First Baptist church has influenced many of its congregants, some of whom were city council members during the 2012 Human Rights Ordinance and who flat-out voted against it. Who benefits from the economic decisions that support conservative climates vs. liberal climates? We continue to fight for rights despite the victory in 2017. We fight over if we get rights then others will lose rights in agreeing to our freedoms. Activists uncover truths, take incredible risks and sometimes at the cost of incarceration or deportation. The list of fighting for rights is endless. We are paving the way for the future to improve the lives of all generations and some of us have a different sense of how this landscape looks. The fight for fairness will always be lifelong for many people while opportunistic for others.

‘Society’ in the New Oxford dictionary lists people living in a particular country or region and having shared customs, laws, and organizations. We have biblical interpretations manipulated by those to suit their biases – stigmatizing populations. Stigma drives fear. Fear drives people to behave in irrational ways, sometimes fully supported by mainstream society or those serving in civic and corporate leadership positions, who have very little understanding outside of their own biased narratives. The passing of laws to protect LGBT people hinges on enforcing them. We know that in some parts of the country psychologists continue treatment modalities to reverse a child’s “sexual orientation” or “gender identity/expression” known as Reparative Therapy. We now know that Reparative Therapy is damaging to the psyche of people: hard to argue the statistics that include reports of suicide. California was the first State to outlaw Reparative Therapy. According to HRC, “California, New Jersey, Oregon, and the District of Columbia have passed laws to prevent licensed providers from offering conversion therapy to minors, and at least 18 states have introduced similar legislation” ( These people are our angels. Support groups are critical in reducing suicide. (2015) published an op-ed piece titled The fascinating if unreliable, history of hate crime tracking in the US. “Since the data collection began, the FBI has published hate crime statistics from 1996 to, most recently, 2015. In 2015, there were 5,818 hate crime incidents reported, the majority of which were biased toward race and ethnicity. There were about 340 more hate crimes in 2015 than in 2014.”

Even within our own LGBT borders, we experience stigma as trans people: soundtracks familiar to anyone experiencing any type of shame. Our goal is to affect change so that individuals do not have to live in fear or seek protection. Our children and youth need opportunities to share their lived experiences without shame; live authentically as who they are in life. We need to talk about gender and sex-rearing assignments tied into the binary models of male vs. female, limiting the role models we offer young children. We also risk displacing intersex children. We need to talk about more than just male and female gender and move beyond the binary rules for gender assignments. We have a disconnect between communities of people who are different from us. We share commonalities within our communities until it is about our sexual orientation and identities and expressions outside of binary roles.

The standards by which our children live doesn’t always match our ideologies, and we freak out without clearly understanding what drives our fears.

Is it any wonder why we are hesitant to Come Out when there is a risk in doing so? It is understandable that individuals Coming Out may need specialized care and protections to spare a life.

According to the WILLIAMS INSTITUTE report, (2019) 57% of transgender and gender non-conforming individuals experience isolation from their families.

Statistics on transgender and gender non-conforming people are directly taken from the FINDINGS OF THE NATIONAL TRANSGENDER SURVEY:

50-54% are bullied at school, 63-78% encounter physical or sexual violence in school; 50-59% encounter harassment at work and discrimination; 64-65% face physical or sexual violence in the workplace while, 60% are refused care in the healthcare system; 57-61% are disrespected and harassed by law enforcement officers while 60-70% encountered physical or sexual violence, 69% are homeless.

We cannot underrate the person’s Coming Out journey, and we cannot afford to stay insensitive and closed off to information, data and research if we are ever to live in a civil society. We cannot hope to see crime rates drop in homicides until we are open to other cultures.

Children need space to figure out who they are without shame – so not one gay, trans or intersex person should have to fight for having a human right. Anything less is dehumanizing.

The type of information in getting the human rights ordinance pass at city council is critical.

Are we presenting packaged language in getting whatever we can to pass to worry about the rest later? Black Lives Matter is a compelling title. In an article by Rose Hackman, (2015, June 26) “‘I am not interested in white allies. What we need are co-conspirators’, Feminista Jones, a 36-year-old social worker, and writer shouted into a bullhorn” during a rally and protest on behalf of Black Lives Matter among a group of 100 mourners who gathered in solidarity over the massacre that took place in Charleston in June of 2015. Jones supports solidarity and does not advocate placing the focus of these issues on the privileged group. She is clear that co-conspirators need to stand up for the black community as much as we are clear that we need co-conspirators to stand with us and speak our language, use our preferred pronouns and break down the language, so it understood by those who must cast a vote; not tightly packaged as fully inclusive without breaking this down. As Dean Spade said in an interview “The seduction of legal equality appears to be very significant in certain strains of LGBT politics, regardless of the availability of critical understanding of its limits.

Unfortunately, just because our rights got voted in, doesn’t mean we don’t have work ahead of us in addressing the need for an all-inclusive language.


