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My visit to Inova hospital marred by binary intake form

‘M’ or ‘F’ excludes trans, non-binary patients from affirming care

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When Inova opened its Pride Clinic in Falls Church last year, an official hailed the new center as an inclusive space where LGBTQ+ patients would be welcomed at the door with the questions, “What are your pronouns? How do you prefer to be addressed?”

But that was not at all my experience when I visited the emergency room of an Inova hospital just a few miles away.

At Inova Alexandria Hospital, intake forms listed only two boxes — M or F — for me to be able to disclose my gender. I did not know how to answer. I am transgender. I am non-binary.

On forms and in life, it is very hard when you can’t find a box that fits you to be able to say who you are. I know this from hard experience.

So I took the intake form to the hospital intake employee who had asked me to fill it out. I pointed to the “X” marker on my gender on my driver’s license.

“The DMV has a box for me to say who I am, but Inova doesn’t,” I said.

The employee was empathetic, but told me she doesn’t make the forms and that I could refuse to answer the question. The point is, I want to be able to answer. I want to be able to say who I am. But the forms did not let me.

“If folks can’t get in the door and be called their proper name and proper pronouns and get their information collected, it doesn’t surprise me they’d be reluctant to come in the door and it doesn’t surprise me that disparities exist,” Alex Waad, health equity manager in ChristianaCare’s Office of Health Equity in Delaware, said in a telephone interview.

Waad, who could not comment on the practices of Inova or other hospitals, was part of a team of researchers at ChristianaCare and the University of Delaware who published a study after surveying dozens of hospital registrars about how they seek and record information on gender.

The researchers found, in some cases, electronic healthcare record systems just did not allow for reporting on nonbinary patients. That affects thousands of would-be patients. According to the Virginia Mercury, more than 5,000 Virginians have recorded their gender marker as nonbinary with the DMV since a 2020 law allowed the designation.

Despite large, unwieldy electronic health systems, change is possible. In January, after all, the nation’s largest healthcare provider, the Department of Veterans Affairs, announced its own medical record system would change to include transgender options for gender.

“All veterans, all people, have a basic right to be identified as they define themselves,” VA Secretary Denis McDonough said at the time. “This is essential for their general well-being and overall health.”

Luckily, my bicycling accident left me scraped and sore but without any broken bones. The clinical care I received at Inova was prompt and professional. Still, a few days later, I told hospital officials about my concerns.

“Your forms have only a male and female box and solicit no information at all to indicate preferred pronouns or any trans existence at all,” I wrote in an email. “I understand it can be important from a clinical perspective to understand somebody’s (assigned) gender at birth, but it’s equally important to understand the entirety of somebody’s identity and experience.”

This goes far beyond hurt feelings. It’s about respect and accuracy. What’s more, after this sort of experience, the next time a trans person has to decide whether they will go to the hospital, they might opt to stay home instead, at a time when they could need critical and life saving care. 

In response to my inquiry, a hospital spokeswoman said Inova would, indeed, be updating its forms and training across its system. More than 2 million patients visit Inova’s hospitals, primary and specialty care practices and other medical offices each year.

“We strive to provide a welcoming and safe environment for all of our patients from the moment they walk through the doors,” Inova spokeswoman Tracy Connell wrote in an email.

Connell also said the nonprofit health system had updated its patient electronic medical records (EMR) back in 2020 to let patients note their affirming gender identity, along with pronouns, legal sex, sex assigned at birth and other inclusive values.

However, she added, “unfortunately, our paper forms do not yet align with our EMR.”

This news of updated, inclusive forms is welcome, if belated.

I asked Connell to send me a copy of any new intake forms, and I’ll be sure to follow up when that happens.

In the meantime, slow down motorists and keep a watchful eye for bicyclists, because I’m not looking to return to the ER anytime soon.

A former newspaper reporter, Jamie McElhatton is a private investigator and organic grocery store worker. They live in Alexandria, Va.

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Calm down about over-the-counter birth control

Oral contraceptives do not constitute abortion

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(Photo by IhorBulyhin/Bigstock)

The first over-the-counter (OTC) oral contraceptive pill in the U.S., known as Opill, will become available in drugstores, convenience stores, and online retail stores in the coming weeks. The pill has been available by prescription for years, and the U.S. Food and Drug Administration (FDA) has recently approved it for purchase without a prescription. Researchers, advocates, and the pill’s manufacturer, Perrigo, have been working for many years to make this pill more accessible to the general public in the U.S., and it is finally becoming a reality. 

