10+ Things I Learned at the 2018 Philadelphia Trans Wellness Conference
This list and the included links include discussions of a number of topics that some people might find dysphoric or otherwise triggering, including discussion about surgical transition care, body image, disordered eating, genitals, sexual activity, violence and discrimination, rape, immigration injustice, incarceration, self-harm, and suicide.
This year, I was lucky enough to attend one of the largest transgender health conferences in the world. I have wanted to attend this conference for several years but was previously unable to secure funding. A major theme of the event was accessibility, including attendees’ responsibility to carry what we learned back to our home communities. To that end, I took very detailed notes at each session I attended, and with the exception of closed spaces where it was not appropriate to share detailed descriptions of what was discussed.
I have created a folder of notes and I invite everyone to read and share. If other conference attendees want to share their notes, I welcome you to upload them there, annotate the notes that exist, or add your own resources. I especially welcome contributions from folks who attended sessions focused on trans women & femmes, as I attended mostly sessions that were general-interest and a few sessions focused on trans men & masculine folks. If you share notes, I request that you consider the privacy of other attendees—when sharing questions others asked or insights derived from other people’s lived experiences, consider how you can express things non-identifiable and general terms.
Without further ado, 10+ things I learned!
Language is the single most important inclusion strategy for making wellness spaces more accessible to trans folks. Using the correct name and pronouns came up over and over throughout the conference as a top priority for making spaces welcoming to trans folks. Part of the reason is because virtually everyone trans folks interact with in a wellness space will use this kind of language when talking to and about them — and part of the reason is because for many of those people, this is the only way that transness will be relevant to their encounter. Many people talked about dental offices as a space where trans-sensitive care was critically needed. You don’t think of gender as being particularly relevant to dentistry, and it’s not — except that in dentistry, the provider is going to spend MOST of the appointment talking about the patient in the third person, which means that it matters a LOT that pronouns are correct.
Notes from “Mis-Gendering My Health”
Referral letters for surgery expire after one year. The process of accessing surgical care can take more than a year for some people, but providers may not feel comfortable providing an updated letter if they haven’t seen the person since they wrote the original letter. Be aware of your surgical timeline and create a plan for securing an updated letter if you end up needing one. Additionally, it is fine to have two letters from independent providers at the same agency or institution, but it’s critical that the letters are sufficiently different that it’s clear they are truly two letters.
Notes from “Getting Your Ducks in a Row: Preparing for Gender-Confirming Surgery”
A lot of data about nonbinary people has been collected but not fully analyzed or communicated. The largest-ever study of transgender people, the 2015 US Transgender Survey, had 27,715 respondents. One third were nonbinary, but the survey wasn’t prepared to handle that data, so a lot of the findings were presented in binary terms. In 2020 the survey will be administered again, with a mind to capturing nonbinary experiences more fully.
Notes from “Using U.S. Transgender Survey Data in Advocacy”
Transgender people are 97 times more likely to experience sexual assault in ICE detention than cisgender people. Sexual assault in detention facilities is a massive problem for criminal detention as well. It is very difficult for incarcerated victims to receive care and protection from their assailants.
Notes from “Interactions with Law Enforcement and Transgender Prisoners’ Rights”
Trans men & nonbinary people who undergo “top” (chest) surgery can experience Post-Mastectomy Pain Syndrome (PMPS), but this is not well-understood in trans populations. The syndrome is the result of nerve signal confusion and makes the chest very sensitive and sore. It can feel like having a very bad sunburn for as long as six months. The prescription medication gabapentin, topical capsaicin, gentle massage, and desensitization through warm, cool, and textured sensations can help relieve pain.
The way fitness professionals talk to trans people often reinforces disordered eating and self-harm behaviors. These are incredibly prevalent in trans communities — trans people are more likely than any other group to experience disordered eating. Rather than pushing trans people toward gender body norms or centering weight loss, we can support physical and mental health by centering self-love through action and a holistic view of health that takes each person’s total situation into account. The notes have some fantastic links for more information about how to do that.
Notes from “Can Body-Positive Wellness and Dysphoria Coexist?”
Adding web content allows support groups to serve massively more people in their service area than will ever come to an actual support group. By adding resources to their website and optimizing web search, this support group brought in many more people to their support group, while also making the website itself a valuable resource for local trans people and their allies.
Notes from “One Size Does Not Fit All: Building a Better Support Group”
The most effective anti-suicide intervention is putting time and space in between the suicidal person and the lethal means they plan to use. People very rarely switch to a new plan, so even relatively small inconveniences can be very effective. For example, installing barriers on bridges reduces suicide rates for the whole area — it doesn’t just shift people toward different means.
The narrative of being “trapped in the wrong body” emerged from a system of pathologizing trans bodies that required trans people to present themselves as being not at fault for their transness. While some trans people do feel like this narrative reflects their experience, others feel stuck between two or more viable possibilities — and the emphasis on determinism makes less space for people who do feel “ in the wrong body” to explore uncertainties about what to do about it. By centering trans care on the value of bodily autonomy, we can hold space for a wide variety of experiences and help transitioning people find the answers that are right for them, regardless of how they conceptualize their body, gender, and transition.
Notes from “Trans Identity Today: Who’s Afraid of Choice?”
Many trans men and transmasculine people experience sexual rejection because of their genitals, and many partnered trans men and transmasculine people experience relationship strain because they struggle to tolerate being seen or touched sexually because of dysphoria. These experiences were complicated by fetishized expectations about Black men’s bodies in particular. Wearing a binder or shirt during sexual activity can help those who have not yet had top surgery but experience chest dysphoria. Those who had been successful in overcoming sexual barriers talked about the importance of good communication and a partner who respected their boundaries and helped make sexual activity safe for them by honoring their need to not be touched or seen in certain ways or parts.
Notes from this session are not available because this was a restricted session.
BONUS: Accessibility is a team project. Throughout the conference, it impressed me how accessible the space seemed to be to people with disabilities, and a lot of that was made possible through the cooperation and advocacy of participants themselves, not just the choices of individual presenters or event organizers. Mindfulness about lighting, movement space, bathrooms, and sound are everyone’s job. Oh, and don’t ask who can’t hear you — they can’t respond to a question they can’t hear!
EXTRA BONUS: The Trump administration is expected to roll back Affordable Care Act protections against anti-trans discrimination in healthcare. While these protections are obviously not a magic bullet, revoking protections removes a powerful tool for self-advocacy. The Trump administration is already refusing to hear discrimination complaints based on transgender status or gender expression, but this new policy will make things even worse. You can help stop this from happening — go to www.protecttranshealth.org and sign up for updates. When this policy drops, you’ll be invited to share your opinion with the administration and help create public pressure to keep trans care protections. Raise your voice about this, and ask your care providers, your spiritual leaders, your PTA, and everyone else you know to do the same.
