Lynn Starkey worked at Roncalli High School in Indianapolis for nearly 40 years. In May, however, the Roman Catholic school fired Starkey as a guidance counselor after officials discovered that she is married to a woman.
In July, Starkey, 63, sued the school and the Archdiocese of Indianapolis, claiming, in part, that they discriminated against her on the basis of her sexual orientation.
Lynn Starkey is suing a Roman Catholic high school and the Archdiocese of Indianapolis after she was fired as a guidance counselor because she is married to a woman. Delaney and Delaney LLC
In May, the school’s principal notified Starkey, who has been married to her spouse since 2015, that her contract would not be renewed, stating in a letter that civil unions are in violation of her contract and “contrary to the teaching of the Catholic Church.”
The archdiocese — which is also being sued by a gay teacherwho was recently fired from a different Catholic school in Indianapolis — claims that it has a “constitutional right to hire leaders who support the schools’ religious mission.”
“Catholic schools exist to communicate the Catholic faith to the next generation,” the archdiocese said in a statement sent to NBC News. “To accomplish their mission, Catholic schools ask all teachers, administrators and guidance counselors to uphold the Catholic faith by word and action, both inside and outside the classroom.”
The issue of gay educators being fired by or excluded from employment at religious schools is not new, and since 2014, several cases have come before the courts. It’s also not unique to Indianapolis or Catholic institutions. In January, Karen Pence, the vice president’s wife, said she would return to teaching at a Christian school at Virginia that refuses to hire LGBTQ employees or to educate LGBTQ students.
So, is this legal? While the majority of Americans across all religious groups support employment nondiscrimination protections for LGBTQ people, according to a recently released PRRI public opinion poll, the law is less straightforward.
“The law is in flux,” said Jenny Pizer, law and policy director for Lambda Legal, an LGBTQ civil rights organization. “There are some principles we are sure of and some that are still being developed and sorted out in the courts and state and federal legislatures.”
In order to understand the rights of lesbian, gay, bisexual, transgender and queer workers employed by religious organizations, one must consider both federal and state law, the Constitution and executive orders.
Federal Law
Title VII of the 1964 Civil Rights Act prohibits employers from discriminating on the basis of race, color, religion, sex and national origin. However, it contains “multiple overlapping exemptions” when it comes to religion, according to Marcia McCormick, a professor of law and gender studies at Saint Louis University.
For one, any employer can discriminate on the basis of religion if religion is considered necessary for the exercise of the job, McCormick explained. For example, a Kosher butcher shop may want to hire only Jewish butchers.
Religious schools can discriminate in hiring in some circumstances. “They get singled out as getting this one provision that talks about schools being able to discriminate if the curriculum is directed toward the propagation of a particular religion,” McCormick said. A school run by Southern Baptists that seeks to encourage more people to convert to the faith could, according to this section of Title VII, hire only Southern Baptists.
Other kinds of religious organizations are also allowed to prefer co-religionists in their hiring — a Catholic charity is allowed to prefer Catholics in the hiring process. However, while religious organizations have leeway when it comes to hiring people of their own faith, they are not supposed to discriminate on the basis of other protected characteristics like sex, race or national origin, McCormick explained.
“That is where there is a big potential clash,” she said, adding that the issue for LGBTQ workers is twofold.
“Title VII has an expansive definition of religion — not just of beliefs but also practices,” she explained. “There are a lot of rules in a lot of religions about how people ought to behave when it comes to what it means to be male and female, or to sexual or romantic activity.”
Then, she added, there is the issue of the definition of “sex” in Title VII. If it is interpreted to include sexual orientation and gender identity, then LGBTQ workers can seek employment protection under federal civil rights law. They have done so in many cases, but the circuit courts are split on the issue. Luckily for Starkey, Indianapolis is covered by the 7th U.S. Circuit Court of Appeals, which has ruled in the case of Hively v. Ivy Tech Community College that sex discrimination encompasses discrimination on the basis of sexual orientation.
The Supreme Court, however, is scheduled to take up three cases this year that could have a major impact on LGBTQ workers’ nondiscrimination protections.
Title VII’s Ministerial Exception
In Starkey’s case, the archdiocese appears to be drawing on what is called the ministerial exception to Title VII under the First Amendment, which guarantees free exercise of religion.
In 2012, the Equal Employment Opportunity Commission sued an evangelical Lutheran church and a school in Michigan on behalf of a former employee, Cheryl Perich, a “called” teacher that underwent theology training and was considered to be in a ministerial position. Perich was diagnosed with narcolepsy and took disability leave as a result. When she was ready to return the work, the church told her she no longer had a job. The EEOC lost the case before the Supreme Court.
Pizer said this case “validated the ministerial exception, which lower courts had said existed but the Supreme Court had not spoken to.” The exception applies only to employees serving a ministerial function, but it affords the religious employer tremendous protection against claims of discrimination.
Maggie Siddiqi, director of the Center for American Progress’ Faith and Progressive Policy Initiative, told NBC News that in recent cases, employers are claiming that many different types of employees serve ministerial functions.
“That is really expanding the definition beyond its original intent,” which can “open the door for discrimination against all of these employees,” Siddiqi said.
Religious Freedom Restoration Act
An individual or a business may also claim protections under the 1993 Religious Freedom Restoration Act, a federal law that prohibits the government from discriminating on the basis of religion.
RFRA comes up in the case of R.G. & G.R. Harris Funeral Homes Inc. v. Equal Employment Opportunity Commission, one of the three LGBTQ workers’ rights cases currently before the Supreme Court. The case involves Aimee Stephens, a transgender woman who was fired from a Detroit funeral home after she informed her employer that she was beginning her gender transition.
In district court, the funeral home claimed that to employ Stephens violated the owner’s sincerely held religious beliefs, and for the EEOC to compel him to employ Stephens was an overreach of government authority in contravention of the Religious Freedom Restoration Act. The Circuit Court sided with Stephens, but the Supreme Court will have the last word in the matter.
State Law
In the absence of a federal law that explicitly protects workers from anti-LGBTQ discrimination, a worker can seek redress in state law. Twenty-one states and the District of Columbia have passed measures prohibiting discrimination based on sexual orientation and gender identity, according to the Movement Advancement Project, an LGBTQ think tank. Three additional states offer some form of LGBTQ workplace protections.
However, more than 20 states — including some of those with explicit state-level LGBTQ worker protections — have religious freedom laws or religious exemptions to their nondiscrimination protections. Indiana, where Roncalli High School is, has such a law. In fact, in 2015, then-Gov. Mike Pence signed Indiana’s Religious Freedom Restoration Act, which spawned significant criticism by those who said it would open the door to anti-LGBTQ discrimination.
Executive Orders & Department Rules
In 1965, President Lyndon B. Johnson signed Executive Order 11246 barring federal contractors who do over $10,000 of business with the government in one year from discriminating on the basis of race, color, religion sex or national origin. In 2002, President George W. Bush issued an executive order that added a religious exemption to the measure, using language lifted from Title VII. In 2014, President Barack Obama added sexual orientation and gender identity to the list of protected characteristics in Johnson’s original order, affording specific protections to LGBTQ workers, but Obama left intact Bush’s protections for religious organizations.
In 2017, then-Attorney General Jeff Sessions issued “religious liberty” guidance that elaborates principles such as “religious employers are entitled to employ only persons whose beliefs and conduct are consistent with the employers’ religious precepts.”
