A Trump-appointed judge just blocked federal agencies from enforcing part of the Affordable Care Act (ACA) on the grounds that it would require doctors to perform gender-affirming care, including surgery, on babies. The wild claim is patently false.
Section 1557 of the ACA states that healthcare cannot be denied to any individual because of discrimination based on their sex, race, disability status, and a variety of other reasons.
Jump to October 2021, the Christian Employers Alliance alleged that the implementation of section 1557 of the ACA was an affront to their religious freedom. Essentially, the suit said that being required to treat patients with gender dysphoria would “[prevent] them from maintaining views and facilities in accordance with their religious beliefs.”
The suit sought to bring an injunction barring the Department of Health and Human Services (HHS) and the Equal Opportunity Commission (EEOC) from carrying out their job duties by ensuring transgender patients are not discriminated against.
Judge Daniel Traynor, a Trump appointee, sided with the Christian Employers Alliance in saying that refusing care to transgender people was an expression of the plaintiff’s religious freedom.
Traynor’s opinion seems to be founded upon the idea that the HHS will be prosecuting doctors for refusing to medically transition infants.
“The thought that a newborn child could be surgically altered to change gender is the result of the Biden HHS Notification and HHS Guidance that brands a medical professional’s refusal to do so as discrimination,” the suit reads. “Indeed, the HHS Guidance specifically invites the public to file complaints for acting in a manner the Alliance says is consistent with their sincerely held religious beliefs.”
The judge has essentially implied that the Christian Employers Alliance’s religious freedom outweighs transgender people’s right to be treated for their gender dysphoria, on the false claim that babies are being transitioned.
A basic search shows that no infants are transitioning. Puberty blockers, the first step for childhood transition, cannot be prescribed until age 12.
What is an issue, though, is the effects of living without proper gender-affirming care.
“Gender dysphoria can have serious health impacts,” wrote Samantha Schmidt for The Washington Post in February. “It can affect a person’s ability to function at school or work and can lead to intense anxiety, depression and suicide risk.”
So a Trump-appointed judge saw fit to side with a religious organization, prioritizing their religious freedom so as to ensure babies don’t transition, something that isn’t an issue to begin with, and as a result, transgender people are in danger of not receiving life-saving healthcare.
A federal judge struck down a Tennessee law Tuesday that would have required businesses in the state to post warning notices on their public restrooms if they have policies allowing transgender patrons to use the facilities that match their gender identities.
The American Civil Liberties Union challenged the law in June on behalf of two business owners — the owner of Sanctuary, a performing arts and community center in Chattanooga, and the owner of Fido, a restaurant in Nashville, among other businesses.
The law went into effect on July 1, but U.S. District Judge Aleta A. Trauger issued a preliminary injunction against it a week later. Then on Tuesday, Trauger permanently blocked the law by granting the ACLU’s motion for summary judgment, which asks a court to decide a case without a full trial.
She wrote in a 40-page decision that the law violates the First Amendment of the Constitution because it compels speech that is controversial and with which the plaintiffs disagree.
“It would do a disservice to the First Amendment to judge the Act for anything other than what it is: a brazen attempt to single out trans-inclusive establishments and force them to parrot a message that they reasonably believe would sow fear and misunderstanding about the very transgender Tennesseans whom those establishments are trying to provide with some semblance of a safe and welcoming environment,” Trauger wrote.
Glenn Funk and Neal Pinkston, both district attorneys; Christopher Bainbridge, the state director of code enforcement; and Carter Lawrence, the state fire marshal, are named as defendants. They did not immediately respond to requests for comment. A representative for Gov. Bill Lee has also did not immediately respond to a request for comment.
The law required business owners with even informal policies that allow people to use whichever bathroom they want to post a sign that reads, “This facility maintains a policy of allowing the use of restrooms by either biological sex regardless of the designation on the restroom,” at the entrances of single-sex public restrooms, locker rooms, dressing areas or other facilities that are “designated for a specific biological sex … where a person would have a reasonable expectation of privacy.”
The law said the sign must be at least 8 inches wide and 6 inches tall and use the colors red and yellow, with a boldface typeface, among other requirements.
Representatives for the state argued that the law is a “content-neutral” rule meant to clarify restroom signage and is not meant to be an endorsement of how gender identity should be understood, according to the opinion. The ACLU’s clients, they argued, have “imagined an idiosyncratic, hidden undertone to the [required] signage.”
Trauger, who was appointed to the court by President Bill Clinton, disagreed, noting that the government’s preferred view of how gender works — that it is dictated by “biological sex,” which is assigned at birth and is limited to male or female — is contested.
“The only thing that is imaginary in this case, though, is the imagined consensus on issues of sex and gender on which the defendants seek to rely,” Trauger wrote. “Transgender Tennesseans are real. The businesses and establishments that wish to welcome them are real. And the viewpoints that those individuals and businesses hold are real, even if they differ from the views of some legislators or government officials.”
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“We applaud the court for recognizing that this law violates the First Amendment and harms transgender people,” Hedy Weinberg, the executive director of the ACLU of Tennessee, said in a statement.“Transgender individuals should be able to live their lives free of harassment and discrimination. Today’s decision ensures that the businesses who welcome them are not forced to become instruments for politicians’ discrimination.”
