Investigations Human Rights

Sentenced to Abuse: Trans People in Prison Suffer Rape, Coercion, Denial of Medical Treatment

Zoe Greenberg

Trans prisoners continue to be housed in facilities with the opposite gender, resulting in discrimination, trauma, and rape.

Read other pieces in Rewire’s Women, Incarcerated series here.

In 2009, Janetta Johnson was sentenced to 71 months for possession and intent to distribute methamphetamine. When the economy plummeted in 2008, Johnson says she panicked and, like many women offenders, began selling drugs as a way to survive.

What makes Johnson’s case stand out, however, is that she is a trans woman. Designated as male at birth, Johnson has identified and lived as a woman since she was a child.

Nonetheless at her sentencing, the judge presiding over her case sent her to Sheridan federal correctional institution, a facility 50 miles southwest of Portland, Oregon that houses more than 1200 male inmates.

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“When I was first sentenced to the men’s facility, I told the judge, ‘You know you’re sentencing me to sexual abuse too,” Johnson told Rewire. “It’s highly likely that a transgender woman in a men’s facility will be sexually assaulted. There’s no ifs, ands, or buts about it.”

Johnson’s prediction turned out to be correct. At Sheridan, she says she experienced sustained sexual assault, including resorting to oral sex to avoid penetrative rape. She also endured harassment from guards, and inadequate medical treatment for her gender dysphoria. The officials charged with her protection often made things worse.

“When we as transgender people make a request for safety, they feel like we’re asking for extra privilege,” Johnson told Rewire.

Johnson was released from custody in April 2013. She is now the program director for the Transgender, Gender Variant, and Intersex Justice Project, an activist organization made up of low-income transgender women of color and their families, who are in prison, formerly incarcerated, or targeted by the police. She is focused specifically on re-entry services for trans women of color leaving prison.

Johnson’s experience of sexual violence in prison is not unique among trans individuals, who, because of continued social stigma and exclusion, are overrepresented among the nation’s incarcerated population.

Discriminated against for housing and employment, trans people face homelessness and poverty at exceptionally high rates. In a 2000 survey of 252 gender variant residents of Washington, D.C., 29 percent of respondents reported no source of income. Another 31 percent reported annual incomes under $10,000. Poverty and lack of opportunity lead to crimes of survival, like sex work, drug sales, and theft, according to a 2007 report by the Sylvia Rivera Law Project.

Despite these realities, correctional systems have so far failed to meet the needs of the trans people, who continue to suffer severe sexual assault, as well as psychological harm from consistent denial of medically necessary hormone treatment, gender-appropriate clothing and personal hygiene products. And, like Johnson, trans individuals are almost always mis-housed in facilities intended for people of the opposite gender.

“Overall, prisons are incredibly gendered spaces,” Jennifer Orthwein at the Transgender Law Center told Rewire. “Right now trans prisoners are at extreme risk for a whole host of damaging and traumatic consequences.”

Rewire’s Women, Incarcerated series documents systemic abuses in prisons and jails that affect women, whose numbers behind bars continue to grow. The experience of trans people further underscores the brutally gendered nature of incarceration.

“I Had to Negotiate”

The word trans encompasses a whole range of identities on the gender spectrum, including people who are transgender, transsexual, genderqueer, and gender nonconforming. Trans is a term for someone who is not a cisgender woman or man.

In the past year, there has been a slow but steady increase in mainstream knowledge and understanding of trans people and the issues they confront.

Popular television shows feature trans characters, and most recently, former Olympian and reality TV star Bruce Jenner publicly announced that he is in transition, becoming a woman. The White House has taken steps to expand legal protections to transgender people.

But trans advocates told Rewire that pop culture can paint a misleadingly rosy picture of life for many trans men and women. Experts were quick to point out that if Laverne Cox’s character in Orange Is the New Black went to prison in real life, she would almost certainly be sent to a men’s facility, where being the sole woman among hundreds of men would jeopardize her physical and mental safety.

It’s difficult to determine how many trans individuals are currently in prisons or jails. The Bureau of Justice Statistics estimates that there were 3,209 transgender prisoners in state and federal facilities in 2011-2012, or about 0.22 percent of the national prison population, according to National Center for Transgender Equality calculations. The justice bureau estimated there were 1,709 transgender inmates in local jails, or about 0.23 percent of the national jail population.

But trans experts say these numbers are likely a gross underestimate. Most corrections facilities don’t keep track of people who identify as trans, and the justice bureau’s data are based on the narrow questions on the National Inmate Survey, which only offers prisoners three options for their gender identity: male, female, or transgender. When the question is asked this way, a large number of transgender people may simply check off “male” or “female,” according to the National Center for Transgender Equality.

The danger of identifying as transgender in prison could also skew the numbers, according to the Sylvia Rivera Law Project, an organization that provides free legal aid to low-income transgender, gender non-conforming, and intersex people of color. Attorneys and advocates at the project say that often prisoners will write two or three letters to them before actually identifying as trans, because of the stigma and vulnerability of that identity in prison, as well on the outside.