This month, the Department of Labor released its own proposed rule expanding religious exemptions available to government contractors and sparking outcry from many LGBTQ advocates. The rule expands the types of organizations eligible for exemptions to “employers that are organized for a religious purpose, hold themselves out to the public as carrying out a religious purpose, and engage in exercise of religion consistent with, and in furtherance of, a religious purpose,” and also allows employers to “condition employment on acceptance of or adherence to religious tenets without sanction by the federal government, provided that they do not discriminate based on other protected bases.”
The Trump administration claims that religious organizations need extra protections from nondiscrimination law, because not having them prevents these organizations from seeking federal contracts.
“It’s not just that they are changing a rule,” Pizer said regarding the impact of the rule, “but the way the change is being done is an explicit signal that this administration favors religious interests over the equality interests of LGBT people and women.”
What’s Next?
The Supreme Court will hear three cases in October that are expected to have a considerable impact on LGBTQ workers’ rights. Two of the cases deal with sexual orientation, the other with gender identity. In the meantime, the Department of Justice made clear in briefs filed this month that LGBTQ workers should not be covered by Title VII protections. In doing so, the DOJ puts itself at odds with the EEOC and the majority of Americans.
Democrats in Congress have responded by reintroducing the Equality Act, a piece of federal legislation that would add sexual orientation and gender identity to the list of classes protected against discrimination by the Civil Rights Act of 1964, and does not allow religious exemptions to civil rights law under Religious Freedom Restoration Act.
Activists have won a long battle to stop an anti-LGBT+ church operating out of Texas a public school, after protesting every week for more than a year.
Celebration Church, which is openly anti-LGBT+, had been renting space at the Austin Independent School District’s (AISD) Mueller Performing Arts Centre for its services.
Protest organiser and pastor for the AntiFascism NonChristian Church, Candace Aylor, said in a press release: “This was the goal, getting bigots out of public spaces. It goes against our closely held beliefs to abide bigotry and oppression, especially when openly, publicly permitted.
“What we learned today, what we confirmed from what those freedom fighters of the civil rights era taught us, is that direct action protests works.”
The protests were made up of AntiFascism NonChristian Church, as well as other organisations including PFLAG Austin.
Activists protested for more than a year. (AntiFascism NonChristian Church/ Facebook)
Anti-LGBT+ Celebration Church says it is moving out because its congregation has grown.
The church claims the reason for it no longer renting the public school space is that the congregation has grown, and it needs to move to a new building.
According to the Austin Chronicle, church spokesperson Christine Haas said: “Celebration Church has entered into a purchase agreement to buy a building in the Koenig Lane area.
“The growth of our congregation has allowed for this opportunity and we are very excited to have a permanent home for our Mueller Campus.”
However, one protester claimed in a post on Facebook: “They say they are leaving because they’ve grown, but the real reason is because when a group of protestors shows up every week to call them out on their hateful policies, they can’t grow (the protestors know because we counted their attendance every week).”
According to Austin newspaper the Statesman, the school district has not been able to prevent the church from using the space because their hands were legally tied, according to state law and the first amendment.
Instead, earlier this year the AISD used $10,000 of its income from the Celebration Church rental to fund student and staff participation in the Austin Pride Parade.
The Zero for Zeros campaign released today, a new round of companies who receive a perfect 100 rating from the Human Rights Campaign’s Corporate Equality Index (CEI), but use their corporate PACs to fund elected officials in Congress who lead opposition to LGBT equality. The list of anti-LGBT elected officials includes Reps. Steve King and Louie Gohmert as well as Senators Mike Enzi and Ted Cruz, among others. The campaign aims to pressure companies to review and end their financial support of these extreme anti-LGBT politicians.
Today’s companies are some of the biggest consumer names in the world and include:
● United Parcel Services
● Chevron Corp
● Northrop Grumman
● Pfizer
● General Motors
● Ecolab Inc
● Dow Chemical Co
● Exelon Corp
● Coca-Cola
● Johnson & Johnson
● Bayer AG
● Boston Scientific Corp● General Mills ● Procter & Gamble ● Cargill
● Nationwide Mutual Insurance● Cardinal Health ● Pepsico ● Diageo
● Best Buy ● Whirlpool Corporation● Merck
“Many of America’s biggest brands say they are proud supporters of their LGBT employees and customers, but at the same time, their corporate PACs are contributing to some of the most strident opponents of LGBT equality in Congress,” said Lane Hudson, Zero for Zeros’ campaign manager. “Those contributions enable the worst of the worst in Congress who work everyday to roll back the
progress we’ve fought hard to win, and who block critical protections for LGBT people like the Equality Act. Our ask is simple, these companies should end their corporate PAC contributions to the politicians who work everyday against equality. It is the right thing for their employees, their customers, and their brand.
Zero for Zeros found that 49 companies that received a 100% rating on the Human Rights Campaign’s CEI have donated to members of Congress that are the most outspoken against LGBT equality, earning a ZERO rating on the Human Rights Campaign’s Congressional Scorecard. These companies have contributed a total of $5,837,331 from their corporate PACs to the worst of the worst Members of Congress. Zero for Zeros is asking that the companies’ corporate PACs cease giving to these members of Congress. A summary of the contributions can be viewed on the Zero for Zero’s website.
“As a veteran of the financial industry and politics, I’ve worked to advance equality in corporate America and government. There is no logical rationale for a company that supports the LGBT community to support politicians that work against it,” said Charles Meyers, Chairman of Signum Global Advisors.
“As a corporate leader, my money goes to candidates that align with my values and the values of the company I lead. I would never contribute to candidates that not only don’t hold those values of equality and fairness, but who in fact work against them,” said Mitchell Gold, Co-Founder and Chairman of Mitchell Gold + Bob Williams.
The campaign has contacted the CEOs of each of these companies as part of the campaign. A diverse group of leading activists signed on in support of the campaign and is running digital ads anddigital video engaging employees and allies to join the campaign.
The full list of Zero for Zeros companies:
● Microsoft
● Facebook
● AT&T
● T-Mobile
● Google
● Intel
● Amazon
● Visa
● Mastercard
● Cisco Systems
● Dell Inc
● Oracle
● Sap America
● American Airlines
● Wells Fargo
● Morgan Stanley
● JPMorgan Chase
● Capital One FinancialCorp
● Citigroup
● Cigna Corp ● PNC Financial Services● KPMG ● Ernst & Young ● Deloitte ● PricewaterhouseCoopers● Massachusetts Mutual
Life Insurance ● BBVA Compass Bank● United Parcel Services
● Chevron Corp
● Northrop Grumman
● Pfizer
● General Motors
● Ecolab Inc
● Dow Chemical Co
● Exelon Corp
● Coca-Cola
● Johnson & Johnson ● Bayer AG ● Boston Scientific Corp● General Mills ● Procter & Gamble ● Cargill ● Nationwide Mutual
On Sept. 15, 2017, Olivia stepped into a full-body scanner at the Fort Lauderdale-Hollywood International Airport.
When she stepped out, a female Transportation Security Administration officer approached. On the scanner’s screen was an outline of a human body with the groin highlighted. The officer told Olivia that because of something the scanner had detected, a pat-down would be necessary.
