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Despite Harris deal, few surgeries granted to trans inmates in California

Campaign says anti-trans bias may play a role in implementation

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Sen. Kamala Harris (D-Calif.) speaking at the HRC/CNN LGBT Town Hall on Oct. 10. (Photo courtesy of CNN)

Sen. Kamala Harris’s presidential campaign said Tuesday anti-trans bias may play a role in the implementation of a policy she helped create under pressure to provide transgender inmates in California with gender reassignment surgery, after a Washington Blade public records request found only seven prisoners ever got the male-to-female procedure out of 130 who asked.

Harris, a supporter of LGBTQ rights, nonetheless continues to be asked about her work as California attorney general in litigation seeking to deny gender assignment surgery to transgender inmates in the state prison system — and the data indicate that Harris cast the settlement in a rosier light than ended up playing out.

Despite the policy she announced in 2015 enabling inmates to obtain gender reassignment surgery, the data from California Correctional Health Care Services — provided to the Washington Blade after a request under California’s Public Records Act — reveals only a small percentage of inmates who have requested the procedure have been able to obtain it, raising questions about its effectiveness.

In a letter dated Nov. 8 to the Blade, the state prison health system reveals 130 inmates requested male-to-female gender reassignment surgery since the policy was announced, but only seven were granted the procedure in the same time period. Meanwhile, 51 inmates requested female-to-male gender reassignment surgery, but only 10 obtained the procedure.

Based on these numbers, only 5 percent of inmates who requested male-to-female gender reassignment surgery obtained the procedure under the policy Harris helped create and has promoted on the campaign trail, and only 20 percent of inmates who requested female-to-male gender reassignment surgery have obtained it.

Kate Waters, a spokesperson for the Harris presidential campaign, said anti-trans bias may be playing a role in implementation in response to a Blade inquiry on the data.

“Kamala Harris believes every American has a right to adequate and comprehensive health care, including transition-related care for those at correctional facilities,” Waters said. “Toward the end of her tenure as attorney general she worked behind the scenes to establish a policy around granting gender-affirming surgeries to individuals who are currently incarcerated — the first of its kind in the country. It’s clear the implementation of this policy should be evaluated and examined for bias.”

Very few trans inmates in California prison have been granted requests for gender reassignment surgery

Over the course of her presidential campaign, Harris has had to defend herself amid questions about litigation in which she sought to block transgender inmates from having gender reassignment surgery. In fact, at her first news conference for her 2020 presidential campaign in D.C. at Howard University, it was the topic of her first question, which was asked by the Washington Blade. 

At the time, Harris implied she disagreed with the position of her client, the California Department of Corrections & Rehabilitation, but defended the agency in court because it was her duty as a public official.

“I was, as you are rightly pointing out, the attorney general of California for two terms and I had a host of clients that I was obligated to defend and represent and I couldn’t fire my clients, and there are unfortunately situations that occurred where my clients took positions that were contrary to my beliefs,” Harris said.

Harris also indicated she wasn’t fully aware of the litigation happening within her office.

“It was an office with a lot of people who would do the work on a daily basis, and do I wish that sometimes they would have personally consulted me before they wrote the things that they wrote?” Harris said. “Yes, I do.”

The issue came up in an interview with the Los Angeles Blade and at the Iowa LGBTQ forum hosted by GLAAD in September, where Lyz Lenz, a columnist for the The Gazette, asked the 2020 presidential hopeful about it.

In both of those instances, Harris brought up in favorable terms a policy agreement she helped institute at the California Department of Corrections & Rehabilitations as evidence she redirected the litigation into something positive for the transgender community.

“I did it quietly, because I actually disagreed with my client initially, when they had the policy, and so I did it behind the scenes,” Harris told the Los Angeles Blade. “I helped to resolve and change the policy. The issue for me was to make sure the right thing would happen.”

Harris added: “Let me just be very clear: I don’t want to take full credit for that, because I don’t deserve full credit for that. I don’t want what I said to be interpreted as that. There were a lot of people involved in that.”

In an interview with the National Center for Transgender Equality, Harris brought up the issue on her own and in particular underscored the importance of that policy.

