Medical treatment carries possible side effect of limiting homosexuality

From The LA Times:  http://www.latimes.com/news/science/la-sci-adrenal-20100815,0,5576220.story

A prenatal pill for congenital adrenal hyperplasia to prevent ambiguous genitalia may reduce the chance that a female with the disorder will be gay. Critics call it engineering for sexual orientation.

By Shari Roan, Los Angeles Times

August 15, 2010

Each year in the United States, perhaps a few dozen pregnant women learn they are carrying a fetus at risk for a rare disorder known as congenital adrenal hyperplasia. The condition causes an accumulation of male hormones and can, in females, lead to genitals so masculinized that it can be difficult at birth to determine the baby’s gender.

A hormonal treatment to prevent ambiguous genitalia can now be offered to women who may be carrying such infants. It’s not without health risks, but to its critics those are of small consequence compared with this notable side effect: The treatment might reduce the likelihood that a female with the condition will be homosexual. Further, it seems to increase the chances that she will have what are considered more feminine behavioral traits.

That such a treatment would ever be considered, even to prevent genital abnormalities, has outraged gay and lesbian groups, troubled some doctors and fueled bioethicists’ debate about the nature of human sexuality.

The treatment is a step toward “engineering in the womb for sexual orientation,” said Alice Dreger, a professor of clinical medical humanities and bioethics at Northwestern University and an outspoken opponent of the treatment.

The ability to chemically steer a child’s sexual orientation has become increasingly possible in recent years, with evidence building that homosexuality has biological roots and with advances in the treatment of babies in utero. Prenatal treatment for congenital adrenal hyperplasia is the first to test — unintentionally or not — that potential.

Continue reading at: http://www.latimes.com/news/science/la-sci-adrenal-20100815,0,5576220.story

This CAH is a referred to as a rare disorder.  It seems as though the cure they are seeking is not for CAH but rather for lesbianism.  Never mind how this sounds like something cooked up by Dr. Mengele, why should lesbianism be something in need of a cure?

On digging deeper the little Mengeles doing this research seem very concerned about cranking out “feminine” girls who will grow up accepting their feminine lot in life.

This starts raising all sort of question regarding the ethic of the Mengeles proposing this.

Would they say support a medication that could prevent autism, a rather frequent birth disorder if it say had a side effect of causing a 100% likelihood of the infant being born gay or lesbian.

When living in a world where right wing religious fanatics wield so much power it is reasonable to not only question proposed treatments for the genocide of lesbians in utero but to ask if these same researchers might not have played a role in the spread of AIDS.

There I have said it…  Given voice to the paranoid conspiracy question my gay male friends and I first asked when the Dispensationalist/Dominionist Taliban Christians first came to power and nearly immediately gay men started dying left and right while the right wingers in power did next to nothing to deal with it.

Just Say No to Pre-Natal Genocide of LGBT/TQI People

“MSM” Revisited: Trans Inclusion in LGBT Medical Study

[Today I added Mercedes Allen’s blog “Dented Blue Mercedes” to my blog role.  It was about time as I kept seeing people coming here from her blog in my blog traffic reports.  And when ever I have gone there (which is fairly often) I have found thoughtful and often thought provoking subjects.  I also think highly of Mercedes writing and not just because we became Facebook friends a couple of hours ago.  I liked her writing when I first encountered it on Trans-Group Blog.]