As a transgender woman, Olivia, 36, had faced additional TSA scrutiny before. On those occasions, a manual search at the checkpoint had been enough to assure TSA officers that there wasn’t a weapon or explosive hidden in her undergarments.
This encounter with the TSA went very differently.
After patting down Olivia and testing her hands for explosive residue, the officer said that she still couldn’t clear Olivia to board her flight and that a further search would be required.
Olivia was led to a private room where, she said, the officer patted her down again, running her hands down Olivia’s legs and over her groin.
“I told her: ‘If the issue is what you are feeling, let me tell you what this is. It is my penis,’” said Olivia, who agreed to be interviewed only if she were identified by her middle name because she fears people will treat her differently if they know she is transgender.
Soon after, three other TSA officers, all of them women and at least one of them a supervisor, entered the room, Olivia said.
TSA rules require that passengers be searched by officers of the same gender as they present. But, according to Olivia, the TSA supervisor told her that she would have to be patted down by a male officer.
After Olivia refused to be searched by a man, the officers told her that because she was not consenting to a search, she could not board her flight and would be escorted out of the terminal.
Olivia said she started crying and pleaded with the officers. “Can I just show you?” she recalled asking them.
TSA officers aren’t supposed to allow passengers to remove undergarments. But Olivia said the officers in the room with her did not object when Olivia pulled her ruffled, black and white skirt and underwear down to her ankles.
Olivia was then cleared to continue to her gate.
A Flawed System
What happened that day traumatized Olivia, who is now fearful of airports, and what she experienced reflects the worst fears of many transgender travelers, who say the TSA is failing them.
Shortcomings in the technology used by the TSA and insufficient training of the agency’s staff have made transgender and gender nonconforming travelers particularly vulnerable to invasive searches at airport checkpoints, interviews and a review of documents and data shows.
The TSA says that it is committed to treating all travelers equally and respectfully. But while the agency has known about the problems for several years, it still struggles to ensure the fair treatment of transgender and gender nonconforming people.
To understand the extent of the problem, ProPublica reviewed publicly available complaint data from the TSA’s website and asked transgender travelers to provide accounts of their experiences at airport checkpoints.
The review, which covered civil rights complaints filed from January 2016 through April 2019, found that 5%, or 298 complaints, were related to screening of transgender people, even though they are estimated to make up slightly less than 1%of the population.
This may understate the proportion of complaints from transgender travelers. When Olivia contacted the TSA, her complaint was filed in a different category — a catchall classification called “sex/gender/gender identity – not transgender.” That category accounts for 15% of the civil rights complaints in the period examined by ProPublica, but the TSA said it did not have a more specific breakdown of these complaints and could not say how many were, like Olivia’s, related in some way to gender identity and screening. ProPublica filed a Freedom of Information Act request in April seeking information about each complaint in those categories, but the agency has not yet provided any response.
When ProPublica asked transgender and gender nonconforming people to tell us about their experiences, we received 174 responses, many of them recounting humiliating treatment after being flagged by full-body scanners for additional scrutiny. Of those people, only 14 said they filed a complaint with the TSA. Many of those who did not file complaints said they didn’t know how, were afraid of outing themselves or didn’t want to relive the experience.
Some of the travelers who responded to ProPublica said they were asked by TSA officers to lift clothing to show private parts of their bodies or were pressured to expose their genitals so that TSA officers would allow them to pass through the security checkpoint.
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“Transgender people have complained of profiling and other bad experiences of traveling while trans since TSA’s inception and have protested its invasive body scanners since they were first introduced in 2010,” said Harper Jean Tobin, director of policy at the National Center for Transgender Equality, or NCTE.
The TSA, which is part of the Department of Homeland Security, was created in an overhaul of transportation security after the 2001 terrorist attacks, with the mission to prevent similar tragedies. The agency, replacing a patchwork of private security providers, initially used metal detectors, which had been standard at checkpoints for years. But after a passenger attempted to blow up a plane in 2009 with plastic explosives hidden in his underwear, the agency began using full-body scanners.
The new scanners were designed to detect potential threats that are not necessarily metal. But TSA officers can’t tell by looking at the monitor whether the machine is detecting a weapon, or as in Olivia’s case, a body part that the scanner was not programmed to associate with a woman.
Since implementing the scanning technology, the agency has grappled with privacy and discrimination issues. Like the transgender and gender nonconforming communities, people with disabilities, people who wear religious head coverings and women of color, whose hairstyles trigger the body scanners to alarm more frequently, have raised concerns about profiling and invasive screening.
Jenny Burke, the TSA’s press secretary, said the screening is done “without regard to a person’s race, color, sex, gender identity, national origin, religion or disability.”
In February, the agency rolled out a new online transgender awareness training, mandatory for its 43,000 screeners, and is studying options for better technology, Burke said.
But advocates and some lawmakers said the improvements have taken too long for a federal agency that interacts with the public more than many others. On an average day, TSA officers screen more than 2 million people and manually search many of them.
“For many, TSA is not just the public face of government — but its hands, too. Its success as a security agency depends upon the trust and compliance of a diverse public,” Rep. Bennie Thompson, D-Miss., said during his opening statement at a Homeland Security Committee hearing in June.
Transgender people have faced growing uncertainty about whether their civil rights are protected by the federal government. In May, the Trump administration announced plans to roll back protections for transgender people under nondiscrimination laws. Earlier last year, the administration barred transgender people from serving in the military. As ProPublica reported last year, some states bar transgender people from obtaining a state-issued ID that matches their gender presentation unless they provide proof they’ve had surgery.
False Alarms
Most of the incidents ProPublica reviewed for this story started with a body scanner issuing an alarm.
Before a person steps into the full body scanner at an airport, a TSA officer must register the person’s gender, pressing a pink button for a female or a blue button for a male. Generally, the officers make the decision in seconds, based on a person’s appearance.
The body scanner is programmed to look for penises on passengers scanned as male and breasts on passengers scanned as female. If the officer selects the female button and the machine detects something in the passenger’s groin area — like in Olivia’s case — it could interpret a body part as a potential threat, issuing an alarm.
ProPublica also spoke to several cisgender women who said they were flagged for additional scrutiny after a TSA officer scanned them as male, causing their breasts to trigger the alarm. (“Cisgender” describes someone who identifies with the sex they were assigned at birth, meaning they are not transgender.) The women told ProPublica that they believed the officers scanned them as male because they had short hair or, in one case, because they were wearing baggy clothes.
Peter Neffenger, who served as TSA administrator for the last 18 months of the Obama administration, said he heard again and again about the anxiety brought on by the scanners.
“As many in the transgender community explained to me, it’s one of the most stressful parts of the screening process for them,” Neffenger said.
In September 2018, Terra Fox, a transgender woman, was at the airport in Albuquerque, New Mexico, on her way to a conference in Orlando, Florida. When she walked through the body scanner, the machine showed a yellow box over her groin.
Fox said she told the officers at the checkpoint that she is a transgender woman and that the machine was merely detecting her genitals.
Fox asked to be patted down by a woman, but the female officers near her refused to do it.
According to Fox, two male officers brought her to a private room and instructed her to pull down her leggings and show them her genitals. She complied, but the screening lasted so long that she missed her flight. She said the experience has taken a toll on her.
“Every time I travel, I have to cry and feel humiliated,” she said.
Fox has to travel for work frequently and said she doesn’t have the option of avoiding airports.