Bob Bernstein, the owner of the Nashville restaurant Fido, has an informal policy that allows customers to use the restroom they feel is most appropriate. He said he has not had any complaints or concerns about the policy, and he objected to the “stigmatizing” message the law required.
“As a former journalist, I believe strongly in free speech,” Bernstein said in a statement. “The government can’t just force people to post discriminatory, inaccurate, and divisive signs in their places of business. I am glad that the court recognized that this law violates the First Amendment.”
A unisex sign and the slogan “We Are Not This” outside a restroom at Bull McCabe’s Irish Pub in Durham, N.C., in May 2016.Sara D. Davis / Getty Images file
Advocates have described the law as a new iteration of “bathroom bills” passed in 2016, such as House Bill 2 in North Carolina, which sought to bar trans people from using the bathrooms that aligned with their gender identities.
The sponsor of Tennessee’s law, Rep. Tim Rudd, R-Murfreesboro, said in legislative debate in May 2021 that the bill is meant to protect women and children “against sexual predators that could be taking advantage of policies, executive orders or legislation that may allow the opposite sex to enter a restroom, shower or locker room,” the Chattanooga Times Free Press reported.
Trauger wrote in her opinion that Rudd “was unable to provide examples or evidence of such a problem,” although he argued that “we shouldn’t wait for people’s rights to be abused” to potentially prevent “an attack.”
The issue is not new, advocates have said, and proponents of bathroom bills passed in 2016 cited similar arguments. A 2018 study from the Williams Institute at UCLA School of Law found there is no evidence that trans-inclusive policies for public facilities increase safety risks.
A federal judge blocked part of a newly enacted Alabama law that made it a felony for doctors to provide certain gender-affirming medical care to minors.
Alabama was the third state to pass restrictions on transgender health care, following Arkansas and Tennessee, but the first to add felony penalties. Doctors and other health care providers who violate the Vulnerable Child Compassion and Protection Act, which took effect May 8 and is partially still in effect, could face up to 10 years in prison or a $15,000 fine, or both.
Civil rights groups and the Justice Department argued against the law on behalf of doctors and transgender minors in the state last week, and in an opinion issued Friday, U.S. District Judge Liles Burke found “substantial likelihood” that part of Alabama’s law was unconstitutional.
He put a temporary block on the portion of the law that bars minors from receivingnonsurgical care such as puberty blockers and hormones, writing that parents “have a fundamental right to direct the medical care of their children.”
“This right includes the more specific right to treat their children with transitioning medications subject to medically accepted standards,” he said. “The Act infringes on that right and, as such, is subject to strict scrutiny. At this stage of litigation, the Act falls short of that standard because it is not narrowly tailored to achieve a compelling government interest.”
Burke allowed other parts of the law to remain in effect, including the ban on gender-affirming surgery for minors. He also allowed two provisions related to education to remain in effect: one that prohibits school officials from keeping information about a child’s gender identity secret from their parents, and another that prohibits school officials from “encouraging or compelling children to keep certain gender-identity information secret from their parents.”
Alabama Attorney General Steve Marshall did not immediately return a request for comment Saturday morning.
Dr. Morissa Ladinsky, a plaintiff in one of the suits challenging the law and a co-lead of UAB Pediatrics’ gender health team, said late Friday that the decision “is a huge relief for transgender children and their families.
“The court’s decision recognizes that this is well established care that has been endorsed by 22 major medical associations,” she said. “This decision will ensure transgender children in Alabama, and beyond, can continue to receive this evidence-based well-known lifesaving care.”
Ladinsky told NBC News after the Legislature passed the bill in March that there were no surgeons in the state who perform gender-affirming surgeries on minors.She said Monday that if thefull law had been allowed to remain in effect, it would’ve forced many of her patients to cease their ongoing treatment, because the law had no grandfather clause for transgender youths who were already receiving care.
“That is one of … the most cruel and ignorant parts of the law,” she said.
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Shay Shelnutt, the bill’s primary sponsor, said during a Senate debate in March that the bill seeks to “protect our children” and “stop these surgeries and these drugs on our children,” local news outlet AL.com reported.
Heather R. who lives in a small town about an hour northwest of Birmingham with her 15-year-old transgender son, Rob, said Saturday that she feels that the decision gives them some “breathing room.” She asked that her last name be withheld for safety and privacy reasons.
“I am worried this is going to increase violence and harassment toward trans people and their families, so I don’t feel we can start celebrating like it’s over,” she said.
Heather created a GoFundMe account so that she could move her family to a more supportive state.
“I don’t think it’s going to get better here, and we’re isolated here,” she said after the law took effect. She had originally planned to move to Maryland but recently decided to move to one of the 19 states that are considering legislation to protect transgender youths.
She said lawmakers who support restrictions on gender-affirming care for minors rely on misinformation to support their views and don’t seem to understand that trans kids are just like other kids. Rob said he likes video games, and when asked how many pets the family has, he said his answer would be “lengthy” before adding, “we have two dogs and a pack of cats.”
Though the part of the law that would affect Rob’s medical care has been blocked, at least temporarily, she said the family still plans to move.
“I do think we need to move somewhere safer so he can have a community of trans and LGBT people to hang out with in his late teens,” she said.
