Notes From the 2012 Philadelphia Trans Health Conference – Part 2 – Speakers, Aging/Estate Planning, Health Insurance

In Part 1 of posts about the 2012 PTHC, I mentioned the venue shared by the conference with the Philadelphia Comic Con, which was pretty cool.  In Part 2 (this part) I thought I would share what were, for me, the take home messages.  Hopefully, this won’t be too boring for y’all.

The conference opened with a welcome from Chief Robert Red Hawk Ruth of the Lenape Nation.  Chief Bob opened the PTHC last year, and his address to the participants of the conference was quite moving.  You could have heard a pin drop as he greeted the full conference room and explained how, after receiving the invitation from PTHC organizers, the decision-makers of the Lenape Nation agreed unanimously that he should accept the invitation and go to Philadelphia and speak at the conference.  Personally, I have to admit that I was choked up to hear that an entire nation supported trans people.

Chief Robert Red Hawk Ruth of the Lenape Nation, 2011 PTHC

Thinking that Chief Bob might be asked again this year to open the conference, I brought my digital recorder with me and got his permission to both record his opening address and post it on this blog along with a photograph I had taken of him last year.

He did not speak as long as he did in 2011, I think perhaps because the mayor was also there waiting to speak, but his words (for me) were still quite moving.  I have uploaded the recording of him here:

The quality is not the best because I could not get to the front row for the opening session – so I have also provided a transcription of his words as follows:

(Gives introduction and greeting.)

I just introduced myself in the three dialects of our language: the Munsee, the Unami and the Muh-he-con-neok, the Mohican. I bring greetings from the indigenous people of this land. We welcome you here to Lenapehoking.

I’m going to break protocol for a second because I wanted to tell you something that happened to me that you might find interesting. I flew in from Wisconsin, and when I come back here, this is where my family has lived for tens of thousands of years, so I always go to a special place. It has a lot of meaning to me, it grounds me. It puts me back in balance. It may not seem like it this morning, but it did.

But when I was going through this trail and I came around this big rock, I came upon, I’d say, 100 to 150 xanikw. If you don’t know what xanikw is, it’s squirrels. Everybody here knows what a squirrel is. I know, people from the city, but they have squirrels in the city. …  Usually, people have seen one or two squirrels running hither and yon. Ha[s] anybody here ever seen about 200 squirrels all gathered together? No.

What do you call a group of squirrels? Are they a herd? A flock of squirrels? I don’t know, but it was a lot of squirrels.

So one squirrel turned around and said to me, “How do you, a two-legged, were able to come upon us and we didn’t hear you?” I said, “Oh, I’m sorry.”

I know what you’re thinking. I’m not fluent in squirrel. But, I know enough squirrel to get by.

I said, “Sir,” I said, “I’m sorry. The reason I came upon you is, I’m a Lenape. My people – this is our sacred land. “

I said, “I walk gently on this earth.”

I said, “I just came from Wisconsin.” He said, “Wisconsin?”

He said, “I know Wisconsin.”

I said, “How does a Philadelphia squirrel know Wisconsin?” Well, I didn’t want to say too much, there was 200 of them there, other than, “I’m sorry to interrupt.”

I said, “How do you know Wisconsin?”

He goes, “At one time a squirrel could be on the Jersey shore, and jump on a tree, and go from tree top to tree top to tree top, ‘til he came to the Mississippi River in Wisconsin.” I thought about that and I excused him — they were holding a pow wow.

I said, “Squirrels are given a special gift.”

Everybody thinks that squirrels run around and they bury their nuts and they forget about them. But The Creator gave the squirrel a gift, that all the great forests that we have, or had, all the great Hickory, the Oak, the Walnut — it was because of a little squirrel doing what he was supposed to do.

Our job, the gift that The Creator has given to us, is to be caretakers. Not only caretakers of the land, of the rivers, but caretakers of each other.

So I was so honored and I was so proud to be able to come here today. And, the first people of this land, my ancestors, we signed the first treaty of brotherhood with William Penn. Our people… his grandson, White Eyes, signed the first treaty with the newly formed United States.

My tribe today was one of the first to recognize and accept the U.N. Declaration of the Rights of Indigenous Peoples. I want you to know, we want to be one of the first nations to recognize you and support you, and to stand with you.

So I am very honored today to be able to come here and welcome you to our sacred land, Lenapehoking… also called Philadelphia.

I am very thankful, and … anishi wanishi. Thank you.

Philadelphia Mayor Michael Nutter

Also moving (for me) were the words of Mayor Michael Nutter, who read an official proclamation declaring the first day of the conference, Thursday, May 31, as “Transgender Health Awareness Day” in the city of Philadelphia. (Although I think it would have been okay to do so, I didn’t record Mayor Nutter because I didn’t have his permission.)