Terra Fox says she was instructed to pull down her leggings during a TSA search at the airport in Albuquerque, New Mexico. (Adria Malcolm, special to ProPublica)
Allister McGuire, a transgender man who lives on Long Island, N.Y., said he didn’t fly for five years after an experience in the St. Louis Lambert International Airport in 2014. McGuire was taken to a private room after the body scanner went off, displaying a yellow patch on his chest.
“I was very nervous,” McGuire said. “I did not feel safe.”
The two male officers in the room told McGuire to remove his chest binder, a cloth undershirt some trans men and gender nonconforming people use to flatten their chests, and then lifted each of his breasts with their hands, McGuire said. He was eventually allowed to leave, but he said he immediately had to take anxiety medication.
McGuire said he did not file a complaint.
In an interview with ProPublica, McGuire wondered: “If I was coming through as a woman, would [the officers] be touching me like that?”
Burke, the TSA press secretary, said that the agency does not conduct strip searches, but that travelers may be required to “adjust clothing” during the pat-downs. The agency didn’t respond to detailed questions about the allegations made by Fox and McGuire.
Neffenger said that during his time as TSA’s administrator, officers were not supposed to ask people to take off their clothes during a screening. But he acknowledged that it was difficult to keep such an enormous workforce consistently trained.
“It wouldn’t surprise me if you said you discovered that people have asked people to undress,” Neffenger told ProPublica. “It’s a big organization; it’s got a lot of turnover.”
The overall attrition rate for the TSA officers is 17%, which is roughly in line with the federal workforce, according to a report this year by the inspector general for DHS. But officers leave the TSA voluntarily at a higher rate than other federal employees, according to the report, which said “retention and training challenges are contributing factors to airport security weaknesses.”
Neffenger spent 33 years serving in the U.S. Coast Guard before being appointed in 2015 to lead the TSA. He arrived amid fallout from damning revelations about the agency. A leaked government report showed that TSA officers had failed to detect nearly all weapons and explosives smuggled through by DHS investigators during a secret test.
Neffenger said his immediate focus as administrator was to develop a nationwide training program. It was a challenging task, he said, because the intrusive nature of the screening process will inevitably make both passengers and officers uncomfortable.
“Pat-downs are, by definition, invasive,” Neffenger said. “What [TSA officers] are asked to do is stuff people don’t like to do.”
Public Comments
TSA officers would need to do fewer pat-downs if the agency had better technology.
The agency uses a machine called a millimeter wave scanner at nearly every airport in the U.S. The machines, manufactured by L3Harris Technologies, rely on an algorithm to analyze images of a passenger’s body and identify any threats concealed by the person’s clothes.
The TSA has spent about $110 million deploying the machines, which cost about $150,000 each, according to a government report.
Since the TSA began deploying body scanners at airports, LGBTQ advocates have expressed concern that the new screening procedures would disproportionately affect transgender travelers.
In a letter to then-TSA Administrator John Pistole in December 2010, NCTE, the Transgender Law Center and the National Center for Lesbian Rights described two incidents in which transgender men were interrogated by TSA officers because their bodies looked different in the scanners than what the officers expected. The organizations urged Pistole to take immediate action to stop discrimination against transgender people. In a written response, Pistole said the agency was “working hard to respond to the concerns of the traveling public.”
The full-body scanners at airports across the country frequently give false alarms for Afros, braids, twists and other hairstyles popular among black women.
In 2010, the Electronic Privacy Information Center, or EPIC, sued DHS in response to the TSA’s decision to make body scanners the primary screening system at airports. EPIC argued that the agency should have given the public an opportunity to comment on the technology before it was implemented. The District of Columbia Court of Appeals ruled in favor of EPIC in 2011, though the TSA didn’t begin accepting comments until 2013.
“They are now blaming the scanners when part of the rule-making process is to surface these kinds of issues,” said Jeramie Scott, director of EPIC’s Domestic Surveillance Project.
Burke said the agency procures equipment, such as body scanners, that can accommodate the largest demographic possible. Burke said the TSA does not develop its own technology and solicits private companies to develop scanners that meet the agency’s needs.
Neffenger said talking to transgender people and advocates helped him realize that the agency had to do better.
“You really have to design a system that is as close to 100% as possible,” he said.
The TSA and L3Harris Technologies did not respond to questions about how the scanner’s algorithm processes images to determine threats. (In June, L3 Technologies and Harris Corporation merged to form L3Harris, which has about 48,000 employees and is a key government contractor.)
In a written statement, Jennifer Barton, a spokeswoman for L3Harris, said details about the company’s research and development are confidential. She also said the company is working “with the TSA” on new technology and products that meet the agency’s “evolving requirements and the needs of all passengers.”
“We recognize the importance of ensuring that security scanning equipment accommodate all gender identities, and that is why (the company) is developing technology that moves away from the current male/female imagery and will safely screen passengers without the use of gender-specific images,” Barton wrote.
Barton didn’t respond to follow-up questions about when the technology would be ready for use at airports.
Beyond Technology
While Olivia was searched in the private room in Fort Lauderdale, her fiancee, Marguerite, was waiting on one of the benches near the security checkpoint. Olivia, a trial lawyer, and Marguerite, a school psychologist, had been dating for a year and were planning to marry that winter. The couple were on their way to New York for Marguerite’s brother’s wedding, and Marguerite was worried that they might miss their flight.
“I didn’t know if I could call the police,” Marguerite said. “I didn’t know what my rights were.”
Olivia said she is used to people questioning her appearance — and even her right to exist — because she is transgender. Showing her naked body to TSA officers, however, was a level of invasiveness she wasn’t prepared for.
“The whole weekend of the wedding I replayed the situation in my mind. It ruined the trip,” she said. “As a lawyer I am used to being in control of the situation, but that situation just completely went off the rails.”
Days after the incident, she filed a detailed complaint with the TSA. Her account describes actions, such as the directive that she submit to being searched by a man, that would violate TSA policy.
“As a lawyer I am used to being in control of the situation, but that situation just completely went off the rails,” Olivia said. (Annie Flanagan, special to ProPublica)
Burke, the TSA press secretary, said transgender people are supposed to be patted down by an officer of the same gender that they present.
A TSA officer, who has worked as a screener since 2016 and spoke on the condition of anonymity, said the officers should not have allowed Olivia to expose herself.
“The moment she [Olivia] said she was going to take her clothes off, they had to say: No, we can’t allow that. That is completely against SOP [standard operating procedure],” the TSA officer said.
Olivia said if she’d known she had the right to bring a witness into the private room, Marguerite would have been there with her.
Six weeks after she filed her complaint, on Oct. 31, 2017, Olivia received a letter from the TSA’s Office for Civil Rights and Liberties, Ombudsman and Traveler Engagement. The letter shared the conclusions of the agency’s investigation into the incident: “Our review to date does finds [sic] that the TSA officers and staff did follow Standard Operating Procedures (SOP) in the overall screening and the pat down procedures,” it said.
According to the letter, the agency’s investigation involved “a collection and review of eye-witness statements, close circuit television footage, and any other evidence tending to prove or disprove a traveler’s factual allegations.”
The two-page letter didn’t address Olivia’s claim that she had to expose her genitals to TSA officers.
“My complaint came back and it was not at all what I said had happened,” Olivia said.
Eventually, Olivia filed a Freedom of Information Act, or FOIA, request for the evidence the TSA said it reviewed to investigate her allegations. Her request was denied.
