Thoughts from Vancouver: Stigma’s role in discrimination

In a little more than an hour, I will be participating in a consultation with Canadian Blood Services. They drew my ire after a stunt earlier this year in which their media correspondent made a number of stigmatizing and regrettable remarks about gay men and trans women. Without going into specifics–I’m not sure what boundaries on reporting will be placed–the planning for this consultation likewise included a lot of stigmatizing language, and I was at times left agape by the phrasing of CBS’s correspondents.

Nonetheless, despite being openly critical of their policy on the grounds of the research they claim supports it (it doesn’t), CBS has brought me here to Vancouver to lay it out for them.

I’ve long lamented that the real crises affecting trans women, especially trans women of colour, are related to things like discrimination in employment, housing, healthcare and public accommodations. These prove to be veritable landmines for trans people and the difficulties these areas pose cannot be understated. These things do need to be fixed, but the other part of making more people willing to donate is tackling the stigma that made people hesitate to support the cause to begin with.

And no doubt, CBS’ announcement was brutally stigmatizing. They know they are party to this. I told them.

After I’ve collected my fee, I intend to donate it straight to Safe Accommodations for Queer Edmonton Youth (SAFQEY). I know I’ve been asking folks to fork over money for charities but if you’re at all familiar with my exasperation at the bullshit coverage of trans people that hits the mainstream when there are more pressing needs than motherfucking pronouns, you’ll understand why I value a queer-inclusive youth shelter.

Canadian Blood Services serves as an ideal example of responsibility: They are flawed, yes, but they are also willing to dialogue. And I don’t think they’d be spending money on this if they didn’t think it was worth something. That willingness to listen is in short supply these days, and perhaps I can help steer CBS in a more constructive direction moving forward regarding QUILTBAG donors.

See y’all later. I’ll be busy this weekend, too, volunteering at Taboo.

(Speaking of which: Let’s play a game called “real news or fake news.” Without using Google, is the headline “Topless women now allowed at Albertan sex shows” real or fake?)

-Shiv

Canadian Blood Services update

Remember when CBS made an arse of itself on national TV announcing changes to its QUILTBAG donor policies?

CBS and I have been corresponding back and forth for a while now. And, to my surprise, they have invited me to Vancouver to join them in a consultation & planning session concerning their next iteration of the policy on November 17th and 18th.

I’m not sure there will be much for me to report. Talk is cheap, and the real prize in this endeavour will be the implementation of a new policy.

However, it speaks highly of any organization that is knowingly inviting someone so critical of their policies and behaviour in the media to speak their piece directly to people who are equipped to change said policy. Throughout my back-and-forth communications with CBS, I am struck by how remarkably perceptive they are to actually listening. This is definitely not the common approach. Most organizations take a Father Knows Best approach and you’ll never get through to them, but CBS has been very willing to collaborate.

It gives me hope, though I will refrain from recanting on my criticisms until there’s an actual policy announcement in place. There are no promises until its in writing.

As for me, I’ll be emphasizing two things on November 17th:

  1. They need to recognize, at minimum, trans people as our own distinct epidemiological category. Since the crux of the policy is around rates of HIV, those rates need to be accurately established. At minimum a distinction between cis men, cis women, trans men, trans women, and non-binary people ought to be considered when CBS commissions its next round of research for Health Canada.
  2. They need to train their staff to respond to trans donors appropriately. I am aware that health risks between donors change based off of certain characteristics, but not all of those characteristics are incontrovertibly married to sex assigned at birth. That means the staff treatment of donors as well as the questionnaires could be more accurate in what information they’re trying to acquire.

After November 17th I’ll likely take another crack at how their policies stack up to their citations.

-Shiv

 

Canadian Blood Services p3: You’re like, halfway there

As part of an ongoing series investigating the research CBS claims to have in support of their new policy, you can follow the progress of my communications with related parties here (list updates with every new related post):

  1. One Step Forward, Two Steps Back
  2. That’s Not The Question I Asked
  3. You’re Like, Halfway There

 

Canadian Blood Services has now posted an information page specific to trans folk, which is an improvement over inserting us as a foot note under the “men who have sex with men” policy. You can check it out here. There’s a few pieces I will draw your attention to.

The first:

We are also working on updating our computer system so that donated blood components can be processed to reduce the risk of transfusion-related acute lung injury (TRALI) without donors having to be identified as female.