It has taken a very long time to approve this form of birth control, and many people are upset that it is being available at all to purchase OTC because contraception has become equated with abortion. This bizarre notion has arisen from anti-abortion groups, who would like the general public to believe that contraceptives, such as the pill, may act as abortifacients (any drug or chemical preparation that induces abortion), and not only as contraceptives. Besides the fact that expanding access to safe and affordable birth control improves women’s healthcare, it also reduces unplanned pregnancies and abortions. Everyone should realize that birth control is not abortion.

Opill is a progestin only pill (POP), which means that it contains progestin instead of the estrogen-progestin combination found in other birth control pills. Progestin is a form of progestogen, which is the hormone that plays a role in pregnancy and menstrual cycles. The POP works by changing the mucus at the entrance to the womb (uterus) so that sperm cannot pass through the fertilized egg. POPs are also sometimes referred to as mini pills and are taken as a form of birth control by mouth every day to prevent pregnancy. 

Some patients are unable to take birth control with both estrogen and progestin because they may have certain medical problems that prevent them from ingesting the combination of the hormones. Many people who cannot take estrogen-progestin pills can safely use Opill, and POPs are safe for those with high blood pressure, diabetes, and cardiovascular disease, among other conditions. Side effects reported by users are mild and include irregular spotting.

Approximately 9 percent of women become pregnant in the first year of use with POPs with typical use (when usage is not consistent or always correct), in comparison to less than 1 percent of women become pregnant with perfectuse (consistent and always correct usage). This makes Opill an incredibly effective form of reversible birth control that is now becoming easily accessible both online and in retail stores in the U.S. Not only is it an extremely effective form of accessible birth control, but it is in demand. The nationally representative 2022 KFF Women’s Health Survey found that more than three-quarters (77 percent) of female respondents ages 18-64 favored making birth control pills available over the counter without a prescription.

Despite the strong effectiveness of the mini pill, easy accessibility, minimal side effects, cost-effectiveness, and safe consumption of the pill without a prescription, some people are still upset about Opill becoming approved. Why is that? 

Antiabortion groups have undertaken a strategic campaign to convince the public that birth control is synonymous with abortion, when it is not. The OTC availability of Opill will mean that the birth control pill will become more accessible to people who may not be able to visit a provider for a prescription, as well as help someone decide if they would like to have children and when that timeline would be. People need to do more research on this subject before they condemn life-changing products such as Opill, which will benefit many people, especially women, in a positive way.

Catalina Desouza is a Public Health graduate student at George Washington University.

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Netanyahu must go!

We should stand with Israelis calling for an immediate election

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Israeli Prime Minister Benjamin Netanyahu (Photo by palinchak/Bigstock)

I stand with the thousands of Israelis who are demonstrating in Tel Aviv and Jerusalem, calling for an immediate election in Israel. The current conduct of the war is counter-productive to achieving peace, and is earning Israel animosity around the world. 

The killing of the aid workers serving with José Andrés, World Central Kitchen, may be the straw that breaks the camel’s back. There must be an immediate pause in the fighting, with food and medicine flowing into Gaza for the innocent women and children.

While I call on Israel to act unilaterally, to do this now, let no one forget who began this current war on Oct. 7 by massacring Israeli women and children, and taking more than 200 hostages. Again, while I call on Israel to act unilaterally, let no one forget, there could be an immediate ceasefire if Hamas would release the rest of the hostages, whether they are alive or dead. The health of the hostages is something no one knows, because Hamas has refused to allow any human rights groups in to see them. Let no one forget, Hamas, a terrorist organization, hides behind the civilians they claim they fight for, using them as human shields. They share responsibility for the deaths of the women and children in Gaza.

Again, I call on Israel to act now, to show the world they are not terrorists. They are a country trying to protect themselves against a terrorist organization whose stated mission is to wipe them off the face of the earth; from the river to the sea. But, despite this, Israel must now show the world its compassion, and its ability to continue to defend itself, while not starving women and children, and cutting off their medical care. Israel has the power to do both. If they do, the world will support them. If they continue to go on as they have, the world will not.

I have for years called for the Israelis to get rid of Netanyahu and his government. He is as much of a disaster for Israel as Trump is for the United States. They both believe they are above the law, and both believe only by clinging to power can they escape the law. A very sad state of affairs for both nations. 

