In Transition: Gender [Identity], Law & Global Health

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The USC Law & Global Health Collaboration hosted a discussion on September 13, 2016, to introduce terminology and how legal scholars, scientists, and activists address key topics impacting transgender populations. Experts included Professor David Cruz and Sofia Gruskin. Thanks to all who attended the first USC Law & Global Health collaboration event Sept. 13, 2016.

See below for a summary of the day’s proceedings.

Sofia Gruskin opened the inaugural meeting of the USC Law & Global Health Collaboration with a brief description of the vision of the Collaboration, and an orientation to transgender rights and health, the topic chosen as the primary area of focus for the 2016-2017 year. In all its work, the Collaboration aims to move beyond disciplinary boundaries, and provide a focused, engaging environment in which scholars from USC and beyond can learn from each other, and engage in critical discussion and development of key collaborations. Bringing the various schools together, the Collaboration will hold one event per month looking at a single topical focus from a variety of entry points related to law and global health.

David Cruz, Professor of Law at the USC Gould School of Law, teaches and writes about constitutional law, federal courts, sex and gender identity, and sexual orientation law, and is a leader in thinking and working on these issues. He agreed to help orient the Collaboration’s exploration of transgender issues, providing a survey of law and health issues affecting trans people throughout the world.

Speaking to a full room, Professor Cruz started with a discussion of terminology as to how legal scholars, scientists, and activists address key topics impacting transgender populations, drawing from work with Equality California to heighten public understanding. Download the presentation slides »

His presentation brought up a multitude of issues, including how institutions in many places assign a binary male/female categorization, which may not be consistent with a trans person’s gender identity. Countries have a variety of policies, laws and procedures in place that affect trans people. Signaling a conversation to be continued next month, he raised the issue of how trans populations are characterized in the diagnostic manuals employed by health professionals: e.g. the US-focused Diagnostic and Statistical Manual of Mental Disorders (DSM) places its emphasis on gender dysphoria, recognizing the societal discomfort and disparate treatment that a trans person may experience, while the International Classification of Diseases (ICD) currently uses a system oriented around gender identity disorder. In additional to their impacts on the perception of the health community, these manuals are linked to access to insurance in almost all countries, which can link directly to access to services, so these categorizations are a critical issue. Moreover, gender markers are prevalent on ID documents, including birth certificates, social security cards, driver’s licenses, national health insurance cards, census forms, voter rolls, passports, and more, all of which can and are used in relation to access to health and other services. A person who has transitioned or is transitioning may not match their assigned ID, which can impair access to a range of civil, political, social, economic and cultural rights and activities. For example, a driver’s license that doesn’t reflect a person’s expressed gender identity can elevate an ordinary traffic stop into a major incident affecting the rights, health and dignity of the person concerned.

Professor Cruz gave an overview of a range of different approaches employed in countries affecting when and how a person can transition: for example, Denmark requires a notification and six month waiting process for transition, and that is sufficient. Portugal requires a letter from a psychologist, and potentially a psychiatric evaluation and an accompanying letter. Some jurisdictions actually require surgeries, including sterilization. Age requirements also vary, and marriage laws are relevant as well, with some jurisdictions mandating divorce of a person who is married regardless of the partner’s preference. In general, he highlighted numerous obstacles for trans people, including with respect to laws and policies, but also through discrimination, anti-trans violence, and more.

The floor was then opened, and Professor Cruz’s presentation prompted lively discussion. The group explored a variety of specific questions, including the (lack of) protections under international human rights law, attitudes from the medical community, progress on paper vs. advancements in lived realities, trans issues in sport, and more.

The USC Law & Global Health Collaboration is off to a great start, and this year looks to be exactly as we had hoped: a lively conversation bringing in a multitude of faculty and students from across the university to share experience and perspectives! The organizers would like to extend their sincere thanks to David Cruz for his excellent presentation. Please join us at our next event!

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