New Standards of Care could transform trans healthcare

Colt Meier and Levi Herman

Colt Meier and Levi Herman

At a presentation at the Houston Transgender Center last Saturday Colt Meier, doctoral candidate at the University of Houston, and Levi Herman presented information on the World Professional Association of Transgender Health’s new Standards of Care 7. The new Standards of Care, released last month, offer a multidisciplinary guide to healthcare professionals working with “transexual, transgender and gender nonconforming” individuals.

According to Meier, the new standards represent a clear departure from the “gatekeeping” approach to trans medicine that had developed under the previous standards “The old [standards] used to be about what trans people have to do to get what they need,” said Meier. “The new ones are about how health professionals should help trans people.”

The new Standards of Care replace the association’s previous version, released in 2001, and reflect an additional decade of scholarly research on the trans community. Meier says that the previous standards were intended to be guidelines, not rules, but that many doctors took the general recommendations of the standards as being unyielding, and assumed that they should be applied to all trans patients. In publishing the new standards WPATH made it clear that, while the standards represent the best medical advice available, they should not be used as a “one size fits all” solution. For instance, the standards recommend that trans people who seek genital surgery or hormone therapy as part of their transition receive psychiatric care, but explicitly state that “psychotherapy is not an absolute requirement for hormone therapy and surgery.”

One of the biggest changes to come out of the new standards is an unambiguous statement on the ethics of medical professional’s efforts to dissuade trans people of the belief that their true gender is not in line with the gender they were assigned at birth. Attempts to change a person’s gender identity are “no longer considered ethical” under the new standards.

The earliest standards of care were published in 1979. According to Meier much of the early research was done by non-trans people and involved certain assumptions about the desired outcome of people seeking to transition. “Much of the research focused on people who had had genital surgery, which is just one form of surgery,” says Meier, adding that not all transgender people desire genital surgery to complete their transition. Because only a small segment of the community was included in the research the results did not reflect the full diversity of the trans experience. Additionally, in the early days there was an assumption that the purpose of gender transition was to allow the person transitioning to live as a heterosexual, with some doctors refusing to provide treatment to female identified, male bodied persons who where attracted to women. Meyer says that assumptions like this can cause participants in research studies to “tell the researcher what they want to hear,” so that the trans person is able to receive the medical care they need.

As more trans people have become involved in the research a broader picture of the community and its medical needs has come to light. For instance Herman says that “we’ve found is that when trans people conduct studies of the incidence of trans people they find far greater numbers. Perhaps because they are better able to work within the trans community.” Meier and Herman both say that there is a great need for additional research.

The full text of the new Standards of Care can be found on WPATH’s website.

—  admin

A cautionary tale for LGBT travelers

Allan Turnipseed

Murder of former Dallas resident in Mexican state of Jalisco should remind us never to get too comfortable, anywhere we live

DAVID WEBB  |  The Rare Reporter

No one knows what thoughts flashed through American expatriate Allan Turnipseed’s mind during the last moments of his life in his Mexican retirement home on Lake Chapala last month.

But they surely must have been thoughts tinged with shock and disbelief.

It was a turn of events that likely came about because the former Dallas resident became too comfortable in a foreign country plagued by violence. He may have let down his guard and placed trust in young strangers whose minds harbored deadly thoughts.

Turnipseed’s 40-year partner, Bob Tennison, reportedly discovered the 62-year-old lying face down in a hallway of their home. The victim’s assailants tied his hand behind his back and shot him in the head, according to published Mexican reports.

Two homeless, teenage Hispanic brothers, who were known associates of a street gang, confessed they had forced their way into the home to rob it. They killed Turnipseed after he threatened to turn them in to police, according to the reports. They allegedly took the equivalent of about $1,000 and a Toyota pickup from the scene before going shopping to purchase tennis shoes and clothing, as well as marijuana and food.

The shocking crime cut short the life of a respected member of Dallas’ LGBT community who had owned a local business and participated in the Stonewall Business and Professional Association. The prominent graphic designer — who was born in Canada, grew up in Dallas and graduated from the University of Texas at Arlington — also left behind several grieving relatives and many close friends.