Mayor Nutter is an eloquent speaker and touched on a number of issues, about his support for the trans community, the conference and even marriage equality (he referenced President Obama’s recent support of same-sex marriage).  Mayor Nutter’s presence lent some significant political clout to the conference, but my impression was that he was not there first and foremost for political reasons. He seemed genuinely invested in the health, rights and welfare of the people at the conference and the trans people of Philadelphia.

Mayor Nutter was followed by Minister Louis Mitchell who gave an inspiring opening keynote address.  According to the post on the Mazzoni Center website:

Keynote speaker Minister Louis “L.J.” Mitchell delivered a rousing address Thursday morning that touched on intersecting identities, the nature of community, and how transgender identified people can realize their potential both as individuals and members of a diverse and vibrant community.

If a video of  Minister Mitchell’s keynote address is posted on the PTHC website, I recommend checking it out

I also attended some workshops that provided some useful information, a couple of which I outline here below.


Growing Old Gracefully: The Transgender Experience
The first part of the panel will consist of showing a 10-minute trailer of the upcoming documentary, “Growing Old Gracefully: The Transgender Experience.” The full-length film is schedule to be released in July 2012. From there, panelists will explore many of the concerns and fears that come up for trans folks who are either growing older and/or are already considered part of the trans senior population. What kind of assisted housing facilities will be available to me? Who will help care for me should I need assistance? What kind of community support will be or is out there for a trans person who is 50, 60, or 70-years of age? What type of trans and non-trans healthcare related issues should I be concerned about as a trans senior? If these questions resonate with you, then please join Jayden Sampson (moderator), Jamison Green, Jaci Adams, Bill Coghill, Josephine Yuvonne Paulovic and Tarynn Witten as we explore the issues impacting the aging trans population and come up with proactive ways to deal with them. Older and younger trans people are encouraged to attend this workshop because you are never to young to think about growing older!

The information provided in this workshop was a real eye-opener for me.  And, to be honest, it scared me a little too, so much so that I emailed a lawyer friend during the workshop to ask for a recommendation for a trans-friendly lawyer with experience in estate planning.

To drive the messages home, Jayden Sampson, the workshop moderator, plus the panelists (mentioned above and bios via the workshop link) presented different scenarios depicting potentially unpleasant situations that could arise if one does not take steps to put their wishes in place.  Without the necessary documents, we and our families and/or partners might be left out in the cold, so to speak, upon our death or incapacitation, for example, from a serious illness or accident.

This type of planning can be particularly important for trans people, especially those who are estranged from their families due to their transition.   Consider the following situation:

A trans person suffers a serious accident and is in a coma, unable to make medical decisions for themselves.  Because they have not put in place a living will and documents assigning durable power of attorney to their partner, it’s their relatives, with whom they had a strained relationship, who are called upon to make medical decisions. Then, the trans person passes away without having a will in place.  The laws of their state of residence dictate that the state becomes executor of their estate, and without a will, their family inherits everything and is not obliged to give anything to the partner. The family also has control over the deceased trans person’s remains because no funeral and burial instructions had been left behind.

You can probably imagine different ways that type of scenario can go.  One story comes to mind for me, of a trans person who had transitioned and was living as their true self for several years and who passed away.  For the wake and funeral, their family dressed them in the clothing associated with their birth sex rather than that reflecting their true gender and used their birth name on the obituary and cemetery tombstone.  We can’t know whether the deceased trans person had actually set up that process with their family ahead of their death, but I can imagine that this sort of situation has happened against the wishes of trans people who pass away without leaving the necessary documents in place.

I don’t like thinking about illness or dying, but I also don’t want to leave a burden behind for others to have to deal with and I want to be sure that my wishes are carried out.  So currently, and because of that workshop, I am in the process of planning my estate and putting these documents in place.  For anyone interested in the different aspects of estate planning (even including how to make sure their pets are cared for in the event that they are incapacitated or pass away), they can check out this link which provides a 25-point estate planning checklist.

There are other considerations for trans people as they age, as mentioned in the workshop description above.  Some of them are touched on in the documentary Growing Old Gracefully:  The Transgender Experience, the trailer for which can be seen on YouTube:

For additional information, I also recommend the recently published and one-of-a-kind book, Transgender Family Law – A Guide to Effective Advocacy, edited by Jennifer Levi, Director of the Transgender Rights Project at GLAD (Gay & Lesbian Advocates & Defenders) and Elizabeth Monnin-Browder.  There is a chapter about estate planning, as well as other aspects of family law as it pertains to trans people.  This is a good book to have on the bookshelf as well as for anyone’s lawyer in the case they do not have (enough) experience with trans legal issues.  (The book can be purchased at Amazon and other book retail outlets.)