In 2011, the National Gay and Lesbian Task Force surveyed 6,450 transgender and gender non-conforming people across the country. Sixteen percent of respondents reported they had been incarcerated at some point in their lives. The risk of incarceration was more pronounced for people of color: 47 percent of Black respondents and 30 percent of American Indian respondents reported they had been incarcerated.

In the past few months, trans prisoners and activists have cautiously celebrated two legal developments that signal progress in the treatment of incarcerated transgender people: Georgia agreed to provide hormone therapy for transgender inmates in state prisons, and a federal judge in California ordered that the California Department of Corrections grant a transgender inmate access to gender-affirming surgery.

But in most jurisdictions, conditions remain deplorable, in part because the vast majority of trans people are housed with inmates of the opposite gender.

At Sheridan, Janetta Johnson says she was the only out trans woman on the compound. Her physical appearance prevented her from being able to pass as a man, even if she had wanted to. With long, black hair, carefully made-up features, and an array of necklaces and earrings, today she looks like any other woman on the streets of San Francisco.

“There was no real way I couldn’t be ‘out,” Johnson says. “I have 38 DDs.”

There were a few other inmates who Johnson suspected were trans women, but she says they would not associate with her because they feared for their physical safety. They claimed to have wives and children back home, and they would not speak or make eye contact with Johnson.

Janetta Johnson

Janetta Johnson is a trans woman who served time at Sheridan, a men’s prison in Oregon.

Tangela Bivens, Johnson’s sister, was one of Johnson’s main advocates during her incarceration.

“I just feel like they didn’t protect her enough. She used to say that people would threaten her,” Bivens told Rewire. Bivens says she called Sheridan to say that her sister was being threatened, but the situation on the ground didn’t change.

“I would cry and cry,” Bivens said. “I used to work overtime just to make sure that I could send her money, so that if something happened, her excuse wouldn’t be, ‘I didn’t have enough money to call.’”

A National Prison Rape Elimination Act (PREA) audit, published in April 2014—two years after Johnson’s release—paints a different picture of conditions for trans prisoners at Sheridan than what Johnson says she experienced. The report said there were four transgender people housed at Sheridan, and the facility met all federal PREA standards, including screening prisoners who might be at risk for victimization and abuse, and training staff on how to conduct pat downs on cross-gender and transgender people. No grievances had been filed regarding sexual abuse at Sheridan, according to the report.

It is difficult to determine whether conditions had simply changed since Johnson’s time at the facility. Sheridan did not answer Rewire’s questions about Johnson’s allegations of sustained abuse, or the facility’s current treatment of trans prisoners.

Johnson describes Sheridan as a place of relentless, life-or-death negotiations for safety, with sex as one of the only bargaining chips. Constantly at risk of being raped, she endured some sexual acts in exchange for protection.

“The best way I can describe it is, I was being raped, and I had to negotiate,” Johnson said.

Many trans women in prison submit to coercive sex—a form of sexual violence—for protection or access to hormones, according to National Prison Rape Elimination Commission testimony. A UC Irvine study found that sexual assault is 13 times more prevalent among transgender inmates than the general prison population, with 59 percent of transgender prisoners reporting being sexually assaulted while in a California correctional facility.

Often, Johnson says, she would wake up to find her cellmate touching her breasts and fondling her. She went to report the assault to a guard, but before she could finish, the guard urged her to stop, according to Johnson. The only place he could house her for protection was in the Security Housing Unit (SHU), a solitary confinement cell where she would be locked in for 23 hours a day. In addition to the isolation, the SHU would make Johnson ineligible for the prison’s residential drug treatment program, and the 18-month-early release that went with it. To stay out of the SHU, Johnson realized she had to face the sexual violence by herself.

Claire Leary, Johnson’s court-appointed lawyer, represented Johnson from 2009 to August 2010, and received troubling letters and phone calls from Johnson while she was at Sheridan.

“I just remember it was a horrible bind,” Leary told Rewire, of Johnson’s time at Sheridan. “You can’t get the access to services or treatments you need, without being in danger.”

A Matter of Life and Death 

In early April of this year, the Justice Department backed a case filed by Ashley Diamond, a trans woman serving time at a maximum-security men’s prison in Georgia. Diamond’s lawsuit details the nightmarish conditions of her incarceration: placement in solitary confinement for “pretending to be a woman,” brutal assaults by fellow inmates, and complete disregard from staff about her safety.

But perhaps most traumatic of all, the lawsuit describes how Diamond was denied the hormones she had taken for 17 years before her incarceration. Without the necessary medication, Diamond “violently transformed,” losing breast tissue and experiencing muscle spasms, according to the lawsuit. Diamond’s lawyer, Chinyere Ezie, said Diamond has attempted to castrate herself so she can go back to being the woman she knows she is.