The Centers for Disease Control and Prevention on Monday alerted gay and bisexual men that monkeypox appears to be spreading in the community globally, warning people to take precautions if they have been in close contact with someone who may have the virus and to be on the lookout for symptoms.
Dr. John Brooks, a CDC official, emphasized that anyone can contract monkeypox through close personal contact regardless of sexual orientation. However, Brooks said many of the people affected globally so far are men who identify as gay or bisexual. Though some groups have greater chance of exposure to monkeypox right now, the risk isn’t limited only to the gay and bisexual community, he cautioned.
“We want to help people make the best informed decisions to protect their health and the health of their community from monkeypox,” Brooks said.
A section of skin tissue, harvested from a lesion on the skin of a monkey, that had been infected with monkeypox virus, is seen at 50X magnification on day four of rash development in 1968. CDC | Reuters
Monkeypox is not a sexually transmitted disease, which is generally passed through semen or vaginal fluid, but it can be transmitted through sexual and intimate contact as well as through shared bedding. The virus spreads through contact with body fluids and sores, Brooks said.
He added that it’s important for physicians and individuals to be aware of the symptoms associated with monkeypox, particularly anal or genital lesions that can be confused with herpes, syphilis or chickenpox.
“Anyone with a rash or lesion around or involving their genitals, their anus or any other place that they have not seen it before, should be fully evaluated, both for that rash but particularly for sexually transmitted infection and other illnesses that can cause rash,” Brooks said.
Monkeypox usually begins with symptoms similar to the flu including fever, headache, muscle aches, chills, exhaustion and swollen lymph nodes. It then progresses to body rashes on the face, hands, feet, eyes, mouth or genitals that turn into raised bumps which then become blisters.
However, the rash has appeared first in some of the recently reported cases, according Dr. Jennifer McQuiston, a CDC official. While the virus has a long incubation period, patients are considered most infectious when they have a rash, McQuiston said. Though monkeypox can spread through respiratory droplets, the virus comes from infected lesions in the throat and mouth that can expel it into the air. But transmission from respiratory droplets requires prolonged face-to-face contact, according to the CDC.
“This is not Covid,” McQuiston said. “Respiratory spread is not the predominant worry. It is contact and intimate contact in the current outbreak setting and population.”
The U.S. has confirmed one case of monkeypox in Massachusetts and four cases of orthopox in New York City, Florida and Utah, according to McQuiston. State labs have tests that can identify orthopox, which are presumed to be monkeypox, but they have to be sent to the CDC in Atlanta for further analysis to confirm that diagnosis, McQuiston said.
The cases identified in the U.S. are a milder West African strain, McQuiston said. Most people who catch the virus recover in two to four weeks without specific treatments, she said.
The World Health Organization has identified about 200 confirmed or suspected monkeypox cases across at least a dozen countries in Europe and North America in recent days.
It’s unusual, though not unheard of, for monkeypox cases to be found outside a handful of West and Central African nations where the virus is endemic. The U.S. had an outbreak of more than 70 cases in 2003 that stemmed from people keeping infected prairie dogs as pets.
There has been a surge of cases in Nigeria in recent years, but the cases identified around the world over the past two weeks are unusual because most of the patients did not have recent travel history to Nigeria or another country where the virus is usually found, according to McQuiston.
The smallpox vaccine appears to be about 85% effective at preventing monkeypox, based on research in Africa, according to the CDC. The U.S. has a stockpile of 100 million doses of an older generation vaccine called ACAM2000 that is approved by the Food and Drug Administration for people at high risk of smallpox, according to McQuiston. However, the vaccine can have significant side effects and any decision to use it widely would require serious discussion, she said.
The U.S. also has more than 1,000 available doses of a vaccine called Jynneos that is FDA approved for people ages 18 and older at high risk of monkeypox or smallpox. It is administered as two shots and doesn’t have the same risk of severe side effects. McQuiston said the number of doses should increase quickly in the coming weeks as the vaccine maker boosts production.
“We are hoping to maximize vaccine distribution to those that we know would benefit from it, so those are people who have had contact with a known monkeypox patient, health-care workers, very close personal contacts and those in particular who might be at high risk for severe disease,” McQuiston said.
Countless trans people are speaking out about their childhoods by writing letters in an effort to humanise the often cruel “debates” about them.
Under the hashtag “Letters 4 Trans Kids“, trans, non-binary and gender non-conforming Twitter users told their own stories.
As adults, they are thriving – and they want to help young people do the same. In a news cycle so often dominated by stories that dwell on bullying, murder and whether to remove their rights, trans people brought the conversation back to joy.
Among them was Arthur Webber, a 24-year-old writer based in London, England, who recalled nights “praying” that he would “wake up a boy” and now considers being trans a “gift”.
In many nations, from the US to Britain, trans folk are facing fire seemingly from all sides. From a belligerent press and politicians that see them as a “culture war”, to the spectre of rising violence and dwindling healthcare options.
But before then, Webber was a young person wishing he could throw on boy’s school uniform and use the men’s bathroom.
“My nights were spent praying that in the morning I would be a boy. I would wake up disappointed,” he tweeted. “However, I already was a boy – no divine intervention required.”
Webber recounted a Christmas Eve when he was seven spent cutting his hair off and rushing to tell his family about it. “I had been watching The Lion, The Witch and The Wardrobe, so perhaps took the time of children coming out of a closet a bit too literally,” he joked.