A human rights ordinance bill with language “fully inclusive” does not guarantee protection for LGBT people. Back in 2014, during a PFLAG meeting with local candidates in Jacksonville, we learned that the language fully inclusive altered the vote once the candidates understood what this meant; They changed their vote once they realized that it meant passing rights for gender identity and expression. It was clear that they had very little understanding about gender identities and expression. We know they have very little statistical data from which they base their biased views. They are not looking at transgender and gender non-variant murder rates any more than they are paying attention to the suicide rates and attempted suicide by youth. We know that our city does not extrapolate data reports of the LGBTQIA population for homicides and death by suicides. We must expect better data collecting practices and do something with this information to reduce crime and address deaths by suicide.

Our work is to replace presumptions that stigmatize people, to continue educating on cultural competency to help people understand and respect differences so we can live in truth. We want to expand roles and move away from insisting that binary identities must match the sex assignments at birth. In closing; We need trans-inclusive spaces.


man in blue and brown plaid dress shirt touching his hair
Photo by Nathan Cowley on

An Goldbauer


While some of us have expressed how we feel over the outcome of this election, others have offered support to their community, taking an active role in joining groups in solidarity. Others lash out at anyone who disagrees with their statements and actions. We have the right to feel upset, angry, and downright concerned over the welfare of many people. This election has served as a trigger for riots, gatherings for support, and rallies.

A loss of hope that feels like death can bring out the ugliness in people. This election has brought out the worst in people from both sides of the spectrum.

Our brains go haywire when we meet a loss of this magnitude. The neurotransmitters that operate logic misfire rapidly once stress sets in. The release of large amounts of corticosteroids (the army that fights to get us to feel better) serves as mediators to balance the stress response to grief. In the meantime, we respond with emotion and a lot of impulses, until the balance sets in overtime with the help and support of others or sometimes as the stress abates. We say things we ordinarily would never say when our hearts are well, and our heads are clear.

We have seen, heard, and read how people behave across the country, some with a sense of entitlement, others scared and uncertain of what their future holds.

Those with a sense of entitlement, feel empowered to lash out without fear of reprisal. Those who fear the worst, react because of past negative experiences. Everyone is at war. An invisible wall exists.

During grief, many things happen within us when we lose control. The loss of power causes some of us to lash out and ‘let go” as in “letting go” of all those pent-up emotions. We will resort to whatever weaponry is available to take back this loss of power and in this case, hate speech or as reported by media, physical violence against others. Our ability to reason is frozen, while our emotional warfare, such as fear, hate, and resentment, override our logic and our ability to stay grounded. Effective communication is essential if we are to remain civil during this discourse. In the world of good grief, when working with dying patients, families and friends are collectively anchored by one pivotal point, to stay rooted. This one crucial point is caring enough to stay close at hand to those dealing with loss. This means standing by to bear witness to all types of behavior as we remain connected to that person. This isn’t always possible, hinging on many kinds of circumstances, and this is when we see people disconnect and break away, while others seek support. There isn’t any right or wrong way to grieve, except when we cannot take back what we said, did or didn’t do. In the world of grief, we see some people, including the person who is dying, fall apart. We have heard the parties say some awful things to one another and about one another, we see people who are a master of stealth, wrapped in a blanket of anger, act untouched by the words and actions of others. I just hope at the end of all of this that some of us can stay friends.

Grief can bring out the ugliness in people, and sometimes we have to recognize this. I am not excusing violence, hateful speech, attacks on another human being, putting up with condescending behavior, lies, or displays of a lack of concern for our welfare. I am talking about what is occurring among ourselves, those of us in line with one another on the outcome of this election. As a post-WWII baby, who grew up in Europe, I too, as many of you, am very concerned for our welfare. I hear the slut-shaming and see the posts of Melania Trump’s modeling photos by those from within my community. They justify their outrage at the outcome of this election. Slut-shaming sends a strong message to all female-bodied people, young and mature alike, about women who pose nude for a living are of little value and non-deserving of respect. It is denigrating to girls and women and tears away at the very core of a women’s right to choose what she does with her body. Spewing this kind of hateful speech directed at Melania Trump by those from the LGBT community isn’t any better than those who attack us with statements that we practice necrophilia and bestiality. Many of us in the trans community or the LGBT community have been referred to perjoratively just for who we are. Those of us who have fought for human rights, continue to uphold the importance of human rights. I am taken back by some of the reactions of those from my community who stood up for human rights, their rights, only to turn around to behave as badly as those who denied their rights.

Grief can bring out the ugliness in people. I hope that in the end, we can stay focused and civil.

©An Goldbauer

Our Transgender Brains

photo of head bust print artwork
Photo by meo on

We are so bent on role assignments. Who exactly doles out these roles? Well, usually, it is the doctor.  

Dr. Stephen Rosenthal, a Pediatric Endocrinologist at Children’s UCSF Benioff in San Francisco, stated,
“We are basically given one of two sex rearing assignments when we are born. Male or female.”