“I made sure that they changed the policy in the state of California so that every transgender inmate in the prison system would have access to the medical care that they desired and need,” Harris said. “I know it was historic in California, but I believe, actually, it may have been one of the first if not the first in the country where I pushed for that policy in a Department of Corrections.”

As California attorney general, Harris in 2015 defended the California Department of Corrections & Rehabilitation, which was being sued for refusing to provide gender reassignment surgery to two transgender inmates: Michelle Lael-Norsworthy, who was serving time in prison in Mule Creek State Prison in Ione, Calif., for second-degree murder, and Shiloh Quine, who’s serving a life sentence for first-degree murder, kidnapping and robbery.

Transgender advocates maintain transition-related care, including gender reassignment surgery, is medically necessary and should be afforded to inmates in prison, where the costly procedure would be provided at taxpayer expense. Withholding the treatment, transgender advocates argue, is cruel and unusual punishment, therefore a violation of the Eighth Amendment under the U.S. Constitution.

At one point, when a trial court ruled against the state in the Norsworthy case and ordered the state to grant her gender reassignment surgery, Harris as attorney general appealed the decision to the U.S. Ninth Circuit Court of Appeals, where she continued to argue the procedure should be blocked.

Among Harris’ critics for defending the California state prison system in those cases is Chase Strangio, a New York-based transgender advocate and attorney.

“It would have been one thing had she chosen to settle a legal challenge to establish a policy that might help people in custody but that is not what she did,” Strangio told the Blade. “Instead, Harris’s office fully litigated a case to try to block care for transgender people while simultaneously implementing a supposedly improved policy, which we continue to learn is grossly inadequate.”

Strangio added Harris sought legal precedent that would have made conditions “substantially worse” for people in the Ninth Circuit and “could have hurt transgender people beyond California and ultimately sent a message to corrections staff in her state that the care being requested was not supported by the state.”

“It is impossible to know whether Sen. Harris personally agrees with the notion of providing health care to transgender people in custody but what is abundantly clear is that when she had various opportunities to take a stand to ensure that the system was improved for prisoners who are transgender she failed to act with a commitment to transgender justice,” Strangio said.

As media scrutiny of these cases continued when the case was before the Ninth Circuit, including with coverage in the Washington Blade, a settlement was announced on Aug. 8, 2015 that would enable the inmates to obtain the procedure (although for Norsworthy the process consisted of being granted parole, then being able to obtain gender reassignment surgery under the state’s MediCal program).

“Members of the LGBT community, especially those who are transgender, are too often subjected to discrimination and forced to live on the margins of our society,” Harris said at the time. “In a groundbreaking settlement, the California Department of Corrections & Rehabilitation has agreed to evaluate and provide sex-reassignment surgery if recommended to Shiloh Quine, a transgender inmate. This is an important step forward in the ongoing effort to protect transgender rights in California.”

As part of this settlement, the California prison system agreed to create a new policy that would ease the process for transgender inmates seeking gender reassignment surgery, enabling them to obtain it without having to win court battles.

But the new data demonstrates only a small number of transgender inmates have been able to obtain the procedure, raising questions about the policy’s effectiveness.

Asked by the Blade to review the data, Strangio said it speaks volumes about the difficulty for transgender people in obtaining transition-related care, including gender reassignment surgery, while serving time in the criminal justice system.

“Sadly, these numbers reflect how dangerously inadequate health care is for transgender people, particularly transgender women, in custodial settings,” Strangio said.

The Washington Blade has placed a request with current California Attorney General Xavier Becerra, who’s responsible for enforcing the policy, on whether the guidelines are not properly being implemented.

It’s unclear why only a small percentage of these inmates have been granted gender assignment surgery. Under policy established by the World Professional Association for Transgender Health, a person seeking the procedure must have medical clearance, which means they can’t have any health issues that would make the surgery pose too great a risk for the individual.

As laid out in the actual policy memo for California Department of Corrections & Rehabilitation, which was most recently updated in December 2018, inmates seeking to have gender reassignment surgery have to go through a multi-step process. 

