News Flash: Abortion and Hormone Therapy, Who Pays?

The 1997 Oscar nominated Simon West film, Con Air, is a story of an ex-convict being transferred home on an airplane that is then taken over by other convicted felons. One of the peripheral characters is a transvestite named Ramon “Sally-Can’t Dance” Marinez played by Renoly Santiago. Check out a picture of the character on the right. While this effeminate prisoner serves as comic relief in the film, his character brings an interesting conundrum to light: the issue of transgender inmates and how they maintain their sexuality while in prison.

On March 31st, 2010 in Madison, Wisconsin, a judge declared inmates have the right to hormone therapy paid for by state issued health care. The New York Times published the article “Judge: Transgender Inmates Have Right to Therapy” by the Associated Press discussing the victory that American Civil Liberties Union of Wisconsin and Lambda Legal, a national gay rights group, won for transgender prisoners in Wisconsin. Continuing the discussion of the government’s role in deeming what Americans can and cannot do with our bodies, the plight of these inmates aligns closely with that of women seeking reproductive rights while on Medicade. In a case where individuals’ well being are the responsibility of the state, where should government funding for medical procedures end?

Gwendolyn Mink in “The Lady and the Tramp (II): Feminist Welfare Politics, Poor Single Mothers, and the Challenge of Welfare Justice” discusses the implications of welfare on poor women and the de facto control the government has over individuals bodies. She uses welfare as a way to talk about freedom and choice, or lack there of. Mink says, “We should not think of welfare as a subsidy for dependence but as insurance for the rights that comprise independence” (Mink 1998:59). In this regard, welfare serves as a control for the socioeconomic status of an individual in order for him or her to completely utilize his or her freedom. Welfare recipients are then seen not as a burden upon the state, but rather the norm. This guarantees all people the right to express their full freedom regardless of their socioeconomic status, as Mink argues is protected by the constitution. If we use this logic to look at the case of inmates with gender identity disorder and women on Medicade who want to have an abortion, we see these individuals not as deviant but as the norm. They are individuals who want use all of their liberties as United States citizens. People who can afford or have the ability to pay for these operations on their own are then very luck, but not the standard.

The original authors of the law, which prohibits transgender inmates from receiving taxpayer-funded hormone therapy, are appealing the decision made by U.S. District Judge Charles Clevert who declared it unconstitutional and unenforceable. They are arguing to Attorney General J.B. Van Hollen that this overturn will soon allow for taxpayer dollars to go to sex-change operations, which Clevert did not address in his three-page decision. According to Mink’s logic, this fear is un-American because it denies some individuals freedom to explore their sexuality while granting that liberty to others. Clevert agrees, claiming the law violated the constitutional ban on “cruel and unusual punishment” because the disregard for inmates with gender identity disorder denied them medical attention that was already determined necessary by medical care professionals. During the lawsuit, Clevert placed a temporary order forbidding prison guards from stopping hormone treatment for inmates already receiving it. The law was originally supported by both parties and signed by Governor Jim Doyle after an inmate tried to sue a prison to pay for his sex change (Associated Press 2010).

Following the famous Roe vs. Wade court decision, Medicade covered abortions for women without any consideration. However in 1977 the Hyde amendment began the long succession of rulings that slowly chipped away women’s rights to have abortions, especially those on Medicade. As of September 1993, Medicade covers abortion only in cases of rape, incest or life endangerment (NAF 2010). In this case the government refuses to pay for medical treatment because some individuals deem the medical procedure controversial. Their argument is that pro-life believers do not want their money paying for abortions. While this makes sense on one level, the practical implication of it creates a situation where wealthy women are able to obtain abortions and poor women are not. It also puts the government in a position of power denying poor women the choice to have an abortion. The inmates are also denied the choice to fully explore and understand their sexuality.

In both of these situations, men and women who are dependent on the government for medical attention are denied procedures that seem optional because of the controversy surrounding the medical assistance and because of the expense. In the case of hormone therapy the individual does not appear to have a life-threatening disease so medical attention paid for by taxes seem excessive. However, I wonder what would happen if gender identity disorder were a physical as oppose to a mental disease. If inmates with gender identity disorder had an external symptom like the loss of a limb, and this law denied them help, in lets say the form of a prosthetic, it would more obviously seem like cruel and unusual punishment. In the case of abortion, poor women are continually disadvantaged because they are denied access to medical care that will better help them manage their lives. If the women are in a situation where they are on Medicade and do not think they could support another person, abortion is a logical explanation. However, by denying poor women access to abortions, the government continues to oppress these women because they are deprived of the same financial freedoms women who can afford abortions enjoy. The system also works against these poor women because it creates greater strains on the women, as more children will be dependant upon her.

With the passage of the new health care public option, Obama had the opportunity to change the ideology around controversial medical procedures. He could have made all situations pro-choice, allowing federal funds to give individuals the opportunity to choose their course of action. However, in order to pass the act, the health care plan took a conservative approach to many controversial issues such as abortion and, as gender transition is rarely covered, the public option mimicked the transgender policies of current health care insurance agencies. The public option did create a point of weakness in the oppressive structure for changes in policy, but in this first step progress for reproductive and transgender rights have been left out. I encourage activists to use the public option as a starting point for pushing for all individuals to enjoy their full freedoms!

References

Associated Press. 2010. “Judge: Transgender Inmates Have Right to Therapy.” The New York Times. Retrieved April 11, 2010 (http://www.nytimes.com/aponline/2010/04/01/us/AP-US-Transgender-Inmates-Wisconsin.html?_r=1&scp=2&sq=hormones&st=cse).

Human Rights Campaign 2010. “Health Insurance Discrimination for Transgender People.” Washington, DC: Human Rights Campaign. Retrieved April 13, 2010 (http://www.hrc.org/issues/9568.htm).

Mink, Gwendolyn. 1998. “The Lady and the Trap (II): Feminist Welfare Politics, Poor Single Mothers, and the Challenge of Welfare Justice.” Feminist Studies 24(1):55-64.

National Abortion Federation 2010. “Public Funding for Abortion: Medicaid and the Hyde Amendment.” Washington, DC: National Abortion Federation. Retrieved April 13, 2010 (http://www.prochoice.org/about_abortion/facts/public_funding.html).