Since childhood, multiple medical providers had diagnosed Diamond with gender dysphoria, a medical condition in which one’s gender identity differs from the gender assigned at birth, causing clinically significant distress. If gender dysphoria is untreated, it can lead to suicidal ideation, and the impulse to self-castrate and self-harm. People with gender dysphoria are often called transsexual or transgender.

There has long been debate about how to treat people with gender dysphoria. In some areas, draconian policies have given way to more humane ones.

The Federal Bureau of Prisons (BOP) used to have a “freeze-frame” policy for people who had gender dysphoria, which froze treatment at the level it was when a person was incarcerated. If, for example, a trans woman was not taking any hormones before she was incarcerated, she would be unable to access hormones during her incarceration, even if prison doctors diagnosed her with gender dysphoria while she was behind bars.

In 2011, BOP changed their policy in response to a lawsuit, and released a memo stating, “Treatment options [for people with gender dysphoria] will not be precluded solely due to level of services received, or lack of services, prior to incarceration.”

The National Commission on Correctional Healthcare (NCCHC), which accredits prison health-care programs, has written that freeze frame policies are “inappropriate and out of step with medical standards.” In court filings earlier this month, the Department of Justice wrote that freeze frame policies are unconstitutional, and violate the Eighth Amendment’s prohibition on cruel and unusual punishment.

Despite medical and legal consensus, trans people in prisons and jails often cannot access the hormones they need.

In the National Gay and Lesbian Task Force survey of 6,450 trans people across the country, 17 percent of people who had been incarcerated reported denial of hormones while in prison. Black and low-income respondents reported even higher rates of denial.

In general, prison healthcare is notoriously bad. Prisoners have sued for being denied prenatal treatment, medically indicated methadone, cancer treatment and mental health services. Even given this backdrop, the authors of the 2007 Sylvia Rivera Law Project report claim that within a context of neglectful and inadequate medical care, trans people in prison receive “additional forms of care-related discrimination and neglect.”

A week after the Justice Department signed on to Diamond’s case, the Georgia Department of Corrections agreed to provide Diamond with hormones. But the dose is still too low to be therapeutic, according to Diamond’s lawyers.

Last week, the federal Department of Corrections transferred Diamond back to a medium-security facility in Georgia after an inmate at the maximum-security prison touched her face, and after Diamond received a sexually threatening note from another inmate, according to news reports. Her lawsuit says that the only time during her incarceration that she has not been subject to sexual abuse was when she was at the same medium-security facility. However, it is unclear whether the transfer will have any effect on her access to hormone therapy.

Diamond is not the only transgender prisoner who has sued for hormones in prison.

Keirra Lacey James is a trans woman currently incarcerated at the Pontiac Correctional Center, a maximum-security prison for men in Illinois. In a handwritten complaint filed in 2012, James detailed how she was denied hormone treatment for her gender dysphoria, even though she had lived as a woman since the age of 16 and had been diagnosed with gender dysphoria by a prison psychiatrist.

When she asked for hormone treatment, the medical director of the prison told James, “We don’t give out hormones. You didn’t get them when you were free, and you won’t now. Deal with it.”

In neat, looping script, James wrote that she had attempted to mutilate her arms, legs, and genitals, and had been on suicide watch multiple times since being denied treatment.

The Illinois Department of Corrections settled with James in October 2014, and denied liability, according to Nicole Wilson, a spokeswoman for IDOC. In an email to Rewire, Wilson said the department could not comment on any specific treatment currently provided to an inmate. She added that the IDOC has not enacted any new policies regarding hormone treatment since the lawsuit.

Joey Mogul, a lawyer for James, says that part of the settlement stipulates that if any changes are made to James’ hormone treatment, the Illinois Department of Corrections must tell James’ lawyers.

“[Keira] courageously sought the treatment on her own,” Mogul told Rewire. “I’m hoping that the tide is turning. All prison and detention institutions have a duty to provide this necessary medical treatment.”

Ezie, Diamond’s lawyer, emphasizes that for transgender inmates like Diamond and James, hormone therapy is not cosmetic.

“It’s not about playing dress up. It’s a matter of life and death,” Ezie told Rewire. “It’s about feeling like you’re living in the right body, and like you have a compelling reason to live.”

Forced Feminization

In addition to high rates of sexual assault and lack of medical care, trans prisoners also describe a general atmosphere of hostility aimed at people who do not express the “correct” gender while incarcerated.

Cookie Concepcion is a trans male activist who has been incarcerated at the Central California Women’s Facility since 1998. In a phone interview with Rewire, Concepcion described a system of “forced feminization,” in which he and other gender non-conforming inmates are disciplined for not obeying rigid gender rules.

Cookie Concepcion is a trans male activist and member of Justice Now, who is currently serving time at the Central California Women's Facility.

Cookie Concepcion

The rules can seem bizarre. Concepcion says inmates had to fight to be allowed to purchase products “made for men”—like Axe body wash, or Irish Spring soap—because they live in a women’s prison.

A spokeswoman for the California Department of Corrections and Rehabilitation said, “Our policies allow for transgender inmates to purchase items that particular gender would use.” She added that she did not know whether someone who wasn’t diagnosed as transgender could purchase those products.