“However, I already was a boy – no (terrible) haircut needed.”
Holidays provided a young Webber with a chance to be himself, a feeling so often stripped from trans kids. “I’d avoid giving them my name and say I was born without one,” he said, “which everybody is, really.
“The devastation I felt when my family would fetch me using my deadname and reveal that the outside world believes I was a girl still lingers with me.”
There were many stories from a childhood spent hiding who he was that he could have included in the letter, Webber told PinkNews. Many show how life-saving inclusive education can be.
“Until I had sex ed in year five, I was convinced that I was just a really late starter at being a boy and one day my d**k would just grow,” he said. “I’d be like all the other boys so sometimes I would look at men out in public and wonder at what age theirs showed up.”
Visiting a train exhibition at a Doncaster museum with his father and grandfather, the pair let him use the washroom with them “because they weren’t about to leave a five-year-old alone”.
“I was so happy to be there,” Webber recalled, “even though it smells.”
“As a child, I thought that eyelashes were a female thing so I would pull them out,” he added.
“So now they’re very thin because when you pull them out for years they sort of stop growing back.”
The Letters 4 Trans Kids hashtag was first started by Ina Fried, chief technology correspondent for Axios. She sought to “find a way to support” trans and non-binary youth amid an anti-trans legislative onslaught in America.
Fried called on social media users to pen a letter to share their experiences growing up trans or show their emphatic support for the community’s rights.
“I can only imagine what it is like to be a trans kid right now, trying to find your own way while having to have your humanity and basic human rights up for discussion every day,” Fried wrote on Facebook on 10 April.
“And then there is the message that debate sends to their community, to their friends and even to them – that they are not seen or valued for who they are.”
“What if everyone who supports trans kids wrote a letter, or made a short video or posted on social media,” Fried added. “Well, why not? Let’s do it.”
And hundreds of people did just that. Trans actors, filmmakers, drag artists and leading LGBT+ advocates grabbed their pens and wrote about figuring their identities out just like any other kid.
The letters are a testament to just how possible it could be for trans youth to flourish when supported, affirmed and loved.
A question so many of the letters raised was how the adults in trans children’s lives – from parents and caregivers to educators and politicians – can choose to care for them, not abandon them, so they grow up into the people they know they can be.
Despite the obstacles he faced, Webber has persevered as a proud trans man – and so will today’s trans youth, he stressed. Webber now considers being trans a “limited edition gift with no receipt”.
“Sometimes you’d give anything to return it because it’s too hard to look after,” he said, “but most of the time you’re thankful that it’s unique.”
Just a month ago, Katie, a Texas mom, had no plans to leave her home.
Even after Gov. Greg Abbott urged Texans in February to report cases of minors receiving gender-affirming care, Katie — who has a 15-year-old transgender son and knew she could be investigated — planned to stay and fight.
But things started to change for Katie when the Texas Children’s Hospital announced last month that it would pause gender-affirming services for minors in light of the directive. Her son lost access to his care program for three weeks until a judge paused the state’s investigations.
“That just really shook me,” said Katie, who asked that her full name not be published to protect her family’s privacy. “The things that you never would think would happen somehow are reality, and I can’t live with the uncertainty. It’s eating us up.”
A spokesperson for the Texas Children’s Hospital said in an email that the hospital “remains deeply committed to our transgender and gender-diverse patients” and will “continue to monitor the ongoing legal proceedings in determining how best to proceed.”
Her son’s initial loss of gender-affirming care was the turning point for Katie and her family. Katie decided that after her son finishes 10th grade this summer, the family would move to Denver.
Her son, N., told NBC News last month that things have been “awful” since the governor’s directive. “It was hard to stay in one piece and not break down on everything,” he said.
Katie said that since the family decided to move, N. has been doing the best he can to stay positive about it.
“But his heart is broken,” she said. “We’re leaving Texas temporarily on our terms with the hope and prayer that come November, we’re going to get to come back home and it will be a joyous homecoming.”
Last month, NBC News spoke to a dozen parents of transgender children, as well as to trans teens, following Abbott’s directive. At the time, only one of those families had planned to move. Now, three, including Katie’s family, have said they will leave the state.
The three families who are departing said they didn’t make their decisions overnight. But they had watched Texas officials become increasingly bold in targeting transgender people in recent years.
In 2015, the state began to consider a “bathroom bill” that would have banned transgender people from using public and school restrooms that aligned with their gender identity.
Since then, the Legislature has ramped up its efforts. Last year, it considered more than 50 bills targeting transgender people. Only one made it to Abbott for a signature: a bill that bars transgender students from playing on school sports teams that aligned with their gender identity.
But one of the other failed bills prompted an opinion from state Attorney General Ken Paxton, who declared on Feb. 21that gender-affirming medical care such as puberty blockers, hormone therapy and surgery cause “irreparable harm” to minors and were child abuse under Texas law. Abbott followed with his directive to the state’s Department of Family and Protective Services the following day.
“I’ll do everything I can to protect against those who take advantage of and harm young Texans,” Paxton said at the time, arguing in his opinion that minors cannot consent to gender-affirming medical care.
He has since taken several actions to defend and double down on his position. He appealed both injunctions issued by judges: a narrow injunction on March 2 that paused one of the state’s investigations into a Child Protective Services employee and a statewide one issued March 11 that paused all investigations. An appeals court reinstated the statewide injunction and it remains in place.
