Update on the New Orleans Women’s Health Clinic: It’s Down

Because of the importance of the issues and my respect for the people and organizations involved, I want to put up full follow-up post to my earlier request for answers and support around the New Orleans Women’s Health Clinic and whether or not trans women can access health care there. Thanks to several readers — especially tghi, who has been a champion the important complexities in this situation — for calling the updates to our attention.

So it turns out that nobody can get health care at the New Orleans Women’s Health Clinic, because they are currently lacking a medical director and have been forced to suspend their programs. I’m sure this represents a terrible drop in services for a lot of women in the area, not just trans women. Queen Emily has posted NOWHC’s response to her questions about getting health care there. The key answer seems to be that the clinic has had difficulty finding medical staff who will serve trans women (among many other oppressed and marginalized populations of women) without stigma, without pathologizing. They haven’t been able to find a medical director (and possibly other medical personnel?) who can accept NOWHC’s priorities without acting like treating all women’s bodies, regardless of age and ability and body type and trans status and a dozen other factors, creates an untenable “risk” or “liability.”

This is really unfortunate and unfortunately common — treating trans women, for instance, is often treated as “too dangerous” by health care providers, or labeled as something “they don’t have the necessary expertise in” even though the vast majority of trans women’s health care is identical to any other woman’s. This happens to many other women as well, and is a very common and often insurmountable barrier to finding health care. It’s happened to me, and probably to most trans women at some point or other. It’s happened to other trans people as well, which is part of why I still wonder why “trans people who were assigned male at birth” were a particular problem for NOWHC, but not trans men or other trans & gender non-conforming people who were female-assigned.

This can be a horribly thorny issue for any social-justice-motivated health care provider. I know that there are community clinics in many areas that keep trying to provide health care even though their staff is not as well-trained in trans-affirmative health care as they should ideally be. Heck, where I live a whole lot of trans people get health care at clinics where they are still occasionally mispronouned or where they encounter transphobia. It’s better than nothing, but it’s not necessarily the right way; it also hurts and creates barriers.

NOWHC faces tremendous challenges and overwhelming odds in trying to be fully responsible, in an economically devastated area where so many people are left without health care, and probably with resources that I can’t imagine are anywhere near sufficient. So I really admire their statement of devotion to doing it right, and providing health care for all the kinds of bodies, and women of different experiences, that they list. I also am glad that NOWHC has made it clear that the policy as worded on their website (currently down, for understandable reasons) did not accurately represent their real policy and goals, or fully explain the struggles going on.

Like I said in my earlier post, I hope that there is some way that online communities that have become aware of these dilemmas can actually help provide support and assistance to NOWHC. That’s in part because of how clear it is to me that their services are badly needed, and partly because I am personally incredibly grateful to their parent organization, INCITE! for years of hard work, analysis, and tools that have Support from the online world might be impossible at this point because of the way this issue blew up across many blogs. Given the volatile, reactive, semi-informed nature of the blogosphere, I respect NOWHC’s right not to get involved or take support from these online spaces.

After all, like I originally said, the people most affected by this particular issue are women trying to find health care “on the ground” in New Orleans, especially women who are marginalized and stigmatized to a degree where it’s hard to find respectful, affirming, sufficient health care. That includes trans women, of course, especially trans women of color and low-income trans women. And all of those people have a right to speak out, make their voices and needs heard. But the bottom line is, NOBODY is getting health care at this clinic right now. I really hope that NOWHC gets what it needs to get back up and running, and I’m willing to put out more calls for support if they do ask, or if there is a way that makes sense. It’s worth a conversation. If you want to start right now, I know that one way might be to donate to INCITE! — which in my experience is certainly a worthy cause.