“What was a scent going to do to somebody?” Concepcion asked. “If a bar of soap says ‘men’ on it, how does that affect the rehabilitation of someone in this institution?”

The prison’s policies target even minute details that people on the outside often take for granted. If a prisoner is not officially diagnosed with gender dysphoria, that prisoner cannot wear boxers, and must wear women’s underwear. (California’s policy on the treatment of transgender prisoners is available here.)

Concepcion says this policy makes no sense, considering the number of inmates who are lesbian, bisexual, or gender non-conforming, but who do not identify as transgender.

“Anybody can walk into any store, lawfully, and they can purchase any type of undergarment they want, and wear it,” Concepcion says. “I want to know what it is about prison that has to regulate that? What is the safety and security issue?”

Sasha Alexander at the Sylvia Rivera Law Project, says this type of policy is understandable within a system meant to impose control at all levels.

“They’re doing this to break people down and discourage people from having gender self-determination,” Alexander told Rewire. “On the outside, this happens as well, but [prison officials] are even more able to enforce those binary ideas of sex and gender.”

Concepcion believes that no matter what he does, he will never fit the image of a rehabilitated female prisoner that the officials at CCWF are looking for. Originally arrested for gang-related murder, Concepcion says he has changed dramatically. He has participated in an at-risk youth intervention program and multiple self-help groups behind bars. He works as a clerk, providing recreational therapy for developmentally disabled people. He also serves on the board of directors of Justice Now, a human rights organization that provides free legal services to people incarcerated in California women’s prisons.

Even so, Concepcion says administrators see his masculinity as a sign that he is still a criminal.

“Really what’s sad about it is the fact that I am so freely able to claim [my gender identity] shows such a growth in my self-esteem. They have it so backwards,” Concepcion says.

When asked whether masculinity could be seen as a sign that a female inmate has not rehabilitated, the spokeswoman for the California Department of Corrections and Rehabilitation told Rewire, “I’ve never heard anyone say that, and I’ve never known anyone to believe that.”

In terms of how to make prisons safer spaces for trans people, activists and currently and formerly incarcerated people were quick to say that the fundamental problem is the disproportionate policing and incarceration of people in the trans community.

Even so, there are some obvious ways to reform the system, according to Alexander of the Sylvia Rivera Law Project. Department of Corrections staff should be trained so they know what it means to be transgender, and what specific safety and health concerns the transgender community may have. Transgender and gender non-conforming administrators and health-care providers should be hired, and trans-specific programs and self-help groups should be available to incarcerated people. Prison health care (which is often inadequate) should include “safe, affirming access to hormones,” and people should not be housed based on their genitalia, but instead where they feel most safe. Finally, prisons should not use solitary confinement as the primary means of protecting trans people behind bars.

But activists say that to truly change the trans community’s relationship with incarceration, they must tackle the underlying problems of poverty, homelessness, and discrimination on the outside.

As Colby Lenz, a volunteer for the California Coalition for Women Prisoners, told Rewire, “What we don’t need is a better cage. What we need is more support and services and resources for people, before they get trapped in prison.”

Editor’s note: In some cases, the individuals in this story have chosen new names that reflect their gender identity. Rewire has reviewed public records to reference legal names in each of these cases. Rewire uses the names preferred by these individuals. Also, this article uses the word trans to refer to transgender, transsexual, genderqueer, and gender nonconforming individuals. A prior version used the term trans*, but we have clarified the terminology in this piece to reflect the current language used in the LGBTQ community.

Analysis Politics

Advocates: Bill to Address Gaps in Mental Health Care Would Do More Harm Than Good

Katie Klabusich

Advocates say that U.S. Rep. Tim Murphy's "Helping Families in Mental Health Crisis Act," purported to help address gaps in care, is regressive and strips rights away from those diagnosed with mental illness. This leaves those in the LGBTQ community—who already often have an adversarial relationship with the mental health sector—at particular risk.

The need for reform of the mental health-care system is well documented; those of us who have spent time trying to access often costly, out-of-reach treatment will attest to how time-consuming and expensive care can be—if you can get the necessary time off work to pursue that care. Advocates say, however, that U.S. Rep. Tim Murphy’s (R-PA) “Helping Families in Mental Health Crisis Act” (HR 2646), purported to help address gaps in care, is not the answer. Instead, they say, it is regressive and strips rights away from those diagnosed with mental illness. This leaves those in the LGBTQ community—who already often have an adversarial relationship with the mental health sector—at particular risk.

“We believe that this legislation will result in outdated, biased, and inappropriate treatment of people with a mental health diagnosis,” wrote the political action committee Leadership Conference on Civil and Human Rights in a March letter to House Committee on Energy and Commerce Chairman Rep. Fred Upton (R-MI) and ranking member Rep. Frank Pallone (D-NJ) on behalf of more than 100 social justice organizations. “The current formulation of H.R. 2646 will function to eliminate basic civil and human rights protections for those with mental illness.”