By Mercedes Allen

Crossposted on:

http://dentedbluemercedes.wordpress.com/2010/08/11/msm-revisited/

http://www.bilerico.com/2010/08/msm_revisited_trans_inclusion_in_lgbt_medical_stud.php

http://transgroupblog.blogspot.com/2010/07/trans-people-msm-and-hiv-study-and.html

August 11, 2010

Recently, I’d blogged about a term that’s increasing in usage in HIV research and outreach: “MSM,” or “men who have sex with men.”  The term was originally invented because of a need to include not just sexually active gay men but also bisexuals and men who are not gay-identified but for whatever reason have casual or incidental sex with men.  It can also include gay- or bi-identified trans males, although they’re often overlooked in the study (or sometimes even thought not to exist).  And, of course, it’s often asserted that it includes or intends to include trans women.  I’d commented:

I get it that effective terminology must be given to identify target high-risk groups for the sake of study.  I get it that the terminology needs to be both simple and encompassing.  I get it that HIV is a serious issue and relevant to the trans community, though not all trans sub-groups are high-risk.  I get it that penile-anal intercourse (PAI) risk groups can include trans women….  What I don’t and will not get is the gay community’s insistence that transsexual women are “really men” and how it’s such a bother having to state otherwise in order to be inclusive.  To be fair, there are many folks in HIV study and advocacy who don’t feel or act that way, but the prevalence of MSM-exclusive study sure reinforces this impression.

As diverse as the trans umbrella is, where MSM really fails is primarily when female-identified or dual-identified trans people (usually transsexual women) are forced into one of those “M” designations (i.e. also encompassing straight-identified men who date trans women).  This is often justified by researchers through noting other cultures where trans women sometimes do identify themselves as “really a man,” because they have not yet had the freedom to develop a language with which to self-identify, and therefore accept the language and logic that is available to and used on them.  For something that was supposed to have been devised in order to respect different male identities and transcend constructions built around terms like “gay,” people sometimes wonder why it’s such a big deal when trans women are similarly not accommodated and their identities as not men are not respected.  Especially when this is the result:

This past Spring, I’d had one such study request forwarded to me by someone who was apparently on one of the mailing lists that I forward communications to.  A few days later, he wrote me, irate that I’d not forwarded it to my trans networks.  I’d pointed out (feigning ignorance) that while a few trans men might qualify and be interested, much of what was being discussed in his email didn’t really fit FTM configuration, or at least pre-surgical.  This resulted in a missive which started off with “you know what I mean” and launched into an accusation that I’d be “guilty of the murder of” every transsexual woman who perished from HIV who might have benefited from the study.  And yet, the survey was written so thoroughly to exclude those of female gender identity, I can’t see any way that any self-respecting trans woman would be able to sit through the whole thing without becoming thoroughly incensed at the obvious refusal to dignify her as who she is.

Additionally, many trans women never have sex with men, being either lesbian-identified or not sexually active.  And for a small few of us, HRT isn’t kind, and it becomes an either-or proposition where we really do have to choose between transition and sex.  So an assumption that all trans women belong in the study is as inaccurate as the assumption that all trans men don’t.

But the solution does get fuzzy.  I’m no longer convinced that any permutation of “MSM + …” works effectively at all (and I see in my original article some failures to look outside transsexual identities to the nuances pertaining to some other flavours of trans).  Possibly some terminology along the lines of PAI practices should be considered, but it’s obvious that the status quo needs to be replaced with something more appropriate.  And if that discussion needs to happen anywhere, it needs to start in the larger LGBT sphere.

This situation is also symptomatic of a fuzzy understanding of trans realities when it comes to inclusion in LGBT medical studies in general.  Trans brings along with it a host of medical questions that are often entirely overlooked in such studies.  Which is fine if the study is presented as a general overview that is not reflecting on trans-specific care or pretending that it encompasses all the issues of the included study groups.  I also get that adding all aspects of trans to a study that is aiming to look at primarily cisgender medical issues will confuse it beyond recognition.  However, too often, these studies use the fact that there is a “transgender” checkbox in the Sex question to claim that what is presented is comprehensive and targets all the LGBT medical issues that need to be addressed — which leads researchers and medical professionals to conclude that they do not have any need to look further.