It appears that Turnipseed had become as socially and charitably active during his seven-year residence in his Mexican community as he had been in Dallas. That probably led to a false sense of security that many tourists and expatriate residents tend to develop in Mexico.

I know that because of my frequent trips over the past two decades to Puerto Vallarta, which is 204 miles west of Guadalajara and Lake Chapala in the same state of Jalisco.

About four years ago, I was robbed on the street in Puerto Vallarta. I had become so comfortable visiting the city that I walked back to my hotel on the beach from a downtown nightclub one night, confident that no harm could come to me.

As I walked toward my hotel, two friendly young Mexican men joined me on the sidewalk. They walked beside me, asking me all of the questions to which I had become accustomed from the tribe of young hustlers that prowl the beach by day and the streets by night.

Suddenly, one of them was grabbing my wallet out of my pants pocket and the other one was sprinting down the street like a football player. He caught the pass of my wallet through the air, and both of them disappeared into the night.

I was lucky. The robbery consisted mostly of subterfuge. But it could just have easily gone very badly in different circumstances with the use of a knife or gun.

As it happened, I only lost a couple of hundred dollars, my credit cards and my peace of mind.

Some would say I was asking for trouble by walking alone at night, and I’m sure that’s true. I would never do the same thing in Dallas, which goes to show how comfortable I used to feel in Puerto Vallarta.

I imagine Turnipseed felt the same level of comfort. After all, he was in his own home, opening the door to a knock from a couple of teenagers with whom he had came into contact through a friend, who reportedly had given the youths food and shelter. The pair of brothers, who reportedly were American citizens abandoned by their parents, were a familiar sight in the community.

What Turnipseed might not have known is that many residents knew the two youths had reputations as thieves.

What I have come to realize is that known criminals commonly circulate in the midst of tourists on the beach and at other public places without interference in Mexico.

That information usually is gleaned only from bartenders and waiters, who either take a liking to a tourist or just don’t want to see a good source of tips disabled or permanently eliminated.

Mexico is an enchanting country, and most of its inhabitants are good people. But it has always been a much more dangerous destination than some people realize, and Turnipseed’s murder is not the first grisly attack on American residents on Lake Chapala.

While most of the recent Mexican violence can be attributed to the drug cartels’ wars with each other and the government, it likely has also created an atmosphere where human life is considered by criminals to be less valuable.

Mexico is a favorite destination for many LGBT tourists from Texas, and many people have successfully retired or maintain vacation homes there. Publicity about Turnipseed’s murder is unlikely to change that.

But hopefully it will be a strong reminder to all Americans that caution is more critical than ever when undertaking travel south of the border.

David Webb is a former staff writer for the Dallas Voice. E-mail him at davidwaynewebb@yahoo.com.

This article appeared in the Dallas Voice print edition Feb. 4, 2011.

—  John Wright

Deaths

Robert  Allan Turnipseed, 62, formerly of Dallas, was murdered in his home at Riberas del Pilar in Jalisco, Mexico, on Jan. 6 (See related news story in this issue.)

Turnipseed immigrated to the United States from Calgary, Alberta in Canada as a child and grew up in the Dallas-Fort Worth area. He was active in the Stonewall Business and Professional Association in Dallas, a precursor to the North Texas GLBT Chamber of Commerce. He and his partner fulfilled their dream of moving to Mexico in 2004 when they bought a home in the Lake Chapala area.

Turnipseed is survived by his partner of 40 years, Bob Tennison.

Mark A. Bieson, 48, died Jan. 10 at Parkland Hospital in Dallas following a prolonged illness.

Born in Indiana, Biesen had lived in the Dallas area for the past 16-plus years and had worked as a demo specialist at Whole Foods Market in Highland Park. Friends remember him as a very kind and gentle person with an amazing spirit. Guests to and his coworkers at Whole Foods Market loved him very much and will remember him always for his sense of humor and good-natured spirit.

Biesen is survived by one sister and two brothers, all of Indiana.

A memorial service is set for 2 p.m. Saturday, Jan. 29, at Unity Church of Dallas, 6525 Forest Lane.

This article appeared in the Dallas Voice print edition Jan. 28, 2011.

—  John Wright