Despite the pushback, Murphy continues to draw on the bill’s mental health industry support; groups like the American Psychiatric Association (APA) and the National Alliance on Mental Illness (NAMI) back the bill.

Murphy and Rep. Eddie Bernice Johnson (D-TX) reintroduced HR 2646 earlier this month, continuing to call it “groundbreaking” legislation that “breaks down federal barriers to care, clarifies privacy standards for families and caregivers; reforms outdated programs; expands parity accountability; and invests in services for the most difficult to treat cases while driving evidence-based care.”

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Some of the stated goals of HR 2646 are important: Yes, more inpatient care beds are needed; yes, smoother transitions from inpatient to outpatient care would help many; yes, prisons house too many people with mental illness. However, many of its objectives, such as “alternatives to institutionalization” potentially allow outpatient care to be mandated by judges with no medical training and pushed for by “concerned” family members. Even the “focus on suicide prevention” can lead to forced hospitalization and disempowerment of the person the system or family member is supposedly trying to help.

All in all, advocates say, HR 2646—which passed out of committee earlier this month—marks a danger to the autonomy of those with mental illness.

Victoria M. Rodríguez-Roldán, JD, director of the Trans/GNC Justice Project at the National LGBTQ Task Force, explained that the bill would usurp the Health Insurance Portability and Accountability Act (HIPAA), “making it easier for a mental health provider to give information about diagnosis and treatment … to any ‘caregiver’-family members, partners or spouses, children that may be caring for the person, and so forth.”

For the communities she serves, this is more than just a privacy violation: It could put clients at risk if family members use their diagnosis or treatment against them.

“When we consider the stigma around mental illness from an LGBT perspective, an intersectional perspective, 57 percent of trans people have experienced significant family rejection [and] 19 percent have experienced domestic violence as a result of their being trans,” said Rodríguez-Roldán, citing the National Transgender Discrimination Survey. “We can see here how the idea of ‘Let’s give access to the poor loved ones who want to help!’ is not that great an idea.”

“It’s really about taking away voice and choice and agency from people, which is a trend that’s very disturbing to me,” said Leah Harris, an organizer with the Campaign For Real Change in Mental Health Policy, also known as Real MH Change. “Mostly [H.R. 2646] is driven by families of these people, not the people themselves. It’s pitting families against people who are living this. There are a fair number of these family members that are well-meaning, but they’re pushing this very authoritarian [policy].”

Rodríguez-Roldán also pointed out that if a patient’s gender identity or sexual orientation is a contributing factor to their depression or suicide risk—because of discrimination, direct targeting, or fear of bigoted family, friends, or coworkers—then that identity or orientation would be pertinent to their diagnosis and possible need for treatment. Though Murphy’s office claims that psychotherapy notes are excluded from the increased access caregivers would be given under HR 2646, Rodríguez-Roldán isn’t buying it; she fears individuals could be inadvertently outed to their caregivers.

Rodríguez-Roldán echoed concern that while disability advocacy organizations largely oppose the bill, groups that represent either medical institutions or families of those with mental illnesses, or medical institutions—such as NAMI, Mental Health America, and the APA—seem to be driving this legislation.

“In disability rights, if the doc starts about talking about the plight and families of the people of the disabilities, it’s not going to go over well,” she said. “That’s basically what [HR 2646] does.”

Rodríguez-Roldán’s concerns extend beyond the potential harm of allowing families and caregivers easier access to individuals’ sensitive medical information; she also points out that the act itself is rooted in stigma. Rep. Murphy created the Helping Families in Mental Health Crisis Act in response to the Sandy Hook school shooting in 2012. Despite being a clinical psychologist for 30 years before joining Congress and being co-chair of the Mental Health Caucus, he continues to perpetuate the well-debunked myth that people with mental illness are violent. In fact, according to the Department of Health and Human Services, “only 3%-5% of violent acts can be attributed to individuals living with a serious mental illness” and “people with severe mental illnesses are over 10 times more likely to be victims of violent crime than the general population.”

The act “is trying to prevent gun violence by ignoring gun control and going after the the rights of mentally ill people,” Rodríguez-Roldán noted.

In addition, advocates note, HR 2646 would make it easier to access assisted outpatient treatment, but would also give courts around the country the authority to mandate specific medications and treatments. In states where the courts already have that authority, Rodríguez-Roldán says, people of color are disproportionately mandated into treatment. When she has tried to point out these statistics to Murphy and his staff, she says, she has been shut down, being told that the disparity is due to a disproportionate number of people of color living in poverty.

Harris also expressed frustration at the hostility she and others have received attempting to take the lived experiences of those who would be affected by the bill to Murphy and his staff.

“I’ve talked to thousands of families … he’s actively opposed to talking to us,” she said. “Everyone has tried to engage with [Murphy and his staff]. I had one of the staffers in the room say, ‘You must have been misdiagnosed.’ I couldn’t have been that way,” meaning mentally ill. “It’s an ongoing struggle to maintain our mental and physical health, but they think we can’t get well.”