“Nobody called me, nobody did anything, they completely blocked my FOIA request,” she said.
ProPublica also submitted a FOIA request for documents related to the investigation into the incident, along with a privacy waiver signed by Olivia to allow ProPublica to access her records. The agency has yet to provide ProPublica with any of the requested records, citing a backlog in FOIA requests.
ProPublica reviewed the narrative that Olivia included in her original complaint to the TSA, as well as photos she took of the officers involved and an audio recording she made at the end of the incident, to corroborate her description of events.
The agency told ProPublica that it does not have cameras in private screening rooms and did not respond to questions about the incident or Olivia’s complaint.
ProPublica contacted one of the officers at her home in South Florida, but she declined to comment. We could not locate the other two officers.
Deficient Training
TSA officers and supervisors started taking a 30-minute online course titled “Transgender Awareness Training” in February. The course is supposed to teach employees how to interact with transgender people respectfully, according to a one-page summary of the training provided by the TSA.
Burke said that the agency would not provide a copy of the training materials because they are “sensitive security information.”
ProPublica reviewed hundreds of posts and comments from a private Facebook group for current and former TSA employees called “TSA Breakroom.” The conversations in the group, which has more than 18,000 members and is not administered by the TSA, shed some light on the content of the training.
In a series of discussions earlier this year, group members, some of them withholding their names, complained about the program. One of the anonymous posts said the course in the Online Learning Center, or OLC, instructed officers to introduce themselves to passengers by stating their name and the pronouns the officer uses.
A post in a private Facebook group for current and former TSA employees called “TSA Breakroom.”
This kind of introduction is common in the LGBTQ community, but dozens of group members wrote that they didn’t understand the instructions or would not be willing to introduce themselves that way.
Many group members wrote that they worried passengers would be upset if officers asked them about their gender identity.
“I shook my head through that whole dang course,” one member commented in April 2019. “Someone will throat punch me if I say that stupid shit.”
A comment from April 2019 about a transgender awareness training course, posted in a private Facebook group for current and former TSA employees.
Other group members wrote that the training didn’t address the fundamental problem that the scanners have only male and female options.
“I got a pink button and blue button. Which one you want?” one group member wrote.
The current TSA officer who spoke to ProPublica on the condition of anonymity said that she came up with her own ways to screen transgender passengers.
“I flip a coin in my head and hit a button, wait for the person to walk out of the scan, point at the screen and ask the person: Did I scan you right?” the officer said. “It is sort of a discreet way of asking.” If the passenger’s answer is no, the officer asks the passenger to walk through the scanner again and hits the other button.
Another TSA employee, who has worked for the agency for over a decade and spoke on the condition of anonymity, said that the gender buttons are stressful for both passengers and officers.
“A lot of the traveling public already hate us,” she said. “We don’t want to offend people by [scanning them] wrong.”
Some members of Congress have tried to address discrimination against transgender people at TSA checkpoints through legislation. In 2018, Rep. Kathleen Rice, D-N.Y., introduced the Screening With Dignity Act, which proposed funding for TSA training and education and a feasibility study for retrofitting or replacing the millimeter wave scanners. The bill died in the Homeland Security Committee and has not been reintroduced this year.
“It is clear that TSA needs to reassess its technological capabilities and improve its screening procedures to be more inclusive,” said Rice, who was the district attorney for Nassau County, on Long Island, before being elected to Congress. “No one should have to go through airport security scared that they might be humiliated, discriminated against or outed.”
In a 2015 survey of transgender Americans, NCTE found that of respondents who had gone through airport security in the last year, 43% had a problem at the checkpoint related to being transgender.
Many transgender people fear interacting with law enforcement in any setting. According to the NCTE survey, 57% of respondents said they would be afraid to ask the police for help.
Fox, the transgender woman who said she was asked to expose her genitals at the airport in Albuquerque, said her boyfriend encouraged her to file a complaint, but she decided against it.
“Dealing with the legal system is scary,” Fox said.
Lasting Trauma
When Olivia left the private room where she was searched at the Fort Lauderdale airport, she ran to Marguerite, who was waiting for her on the bench, and wept.
“Calm down, calm down, get your stuff together,” Marguerite can be heard telling Olivia in the audio recording Olivia took on her phone near the end of the incident.
Olivia and her wife, Marguerite. When they have to fly, Marguerite prints out the screening procedures from the TSA’s website in case Olivia is stopped again. (Annie Flanagan, special to ProPublica)
From the time Olivia stepped in the body scanner to the time she was allowed to head to her flight, the encounter spanned just 20 minutes. But it’s been impossible to forget.
Marguerite and Olivia, who married last year, have traveled a few times since the September 2017 trip. Marguerite prints the screening procedures from the TSA website and keeps a copy in her purse, in case she has to show it to a TSA officer.
Each time they travel, Olivia panics as she approaches an airport checkpoint.
“I feel my heart speed up. I start thinking: It is going to happen again, it is going to happen again, it is going to happen again,” she said.
This May, while flying back to Florida from North Carolina, a TSA officer asked Olivia to step aside. The airport body scanner issued an alarm in her groin area. The officer patted her over her jeans and allowed her to head to her flight.
When she left the checkpoint, Olivia ran to Marguerite, who held her as she cried.
In January of 2019, Japan’s Supreme Court upheld a law requiring trans people to be sterilized in order to legally change their gender. After the ruling, I remember seeing a tweet by the Economist sharing the article,“Should transgender people be sterilised before they are recognised?”. Posing this as a question legitimizes the idea that individual reproductive rights are up for debate. They are not.
I was infuriated, and deeply hurt. The right to reproduce is fundamental. To be told by the state that you must trade your right to have biological children to have your gender legally recognized is a chilling violation of human dignity.
It also got me thinking about how, reproductive rights violations aside, trans people’s fertility options are often overlooked, discounted or stigmatized. Oftentimes, conversations about fertility are glossed over by practitioners with trans clients seeking gender-affirming care. Maybe it’s difficult to think about having a biological child if you’re young, if you are just at the beginning of your medical transition or for any number of other reasons. But you should at least know about your fertility options.
To bring more awareness of fertility options for trans people, I recently organized a panel discussion with two reproductive health specialists who specialize in providing services to trans people: Evelyn Mok-Lin, MD, medical director of UCSF Center for Reproductive Health, and Pratima Gupta, MD, medical director of St. James Infirmary and board member of San Francisco AIDS Foundation. They answered questions about the effect of hormones on fertility, pregnancy options for trans people, and more. Here’s what we learned.
Do you get many trans clients who initiate conversations about their fertility?
Pratima Gupta, MD: It’s a very small percentage of my patients that ask. Anecdotally, I would say that this is just not something that’s on their radar. When people are initiating hormones, that is usually their priority. Fertility isn’t something that they are considering. They’re thinking about gender-affirming care, so it is important for us, as providers, to discuss it.
Why is it important for trans people to start conversations about their fertility with their health care provider?
Evelyn Mok-Lin, MD: The ideal right now is to try to conceive or try to preserve one’s fertility before starting hormone therapy. We know that people that have transitioned can still conceive. We also know that people who have not started hormones are more likely to conceive. So that’s why it’s important to have a discussion with your doctor about your future fertility plans and family plans before starting hormone therapy or having surgery.