Parents don’t stop to think about the fact that they choose their child’s gender based on their infant’s genitalia. Parents don’t realize that there is a difference between the gender of a child versus the sex of a child.  They think of these as one and the same. Parents raise them as boys or girls as opposed to just raising children. Most of the time, parents are proud to know the sex-rearing roles given to them, hence, boy vs. girl, without knowing that this has taken place. They often are excited, have already known for months in advance, prepared the nursery, and primarily written a script for their child’s gender role. They feel relatively competent in understanding the differences between a boy and a girl and do not require any additional study or test-taking, that is until their child turns out to be trans. The child whose brain is genuinely different. Not warped. Not sick. Not weird. Just different from the cisgender child. Parents now look for textbooks, help, and support. Parents who have raised trans kids can attest to this. The child is a child and not much different except in their identity and expression.
The parents of trans kids who choose the happy child over the sad child win. There is nothing more heart wrenching than not feeling as if your child doesn’t belong within this shell and having to perform just for those who cannot accept your child for who they are. What is worse, is not knowing if your child will ever be happy or safe. Parents who accept their trans kids seek out other parents of trans kids, and the discussions are paramount to their family structure and practices.
The families of cisgender children certainly have their struggles, but never have to think about bathroom issues or dress code (except for those with a disability) entirely in the way families of transgender children do.
I am trans and queer. I have beautiful children and grandchildren and a partner who “gets me.”  But who are we really? We are not acting. We are these very kids who grew up having to conform to societal social constructs of having to be one of the two binary ideologies and when we no longer could? Well …, everyone has their own story. Their personal experiences. Some not so good. But, when parents support their trans kids, it is the most beautiful expression of love a parent could ever impart to their child. They are not our possessions. They are gifts. There is nothing more fulfilling than to have a child who expresses themselves in the image of love. Why is it we want to shame them? It is so terribly painful. It is wrong to make someone feel less just because they are different. We get too hung up on what others think when we should really focus more on the well-being of our children.
What about our brains?
We have this magnificent organ we seem to know so little about. Most of us don’t give it much thought, and we just assume that this organ is somehow pre-programmed based on our genitalia. We forget that this organ is a muscle, and among many other exciting features, it operates as a message center delivering mail via its neurons. Now for starters, I took this information directly from
1. Just know this…, “It weighs approximately 3 lbs or so. It contains a hundred billion neurons: 1000 to 10,000 synopsis for each neuron.”

2. “Our brain is 75% water. Blood vessels cover 100,000 miles in our brain. It is the fattest organ in our bodies and contains at least 60 percent fat.”

3. “Within the first year, our brains grow three times its size. This means that the developing brain never stops working.” Why? Because we continue to make neurons so long our brains are kept active. Our brains continue developing all the way into middle age. I could go on and on about our brains, but I am going to stop right here with this statement. There is a reliable connection between our brains and bodies when we are cisgender.  However, when we are not, there is a disconnect. Much research has been done in this field for many different reasons that I won’t go into for the sake of keeping this related to the issue.
There are children as young as two who insist that they are not the sex they were assigned at birth. Think about this for a moment. We are given roles based on our sex assignment. According to Rosenthal, “…, we are given sex rearing assignments, but how do you assign a role?” when talking about gender variant children and transgender children.
I think most parents raise their children within the binary social structure, while a few may have children who vacillate between the two and some parents might be okay with exceptions to these rules, but may worry when these become more of the norm. Joel Baum, Senior Director of Development and Family Services at Gender Spectrum, stated: “We have too many rules and not enough roles.”

Why is it that we only offer two? We have so many more to offer.

If children turn out to be really great at something, most parents would be proud. So …, does gender dysphoria have anything to do with roles? Does gender dysphoria have more to do with fitting in and being accepted as one or the other and does this affect their gender role? Does gender dysphoria ascribe to other sets of explanations? How do these children know they are different?

4. “Psychobiologist, Antonio Guillamon in Madrid, Spain at the National Distance Education University and neuropsychologist Carme Junqué Plaja of the University of Barcelona—were able to show through MRI’s that the brain structures of the trans individuals were more aligned with respects to their innate gender than from those of their natal gender. The results were published in 2013.”

Much research is needed and remains ongoing to try to solve the many questions parents have. Some even blame themselves or each other, groping for straws in trying to come to terms with their transgender children.

5. “Scientists explain it in simple terms. “Guillamon says. ‘It is simplistic to say that a female-to-male transgender person is a female trapped in a male body. It’s not because they have a male brain but a transsexual brain.’” There are other types of research conducted in the Netherlands with the use of MRI and hormones with pheromone properties and to review this information just select the listed site included in this write-up.

What about intersex children? There are so many variances of intersex. Some overt while others are not identified until much later in life. Sometimes when the couple is unable to get pregnant, for instance. How will we treat these individuals when they don’t quite look the part?

Why do we get so sideways with the transgender issue? We have more information now than we have ever had before. Should we not be thankful for this? We are more educated now on this subject than even a decade ago. Don’t we want our children to be happy? Does it really matter? These are our upcoming stars in life who will turn out to be politicians, doctors, attorneys, brick masons, performers, teachers: the list is infinite. They will make the world a better place. A place where everyone may have a seat at the table without having their gender policed.

©An Goldbauer





#Children’s UCSF Benioff Hospital