Several of the bloggers involved in publicizing this story have given more thoughts or apologies:
Emily: http://questioningtransphobia.wordpress.com/2009/06/30/clarificatio/
bfp: http://flipfloppingjoy.com/2009/06/30/1412/ (and follow-up open letters 1 2 3)
belledame: http://fetchmemyaxe.blogspot.com/2009/06/i-also-want-to-apologize.html

I also want to apologize for further fanning the flames by calling more attention onto this issue — which ideally, by Emily’s account, could have been handled more productively through waiting longer for a response. I tried, in my original post, to express my hope and admiration for INCITE! and their local chapters and organizing projects at the same time as I joined the general (and ongoing, neverending) frustration and anger at the exclusion of trans women from vital services. But bringing another spotlight to shine on a complex, problematic situation doesn’t necessarily help.

I also wanted to say a few words about anger. It’s nothing new for the blogosphere — anger erupts, there are reactions to it, more anger flies back and forth. There have been regrets and apologies about how all of these feelings played out, while on the ground in New Orleans a whole lot of women are getting no health care at all. Online spaces, all mad up of ideas and words and feelings, can easily feel out of control when those mental energies swirl around — rapid, reactive, bursting up and dying down. And it’s probably true that blogs are better at dealing with and putting a stop to something like Tranny-Alert.com than with trying to improve the way a WOC organizing project provides health care to local women in a hard-hit region of the country. A lot of that has to do with anger, and how anger is and isn’t productive.

Here’s what I really want to say: all oppressed peoples have a right to anger. A right to express anger, and be heard. Sisters, your anger over oppression is justified — as women, as people of color, as trans women, as the disenfranchised, as immigrants — when you see yet another door slamming in your face as it has so many times before. I don’t ever want to label that anger as wrong. It’s important to me that this blog continue struggling to be a place where that anger can be expressed and heard. We’re not just trying to be Nice Feminists, after all, even though there’s a time and a place for niceness. Not everyone can hear it and really listen to anger, not all the time. But hearing, listening, and understanding the anger of marginalized and stomped-upon peoples can sometimes be a critically important teaching about privilege, for privileged people. Including me — I certainly enjoy plenty of privileges.

I was talking about anger last night with my girlfriend. We both have a lot of anger, about many different things — unaccountable, white, privileged faux-feminist dudes, Zionists, transphobic comedians, people who insist on “taking care of” the poor faux-feminist dudes — and we’ve both dealt with temper problems. She pointed out that whether anger is “right” or “wrong” is a very different question from the tactical question of whether anger worked well in any given situation. This may sound obvious to some of you, but it’s a very important point to me.

Anger — especially the anger that arises from having privilege denied to you, of being othered and discriminated against and excluded from basic needs — does not deserve to be invalidated. It’s often hard to recognize that when we encounter anger and have a whole host of our own feelings in response — not feeling trusted, guilt, responsibility, shock, confusion. So it can be hard to separate these things out, but it’s important. Sometimes even the most valid anger can end up being a bad idea purely for the reason that it doesn’t help us get to a better place and build real, transformative change. That doesn’t make it wrong, and that makes it all the more important that we have places to express it, hear it, share it, channel it into the next good idea.


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16 Responses to Update on the New Orleans Women’s Health Clinic: It’s Down

  1. tata says:

    They haven’t been able to find a medical director (and possibly other medical personnel?) who can accept NOWHC’s priorities without acting like treating all women’s bodies, regardless of age and ability and body type and trans status and a dozen other factors, creates an untenable “risk” or “liability.”

    I don’t get it. This makes my brain hurt.

  2. Estrobutch says:

    Yeah, I’ve been thinking about that all day yesterday. I just ran on burning rage for about two weeks straight and made a lot of things happen because of it and kept a lot of bullshit at bay until it finally burned out.

    Its really sucks about the NOWHC and it sounds like the on the ground situation was different from how it was represented on their site. I think they do clearly have a problem with accountability and representation of trans women to have gotten that on the website in the first place. It is still cis-centric trans friendliness. And its pretty unambiguous what the message was to trans women even if they didn’t want to exclude. Anger at that is totally justified but now that the dust has settled its time to figure out how to support them making sure services accountability are available for all women.

  3. Claire says:

    The song goes as follows:

    “Trans women have such a fucked-up, freaky-deaky physiology that I, as a people-doctor, don’t know how to treat them, and would open myself to malpractice claims if I even tried.”