Gupta: It’s really important for health care providers to have thorough discussions about options, planning and cost with their trans clients. It’s so much more than just ticking a box and asking trans clients if they want to get pregnant or get someone else pregnant. Although there are these recommendations for health care providers, it’s also good for people to advocate for themselves. It’s a good conversation to start, even if your provider doesn’t initiate it.
What are options for trans people to have a baby?
Mok-Lin: Of course adoption is always an option, but here I’ll discuss options for having a genetically related child. To have a genetically-related child, you need an egg, a sperm and a uterus. That’s the foundation of it. It depends on which of these you have, and which your partner (if you have one) has.
If between you and a partner, you have eggs, a uterus and sperm, spontaneous conception (getting pregnant “naturally”) may be an option.
Intrauterine insemination (IUI) may also be an option. This is when your sperm, a partner’s sperm, donor sperm or frozen sperm is put into the uterus.
In vitro fertilization (IVF) may also be an option. We can use frozen eggs from someone who may have frozen them prior to having ovaries removed or before starting hormone treatment. Or you can use donor eggs or a partner’s eggs and combine them with a partner’s sperm, donor sperm, or frozen sperm. If you have a uterus, the embryo could be transferred there, or it could be put into the uterus of a surrogate. There are a lot of ways to make it happen.
What are the costs associated with these procedures?
Mok-Lin: It depends on your insurance. We live in a unique place where a lot of people who work in Silicon Valley have coverage for fertility treatments. But not everyone does.
If you don’t have coverage, intrauterine insemination can cost about $1,000. That doesn’t include the cost of sperm. If the sperm comes from the couple, then there’s little to no cost. If you get donor sperm, the cost may be another $700. IVF can cost around $15,000 to $20,000 per cycle. If you use a surrogate, that can be on the order of $150,000.
There are a lot of options, but it can be extremely cost-prohibitive, unfortunately. Some people who need fertility coverage switch companies to get the right insurance coverage. They may move to another state (such as Massachusetts), or look for jobs that are local but at a company based in Massachusetts.
Gupta: I recently had a client who did that: She took a position at a company that was, job-wise, a bit of a demotion in terms of her career. But the company offered fertility coverage, and she did the math.
Can you get pregnant, or can you get a partner pregnant, if you’re taking hormones?
Mok-Lin: This is one of the things I always talk to teenagers about before they start testosterone. T (testosterone) is not a form of contraception! We know that people have gotten pregnant on testosterone. If you don’t want to get pregnant, and are having intercourse with someone who has sperm, you need another form of protection.
That said, there aren’t that many people who have gotten pregnant when on T, because T can prevent ovulation and the thickening of the uterus. When the lining of the uterus is thin, an egg—if one is released—isn’t able to implant properly.
There was one study by Alexis Light of trans men who had pregnancies. The group of men included those who had never taken T and those who had taken T and come off of it. This study concluded that men who had never taken T were three times more likely than those who took T to get pregnant. But the number of people in the study was so small, it’s hard to know for sure.
Gupta: The same is true for people on estrogen. Feminizing hormones, similarly, do not cease sperm production. You can’t rely on estrogen as contraception.
What about for trans people who do want to become pregnant or get someone else pregnant? What are the effects of hormones?
Mok-Lin: It’s more difficult to conceive naturally on hormones, but we know it’s not impossible. The recommendation now is to come off of hormones three to six months before trying to conceive. Time off of hormones allows the lining of the uterus to thicken, which allows the egg to implant properly. The life cycle of sperm is about 70 days so it takes between two and three months to resume spermatogenesis.
There is one study from our center comparing sperm samples from people who had never taken estrogen, who had taken estrogen but stopped and who were currently on estrogen.
The people who had never taken estrogen had the highest sperm counts. People who took hormones but stopped had relatively normal sperm counts, but had lower sperm counts than people who had never started hormones. The folks who stayed on hormones had really low sperm counts. This shows us that the decreased sperm count is reversible. That’s reassuring. Sperm seems relatively hardy.
Testosterone doesn’t make someone completely infertile. We know that people who have never taken testosterone are three times more likely to conceive naturally than people who have taken testosterone, even if the testosterone is stopped.
From the data we have on pregnancies that happened when people were on hormones, we know that there were no higher risk of birth defects or other issues.
How can the intersection of being trans and a person of color impact someone’s reproductive journey?
Gupta: I think it’s very complicated – this issue of being black or brown, being trans, and seeking pregnancy. We know that structural and institutional racism contribute to maternal mortality rates that are three to four times higher for African American women than white women. On top of that, you have challenges to health because you are trans. It’s not necessarily true that all providers are aware of and support trans health. There’s higher risk pregnancy and delivery. There’s postpartum depression. There may be complications. It’s something we need to be aware of and supportive of our trans brothers and sisters who are seeking pregnancy.
What are the options for trans people to breastfeed or chestfeed a baby?
Gupta: If a trans man who has had top surgery wants to breast or chest feed, it can be difficult. This is something to discuss before initiating gender-affirming care. If there isn’t any breast tissue left after a mastectomy, there aren’t any mammary glands to produce milk. That being said, there are options to use donor milk or formula.
For trans women, induction is an option. We can stimulate breast milk production—it’s similar to if a cis-woman adopts a baby and wants to breast feed. It does take a lot—it’s a lot of work.
What would you say to someone who says that trying to have a baby makes you less authentically trans?
Gupta: That’s horrible. And completely untrue! Everyone has their own journey. There’s no one way to be a trans person. Wanting to have a baby doesn’t make a person more or less trans.
Mok-Lin: Agree. Reproduction is a completely separate thing from gender identity. It’s like saying to a cis-woman who chooses not to have children that they are somehow less of a woman.
A woman in Idaho could be the first transgender inmate to receive gender-confirmation surgery through a court order.
A panel of judges ruled on August 23 that Adree Edmo’s gender-confirmation surgery should be provided by Idaho and Corizon, the state’s prison healthcare provider.
The surgery is estimated to cost between $20,000 and $30,000.
Edmo is serving 10 years for sexually abusing a 15-year-old boy when she was 22 and is scheduled for release in 2021. She is not eligible for parole.
The 9th circuit court of appeals ruling agreed with a December 2018 ruling from US District Judge B Lynn Winmill that was in Edmo’s favour and ordered the state to provde her with surgery.
The 9th circuit court of appeals judges wrote that Windmill’s findings were “logical and well-supported” and that “responsible prison officials were deliberately indifferent to Edmo’s gender dysphoria, in violation of the Eighth Amendment”, according to NPR.
Idaho has 90 days to appeal the ruling to the Supreme Court. In a statement, Idaho governor Brad Little said, “We cannot divert critical public dollars away from the higher priorities of keeping the public safe and rehabilitating offenders.”
“The hardworking taxpayers of Idaho should not be forced to pay for a convicted sex offender’s gender reassignment surgery when it is contrary to the medical opinions of the treating physician and multiple mental health professionals,” he said.
But the ruling consistently rejected the medical opinions of the prison’s healthcare providers.
“It is enough that [her doctor] knew of and disregarded an excessive risk to Edmo’s health by rejecting her request for [gender confirmation surgery] and then never re-evaluating his decision despite ongoing harm to Edmo,” the judges wrote.
“Prison authorities have not provided that treatment despite full knowledge of Edmo’s ongoing and extreme suffering and medical needs,” the judges wrote.