Multiple attempts to reach Murphy’s office by Rewire were unsuccessful.

LGBTQ people—transgender, nonbinary, and genderqueer people especially—are particularly susceptible to mistreatment in an institutional setting, where even the thoughts and experiences of patients with significant privilege are typically viewed with skepticism and disbelief. They’re also more likely to experience circumstances that already come with required hospitalization. This, as Rodríguez-Roldán explained, makes it even more vital that individuals not be made more susceptible to unnecessary treatment programs at the hands of judges or relatives with limited or no medical backgrounds.
Forty-one percent of all trans people have attempted suicide at some point in their lives,” said Rodríguez-Roldán. “Once you have attempted suicide—assuming you’re caught—standard procedure is you’ll end up in the hospital for five days [or] a week [on] average.”

In turn, that leaves people open to potential abuse. Rodríguez-Roldán said there isn’t much data yet on exactly how mistreated transgender people are specific to psychiatry, but considering the discrimination and mistreatment in health care in general, it’s safe to assume mental health care would be additionally hostile. A full 50 percent of transgender people report having to teach their physicians about transgender care and 19 percent were refused care—a statistic that spikes even higher for transgender people of color.

“What happens to the people who are already being mistreated, who are already being misgendered, harassed, retraumatized? After you’ve had a suicide attempt, let’s treat you like garbage even more than we treat most people,” said Rodríguez-Roldán, pointing out that with HR 2646, “there would be even less legal recourse” for those who wanted to shape their own treatment. “Those who face abusive families, who don’t have support and so on—more likely when you’re queer—are going to face a heightened risk of losing their privacy.”

Or, for example, individuals may face the conflation of transgender or gender-nonconforming status with mental illness. Rodríguez-Roldán has experienced the conflation herself.

“I had one psychiatrist in Arlington insist, ‘You’re not bipolar; it’s just that you have unresolved issues from your transition,'” she said.

While her abusive household and other life factors certainly added to her depression—the first symptom people with Bipolar II typically suffer from—Rodríguez-Roldán knew she was transgender at age 15 and began the process of transitioning at age 17. Bipolar disorder, meanwhile, is most often diagnosed in a person’s early 20s, making the conflation rather obvious. She acknowledges the privilege of having good insurance and not being low-income, which meant she could choose a different doctor.

“It was also in an outpatient setting, so I was able to nod along, pay the copay, get out of there and never come back,” she said. “It was not inside a hospital where they can use that as an excuse to keep me.”

The fear of having freedom and other rights stripped away came up repeatedly in a Twitter chat last month led by the Task Force to spread the word about HR 2646. More than 350 people participated, sharing their experiences and asking people to oppose Murphy’s bill.

In the meantime, Sen. Lamar Alexander (R-TN) has introduced the “Mental Health Reform Act of 2016” (SB 2680) which some supporters of HR 2646 are calling a companion bill. It has yet to be voted on.

Alexander’s bill has more real reform embedded in its language, shifting the focus from empowering families and medical personnel to funding prevention and community-based support services and programs. The U.S. Secretary of Health and Human Services would be tasked with evaluating existing programs for their effectiveness in handling co-current disorders (e.g., substance abuse and mental illness); reducing homelessness and incarceration of people with substance abuse and/or mental disorders; and providing recommendations on improving current community-based care.

Harris, with Real MH Change, considers Alexander’s bill an imperfect improvement over the Murphy legislation.

“Both of [the bills] have far too much emphasis on rolling back the clock, promoting institutionalization, and not enough of a preventive approach or a trauma-informed approach,” Harris said. “What they share in common is this trope of ‘comprehensive mental health reform.’ Of course the system is completely messed up. Comprehensive reform is needed, but for those of us who have lived through it, it’s not just ‘any change is good.'”

Harris and Rodríguez-Roldán both acknowledged that many of the HR 2646 co-sponsors and supporters in Congress have good intentions; those legislators are trusting Murphy’s professional background and are eager to make some kind of change. In doing so, the voices of those who are affected by the laws—those asking for more funding toward community-based and patient-centric care—are being sidelined.

“What is driving the change is going to influence what the change looks like. Right now, change is driven by fear and paternalism,” said Harris. “It’s not change at any cost.”

Analysis LGBTQ

Reimagining Safety for Queer and Trans Communities in Wake of Orlando

Tina Vasquez

“We need to have a national conversation about racism, homophobia, and transphobia,” said Alan Pelaez Lopez, a member of the organization Familia: Trans Queer Liberation Movement. “If these things do not happen, the nation, by definition, will have done nothing to support our communities.”

The same day of the Orlando Pulse nightclub shooting that would take the lives of 49 mostly Latino and LGBTQ-identified people, thousands of miles away in Santa Monica, California, a man was found with weapons, ammunition, and explosive-making materials in his car with plans to attend the annual Pride festival taking place in West Hollywood later that day.

