Trump’s “trans ban” is an attack on health care

 — and an especially cruel one

Marginalizing health care for trans people is nonsense. It’s also unnecessary and needlessly hurtful

On Tuesday, a rash of extremely misleading headlines, from the New York Times to the Washington Post to ABC News, reported that Defense Secretary Jim Mattis had “frozen” Donald Trump’s ban on transgender people serving in the military. This was misleading to the point of being a flat-out lie. As Mark Joseph Stern of Slate wrote:

This framing is an extreme mischaracterization of the facts. Mattis did not “freeze” the trans ban, and he is not “buy[ing] time” in some potentially insubordinate effort to buck Trump. In reality, the secretary is doing exactly what Trump directed him to do in a recent memo.

Mattis’ claim that the issue needs more study is a lie designed to make a decision based in raw bigotry look more thoughtful than it is. The reason we know this is that the military has already studied this issue extensively, releasing a 2016 report that found “allowing transgender personnel to serve openly” would have “little or no impact on unit cohesion, operational effectiveness, or readiness.”

The excuse that Trump used when he first announced this ban on Twitter, and the excuse he will almost certainly continue to use, is that medical care for trans people, such as hormone therapy or gender confirmation surgery, is too expensive. Not only is this another lie — it was widely reported that the military spends five times as much on Viagra as it expects to spend on gender confirmation treatments — but this excuse is in itself a form of bigotry, a way to demonize transgender people by stigmatizing the health care they need.

“The only reason we’re even having this conversation is because the president and others don’t actually consider health care for trans people to be real health care,” Chase Strangio, a staff attorney with the ACLU’s LGBT & AIDS Project, explained to Salon. “It’s only because we stigmatize this care and we don’t understand trans people that part of the conversation even comes up, because all of the evidence shows that the costs are negligible in a budget that’s billions and billions of dollars.”

Strangio, who helped Chelsea Manning with legal issues during her time in a military prison, is working on a suit that the ACLU filed against Trump and the Department of Defense on behalf of five active service members. The ban would not only bar trans people from enlisting and threaten the status of those currently serving, it would also forbid them from having equal access to health care.

“From a medical aspect, transgender care is regular health care,” explained Dr. Jenn Conti, an ob-gyn who has helped trans men with their gender confirmation care and who is an advocate for Physicians for Reproductive Health. Trump’s “statements and his tweets are truly not founded in medical science,” she continued. “It’s a political issue, and it’s something that’s happening at the expense of an already stigmatized and underserved population.”

What Conti and Strangio both emphasized repeatedly is that there is no reason, morally or medically, to single out trans health care as any different from any other kind of medically necessary care.

“There are enormous medical and psychological consequences that stem from being forced to live in the wrong body,” Conti explained. She has provided gender confirmation surgeries for trans men, including some veterans, and reports, “The relief they feel afterwards is indescribable.”

It’s frustrating to even have to write about this, because people’s right to private medical care that makes them healthy and whole should not be up for debate. Unfortunately, however, trans care — like contraception and abortion care — has been politicized by forces that wish to exploit these private health issues in interests of marginalizing entire classes of people.

“In all contexts, the data shows that not providing health care that’s necessary is more costly than providing it,” Strangio said. He contrasted the $8 million the Pentagon estimates they will spend on trans medical care versus the $960 million bath that the military will take by trying to implement a ban on trans troops.

Beyond the money, however, there is a human cost involved in marginalizing trans health care from any system, military or otherwise. Conti has firsthand knowledge, because she’s worked with patients who get health care through the Veterans Administration, which currently does not cover gender confirmation surgery or related trans medical treatments.

“These people, in addition to feeling really stigmatized, are tasked with this additional stressor of getting creative” in their pursuit of  health care, Conti said. Some of her patients have been forced to claim “that they need these procedures for other indications, like abnormal uterine bleeding or heavy bleeding.”

As far as Conti is concerned, any uterine bleeding is abnormal in a trans man, because they “aren’t meant to have a uterus.” However, the more humane and simpler solution is to simply treat health care for trans people as part of a regular health care system.

Banning trans service members adds another burden to the military medical care system by encouraging trans troops to hide their identity, Strangio added. Once inside the system, there are a number of situations, such as when getting sexual health or mental health care, that a closeted trans person may need to disclose his or her status to a doctor to get proper treatment. But doing so risks a discharged, creating an impossible and stressful choice that does no good for the patient, the doctor or the military.

Strangio expressed confidence that the ACLU’s case against Trump and the Department of Defense would be successful. Pentagon-financed research backs the inclusion of trans troops and coverage of their health care needs. There’s also “significant evidence,” Strangio added, that the president’s alleged concerns “are pretextual for animus that is driving the policy.” Even if the plaintiffs win, he hastened to note, Trump’s actions have done a tremendous amount of needless damage.

“Surgeries have been cancelled. People have been emboldened to act out their individual biases,” he said. The president has sent a message, in Strangio’s judgment that “the government doesn’t value our participation in public life, doesn’t take seriously our health needs.”

Embattled Trump plays homophobia card to strengthen his fascistic base

REUTERS/Karen Pulfer Focht

29 July 2017

The Trump administration’s attack on the democratic rights of lesbian, gay, bisexual and transgender (LGBT) people is the implementation of a reactionary political strategy. It seeks to combine appeals to homophobic hysteria, religious bigotry, the glorification of police and xenophobic American nationalism to encourage the growth of a fascist movement.