An inmate’s request for surgery is submitted to the Statewide Medical Authorization Review Team, or SMART, which will then refer to the Gender Affirming Surgery Review Committee before that panel sends it back to SMART for final review.

According to the documents, factors the committee should consider when evaluating the request is a verifiable diagnosis of gender dysphoria; whether other treatments besides surgery should be considered; whether the inmate has no other health conditions the surgery would exacerbate; and if the inmate has been consistent with his or her gender identity for 12 months.

The California Department of Corrections didn’t respond to multiple requests from the Blade to comment on whether the system is adequate given the low numbers of requests for gender reassignment surgery from inmates that have been granted.

Transgender advocates, however, said the numbers are evidence the California state prison system, despite the policy Harris helped create, is woefully inadequate in providing necessary transition-related care to transgender inmates.

Mara Keisling, executive director of the National Center for Transgender Equality, said the paucity of requests granted indicates transgender inmates aren’t being denied the procedure for medical reasons, but due to anti-trans animus and budgetary limits.

“It’s not about whether or not they are medically able to have the surgery, it is about the prisons and the state not wanting to do it,” Keisling said. 

Strangio placed blame with both the California state prison system as well as Harris, saying regardless of the role she had in crafting the guidelines, the data show “it is not a policy that is adequately being implemented.”

“It is impossible to extricate the ongoing recalcitrance on the part of the agency from the message sent from the state’s highest officials, Harris included, that providing health care to transgender people in custody should be fought aggressively in court,” Strangio said.

Keisling, however, was reluctant to criticize Harris, saying her actual role in creating the California guidelines is impossible to verify and bureaucracies have a way of stymying policies created by public officials.

“Definitely the bad guy is the Department of Corrections,” Keisling added.

Shawn Meerkamper, senior staff attorney for the San Francisco-based Transgender Law Center, also responded to the data with generalized concerns that weren’t aimed at Harris.

“Transgender people’s medical needs are real and cannot be dismissed by the state,” Meerkamper said. “California’s prisons affirmed they have the responsibility to provide medically necessary treatment for gender dysphoria, including surgery, in 2015 following the Norsworthy and Quine cases. While policies are a good first step, unfortunately the California prisons continue to deny this life-saving health care to the vast majority of people who need it.”

The Transgender Law Center represented Norsworthy and Quine in litigation and hailed the settlement in 2015 when it was reached with the California Department of Corrections & Rehabilitation.

More recently, the U.S. Ninth Circuit Court of Appeals has issued a ruling that made access to gender reassignment surgery for prison inmates binding precedent in all states within its jurisdiction, including California. 

In August, a three-judge panel on the Ninth Circuit issued the per curium opinion in favor of Adree Edmo, who was denied gender reassignment surgery while being incarcerated for sexual abuse at the Idaho State Correctional Institution.

“We hold that where, as here, the record shows that the medically necessary treatment for a prisoner’s gender dysphoria is gender confirmation surgery, and responsible prison officials deny such treatment with full awareness of the prisoner’s suffering, those officials violate the Eighth Amendment’s prohibition on cruel and unusual punishment,” the decision says.

At the time, Harris said in a statement to the Blade she supports the ruling, maintaining it “rightly reaffirms the right to adequate and comprehensive health care, including transition-related care for those at correctional facilities.”

Despite the Ninth Circuit ruling, Strangio said denial of care to transgender inmates remains a “systemic problem across corrections systems” and requires “truly committed reformers” to make change. 

But Strangio said that isn’t Harris.

“It is not enough to suggest passive support while publicly opposing humane treatment of transgender people, which is ultimately what Harris did as attorney general,” Strangio said. “As the numbers show, people are not getting the health care that they need and Sen. Harris should take responsibility for the roadblock her office was to improving life chances for transgender people across the state.”

UPDATE 11/25/2019: The California state prison system, after the initial publication of this article, responded to the Washington Blade with a statement announcing current policy on gender reassignment surgery for transgender inmates is under review.

Terry Thornton, a spokesperson for the California Department of Corrections & Rehabilitation, said the prison system has several policies in place on transgender inmates and recognizes the value of gender reassignment surgery as medically necessary care.

