The Cutting Edge June 2012

                                                                        THE CUTTING EDGE
                                                                  Barbara F. Anderson, Ph. D., LCSW
A notice dated March 27, 2012 has come to my attention describing an organization that provides monetary grants for sex reassignment surgery.  The JIM COLLINS FOUNDATION “is a non-profit, all-volunteer organization whose mission is to provide financial assistance to transgender people for gender-confirming surgeries.  Founded by two transgender people in 2008, the organization operates on individual donations and is run by a board comprised of medical professionals, attorneys, and activists.  Last year the JIM COLLINS FOUNDATION gave away its first grant to Drew Lodi, a transgender man on Medicaid who resorted to collecting cans toward his surgery expense.

“‘Not every transgender person needs surgery as part of their transition.’  says Dru Levasseur, co-founder of the JIM COLLINS FOUNDATION and national transgender rights attorney.  ‘However, we’ve seen first-hand the significant harms that transgender people face when they cannot access treatments that their doctors deemed medically necessary.  The JIM COLLINS FOUNDATION is proud to provide some assistance to people who face discriminatory barriers to coverage in public and private health insurance.’

“This past year, the foundation received over 300 applications, many from people who were desperate for assistance.  A nation-wide selection committee comprised of anonymous transgender individuals chose the 2012 grantees based on financial need.  Thanks to the generous donation of pro bono services from Dr. Christine McGinn at the Papillon Center in New Hope, PA, the foundation is able to fund two surgeries this year.  Dr. McGinn is one of the nation’s leading surgeons specializing in gender-confirming surgery and an out transgender person herself.”  Their website is www.jimcollinsfoundation.org

A revision of the current Diagnostic and Statistical Manual, rev. IV, is in process as we speak. The DSM is the “bible” of mental disorders to which mental health professionals pledge obeisance when they complete the insurance forms presented by trans clients at the time service is rendered.  Along with other information, insurers require that a diagnosis be given in order for treatment to be covered. Currently, most trans clients receive a diagnosis of Gender Identity Disorder (GID).

 A prominent Bay Area physician objects to this diagnosis saying, GID “is a misnomer.  The ‘afflicted’ individuals often have no doubt about their gender identity; it just doesn’t match their genitalia or societal expectations.  The real problem is gender dysphoria, the discomfort with one’s assigned gender or the profound feeling that one is in the wrong gender.”  He suggests an alternate category, Gender Dysphoria Disorder (GDD), which emphasizes the significance of the discomfort and depathologizes the client’s sense of his/her own cross-gender identity.  He adds, “gender variance [alone] is not a sign of a mental disorder” and illustrates this by citing trans people, the bi-gendered (those who present at alternate times), androgynous (those who present ambiguously) and intersex people (those with ambiguous genitalia) who may not suffer from gender dysphoria.  Nor is complete transition an indication of the resolution of gender dysphoria.  In future columns I hope to point out progress made on improvements in diagnoses impacting on the trans population in the DSM revision
5.

More will follow on this subject as developments occur.

In brief:  The Advocate’s commentary featured an article, “14 Reasons That Made 2011 Great For Trans People.”  Here are some of them:
                  More state and local laws have passed TG anti-discrimination laws in 2011 than in any prior year.
                  The White House has hosted 2 major meetings—one with a group of advocates to discuss a range of trans-related policy issues and another with trans anti-violence advocates.
                  The 1st openly trans actor, Harmony Santana, got a major award nomination for her portrayal in “Gun Hill Road.”  She was nominated for best supporting actress by the Independent Spirit Awards.
                   Trans health policy improved with the American College of Obstetrics & Gynecology issuing a policy statement on proper treatment of trans people.
                   Shaun Donovan of HUD, became the 1st sitting Cabinet Secretary  to give a keynote address to a major trans organization, the National Center for Transgender Equality. He acknowledged that he was the first “but I will not be the last.”  He also has the distinction of being the highest ranking U.S. official to support marriage equality.
                    The results of the 1st National Transgender Discrimination Survey were published. Sixty-five hundred people responded and the study has become the most up-to-date resource for understanding the extent of barriers facing trans people.
                    The US Department of Veterans Affairs issued a directive spelling out what constitutes the respectful treatment of trans veterans.

Responses, reactions and corrections are welcome.
Dr Anderson can be reached at basu62@aol.com