Embroiled in perpetual crisis, the Trump administration is attempting to establish a base of political operations centered around the demagogic president and outside the existing structure of the two-party system. By firing former Republican Party Chairman Reince Priebus as chief of staff and replacing him with Department of Homeland Security Secretary John Kelly, Trump has taken another step toward his goal of establishing a personalist executive comprised of a close group of fascists, generals, family relations and billionaire oligarchs.

The pattern of Trump’s maneuvers this week proves the attack on LGBT rights is central to this strategy.

On Wednesday, the Department of Justice filed an advisory “friend of the court” brief in a private New York lawsuit arguing that corporations can fire LGBT people because of their sexual orientation on the pseudo-legal grounds that Title VII of the Civil Rights Act of 1964 does not protect LGBT people. After half a century marked by growing social acceptance and advances in the legal rights of LGBT people, millions of LGBT workers are again at risk of immediate firing because of their second-class legal status.

Earlier on Wednesday, Donald Trump tweeted an announcement that his administration would bar transgender people from military service “in any capacity” on the reactionary grounds that transgender people cost the military too much and because of the “disruption that transgender in the military would entail.”

The same day, Trump announced the nomination of Kansas Governor Sam Brownback as the State Department’s ambassador at large for international religious freedom. This move is aimed at bringing the evangelical and Catholic organizations that bankrolled Brownbank’s short-lived 2008 presidential campaign into a bloc with Trump. After the Supreme Court legalized same-sex marriage in 2015, Brownback issued an executive order prohibiting the state government from suing or punishing churches that refuse to provide marriages and other social services for LGBT people.

White House sources told the Daily Beast that Trump and Bannon are working closely with Vice President Mike Pence, who has the closest ties to the evangelical establishment and who personally orchestrated the transgender ban tweets. According to the unnamed sources, Trump, Pence and Bannon thought that the move would be popular “with his base.” The fact that military advisors said they were not consulted about the tweets confirms the fact that Wednesday’s policy announcements were conceived within the West Wing.

Wednesday’s policy announcements were bookended by two major speeches, the first on Tuesday night in Youngstown, Ohio, which set the political tone for the moves. Paying tribute to “our values, our culture, our borders, our civilization and our great American way of life,” Trump told a raucous crowd that “family and faith, not government and bureaucracy, are the foundation of our society.” He continued: “In America, we don’t worship government, we worship god.” This out of the mouth of a man who has never worshiped anything but money and himself.

Speaking yesterday in Long Island, New York, Trump addressed another of his key constituencies: police and immigration officers. He announced a major escalation of immigration raids to be carried out under the pretext of fighting the El Salvadoran gang MS-13.

“We have blood-stained killing fields,” Trump said, describing in gruesome detail the violent tactics of the gang. Police and immigration officials “are liberating our American towns,” he added, and told officers he loved watching criminal suspects “get thrown into the back of a paddy wagon.” He appealed to the country’s over 1.1 million full-time police officers in the United States, 50,000 border patrol agents, and 20,000 ICE officials: “Please don’t be too nice.”

The official response of the Democratic Party has been remarkably restrained, with criticism limited to arguing that Trump’s transgender ban would weaken the military.

Given the significance of Trump’s attacks, the muted character of the Democratic Party’s response contains a real warning. None of the democratic rights gained over the last century are secure so long as their enforcement is left in the hands of one or another faction of the ruling class, and are therefore vulnerable to shifts in the political winds.

The Democratic Party has dropped all references to democratic questions such as immigration, LGBT rights and abortion in its new “Better Deal” agenda, announced last week. Defending the new program, Democratic Minority Whip Steny Hoyer told reporters that social issues such as the rights of LGBT people and immigrants “won’t be the focus” of the new agenda. “Essentially,” he added, “what we don’t want to do is distract people… we don’t want to distract ourselves.” In other words, the Democratic Party leadership is appealing to social reaction and religious bigotry to win votes in the 2018 midterm elections.

Several Democratic leaders have expressed concerns over the “Better Deal” program’s failure to mention any democratic or social questions, and many will oppose the Trump administration’s attack on LGBT rights. But the decision to promote a policy based on a pledge to “aggressively crack down on unfair foreign trade” (as the program states) will only fan the flames of nationalist chauvinism and further strengthen Trump’s maneuvers.

The fight to defend democratic rights is urgent: Trump’s efforts to establish a fascistic movement based on nationalism and religious bigotry threaten the social rights of hundreds of millions of people, not only immigrants and LGBT people. But to fight political reaction, one must understand its objective roots.

Political reaction draws its strength from a set of economic and social relations that have arisen on the basis of the dramatic expansion of social inequality and wealth concentration under capitalism. After more than 15 years of permanent war fought for the profits of American corporations, the military and intelligence agencies control the elected officials and dictate the policies of the government. Faced with growing social polarization, the police are armed with military weapons left over from the wars waged in the name of the “war on terror.” They have been granted a license to kill by the courts.

Since the growth in the power of the military, the police, the churches and the deportation agencies is the product of the growth of inequality, the fight for democratic rights must be based on the struggle for social equality. Such a struggle must involve the political activation of the working class, the powerful social force that produces all of society’s wealth under capitalism, but which is exploited by the capitalists regardless of race, ethnicity, sexual orientation or gender identity.

Genuine democracy can be achieved only by abolishing capitalism, the system of economic relations that gives rise to political reaction in all its interrelated manifestations. Only on the basis of the unity of the working class in the struggle for socialism can democratic rights be won and preserved.

Eric London

http://www.wsws.org/en/articles/2017/07/29/pers-j29.html