I am the child of Jewish immigrants who escaped the Nazis. My mother as a child from Austria, and my father from Germany. My father’s parents were killed in Auschwitz. I am a first generation American. I am, and will continue to be, a strong supporter of Israel. Calling for Netanyahu’s removal doesn’t change that. But it has become clear that his right-wing government will never be willing to do what is necessary to have a real peace, and both the Israeli and Palestinian people will suffer. A new Israeli government must take action to stop any new settlements, and be prepared to remove some that are there now. Some of those lands would become part of a new Palestinian state, if we are ever to move to a two-state solution. If Israel is willing to do this, then we must convince Arab countries like Jordan and Egypt to condemn Hamas. They must work to convince the Palestinian people they will support them in getting their own state, if they rid themselves of Hamas. They cannot continue to be represented by a terrorist organization, and expect to live in peace. 

The Palestinians turned down their own state in 1947, and missed maybe the last best chance to come to an agreement at the summit President Bill Clinton convened at Camp David, Maryland with Yasir Arafat, and Ehud Barak. It was an ambitious attempt to reach a sweeping settlement on questions such as the shape of a new Palestinian state, and the future of Palestinian refugees, that have kept the two sides in a state of conflict for 77 years. It is generally felt it was Arafat who couldn’t bring himself to move to a final agreement. 

There is no ‘right’ in this war at this time. Israel is wrong in some of what they are doing, and Hamas is wrong in what they are doing. This isn’t a one-sided situation. But after six months of war, Israel must be the bigger party at this time, and show the world they are ready to move on in their tactics, and give peace a chance.

Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist. He writes regularly for the Blade.

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The beauty in queer relationships

Our love is more inclusive and beautiful than straight love

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Recent exposure to social circles of queer men — predominantly gay men — has led me to appreciate how queer people often lead romantic and sex lives. In general, I’ve found that queer love supersedes straight love: in many prior and current interactions, queer people, in my opinion, are more open to flirting with polyamory, varied sexual experiences, and a more general openness to experimenting with romance. 

I am someone who generally prides myself on being against stereotypes. I don’t like to stereotype transmen as aggressive, violent abusers, because that is far from true, as my experience with transness has found that transmen can take on all types of dimensions, ranging from feminine, gay types to traditionally straight people interested in women. I also don’t like stereotyping queer women, as many types of queer women abound, ranging from lipstick lesbians to butch girls and all in between. 

But I can’t help observe that the men I interact with who identify as gay often are in partnerships where they allow the other spouse or boyfriend to experiment with other people. This doesn’t happen all the time, and monogamy still certainly abounds, but in many cases, relationships are made open, with steady agreements in place. 

When I first read the book “The Ethical Slut,” authored by Dossie Easton and Janet Hardy, I was against their theory of polyamory and open sex. I still am a monogamous person in relationships, but when single, I am now more open to sexual encounters with others in open relationships. The premise of “The Ethical Slut” is that non-monogamy can be practiced on moral terms, and safely, and consensually, and respectfully. The book even argues that non-monogamy is a favorable act sometimes, and that couples who practice non-monogamy can still lead healthy lives. 

I both agree and disagree with the thesis of “The Ethical Slut.” But once again, as a single person, the book captures my attention. This is all to say that, when socializing with queer men, I greatly appreciate their openness to sleeping with others–even when maintaining a spouse or boyfriend. 

I first came out as transgender in 2015, but have since felt a mini-revolution in the way society perceives trans people. We still have a long ways to go, repealing awful bathroom bills and ensuring that gender nonconforming teenagers have access to affirming healthcare. We need to push back against transphobia, particularly in regions like the South and rural areas of the Midwest. 

In the year 2024, though, I’ve found more cisgender gay men to be open to sleeping with transmen, and some even do extensive research on how to fulfill our romantic and sexual needs. The relationships between cisgender queer men and transmen should improve over time, and develop through organic interactions at parties, at conferences, and on queer-specific dating apps. There are still plenty of cisgender gay men who openly reject sex with transmen, but that number is shrinking as the years progress. At the very least, cisgender gay men are more and more able to understand the trans struggle on a platonic, friendship-based level. This decency gives me great hope for the future. 

All in all, queer love, to me, is more beautiful than straight love. Queer people are more accommodating of differences in sexual preferences, and fulfilling divergent needs in bed. I hope this kind of unfettered and unbound love continues.

Isaac Amend is a writer based in the D.C. area. With two poetry books out, he writes for the Blade and the Yale Daily News. He is a transgender man and was featured in National Geographic’s “Gender Revolution” documentary. He serves on the board of the LGBT Democrats of Virginia and in his free time, runs a chess club in Fairfax. Contact him at [email protected] or on Instagram at: @literatipapi. 

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