Expanding the definition of discrimination

The American Medical Association moves to include transgender people in its anti-discrimination policies.

Published July 19, 2007 5:43PM (EDT)

In these days of medical malpractice, hospital mergers and a seriously sicko insurance system, there's not much good news coming out of the healthcare industry. But recently the American Medical Association gave transgender folks something to cheer about. Eighty-four years since its birth and a decade since upholding the rights of lesbians and gays, the AMA has changed its anti-discrimination policies to include transgender people.

At first glance this struck me as a meaningful institutional shift -- at least as important as that of the DSM-II (Diagnostic and Statistical Manual of Mental Disorders), which removed homosexuality from its list of pathologies in 1973. The new policy covers discrimination against doctors and medical students as well as patients, and targets insurance companies that refuse coverage of transgender people.

But until I read James Tyroler's response to the new policy, I had no idea how brutally cruel and flagrantly inhumane some of the medical establishment has been to the transgendered. Some doctors, hospitals and paramedics simply refuse to treat transgender patients -- period. Among the horror stories Tyroler mentions are a transgender woman who died after an automobile accident because the paramedics stopped treating her when they found she had male genitalia and a friend of Tyroler's who languished in an intensive-care unit because the nurses ignored her, even refusing to take her to the bathroom. Tyroler says that in Kansas City, where he lives, there are only two doctors who will treat transgender patients.

Although the AMA has been moving toward prohibiting discrimination based on sexual orientation or identity since 1988, when it passed an antidiscrimination policy vis-à-vis admissions in medical schools (go here for a mini-history of the AMA's relationship with the LGBT community), some regard the AMA's new policy as self-interested. As one reader of Queerty put it: "The AMA and big pharm are just pissed that all the transfolk figured out they could get 'mones on the cheap from India, and surgeons in Thailand to perform FFS and SRS for half what the docs charge in the U.S. The average transsexual spends between $50K and $80K on transition, and that's a lot of dollars walking out of the country."

Sure, the new policy may do more to treat doctors' ailing bottom lines than balance the scales of justice. (I can't imagine the bigoted paramedics will behave any differently just because of an AMA policy.) But even the idea that transgenders are voting with their purses and the American medical establishment may have noticed seems like something to snap about.

By Carol Lloyd

Carol Lloyd is currently at work on a book about the gentrification wars in San Francisco's Mission District.

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