When transsexuals are factored in, there are numerous medical realities surrounding access to and cost of treatment, the fact that said treatment is part of a necessary course to righting one’s life, issues around hormone access and use, or access to surgeries or tests (i.e. obtaining a mammogram for someone with a penis, or finding a surgeon willing to perform a hysterectomy on a man).  Even outside the transsexual process, we find unique issues affecting genderqueer identification, or the existence of another DSM diagnosis intended for crossdressers (and which serves no useful purpose beyond stigmatization as well as the annexation of transsexuals): Transvestic Fetish.

Superficial inclusion can generate problems with survey questions like, “Have you ever been diagnosed with a mental illness?”   Is this supposed to include GID?  If so, isn’t that a bit like rubbing one’s nose in the fact that our little community still carries this stigma?  And if there is no means to elaborate, how are the people conducting the study ever going to know if the respondent is referring to GID (or TF), or to something else entirely?

Such surveys can often be accompanied by assumptions: the assumption that we’re sexually active; assumptions that we engage in risky sexual behaviour; sometimes assumptions that ones genitals dictate how they should be addressed; assumptions about who we’re attracted to and sexually active with; assumptions that we can see just any medical professional when we need to; assumptions that prejudice in the clinic could never take the form of being treated like we’re deluded or freakish by the doctor, medical staff and/or other staff; assumptions that we can access HRT, surgery and other forms of treatment without requiring letters of permission from someone who has psychoanalyzed us; assumptions that anyone with a trans history has to identify as trans(fill-in-the-blank), rather than as male or female.  It can also overlook issues entirely, such as that of changing one’s name on file, having it acknowledged by staff, and not having it create a crossed-wires situation were your lab tests from elsewhere don’t get where they’re supposed to.

And finally, there is an issue of relevance.  When trans-specific care isn’t in the study at all, what remains seems almost irrelevant or even foreign to trans participants.  It does seem a little humorous to me to be asked, for example, “Do you trust your medical provider enough to discuss issues with him or her that might out you as being LGBT?” when an adam’s apple (not to mention genitalia), medications, gender markers on identification or surgeries recorded on file all leave no doubt.

I don’t mean this to be entirely scathing — studies do vary, and I’m elaborating on the worst I’ve seen in order to open discussion on making them better overall.  While the MSM terminology is glaring, many other issues stem from cisgender privilege — not in the sense that cisgender people often complain about being accused of (i.e. wilful ignorance), but from the privileged standpoint of never having experienced these things, and therefore not realizing that they need to be addressed.

There is a concern that conducting separate studies can be seen as a license to not do trans population studies at all.  But because the medical situation can be significantly different for trans people, I wonder if these issues would be best handled as a trans-specific addendum?  And where language fails altogether — terms like MSM — there is a serious need for reassessment.

Readers’ thoughts on MSM and inclusion in general?

(Crossposted, and I don’t want any grief about it)

Condoms = Arrest?

From Ms Magazine

Police policies often discourage sex workers from carrying protection

By NADIA BERENSTEIN

“First [the police officer] asked me what I was doing with all these condoms. Then he took the bag and threw it in the garbage. Then he arrested me.” —A transgender woman in New York City, from a 2009 Sex Workers Project survey.

Sienna Baskin, staff attorney at the Sex Workers Project in New York City, says there’s a question she’s always asked at the “Know Your Rights” workshops she leads for prostitutes and other sex workers: “How many condoms are we legally allowed to carry?”

There is no law in any state in the U.S. restricting condom possession, but if you’re a sex worker, you might have reason to believe there is a legal limit. Law enforcement officers in New York City, Washington, D.C., and the San Francisco Bay Area routinely confiscate condoms from suspected suspected sex workers, sometimes filing them as evidence of prostitution. Almost everyone interviewed for a recent Sex Workers Project survey, Baskin says, “mentioned a certain number of condoms over which they
felt more concerned about increased harassment.” Cyndee Clay, executive director of D.C.-based Helping Individual Prostitutes Survive, says, “It’s a common enough practice that everyone knows about it.”