Focus on Trans Health: A Legal Perspective
The transgender community’s lack of access to health care is nothing short of a crisis. The alarming statistics have spoken – trans people often face indifference, hostility and flat-out rejection from health care providers and insurance companies. These factors not only help contribute to a high mortality rate in the transgender population, but also reduce the quality of life to an unacceptable level that no human should have to bear. What can the law do to help bridge this massive gulf that separates the trans community from the medical care we so desperately need? And, until the law is in place to guarantee the trans community health care, what can we do to better position ourselves for access to medical care? This workshop will cover the range of barriers that exist from bias and lack of cultural competency training of health care staff to discrimination in coverage of transition-related care. It will provide an overview of work being done on trans health, ranging from grass-roots organizing and educational campaigns to cutting-edge policy work and litigation in the courts. Using Lambda Legal Transgender Toolkits, this workshop will provide examples of successful strategies that trans people can use to better access care in the absence of legal protections. Participants will leave with action items to bring trans health into focus in their everyday lives and work.

Lambda Legal Trans Rights Tool Kits

This workshop was presented by Dru Levasseur, a lawyer with Lambda Legal.  (His bio can be seen via the link above for the workshop.)  Dru spoke about different legal issues and cases involving health insurance coverage for trans people. He also gave out Lambda Legal fact sheets and tool kits which are also available on the Lambda Legal website.

In addition to the helpful information provided by Lambda Legal, more info about health insurance coverage for trans people can be found on the website of the HRC (Human Rights Campaign), here.

The HRC recently added transition-related health insurance coverage, which includes surgeries, to its diversity report card and Corporate Equality Index (CEI).  A number of companies were already adding this coverage to their corporate health insurance policies for their trans employees prior to the changes to the HRC CEI, which was reported by The Huffington Post last year (“Transgender Surgery Covered By Growing Number Of U.S. Companies“).

What is not mentioned in the article is that some (many? most?) of the surgeons who perform transition-related surgeries don’t take insurance.  That sets up the scenario with some surgeons that an insured trans person would still need to pay for the procedure out-of-pocket and then file a claim with their insurance company to get a percentage of the costs reimbursed.

The percentage that isn’t reimbursed could then be deducted as medical expenses on federal income taxes thanks to a case that was won by GLAD with a decision by the U.S. Tax Court in 2010 (O’Donnabhain v. Commissioner of Internal Revenue), followed by an announcement from the IRS in 2011 that it would abide by the decision (“IRS Allows Sex Change Surgery to be Deductible by Transgender Taxpayers”).

Of course, all of this does nothing for the uninsured or those who have health insurance with exclusions for transition-related surgeries.  The times are changing, but certainly not quickly, not everywhere and not in all aspects of transgender healthcare and insurance, unfortunately.

There were other interesting workshops and aspects of the 2012 Philadelphia Trans Health Conference but I’ve hit what were the high points for me.  The organizers are currently posting slide presentations on the PTHC website if presenters send them in by June 30th, so interested parties can check out the workshop schedule and see whether the slides for talks of interest have been uploaded.

For me, this has been a great conference for the past two years, and the registration is free which adds to its value. There were over 2400 attendees this year, making it the largest trans conference in the country.  If you have never attended the PTHC, I recommend this conference to anyone who might be interested.


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4 Responses to Notes From the 2012 Philadelphia Trans Health Conference – Part 2 – Speakers, Aging/Estate Planning, Health Insurance

  1. A Noun says:

    Thank you for posting this.
    I too was at PTHC and at the Growing Old Gracefully workshop. A couple of things that stuck out for me in that workshop were:
    “No one can isolate like a trans person and we have NO business doing so. We cannot afford to do so.” J.S.
    The scenarios, one of which you posted.

    I’ve been going to PTHC for four years now and it’s been amazing to see how many people come, and the numbers keep growing. It’s nice to see people I only see once a year, as well as to make new acquaintances and friends.
    The months of hard work and dedication from all of the organizers, Mazzoni staff and volunteers is mind-boggling, yet they pull it off and make it look easy every year.

    Thanks to the people who were in charge of the spirituality track, I was able to go to my first Shabbat dinner.

    I love PTHC. It recharges my soul to be around so many trans and gender variant people and our allies.

    Be well,
    A Noun

  2. libertywolf says:

    Wonderful post with so much inside, and – some very practical and much needed information as well. I am thinking about the info on estate planning. All things we need to consider no matter what our age is, since — shit happens. I need a literary executor, for one thing, and need to get on that, even as a temporary measure.

    I thought as I read this that I am so glad that you are active and in the trans community! People like you are people we need!

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