Conversations around security and safety were raised by law enforcement almost immediately. In the days since, reports have emerged that from San Francisco to New York, there will be more police and “ramped-up security measures” at Pride events nationwide.

But queer and trans people of color (QTPOC) say these responses are missing the mark, because what their communities really need are deeper conversations and more resources that address their specific experiences, including fewer police at Pride events.

House Democrats held a sit-in on gun control this week as a direct response to the Orlando shooting. Though Alan Pelaez Lopez—an Afro-Latinx, gender-nonconforming immigrant, poet, and member of the organization Familia: Trans Queer Liberation Movement—agrees that gun control is important and should be considered by Congress, they said it can also feel like the community affected by the shooting almost always gets erased from those discussions.

“We need to have a national conversation about racism, homophobia, and transphobia,” the poet said. “If these things do not happen, the nation, by definition, will have done nothing to support our communities.”

Rethinking ‘Pride’ for People of Color

In mid-May, Rewire reported on the National Queer Asian Pacific Islander Alliance (NQAPIA)’s week of action to #RedefineSecurity, which encouraged participants to reimagine what safety looked like in Asian and Pacific Islander communities, and called for them to push back against police presences at Pride events.

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Pride events and festivals take place each June to commemorate the Stonewall riots in New York City, a clash between police officers and members of the LGBTQ community—led by trans women of color—that would kickstart the modern LGBTQ movement.

Even after the Orlando shooting at a gay nightclub, NQAPIA organizing director Sasha W. told Rewire their stance on police at Pride events hasn’t changed, but only grown more resolute.

As an organizer working with queer and trans Muslim, South Asian, and Middle Eastern communities, Sasha W. said the populations they work with say that framing the Orlando shooting as a “terrorist attack” makes them feel “increasingly unsafe.”

“I think part of what we need to remember is to examine what ‘terror’ looked like in queer and trans communities over the course of our history in this country,” Sasha W. said. They cited the Stonewall riots and the inaction by the government during the HIV and AIDS epidemic as examples of some of the many ways the state has inflicted violence on queer and trans communities.

Sasha W. added that pointing blame at Daesh is too easy, and that the oppression queer and trans people face in the United States has always been state-sanctioned. “We have not historically faced ‘terror’ at the hands of Muslim people or brown people. That is not where our fear has come from,” they said.

What’s missing, they said, is a conversation about why police officers make certain people feel safe, and “interrogating where that privilege comes from.” In other words, there are communities who do not have to fear the police, who are not criminalized by them, and who are confident that cops will help them in need. These are not privileges experienced by many in queer and trans communities of color.

Asking the mainstream LGBTQ community to rethink their stance on police and institutions that have historically targeted and criminalized communities of color has been challenging for queer and trans people of color.

What’s become clear, according to Familia: Trans Queer Liberation Movement founder Jorge Gutierrez, is that after a tragedy like Orlando, white LGBTQ members want to feel united, but many don’t want to discuss how things like race and citizenship status affect feelings of safety. Instead, some will push for a greater police presence at events. 

There have already been instances of white members of the LGBTQ community publicly shutting down conversations around racial justice. Advocates say the public needs to understand the broader context of this moment.

“The white LGBTQ community doesn’t face the criminalization and policing that our community faces every day. Not just at Pride, but every day, everywhere we go. That’s our life,” Gutierrez said. “If you don’t listen to us when it comes to these issues of safety, you’re not just erasing us from a tragedy that impacted us, but you’re really hurting us.”

As Gutierrez explained, in the hours after the shooting, some media coverage failed to mention Pulse was a gay club, failed to mention it was people of color who were killed on Latino night, and failed to mention that trans women were performing just before the shooting broke out. Gutierrez told Rewire he felt like his community and their pain was being erased, so his organization put together a video featuring queer and trans immigrants of color, including Lopez, to discuss their immediate feelings after the Pulse shootingand many shared sentiments similar to Sasha W.’s and Lopez’s. One trans Latina said the shooting was “years in the making.”

“The video was important for us to release because the shooting was being framed as an isolated event that randomly happened, but we know that’s not true. We know that the United States has a history of hurting queer and trans people of color and we needed to produce our own media, with our own messaging, from our own people to tell people what really happened, the history that lead to it happening, and who it really impacted. We didn’t want our voices and our realities as immigrants, as undocumented people, as queer and trans people of color, erased,” Gutierrez said.

Without even factoring in an increase in law enforcement, Lopez told Rewire Pride already felt unsafe for people like them.

“I have experienced a lot of racism [at Pride events], the pulling of my hair from people walking behind me, and I have also been sexually harassed by white people who claim to want to experiment with being with a Black person,” Lopez said.

Though Lopez didn’t attend any Pride events in Los Angeles this year, they told Rewire that in previous years, there was already a large police presence at Pride events and as a “traumatized person” who has had many negative interactions with police officers, including being racially profiled and stopped and frisked, encountering law enforcement was scary.