Transgender youths, parents and several Democratic lawmakers rallied at the Texas Capitol on April 28, 2021.Bob Daemmrich / USA Today Network
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Paxton also filed investigative demands on March 24 against two pharmaceutical companies, Endo Pharmaceuticals and AbbVie Inc., alleging that they advertised their products as treatment for gender dysphoria rather than the medical conditions they were approved to treat.
The efforts from Paxton, Abbott and the state Legislature have had widespread effects. The Children’s Medical Center in Dallas removed all references to Genecis, its gender-affirming care program for minors, from its website in November and said the program would no longer take new patients. Last month, 850 doctors, medical students and employees at two Dallas hospitals signed a petition opposing the decision.
Paxton has also tweeted about transgender people, even repeatedly misgendering Dr. Rachel Levine, assistant U.S. health secretary and the first openly transgender Senate-confirmed federal official, prompting Twitter to flag the tweets.
All of it is adding up, and parents and LGBTQ advocates say they are exhausted. The Rev. Remington Johnson, a Presbyterian clergy member and a trans advocate, said she spends her days texting with the parents of trans kids in Texas and doesn’t know of any family who hasn’t considered leaving the state.
Even if advocates continue to defeat anti-trans bills, and even if the courts ultimately shoot down Abbott’s directive, they will leave behind a persistent “climate of terror,” she said.
“This is why there have been doctors that have just stopped treating trans kids,” she said. “It’s not because there’s a law, it’s because this is what terror-inducing bills do. It is the same playbook as the bounty-hunter style abortion bill, where it’s about causing anxiety and fear to stop the thing that you don’t want to be happening.”
She noted that Lt. Gov. Dan Patrick has already signaled support for a bill similar to one recently signed into law by Florida Gov. Ron DeSantis, the Parental Rights in Education Act, which bars discussion of sexual orientation and gender identity in some classrooms. Critics of the bill have dubbed it the “Don’t Say Gay and Trans” bill.
“Texas will work to pass what Florida passed but make it worse,” Johnson said. “It will be harsher, it will be more extreme.”
K., another Austin mom of a 10-year-old trans daughter testified against anti-trans bills at the Capitol last year, when the Legislature held three special sessions to pass the trans athlete restriction. She said that once it was over, she and the other advocates planned to take time off to recover and strategize for the next session.
But then Paxton and Abbott released their letters two months into the new year.
“Here we see that these two extremist politicians circumvented the legal process in order to implement these policies,” she said.
K., who also asked that her full name not be published out of privacy concerns, said that she realized that even though she and the other parents and advocates “followed the rules” and won, they’re still losing. “It makes me uncertain that we would be protected even though our kids have not received gender-affirming medical care at this point,” she said. “And I can’t fight offensively when I’m already down on the ground just trying to fend people off of my kids.”
She plans to move her family to Oregon this summer.
Parents also expect that the next legislative session, which starts in 2023, will be worse than the last. That’s why Heather Crawford, an Austin mom whose 15-year-old is trans, said she plans to move her family to Minnesota this summer.
“I have zero faith that it will stop,” she said. Her 15-year-old, Cass, was born and raised in Texas, but “I cannot ask them to spend the last years of their childhood in a state that wants to criminalize their existence.”
Cass, who uses “he” and “they” pronouns, said the idea of moving to a state with a number of pro-LGBTQ laws — and was the first to outlaw discrimination based on sexual orientation and gender identity in 1993 — is a huge relief. He said Paxton’s and Abbott’s efforts will put trans people in danger. “It’s saying that people can get away with transphobia towards everyone in the community, including kids,” he said.
Heather Peto had been feeling run down for a while before she realised there might be something wrong.
At first, she blamed her recent experience with COVID for her feelings of exhaustion – but gradually, she started to notice other, more troubling symptoms creeping in. Eventually, she realised that she was exhibiting some of the signs and symptoms of prostate cancer.
Getting to that realisation wasn’t easy. As a trans woman, Heather often has to fight to access the healthcare she needs. Some doctors and specialists are unaware of the specific symptoms trans women might experience when they have prostate cancer, while others don’t even know trans women can get prostate cancer.
Right now, Heather is undergoing tests to determine what’s causing her prostate issues. In the mean time, she wants to speak out about the symptoms she is experiencing so others will know what they need to watch out for.
Aside from the exhaustion, the first thing Heather noticed was that she started to experience urinary incontinence during sex.
“It was only a small amount, but that had never happened before,” Heather tells PinkNews. “It then started to happen regularly… One of the key things to get across is that if you’re noticed a change in your urinary habits, whether that’s incontinence or other things, then it’s important to get it checked out.”
Increasingly worried about her symptoms, Heather went to her GP for blood tests.
“The blood test measures something called prostate-specific antigen (PSA), and if you’ve got higher levels of that it tends to mean there’s something wrong with the prostate – it could be cancer, could be prostatitis,” Heather explains. Prostatitis refers to the inflammation of the prostate gland.
Heather Peto pictured with Keir Starmer. (Provided)
“Mine was quite high for my age,” Heather says. The tests were evidence enough that something was wrong, but that’s where Heather’s issues with the healthcare system begin. As a trans woman who has had hormone treatment, she should in general have lower PSA levels than a cis man would have.