  4. voz says:

    Anger at that is totally justified but now that the dust has settled its time to figure out how to support them making sure services accountability are available for all women.

    Well said. But, attacking the bigger problem of trans female exclusion is important, too. NOWHC is just one clinic among many that openly or covertly discriminates against us.

    I think letting NOWHC take the lead, and tell US how they want to be supported, and telling their staff how trans females wish to be served is the way to go.

    There are many groups out there that are working on the larger problem, so there are no shortage of choices for trans females to pick from. I do think that non trans people should center our voices at all times, and step aside and let us speak for ourselves, and that is still not happening in too many places. That is what made this policy in the first place, and oh so many like it.

  5. piny says:

    “Trans women have such a fucked-up, freaky-deaky physiology that I, as a people-doctor, don’t know how to treat them, and would open myself to malpractice claims if I even tried.”

    Right: a trans woman’s hormonal balance is completely different from the hormonal balance of a cis woman, even one on exogenous hormones via the same pill.

    On top of that: they’re not exactly wrong about their ignorance. Most physicians aren’t trained to be friendly to trans people, or to consider issues specific to trans patients their responsibility. So they enter practice with a knowledge base that really does turn trans people into alien creatures, and even trans patients who manage to find a well-intentioned doctor end up supervising their own medical care. It’s like with abortion procedures: at some point, the marginalization climbs into the system.

  6. woland says:

    I am lucky beyond words that this is my health clinic. Because the lgbt program is so unusual, they do a lot of training/talks all over the place, and provide a lot of written resources to help doctors meet the needs of trans patients.

    I wonder if it might be possible/welcome to connect them with NOWHC or other medical services in NOLA? It’s obviously not going to help while there’s no doctor at all, but it could help address the issue of medical providers not feeling like they can serve trans patients.

    I wish there were more programs like Sherbourne/Rainbow Health Network. Even perfectly inclusive women’s health care can’t generate the knowledge base and standard of care that emerges from an lgbt-focused progam – and then that knowledge can be passed on to practitioners who serve more general populations.

  7. voz says:

    I wonder if it might be possible/welcome to connect them with NOWHC or other medical services in NOLA? It’s obviously not going to help while there’s no doctor at all, but it could help address the issue of medical providers not feeling like they can serve trans patients.

    There are a lot off good programs and information out there to refer them to.
    But I think helping NOWHC back on its feet, and helping them on their terms needs to happen first. Trans women do need to talk to them about our care, and I think that is happening. But first things first.

    In the meantime, NOWHC is one among many that exclude or mistreat trans women. This problem is much bigger than one clinic, and its important to remember this.

  8. GallingGalla says:

    woland@6: along similar lines, i am receiving health care at the Mazzoni Center in Philadelphia, and have been very happy with my doctor and all of the staff there. so this might be another resource for NOWHC to connect with.

  9. NiceFeminist says:

    This post is really enlightening, and serves as a good reminder to people who are not owning up to their privilege as much as they should (I definitely include myself in this category). I couldn’t help but notice a slight level of snark in the link to my blog, so I wanted to add that I have been writing a draft about privilege, that I will post soon, probably tonight, which will hopefully spark a discussion among any readers/commenters to own up to their/our own, and figure out how to reconcile that with our own ideas of our own individuality. It seems that those who are most privileged in a general sense are the first to get mad about how “our” oppression isn’t heard or taken seriously, and that idea needs to be combated before any real change can happen, in my opinion.

    If that makes sense.

  10. inmotme says:

    Hi there! I share an IP with “Nice Feminist” given our living arrangement, so I hope that’s not an issue.

    I just wanted to hop in and clarify one fine point. The link to our blog is delivered with the pretext that Nice Feminist has an issue with oppression associated anger. I would really like to state firmly right now that by no means do the creator of Nice Feminist or its contributors (me, for now) discourage protest, organization or even violence if it ever made itself necessary in the name of thwarting an oppressive force. We find inspiration in those people’s willing to take to the streets. Even today as the Westboro clan held their “God Hates Fags” signs outside of my workplace I commented to a co-worker that I would be perfectly willing to go to jail over what I would consider my justified outrage and expressions thereof regarding their protected hate-speech (as a matter of fact, they had disbanded by the time I found out about their presence and still don’t know why they were here).