Credit where credit is due, I suppose. As aggravating as CBS’ announcement has been, it’s still progress to acknowledge that trans men generally don’t want to be called women. TRALI is an elevated risk in blood from people who have at some point been pregnant. Under a cissexist system, this means any women who have been pregnant have their blood flagged for additional screening–this policy appears to redress the fact that trans men can also have pregnancy somewhere in their history, which still justifies flagging their donations as a TRALI risk, but without forcing trans men to suffer the indignity of misgendering in order to donate. As I observed previously, the correct risk factor is “has been pregnant,” not “was assigned female at birth.”

Things still crash and burn elsewhere, even if this policy is a good start.

 

The second:

Canadian Blood Services is dedicated to providing the safest possible blood to transfusion recipients. Donor criteria that affect recipient safety should be based on available scientific evidence. And, these criteria must be approved by Health Canada, our regulator.

I’ll also draw your attention to the word “available.”

There is little information available on the safety of subgroups of trans* individuals and blood donation.

That’s practically an admission they drafted policy this policy without accurate data.

There is very little information available on the risk of HIV in trans* individuals in Canada, as they are not included in a separate risk category by the Public Health Agency of Canada in their annual reports of HIV and AIDS in Canada.

You don’t say.

However, in a review of available studies,

The same ones that lump sex workers and needle-sharers in the same risk category as monogamous MSMs?

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Canadian Blood Services p2: That’s Not the Question I Asked

As part of an ongoing series investigating the research CBS claims to have in support of their new policy, you can follow the progress of my communications with related parties here (list updates with every new related post):

  1. One Step Forward, Two Steps Back
  2. That’s Not The Question I Asked
  3. You’re Like, Halfway There

 

 

Following the announcement from Canadian Blood Services that pre-operative trans women who’ve had sex with men would be considered “males who have sex with males, (MSMs)”–and therefore subject to the 12-month abstinence requirement for blood donation eligibility imposed on gay men–I sent a letter to their public inquiry box stating a concern with the methodology. I have reproduced my communications so far.

I establish that health statistics on trans folk is shoddy and incomplete because of medical establishments subsuming us into cisgender male and female populations; and also that CBS, in lumping pre-op trans women with MSMs, was not only perpetuating misinformation, but also doing something flatly unscientific.

Their public email clerk responded thusly: (emphasis added by me in all emails)

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One step forward, two steps back: CBS adds trans women to MSM deferral

As part of an ongoing series investigating the research CBS claims to have in support of their new policy, you can follow the progress of my communications with related parties here (list updates with every new related post):

  1. One Step Forward, Two Steps Back
  2. That’s Not The Question I Asked
  3. You’re Like, Halfway There

Canadian Blood Services has announced a new policy that will defer trans women from donating blood if they’re pre-op and sexually active with men:

But many activists are upset with the policy because it focuses on whether or not a trans person has undergone gender confirming surgery.

Goldman says the criteria will create a countrywide, streamlined mandate for all trans blood donors.

According to Canadian Blood Services, there has been an increase in potential trans donors and this prompted the organization to implement criteria for those individuals.

The policy specifically targets trans women and is similar to Canadian Blood Services’ updated guidelines for gay blood donors. On June 20, Health Canada announced that gay men would be allowed to donate blood if they had abstained from sex for at least one year.

Trans women who undergo gender confirming surgery will have to wait one year before they can donate blood. After the wait period, Canadian Blood services will also identify them by their reconfirmed gender. “If a trans woman has not had [gender confirming surgery], that person would be considered as a male having sex with a male,” Goldman said.

Canadian Blood Services says there are regulations specific to trans women because that demographic is at high risk for HIV.

According to the Interagency Coalition on AIDS and Development, an estimated 27.7 per cent of trans women in Canada are living with HIV.

“There is a very high HIV prevalence rate in trans women,” Goldman said. “So we are obliged to treat (them) as a high risk group.”

There seems to be a taken assumption made by Dr. Goldman that post-operative trans women are less likely to contract HIV than pre-operative. Now as a demographic the stats hint that we do experience higher rates of HIV, but the exact extent to which this is a problem is difficult to pin down with existing data for reasons I’ll get to in a minute. And I suspect the elevated rates of HIV in our community have far more to do with socioeconomic discrimination than our genitals. So what does the Interagency Coalition on AIDS and Development even say?

Let’s find out: (emphasis mine, plus I’ve added paragraph breaks to make it more readable)

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