“The Eighth Amendment of the U.S. Constitution requires that prisons provide medically necessary treatment for prisoners’ medical needs based on medical considerations,” Thorton said. “For the past several years, gender-affirming surgery has been increasingly viewed by the medical and mental health community as a safe and effective treatment for some people suffering from gender dysphoria.”

Key memos guiding those policies within the California Correctional Health Care Services, Thornton said, are currently under revision: The “Gender Dysphoria” care guide, last modified in May 2015, and the supplement to that care guide, “Guidelines for Review of Requests for Gender Affirming Surgery,” effective in May 2015 and revised in December 2018.

“Guidelines and supplemental documents are continuously revised to align with community standards and as needed to ensure operational efficiency,” Thornton added.

Treatment for gender dysphoria is individualized between a patient and their provider, Thornton said, and each patient is reviewed on a case-by-case basis “taking into account their medical and mental health history and current condition.”

In response to the few number of surgeries granted to transgender inmates, Thornton said a person requesting surgery may not be eligible at first, but subsequently eligible upon resubmittal. Inmates may appeal any health care decision, Thornton said, including denials of gender reassignment surgery.

Thornton identified several reasons why inmates would be denied gender reassignment surgery, including other health conditions that make the procedure too high a risk to their well-being or that must be well controlled; not meeting the WPATH criteria for the surgery; having mental health conditions that would likely worsen with surgery or impede surgical recovery; or simply completing a prison sentences and being released to parole.

“As far as we know, California is the only prison system in the United States with a process to approve gender-affirming surgeries and has policies to improve safety, help prevent sexual abuse, create a more respectful environment, improve outcomes for reentry and improve medical care for its incarcerated transgender community,” Thornton concluded.

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Bill to ban conversion therapy dies in Puerto Rico Senate committee

Advocacy group describes lawmakers as cowards

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Puerto Rico Pulse nightclub victims, gay news, Washington Blade

 

A Puerto Rico Senate committee on Thursday killed a bill that would have banned so-called conversion therapy on the island.

Members of the Senate Community Initiatives, Mental Health and Addiction Committee voted against Senate Bill 184 by an 8-7 vote margin. Three senators abstained.

Amárilis Pagán Jiménez, a spokesperson for Comité Amplio para la Búsqueda de la Equidad, a coalition of Puerto Rican human rights groups, in a statement sharply criticized the senators who opposed the measure.

“If they publicly recognize that conversion therapies are abuse, if they even voted for a similar bill in the past, if the hearings clearly established that the bill was well-written and was supported by more than 78 professional and civil entities and that it did not interfere with freedom of religion or with the right of fathers and mothers to raise their children, voting against it is therefore one of two things: You are either a hopeless coward or you have the same homophobic and abusive mentality of the hate groups that oppose the bill,” said Pagán in a statement.

Thursday’s vote comes against the backdrop of continued anti-LGBTQ discrimination and violence in Puerto Rico.

Six of the 44 transgender and gender non-conforming people who were reported murdered in the U.S. in 2020 were from Puerto Rico.

A state of emergency over gender-based violence that Gov. Pedro Pierluisi declared earlier this year is LGBTQ-inclusive. Then-Gov. Ricardo Rosselló in 2019 signed an executive order that banned conversion therapy for minors in Puerto Rico.

“These therapies lack scientific basis,” he said. “They cause pain and unnecessary suffering.”

Rosselló issued the order less than two weeks after members of the New Progressive Party, a pro-statehood party  he chaired at the time, blocked a vote in the Puerto Rico House of Representatives on a bill that would have banned conversion therapy for minors in the U.S. commonwealth. Seven out of the 11 New Progressive Party members who are on the Senate Community Initiatives, Mental Health and Addiction Committee voted against SB 184.

“It’s appalling. It’s shameful that the senators didn’t have the strength and the courage that our LGBTQ youth have, and it’s to be brave and to defend our dignity and our humanity as people who live on this island,” said Pedro Julio Serrano, founder of Puerto Rico Para [email protected], a Puerto Rican LGBTQ rights group, in a video. “It’s disgraceful that the senators decided to vote down this measure that would prevent child abuse.”