    The reason for the name of the blog has much more to do with creating an environment of security in the feminist blog-o-sphere, which often condescends the under-studied or novice social thinker. We just want people to talk honestly about their experiences so that a greater cumulative sense of understanding can be reached between those who think Feminism is obsolete and those who think we have a long way to go.

    We appreciate and are avid readers of Feminste and fully support all outcry against injustice. Thoreau puts it best in Civil Disobedience: “Under a government that imprisons any unjustly, the true place for a just [person] is also in prison.”

    Thanks for the discussions and we hope that Nice Feminist does not find ill-will in the feminist blog community. Also, consider our current blog a “beta.” Input is welcome, and in the future it will transition to a privately hosted multi-functional website.

  11. woland says:

    Yeah, NOWHC clearly needs some time on their own to even figure out what it is they need, and that needs respect. I just hope that once they’re in a position to start marshalling resources, the same energy that went into critiquing them is available to help them access what they need.

    As far as trans women accessing health care it seems to me (as an outsider) that ensuring women’s services welcome trans women is an absolutely necessary but not sufficient step for expanding access to appropriate care. My own experience with non-lgbt-focused women’s healthcare as a cis lesbian has been mixed, and I’ve gotten significantly better care as a result of the Ontario initiatives that discovered that, guess what, lesban health care involves more than just knowing that not all your female patients need the pill. I suspect the same is even more true for trans women – for example, an inclusive women’s clinic with a tiny percentage of trans women patients is maybe not going to have the same sensitivity in performing cross-gender physical exams (ex. prostate exams on trans women) as a clinic with trans women medical staff and 400 trans clients. So part of the focus in Ontario has been on figuring out how to document the knowledge gained by specialised services and make it accessible to other providers (with the aim that a trans person going to a gp in small town Northern Ontario can be treated just as well as the person with access to an lgbt practice in Toronto.) It looks as if the Philadelphia clinic GallingGalla uses is similarly involved in training others – and US resources are probably way more appropriate to highlight since issues of funding, liability, etc are very different in Canada and the US.

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  13. Holly says:

    Hey imnotme and Nice Feminist, thanks for dropping by! I’m sorry if the nature of the link came off as snarky. I mostly was just referring to the way (as I understand it, maybe I have it wrong) you guys seem like you have positioned your blog as different from other feminist blogs like this one — how it’s “nice” as opposed to hostile or brusque towards people who are still learning or new to feminism, etc. I came across your site recently and that’s how your mission statement read to me, at least. I really did mean it when I said there’s a time and a place for niceness (not to mention 101 education), and how it’s important to me that Feministe, for instance, has a slightly different approach than Nice Feminist.

  14. imnotme says:

    All is well then. As the site is refined the verbiage may change.

  15. NiceFeminist says:

    Holly: You’re totally right about the mission statement, but when I read the later part of your post:

    hearing, listening, and understanding the anger of marginalized and stomped-upon peoples can sometimes be a critically important teaching about privilege, for privileged people.

    I totally understood where you were coming from. Both are important and useful types of spaces.

  16. Lauren says:

    I’ve had awful experiences with doctors that have made me reluctant to see them even when I’m grossly ill, and I’m some straight, cis white lady in the Midwest — I can’t imagine the fear and anxiety associated with doctors that QE has been writing about if you must worry about discrimination on top of that. Doctors and health care providers have a lot of authority that can be abused when it comes to vulnerable patients — frankly that authority scares me, it’s the shit that nearly killed me when I was vulnerable. Just following doctors’ orders.

    I can’t imagine how hard it must be to try and organize another kind of health care option wherein the social goals of progressive peoples is inseparable from medical wellness goals. Sometimes it’s hard to get the medical community to see patients as people instead of as problems that need to be fixed or pathologized.

    Much love and support for NOWHC and INCITE. I can certainly see why they may fear organizing anything with the blogosphere, but if they do need help I’m on board. This is where medicine needs to go.

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