Edmo’s lawyer, Lori Rifkin, said news that Idaho would appeal was “reprehensible”.
“She suffers every single day while they have denied this treatment to her for years and there can be no reason justifying Idaho’s continued refusal to provide her care except bias,” Rifkin said.
Edmo has twice attempted self-castration while in prison.
The ruling doesn’t mean that all trans inmates in Idaho would be eligible for state-funded gender-confirmation surgery, but it would set a standard for providing the surgery to certain inmates with severe gender dysphoria like Edmo.
Publication of the largest-ever study of the roles of genes in homosexual behavior is fanning the debate over whether being gay is due to genes or environment.
“There is no ‘gay gene’ that determines whether someone has same-sex partners,” says Andrea Ganna, a geneticist at the Broad Institute of MIT and Harvard and the University of Helsinki.
Family studies have suggested that genetics account for about 32 percent of heritability of homosexual behavior. But each SNP, or single nucleotide polymorphism, has a very small effect on whether someone has ever had a same-sex sexual partner, the new research found.
Taking into account all the SNPs measured in the study, including those that weren’t statistically significantly associated with same-sex behavior, explained only 8 to 25 percent of heritability of same-sex behavior. When considering just those five statistically significant SNPs, that number drops to much less than 1 percent.
But those variants could point to biological processes that are involved in choosing sex partners, the researchers say. For instance, one variant identified in the study has been linked to male-pattern baldness, and another to the ability to smell certain chemicals, which may affect sexual attraction.
“The study is a big step forward because of its huge size,” says J. Michael Bailey, a psychologist at Northwestern University in Evanston, Ill., who has worked on sexual orientation genetics but was not involved in the work. It included more than 470,000 people, dwarfing previous research.
“This is the first study that we can be pretty sure that they’ve identified genetic variants associated with an aspect of same-sex behavior,” Bailey says. “I’ve been a coauthor on some previous molecular genetic studies that were much more tenuous. I believe these results will replicate.”
But Bailey disagrees with some of the study’s conclusions. For instance, Ganna says that people who have exclusively same-sex or exclusively opposite-sex partners are genetically distinct from people who have partners of both sexes. That means that sexuality may not be a continuum from completely heterosexual to homosexual after all. So the Kinsey scale, which scores people’s sexual behavior along a spectrum with bisexuality in the middle, may need to be rethought, the researchers say.
But the Kinsey scale accurately predicts men’s arousal when shown erotic pictures of either men or women, Bailey says. That makes it a far better tool than the genetic score for predicting sexual preference, he says.
Qazi Rahman, a psychologist and sexual orientation researcher at King’s College London, has bigger quibbles with the study. “I should be really excited about this,” he says. But “despite being an ardent believer in the biological basis of sexuality, I’ve found this study problematic, and I’m not at all sure what was found and whether that holds up.”
Rahman points to what he sees as inconsistencies in the data and possible bias in the people who volunteered to participate in the study. The study drew volunteers from two big genetic databases, the UK Biobank and the consumer DNA testing company 23andMe, and from three smaller studies. Participants answered questionnaires about how many sexual partners of each sex they had ever had. 23andMe customers also responded to questions about attraction, sexual identity and fantasies.
But only 5.5 percent of UK Biobank participants and about 1.5 percent of 23andMe’s customers joined the study. Such low participation rates could skew the results, or point to genetic variants that make people more likely to sign up for a study. “What you’re getting is genetic influences on self-selection into a study, not genetic influences on same-sex behavior,” Rahman says.
It’s legitimate to question where study participants come from, but there’s no way to know whether that bias is affecting the results, says coauthor Benjamin Neale, a geneticist at Massachusetts General Hospital in Boston and the Broad Institute.
The study wasn’t designed to address sexual orientation or identity, but the same variants associated with same-sex behavior were also associated in 23andMe participants with attraction, sexual identity and fantasies. The small contribution of genetics to sexual behavior is in line with genetic contributions to other behaviors, such as level of education attainment. “There’s a lot of room for nongenetic effects,” Bailey says.
The authors don’t disagree. The study underscores that elements of both biology and one’s environment may play roles in shaping sexual behavior, Neale says. Environmental influences may include an array of developmental, social and cultural factors that all could affect behavior, he says.
That’s true, says coauthor J. Fah Sathirapongsasuti, a computational biologist at 23andMe in Mountain View, Calif. But, he says, “just because something is not completely genetic or something has an environmental, or what we call nongenetic, component doesn’t mean it’s a choice.”
Police investigating the murder of Tracy Single, the 16th trans woman of colour killed in the US this year, have arrested a man she had been dating.
Joshua Dominic Bourgeois was arrested Friday, August 23, on suspicion of Single’s murder, according to ABC News.
The 25-year-old became a suspect after investigators learned he had been in a “dating relationship” with Single, also known as Tracy Williams.
Police said she was found dead with a puncture wound and several lacerations in a gas station parking lot in west Houston on July 30. She was 22 years old.
It took officials two weeks to identify her body with the help of local LGBT+ activists.
Tracy Single was ‘larger-than-life’.
Originally from New Orleans, Single had been living in a west Houston apartment after spending time at a shelter for homeless youth.
Friends told local paper the Houston Chronicle that she was a “larger-than-life” personality and who loved fashion, drag and performance.
After moving to west Houston, she would visit the a local centre for people “of all sexual orientations and gender identities” who were experiencing homelessness, where she would give peers and mentors dance lessons.
Her death was described as a “big loss for the community” by Courtney Sellers, executive director of the Montrose Grace Place centre.
16 trans women of colour killed so far in 2019.
Single’s death is the latest tragedy in an epidemic of violence against trans women of colour.
At least 15 other trans people of colour have been shot dead or violently killed so far this year, according to Human Rights Campaign.
Human Rights Campaign said that “it is clear that fatal violence disproportionately affects transgender women of colour, and that the intersections of racism, sexism, homophobia, biphobia and transphobia conspire to deprive them of employment, housing, healthcare and other necessities, barriers that make them vulnerable”.
When Maurice “Reese” Willoughby died by suicide last week, it came at the tail end of months of cyberbullying after a video emerged of him defending his girlfriend — a transgender woman named Faith — to a crowd of people who were hurling transphobic and homophobic comments.
“You f— what?” shouts the person holding the camera, in a video that racked up millions of views.
Willoughby was an aspiring rapper from the Philadelphia area, and initial reports stated that he took his own life because of the bullying seen in the viral video. However his girlfriend, Faith Palmer, said on social media that he struggled with drug addiction and intentionally overdosed.
“Oppressors will always find a label for you, so it’s better to have your own that’s a positive word that puts you in a positive light.”
PIPER DAWES
For transgender activists, however, the viral video was a rare opportunity to shine a light on the harassment and violence inflicted on the cisgender (non-transgender) people who openly love transgender people.
Kiara St. James, executive director of the New York Transgender Advocacy Group, said this moment is a time to teach people about the concept of “transamory,” which she defined as people who are attracted to and seek out relationships with transgender people.
“Transamory has had many names,” St. James told NBC News. “One of the original names, which was more stigmatizing, was ‘tranny chaser,’ which we don’t use any more. But for a lot of community members, there were a lot of gentlemen who dated a series of trans women. The term was used to kind of say that they had a fetish for trans women.”