The result is that some trans women and non-binary people with prostates can show lower levels of PSA in blood tests, but they could still have prostate cancer. According to Prostate Cancer UK, some experts believe a PSA level above 1 ng/ml in a trans woman should warrant further investigation.
Trans women can experience different symptoms of prostate cancer
Another barrier to treatment and diagnosis for trans women is that the symptoms can be different. One of the symptoms most commonly associated with prostate cancer is the need to get up and urinate frequently during the night – but that’s largely based on the experiences of cis men. Heather noticed some different symptoms.
“One of those symptoms is that there’s a form of incontinence by which you go to the toilet for a wee but you don’t expel all your wee… so you have that little residual amount that you can’t seem to expel. You know it’s there but it’s not completely gone. When it discharges, which it does, it ends up leaking all at once.”
Something else Heather experienced is that she would orgasm spontaneously during urination. “It’s very awkward,” she says. Unfortunately, Heather experienced some “disinterest” from medical professionals when she raised concerns about the symptoms she was experiencing – although she stresses that the care she has received has generally been good.
I’m left in this never-never of not knowing if it’s cancer that’s getting worse or if there’s another, more benign explanation such as prostatitis.
After noticing those symptoms, Heather went to her GP and was referred to a specialist. She was supposed to have a urine test in November 2021, but it was subsequently pushed back several times.
“I’m left in this never-never of not knowing if it’s cancer that’s getting worse or if there’s another, more benign explanation such as prostatitis, or if it could be another form of cancer that’s affecting the area. My health is getting worse, I’m OK but not OK in terms of living a normal live. So that’s my experience.”
Heather is speaking out about her experience because she wants both the medical field and the wider public to have greater awareness about the fact that trans and non-binary people with prostates are susceptible to developing prostate cancer too.
Heather Peto pictured on the left. (Provided)
“There is this list on the NHS website of symptoms that you might experience with prostate cancer, but it does seem to me to neglect certain things trans and non-binary people with prostates might experience, and it possibly neglects people who have sex with men.
“There needs to be more research and more guidance around trans people with prostate cancer,” Heather says. “I don’t want to be too alarmist, but I think we need to communicate this – there are people who are needlessly being treated further along in their prostate cancer than is necessary.”
Heather says there’s a level of ignorance in the medical field about the reality of prostate cancer for trans people. That’s not necessarily anybody’s fault, she points out – but she would like to see better education and training for GPs and other medical professionals. Right now, trans and non-binary people with prostates often have to educate healthcare professionals themselves.
“People need to talk more broadly about the problems trans people have,” she says. “We need to make sure GPs know about it, but also patients know about it so they can go to their GP in the first place… Your life is in their hands.”
Heather still doesn’t know what her symptoms mean, but she’s trying to remain optimistic while she waits on a firm answer.
“There’s always that nagging feeling in the back of my mind that it’s something worse that’s not being tackled, that I’ll end up dying from it, or that I’ll end up being more seriously ill than I need to be.”
What’s worse is that Heather knows she will likely experience transphobic abuse online because she’s daring to speak out about her experience. She has received brutal, cruel messages on social media over the years – all because she’s a trans woman. Some of those have wished cancer on her.
This culture of abuse only further silences trans people and makes them less likely to seek the support they need.
There needs to be greater awareness in the medical field about trans women’s medical needs
Heather’s experience is echoed by Suzanna Hopwood, also a trans woman. She developed prostatitis a number of years ago – she went to her GP and was referred to a consultant. The care she received was excellent.
“They don’t want to do any surgery on me, they’re just treating it with drugs. They didn’t think there was anything sinister lurking in my prostate and it wasn’t hugely big. That’s the process that I went through and I came out the other side reasonably satisfied,” Suzanna says.
“On the other side, you can fall into a bit of a hole really and not get properly diagnosed.”
Heather Peto. (Provided)
That’s why Suzanna worked with Prostate Cancer UK to help help bring its information on prostate cancer in trans and non-binary people up to date. She reached out to the charity when she started having issues with prostatitis and learned that the charity was already working on updating its information to make it more inclusive.
Today, Prostate Cancer UK provides in-depth information about the realities facing trans women and non-binary people with prostates. Worryingly, the charity points out that many people don’t even know that trans women and some non-binary people have prostates, meaning they’re less likely to seek and access the right supports.
For Heather and Suzanna, the path forward is education – both for medical professionals and for trans and non-binary people. Without that, lives could continue to be needlessly lost.
If you’re trans or non-binary and are worried about prostate cancer or prostatitis, you can visit the Prostate Cancer UK website to find out more.
An internet forum where people pretending to be parents forcing their children to be transgender has gotten shut down after it was found to be full of fake stories.
As the U.S. plunges even deeper into a moral panic over children who are supposedly being forced to transition, some anti-transgender people are reacting to the fact that that never happens by making up stories about it and trying to pass them off as real.
“Anyone else have trouble convincing your teen kids to continue transitioning?” user “Funkyduffy” wrote on the subreddit r/TransParentTransKid. “My 15-year-old daughter (AMAB) has started refusing her estradiol so I’ve been crushing the pills and putting it in her cereal in the morning.”