“Seeing [cops] at Pride makes me remember that I am always a target because at no time has the police made me feel protected,” the poet said. “Signs of heavy police presence are really triggering to people who have developed post-traumatic stress disorder from violent interactions with the police, for undocumented communities, for transgender communities, for young people of color, and for formerly incarcerated individuals. When I think of security, I do not think of police.”

Lopez isn’t alone. Whether it’s law enforcement violence against women and trans people of color, law enforcement working with Immigration and Customs Enforcement (ICE) for the detainment and deportation of undocumented people, or the way law enforcement has reportedly discriminated against and harassed gender-nonconforming people, QTPOC have very real reasons for feeling vulnerable around police officers, advocates say.

Another reason Lopez chose not to attend Pride this year: It was being sponsored by Wells Fargo. The banking corporation sponsors over 50 yearly Pride events and has been called a “longtime advocate of LGBT equality” by organizations like the Human Rights Campaign, which also lists Wells Fargo as a top-rated company on its Corporate Equality Index. But Wells Fargo has a history of investing in private prisons, including detention centers. Calls to drop Wells Fargo from Pride events have been unsuccessful. For queer immigrants like Lopez, attending Pride would mean “financially contributing” to the same corporation and system that they said killed their friends, the same corporation that they said has incarcerated their family, and that they said has tried—but failed—to incarcerate them.

Sasha W. told Rewire that for QTPOC, it’s easy to forget that the event is supposed to be about celebration.

“For many of us, we can’t really bring our whole selves into these places that are meant to make us feel free or we have to turn off parts of who we are in order to enjoy ourselves” the organizer said. “And as far as the policing of these events go, I think it’s worth noting that policing has always been about protecting property. It’s always been about property over people since the days of the slave trade. When we see police at Pride events the assumption [by our communities] is that those police will protect money and business over our queer brown and Black bodies.”

“Really Troubling Policies”

As organizations and corporations work to meet the short-term needs of victims of the Orlando shooting, advocates are thinking ahead to the policies that will adversely affect their communities, and strategizing to redefine safety and security for QTPOC.

Gutierrez told Rewire that what has made him feel safe in the days since the Orlando shooting is being around his QTPOC community, listening to them, mourning with them, sharing space with them, and honoring the lives of the brothers and sisters that were lost. His community, the organizer said, is now more committed than ever to exist boldly and to make the world a safer place for people like themand that means pushing back against what he believes to be a troubling narrative about what safety should look like.

However, Gutierrez said that politicians are using his community’s pain in the wake of the Orlando shooting to push an anti-Muslim agenda and pit the LGBTQ community against Muslims, conveniently forgetting that there are people who live at the intersection of being queer and Muslim. Perhaps more troubling are the policies that may arise as a result of the shooting, policies that will add to the surveilling and profiling Muslims already experience and that will further stigmatize and criminalize vulnerable communities.

“The government, the police, politicians, they’re trying to equate safety with having more police on the street, at gay clubs—that are like home to many of us, and at Pride. We know that doesn’t make us safe; we know police are part of the problem,” he said.

“Of course we need to make it more difficult for people to get guns, but we also need more resources for our communities so our communities can truly be safe on the streets, in the workplace, at school, at the clubs, and at Pride,” he said. “That means having healthy communities that have resources so people can thrive and live authentically. The answer to our problems is not more police.”

Sasha W. echoed Gutierrez, saying that their community is already fearful of what’s to come because moments of national crisis often create the space for “really troubling policies.”

“That’s how we got the Patriot Act,” the organizer said. “There is a fear that we are in another one of those moments where there are calls for protection and it’s being tied to the false idea of a foreign threat that requires an increase of surveillance of Muslims. Think of how calls for protection have also hurt queer communities, communities of color, trans communities, like the idea that bathrooms aren’t safe because of trans people. Who is really unsafe in this country, and why do policies hurt us instead of protect us?”

Lopez added: “The Orlando shooting was powered by the fact that the United States has a history of violence against LGBTQIA communities, a history of violence against immigrants, a history of violence against women, and a history of colonization of the island of Puerto Rico … The U.S. needs to address institutional problems of race, ethnicity, class, gender, sex, and sexuality if it wants to put an end to future massacres.”

The question remains: How can vulnerable communities be made to feel safer not just at Pride events, but in a political moment when transphobia is state-sanctioned, Islamophobia is applauded, and communities of color still have to fight for their humanity?

Sasha W. urges QTPOC to “expand their political imagination” and re-envision what security looks like. In the long term, the organizer said, they hope more people recognize who their communities’ “actual enemies” are, instead of turning on each other.

“Let’s recognize that the state has always been something we’ve had to fight to survive and that institutions that hurt us are growing increasingly strong in this moment of crisis, as they often do, so we have to work to disarm and dismantle the institutions that terrorize our communities” they said.

“On another note, we have always been our own best defense, especially in communities of color,” they said. “Supporting each other to protect ourselves better doesn’t happen overnight, I know, but so much of this starts with building community with each other so that we know each other, love each other, and throw down for one another.”

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