“I think that as we have evolved, we have understood that there are people out there who are transamorous, who intentionally seek trans women or trans men for relationships and, it’s something that’s ongoing,” St. James continued.
For viewers of the hit FX drama “Pose,” this will be familiar: The show features several transamorous story lines, particularly with Angel, a sex worker and model, played by Indya Moore.
Indya Moore as Angel and Evan Peters as Stan in “Pose” on FX.JoJo Whilden / FX
In a tweet posted Tuesday, transgender author and “Pose” producer Janet Mock shared the video of Willoughby being bullied and condemned his harassers.
“These men screaming at him are beyond fragile, standing on a shaky altar of masculinity, too insecure to do what Reese did: Unapologetically love a woman who everyone says is unworthy of love,” she wrote.
Mock later shared an image from “Pose” of transgender woman Angel and cisgender man Lil’ Papi, whose romance blossomed in season 2.
St. James said she has been using her platform as executive director of a trans advocacy group to draw attention to transamory, because the violence that is faced by so many transgender women is the same violence faced by those who openly love them.
“Over the past couple of years, especially around Trans Day of Remembrance, we talk about the number of especially black trans women who have been murdered. Oftentimes, they were murdered by someone who they were intimate with over a period of time,” St. James said. “One of the reasons for those types of incidents is fear from the transamorous man of being outed.”
Ashlee Marie Preston, a trans activist based in Los Angeles, echoed this sentiment on Twitter: “When trans attracted men kill us; it’s out of fear that this will happen to them if they are outed.”
St. James said one of the ways to fight back against the violence that so many trans women face is to “create spaces where we see transamorous relationships as normal and healthy.”
“Transamorous does not necessarily mean men who are attracted to women, it can be men who are attracted to men who are of transgender experience; it can be women who are attracted to trans women; it can be women who are attracted to trans men — it’s not just a cis male-trans woman situation; it really runs the gamut of sexual orientation,” St. James said.
Piper Dawes, a trans woman living in northern England, was one of the first people to coin the term “transamory.” Her 2013 blog post used the term after wrestling with more stigmatizing and cumbersome terms like “gynandromorphophilia.”
“Oppressors will always find a label for you, so it’s better to have your own that’s a positive word that puts you in a positive light,” Dawes told NBC News.
Dawes said she realized that some people she dated really preferred transgender people. “It’s not fetishized, but it is a specific love for people like me,” Dawes said.
So, she created the term so that people could find a better way to express their attraction. “I don’t think, really, that it’s necessary to delve deeper than that, because it’s such a personal thing,” Dawes said.
St. James said that showcasing positive transamorous relationships also works to dismantle the stigma felt by trans people themselves.
“Too often, trans women are socialized to think that we cannot be in relationships, so the only way that we can really express ourselves is through sex work and things of that nature,” St. James said.
“I’m in a relationship, so I’m always sensitive of where we go,” St. James said of her and her boyfriend. “Even though he is very comfortable being seen with me, I still have that reservation of making sure we are in spaces where no harm will come to either him or me.”
“I think that’s something that a lot of transamorous couples think about if we go out in public,” she added.
If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.
There’s a new antiretroviral, from a new class of medication, currently being tested for both PrEP and HIV treatment. Named islatravir (formerly MK-8591), this Merck drug is showing promise as part of a novel drug delivery system and because of its long half-life, great potency and high barrier for resistance.
“It is clear that PrEP and HIV medication alternatives are evolving,” said Christopher Hall, MD, MS, AAHIVS, vice president of medical affairs at San Francisco AIDS Foundation. “More options are needed especially for PrEP, because a single agent will never meet the needs of all people. Personal choice certainly will take on greater significance as alternatives evolve.”
Islatravir in a PrEP implant
Based on a design similar to that used for the Nexplanon/Implanon birth control implant, the islatravir implant is a removable implant designed to be inserted under the skin in the upper arm for a year. In the study presented by Matthews, researchers tested the drug concentration levels delivered by the islatravir implant over 12 weeks in 16 individuals.
The implant device, with size shown relative to a penny. The implant is 4 cm in length x 2 mm. Photo courtesy of Merck.
In a double-blind, placebo-controlled study, the researchers tested two doses of the islatravir implant: 54 mg and 62 mg. Throughout the study, the researchers collected drug concentration levels in plasma and PBMCs, and were primarily interested in how much time the drug concentration levels fell below a threshold of 0.5 pmol/106 (a threshold which is believed to provide an adequate level of drug for HIV prevention based on animal studies).
At both doses, drug concentrations remained above the 0.5 pmol/106 threshold for the 12 weeks of the study, although the lower limit of the estimated range for the 54 mg dose dipped below the threshold for a brief period. The 62 mg implant delivered drug concentration levels well above the threshold for the duration of the study.
In a later analysis, the researchers projected that the 62 mg implant would lead to concentrations above the threshold for at least 12 months, falling below the threshold at around 16 months.
Slide: Randolph Matthews, MD, PhD
“This supports the potential of the islatravir implant as a once-yearly PrEP option,” said Matthews.
Future research, he said, will continue to test other prototype implants and additional doses.
“Just as in birth control, implanted, long-acting pharmaceuticals are likely to earn a place in the biomedical HIV prevention armamentarium,” said Hall. “While more study is needed, clearly the future of PrEP is one of greater alternatives, with agents that bring fewer side effects, are less susceptible to resistance, are easier to administer, and improve the experience of people who take them. The future promises a broader array of options than we have seen since the advent of FDA-approved Truvada for PrEP in 2012, and it is bright.”
Islatravir for dual-therapy HIV treatment
There are a few unique characteristics of islatravir that may make it suitable as part of a two-drug regimen, said Molina. In preclinical studies, islatravir showed more than 10-fold greater potency compared to other approved antiretrovirals. The drug is also known to act against a number of resistant HIV variants, has a long half-life and has a high barrier to resistance.
“This [two-drug regimen] may maintain efficacy comparable to a three-drug regimen,” said Molina.
To test this, a double-blind study involving 120 treatment naïve adults living with HIV randomized participants to receive islatravir 0.25 mg, 0.75 mg, 2.25 mg or doravirine plus 3TC (lamivudine)/TDF (tenofovir disoproxil fumarate). At 24 weeks, or once viral loads were suppressed to <50 copies/mL on the triple-therapy, 3TC was removed.
There were very high response rates to the dual therapy at every dose level of islatravir.
After 24 weeks on the dual therapy, close to 90% of people receiving either islatravir 0.25, 0.75 and 2.25 mg with doravirine had viral loads <50 copies/mL. (96% of people receiving the control treatment of doravirine, 3TC and TDF had viral loads suppressed to this level.)
There were very few adverse events during the study, with two out of 90 participants receiving islatravir discontinuing the study because of adverse events.
“These results are quite promising, and demonstrate that the dual combination of islatravir and doravirine has the potential to be a potent, two-drug regimen and supports its further exploration in Phase 3 trials,” said Molina.
More research on islatravir’s safety and efficacy is needed before the drug may be granted FDA approval and brought to market. Based on the results of these studies, Merck plans to continue Phase 3 research on islatravir for HIV treatment as part of a once-daily, oral two-drug regimen. Using islatravir for PrEP, Merck is pursuing a Phase 2 study, set to begin enrolling in September 2019, that will evaluate the safety and tolerability of once-monthly oral islatravir.