Reddit is a largely anonymous internet platform where most users create unidentifiable handles and connections between users aren’t the focus, a contrast to social media platforms like Facebook, Instagram, and Twitter. This makes it easier and more accepted for people to create temporary profiles to say whatever they want on various forums called subreddits.
One such subreddit, r/TransParentTransKid, was started last August when some users decided to post fake stories to it to promote the negative stereotype that parents and schools are forcing kids to be transgender. In reality it is common for schools and parents to be obstacles to trans kids expressing their identities while it’s unheard of for schools and parents to impede cisgender kids the same way.
The user who called for the subreddit’s creation said that it would be “filled with stories about how our real/adoptive children magically learned they were also trans after finding out about their parents,” according to Reuters.
According to another subreddit, r/AgainstHateSubreddits, r/TransParentTransKid was shut down for violating Reddit’s rules because they were “engaged in promoting hatred of transgender people, as well as targeted harassment.”
But the stories still spread outside of Reddit to rightwingers who were all too willing to believe them.
“This is fucking child abuse and I’ll die on this Hill,” wrote libertarian author Justin O’Donnell on Twitter, posting a picture of Funkyduffy’s fake story. He got almost 46,000 likes for it.
Ian Miles Cheong – who has a history of posting misinformation about trans people online and even riling Rep. Marjorie Taylor Greene (R-GA) up – shared the story with the words “Good parenting.”
The story comes as conservative politicians and activists are claiming that there is a massive effort by schools and parents to turn children transgender.
For example, Rep. Greene said in February that there are “these mothers that think [having a trans child] is like having a handbag. They need to have a boy, a girl, and a trans child like as if they’re some kind of accessory.”
Funkyduffy’s story may have been one that pushed her to believe that such parents exist.
“I have never – not once – heard of a child being forced to transition,” said the ACLU’s Gillian Branstetter. “The exception is intersex children who are frequently forced into surgeries, yet every effort to ban gender-affirming care exempts those surgeries.”
But honestly? I don’t think we look anything alike. Michael has a full head of silver hair — and I’m bald. Michael is at least three inches taller than I am.
And yet, as we travel, I’ve literally lost track of the number of times people have mistaken us for brothers. People often — often — even assume we’re twins!
Here’s the explanation I’ve come up with for why this happens: it’s unusual for two middle-aged men to be traveling together, especially if we’re sharing a room. If we’re in a country or culture where out same-sex couples are unusual or non-existent, people search for a label to apply to us. “Brothers” is the best explanation they can come up with that makes sense to them.
Plus, we act very comfortable and familiar together, like, well, brothers.
Truthfully, if this is the worst thing that ever happens to us on our travels, we’ll be very lucky. And so far, it is the worst thing, at least when it comes to our being gay.
In fact, we’ve found the world to be far more gay-tolerant than we expected, even in countries known for LGBTQ bigotry.
Then again, we’re relatively wealthy Westerners, and the locals in most countries have a financial interest in treating us well. Things are often very different for resident LGBTQ people.
We’re also men, who don’t have to deal with sexism, and we’re conventionally masculine, which means we can easily maneuver in cultures with more traditional gender roles.
We also try to do our due diligence before going anywhere, and we always approach travel with the idea that we’re guests in the places that we visit. That means we try to learn about and respect local customs and values — within reason, of course.
Surprisingly, we haven’t seen much of the homophobia monster in our travels.
But this doesn’t mean there aren’t still challenges to travel while being LGBTQ.
For one thing, something serious probably will go wrong at some point in our travels, and we’ll have to deal with the local authorities and/or police.
If it’s obvious we’re a gay couple, and there’s some kind of dispute, will the authorities take our side? If the problem involves homophobia, might the authorities even take the side of the bigot?
It’s a scary thought.
Then there’s the general discomfort of constantly having to decide whether or not to come out — and exactly how “out” we want to be in any given situation.
When we were living in Tbilisi, Georgia, we decided to hire a driver to take us and some friends on a road trip into neighboring Armenia for three days. The deal was the driver would supply the car and his expertise, and we would pay him a fee — and also pay for his food and lodging along the way.
But when Michael was making the arrangements via text, he asked me, “Do you think I should tell the driver we’re gay?”
“Why would you do that?” I responded.
“Well, we’re all going to be together in his car for three days. If he’s got an issue, I’d rather know now than once we’re in Armenia.”
“Don’t tell him,” I said. “That seems weird. ‘By the way, we’re gay’? He’ll probably be more freaked out by that than anything.”
“But if I don’t tell him, then it’ll come up during the trip. And how weird would that be? We’re all staying in the same hotels. He’ll see you and I are sharing a bed.”
This was a very familiar conversation — the kind of thing Michael and I discuss all the time. I’m generally more cautious than he is. And in this particular case, the driver had come with a very reasonable price and a strong recommendation from someone we knew. I really didn’t want to lose him, and I said so.
“What if he asks us directly?” Michael asked me.
“If we’re gay?” I said. “Please. He won’t ask. And if he does, we can always lie.”
I could tell Michael didn’t agree with me, but he went ahead and booked the driver without mentioning our being a couple.
And a few weeks later, when we finally met the driver in person, literally the first thing he said, once we were all settled into his car, was, “So, Michael, are you married?”