Keeping a few condoms tucked in your handbag probably won’t land you behind bars—unless police profile you as a possible sex worker. Are you in an area known for street prostitution? Are you a transgender woman? Are you a woman of color? Do you have a prior record? If you answer yes to any of these questions, the number of condoms you’re carrying could suddenly become grounds for suspicion, even if you are not engaging in illegal activity.

Continue reading at: http://msmagazine.com/winter2010/condomsarrest.asp

There have also been cases of AIDS Prevention Workers doing outreach work passing out condoms to sex workers in the streets being harassed and arrested by cops who think it is their duty to enforce some sort of faith based morality and that AIDS is divine retribution on sex workers, especially if those sex workers are trans or gay.

December 1, World AIDS Day

In the Summer of 1981 I was dating a woman , who lived on Delores Street in San Francisco across from Mission-Delores Park.

It was just a few months into the Reagan Regime and the war between sex positive and pro-censorship lesbians was just on the horizon.  I was going to school in Santa Rosa and would hang out with her on the weekends as well run around with a gay male friend of mine who lived up on Twin Peaks.

It was a hedonistic time.  I was still in Shane mode (L-Word reference) and loving freely.  I was having unprotected sex with one sister who was a sex worker and another sister who was also promiscious, mostly with women.  My main girlfriend had been in a relationship with Kim, a sister I knew from the days we were both in the program at Stanford.  If this all sounds like the plot to a Michelle Tea book…  Well.. Valencia Street is only a couple of blocks away from where my girlfriend lived.

That summer gay men started getting sick, by fall they were dying of a disease that had no name.  One of the men who lived down stairs from her died and his partner was dying.

As summer faded the few cases turned into many cases and as winter set in they started calling it “the gay cancer”.  Soon it would become GRID or (Gay Related Immune Deficiency).

By Pride Day 1982 I would be more or less celibate, yet marching bare breasted in S/M leather with the women of Samois, a sex positive lesbian group that both opposed censorship and was at that point just about the only lesbian group that was openly supportive of women born transsexual.  My leather was more punk than S/M but the defiance was the same.

“And the Band Played On”  (see both the Randy Shilts book and the film).  As the number of deaths passed a thousand gay men still fought to defend the hard won sexual freedom of the 1970s.  And President Reagan never uttered the word AIDS as the disease had come to be named.

By 1985/86,  San Francisco had become like Camus’ Oran, a city of Plague where death walked stealing friends and co-workers, leaving those who were HIV- with address books filled with scratched out names.  A city of mourning, yet the research dollars trickled instead of flowing.

A grim joke at the time was, “What is the hardest part of having AIDS?  Convincing your parents you are Haitian.” Because AIDS was never only a gay male disease. Haitians, drug users, hemophiliacs and women, people who had blood transfusions.

Yet I would go to offices to service computers and ask where so and so was only to hear he had died.  I stopped asking and started drinking more often.  A sign in the Metro said “We all have AIDS Now”.  I tried to deny that one, but then I one gray day I saw a group of men gathered around one of their friends who had collapsed in the street and died, just as the rescue crew was arriving.

I fled the City for Los Angeles.  San Francisco’s compactness had made it all too claustrophobic, in LA even though there were far more people with AIDS the size of the city meant that it was less concentrated. I still got the phone calls.  Bear died, Kim too.  In LA it seemed as though half the queens I had known who were sex workers or performers at the C’est la Vie were either sick or dead.  But mostly though it seemed as though  post-SRS women had by and large escaped the disease, at least among my circle of friends.

Now we have lived with AIDS for nearly 30 years.  It isn’t an automatic death sentence.  It is “manageable” for those who can pay the thousands for the “cocktail”.  Some times it seems as though Larry Kramer is the only angry prophet left voicing outrage at how this disease has become yet one more profit stream for the drug corporations to use as an instrument of control.

Perhaps we need to ask some Krameresque questions:  Who is being controlled, and who is doing the controlling?  Who is profiting?  Why?  Who is still dying?  Why?

Why does it seem as though every disaster becomes a corporate money stream?

 

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