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Undocumented LGBTQ immigrants turn to Fla. group for support

Survivors Pathway is based in Miami

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Survivors Pathway works with undocumented LGBTQ immigrants and other vulnerable groups in South Florida. (Photo courtesy of Francesco Duberli)

 

MIAMI – The CEO of an organization that provides support to undocumented LGBTQ immigrants says the Biden administration has given many of his clients a renewed sense of hope.

“People definitely feel much more relaxed,” Survivors Pathway CEO Francesco Duberli told the Washington Blade on March 5 during an interview at his Miami office. “There’s much hope. You can tell … the conversation’s shifted.”

Duberli — a gay man from Colombia who received asylum in the U.S. because of anti-gay persecution he suffered in his homeland — founded Survivors Pathway in 2011. The Miami-based organization currently has 23 employees.

Survivors Pathway CEO Francesco Duberli at his office in Miami on March 5, 2021. (Washington Blade photo by Yariel Valdés González)

Duberli said upwards of 50 percent of Survivors Pathway’s clients are undocumented. Duberli told the Blade that many of them are survivors of domestic violence, sexual assault and human trafficking and victims of hate crimes based on their sexual orientation and gender identity.

“Part of the work that we have done for years is for us to become the bridge between the communities and law enforcement or the justice system in the United States,” said Duberli. “We have focused on creating a language that helps us to create this communication between the undocumented immigrant community and law enforcement, the state attorney’s office and the court.”

“The fear is not only about immigration,” he added. “There are many other factors that immigrants bring with them that became barriers in terms of wanting to or trying to access the justice system in the United States.”

Duberli spoke with the Blade roughly a week after the Biden administration began to allow into the U.S. asylum seekers who had been forced to pursue their cases in Mexico under the previous White House’s “Remain in Mexico” policy.

The administration this week began to reunite migrant children who the Trump administration separated from their parents. Title 42, a Centers for Disease Control and Prevention rule that closed the Southern border to most asylum seekers and migrants because of the coronavirus pandemic, remains in place.

Duberli told the Blade that Survivors Pathway advised some of their clients not to apply for asylum or seek visa renewals until after the election. Duberli conceded “the truth of the matter is that the laws haven’t changed that much” since Biden became president.

Survivors Pathway has worked with LGBTQ people in U.S. Immigration and Customs Enforcement custody in South Florida. American Civil Liberties Union National Political Director Ronald Newman in an April 28 letter it sent to Homeland Security Secretary Alejandro Mayorkas called for the closure of the Krome North Service Processing Center in Miami, the Glades County Detention Center near Lake Okeechobee and 37 other ICE detention centers across the country.

The road leading to the Krome North Service Processing Center in Miami on June 7, 2020. (Washington Blade photo by Michael K. Lavers)

Survivors Pathway responded to trans woman’s murder in 2020

Survivors Pathway has created a project specifically for trans Latina women who Duberli told the Blade don’t know they can access the judicial system.

Duberli said Survivors Pathway works with local judges and police departments to ensure crime victims don’t feel “discriminated, or outed or mistreated or revictimized” because of their gender identity. Survivors Pathway also works with Marytrini, a drag queen from Cuba who is the artistic producer at Azúcar, a gay nightclub near Miami’s Little Havana neighborhood.

Marytrini and Duberli are among those who responded to the case of Yunieski “Yuni” Carey Herrera, a trans woman and well-known activist and performer from Cuba who was murdered inside her downtown Miami apartment last November. Carey’s boyfriend, who had previously been charged with domestic violence, has been charged with murder.

“That was an ongoing situation,” noted Duberli. “It’s not the only case. There are lots of cases like that.”

Duberli noted a gay man in Miami Beach was killed by his partner the same week.

“There are lots of crimes that happen to our community that never gets to the news,” he said. “We got those cases here because of what we do.”