I was sitting in the back seat with our two friends, which was a good thing because I was pretty sure Michael wanted to strangle me. He lied and told the driver he wasn’t married, just like I had instructed, but even that didn’t help matters. For the next three days, our driver repeatedly peppered Michael — and only Michael — with questions about his love life.
During those three days, I was also very aware how often LGBTQ issues — or details about Michael’s and my relationship — came up in casual conversations with our friends.
In Armenia with friends, during a brief moment when Michael didn’t want to strangle me.
By the time we returned to Tbilisi, our driver must have figured out we were a couple. But whether he had or hadn’t, Michael was right: we should have told him in advance.
Still, who needs all that stress?
Then there’s the fact that, safety issues aside, we genuinely want to be out. It’s undignified and humiliating to have to pretend you’re someone you’re not.
And, frankly, we’re from a generation where we’ve always seen our being out as a political act — about yourself but also about a greater “cause”; younger generations seem to see it as more about individual expression, but that’s cool too.
Either way, visibility matters. In homophobic countries, it matters even more. By being out and proud, we can act as role models for younger LGBTQ folks, and we can confound the stereotypes or misinformation that straight people might have about us.
But that’s complicated too. When we lived in Istanbul, Michael got to know the man who ran the bakery near our apartment.
In his regular chats with the man, Michael revealed the details of his and my travels, and the two of them shared social media profiles. But Michael was always unsure how this traditional Muslim family man might react if Michael specifically referred to me as his “husband.”
Which is precisely the point. For me, the best part of our travels has been the connections I’ve made with all the people I’ve met along the way.
But in more conservative countries, being gay — and feeling anxious how people might react to that fact — makes those connections more difficult. How close can you get to someone if you can’t be honest about something so basic about yourself?
On the other hand, sometimes being gay has made those connections even deeper.
That Turkish baker Michael met? Not long after we left town, the baker “liked” a picture of Michael and me being affectionate on social media.
An ever better example came in Vietnam, where we lived several years ago. Michael and I joined a local co-working space, which was run by a Vietnamese woman.
Michael does the grocery shopping in our family, and he also knows that I liked the fruit smoothies made by a vendor there. So every time he made a trip to the local market, he would pick up a mango smoothie for me and stop by the co-working space on his bike to drop it off on his way home.
Not Vietnam, alas.
Before long, the Vietnamese woman began to notice, and she would smile every time Michael delivered me another mango smoothie.
Finally, one day the woman said to me, “You two are a couple, yes?”
I was surprised she’d said this out of the blue, and it made me a little nervous. I knew this woman hadn’t traveled much, and I suspected she didn’t know many out gay people.
But I nodded and said, “Yes. We’ve been together twenty-five years now.”
“He is very loving,” she said. “You are very lucky. You are both loving to each other.”
At that, I couldn’t help but blush. I wasn’t so sure about my always being loving to Michael, but I could absolutely agree with the other part.
And so I laughed and said that. “Well, you’re definitely right about Michael.”
She shook her head. “No. I watch, and I see. You are one of the best couples I’ve ever met.”
I loved that she’d been observing us and had come to such a nice conclusion. Now, more than anything, I felt seen. “Well, thank you very much. That’s one of the nicest things anyone has ever said to us.”
“I am just saying the truth.”
It was another one of those elusive but wonderful travel connections. And if I wasn’t gay — and if Michael wasn’t such a thoughtful person — it might never have happened at all.
Brent Hartinger is a screenwriter and author, and one half of Brent and Michael Are Going Places, a couple of traveling gay digital nomads. Subscribe to their free travel newsletter here.
A married gay couple has filed a federal complaint against New York City because the city’s health insurance doesn’t cover in vitro fertilization (IVF) procedures for male same-sex couples.
Corey Briskin, 33, and Nicholas Maggipinto, 36, were married in 2016. They want to have a child using IVF and a surrogate. However, they can’t afford to do so without their health insurance covering a portion of the costs.
IVF procedures can run tens of thousands of dollars, and the surrogate’s time and labor (which isn’t typically covered by health insurance) can cost $100,000 or more. Additionally, Maggipinto has a six-figure student loan debt.
So the couple tried to use Briskin’s health insurance, a benefit he earns as an employee of the city of New York. However, the couple were told they were ineligible for coverage.
The city’s insurance limits IVF coverage to employees or spouses who are “infertile,” that is, unable to get pregnant through heterosexual intercourse or intrauterine insemination. This policy covers women, heterosexual couples and lesbian couples, but not gay male couples.
As such, the city’s policy discriminates on the basis of sex and sexual orientation, violating the state’s anti-discrimination law and Title VII of the federal Civil Rights Act of 1964, the couple argued in its complaint to the Equal Employment Opportunity Commission (EEOC).
New York state law specifically directs insurance providers that cover more than 100 workers to cover at least three cycles of IVF for all insured people, regardless of their gender identity or sexual orientation, the couples’ EEOC filing notes.
“I think what we have here is an old paradigm of what families should look like,” Maggipinto said. “You have policymakers who think a family consists of a man and a woman and two and a half children…. But that’s not what my family will look like.”
The couple now wants the policy changed so that they and other male couples can afford to have children. They also hope the complaint could help encourage insurance providers to cover IVF for male couples across the nation.
A city spokesperson said it would review the couple’s complaint once it was received.