Yunieski “Yuni” Carey Herrera was murdered in her downtown Miami apartment in November 2020. (Photo courtesy of social media)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Patrick O’Connell, acclaimed AIDS activist, dies at 67

Played key role in creating red ribbon for awareness

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Activist Patrick O’Connell was instrumental in creating the red ribbon to promote AIDS awareness. (Photo courtesy of Allen Frame; courtesy Visual AIDS)

Patrick O’Connell, a founding director of the New York City-based AIDS advocacy group Visual AIDS who played a lead role in developing the internationally recognized display of an inverted, V-shaped red ribbon as a symbol of AIDS advocacy, died on March 23 at a Manhattan hospital from AIDS-related causes, according to the New York Times. He was 67.

Visual AIDS said in a statement that O’Connell held the title of founding director of the organization from 1980 to 1995.

During those years, according to the statement and others who knew him, O’Connell was involved in the group’s widely recognized and supported efforts to use art and artist’s works to advocate in support of people with HIV/AIDS and efforts to curtail the epidemic that had a devastating impact on the art world.

Thanks to a grant from the Art Matters foundation, Visual AIDS was able to retain O’Connell as its first paid staff member in 1990, the group said in its statement.

“Armed with a fax machine and an early Macintosh computer, Patrick helped Visual AIDS grow from a volunteer group to a sustainable non-profit organization,” the statement says. “A passionate spokesperson for the organization, he helped projects like Day Without Art, Night Without Light, and the Red Ribbon reach thousands of people and organizations across the world,” the group says in its statement.

“We were living in a war zone,” the statement quoted O’Connell as saying in a 2011 interview with the Long Island newspaper Newsday. “But it was like a war that was some kind of deep secret only we knew about,” O’Connell said in the interview. “Thousands were dying of AIDS. We felt we had to respond with a visible expression,” he told the newspaper.

With O’Connell’s help, Visual AIDS in 1989 organized the first annual Day Without Art in which dozens of galleries and museums in New York and other cities covered art works with black cloths to symbolize the mourning of those who died of AIDS. Among those participating were the Brooklyn Museum, the J. Paul Getty Museum in Los Angeles, and the Metropolitan Museum of Art in New York, which replaced a Picasso painting with a “somber informational placard,” according to the New York Times.

In 1990 O’Connell helped Visual AIDS organize the first Night Without Light, which was held at the time of World AIDS Day. New York City’s skyscraper buildings, bridges, monuments, and Broadway theaters turned off their lights for 15 minutes to commemorate people who lost their lives to AIDS, the New York Times reported.

In the kickoff of its Red Ribbon Project in 1991, McConnell helped organize volunteers to join “ribbon bees” in which thousands of the ribbons were cut and folded for distribution around the city, the Times reports. Those who knew McConnell said he also arranged for his team of volunteers to call Broadway theaters and producers of the upcoming Tony Awards television broadcast to have participants and theater goers display the red ribbons on their clothes.

Among those displaying a red ribbon on his label at the Tony Awards broadcast was actor Jeremy Irons, who was one of the hosts. In later years, large numbers of celebrities followed the practice of wearing the red ribbon, and in 1993 the U.S. Postal Service issued a red ribbon stamp.

The Times reports that O’Connell was born and raised in Manhattan, where he attended Fordham Preparatory School and later graduated from Trinity College in Hartford, Conn., in 1973 with a bachelor’s degree in history. According to Visual AIDS, O’Connell served as director of the Hallwalls arts center in Buffalo, N.Y. from 1977 to 1978 before returning to New York City to work for a gallery called Artists Space.

The Times reports that O’Connell learned in the middle 1980s that he had contracted AIDS and began a regimen of early AIDS treatment with a cocktail of over 30 pills a day. His involvement with Visual AIDS, which began in 1989, ended on an active basis in 1995 when his health worsened, the Times reports.

As one of the last remaining survivors of his New York contemporaries who had HIV beginning in the 1980s, O’Connell continued in his strong support for AIDS-related causes through 2000s and beyond, people who knew him said.
Visual AIDS says it is gathering remembrances and photos for a tribute post for O’Connell on its website. It has invited people to share their memories of him by sending written contributions and images via email to: [email protected].

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