TRANSCRIPT: Trans Health-Care and COVID-19

IMARA JONES: Hello, Imara Jones, and welcome to #LivesAtStake: a series of monthly discussions about critical issues facing trans and gender non-conforming people across the United States.

Lives At Stake is joint production with The Green Space, and my project, TransLash. Be sure to visit and to find out more about our work and to follow our newsletters.

Now, today we’re gonna continue our journey in exploring the way in which COVID-19 is impacting transgender and gender non-conforming communities, but this time through the lens of healthcare. Now, I promise you that one day we’re gonna do a show that doesn’t focus on COVID-19, but today is not that day, however, in our first for our show, a majority of our guests are trans masculine.

People say that trans men don’t have visibility, why aren’t trans men seen? But we are rectifying that today, and besides, we like trans men. We love trans men, we may have dated one or two or three…

Now, the 100,000 deaths recorded due to COVID-19, a grim milestone which we marked this week, underscored the precarity of the U.S. healthcare system for us all. But for historically marginalized populations, that precarity is even potentially more deadly. A recent study, for example, by APM research, shows that African Americans are three times more likely to die from COVID-19 than whites, that’s due to underlying conditions.

Now, for trans people who also have underlying conditions as well, higher than the general population, that puts trans folks further at risk. Not to mention to be Black and trans. Now the heightened sense of anxiety that trans people have is not only due to these common fears or underlying conditions and healthcare access and the COVID-19 gentleness overall, but also because the fact that a series of life saving procedures, such as gender-affirming care, have been deemed to be elected by the healthcare system overall, meaning that they are canceled due to COVID-19.

Moreover, trans people have in some cases, a deadly fear of walking into emergency rooms and hospitals out of the fear of discrimination and a history of discrimination.

This combination of a lack of care and a lack of surgery access for many puts trans people even more at risk yet still. And all of this is taking place against the backdrop of the Trump administration moving to deny or access of trans people to healthcare, yes during the COVID crisis, and removed 20 states across the country to deny equal access to trans teens for their health care.

Here to help us unpack all of these complex issues are Dr. Asa Radix, who is the Senior Director of Education Research at Callen-Lorde Community Health Center, the single largest provider of trans health care in the United States. They will be followed by trans journalist, Tati Bellamy Walker, and Evan Urquhart of Business Insider, who have both written about their experience with COVID-19 and healthcare in their respective publications. And they will then be followed ultimately capped off by Miss Mojo Disco, a piece that they have put together on the importance and their experience with hormone replacement therapy.

Now, The Green Space is actually a space––which means that one day I will be able to look out upon your shining faces, but today is not that day due, well, to COVID-19. I’m really looking forward to that date ’cause I’m really tired of trying to imagine all you through my iPhone. But because for now this is an interactive program, a virtual program, that means that we rely on you to give us your energy, your input, your ideas, your comments, so do that across all of the social media platforms, Facebook, YouTube and Twitter using the hashtag LivesAtStake and TransLash. We will also on those same channels be posting resources that you will be hearing about throughout the program. So on Twitter, put your questions and we’ll throw them into the program.

But before we get into tonight’s topic, which at some points will be heavy, like we always do it every single program, we like to start with gifs and memes that are getting us through at this particular moment.

Not surprising, we are starting with the collaboration between Amy Cooper and Christian Cooper in Central Park, the bird watcher, and the lawless dog walker. Someone has created a spoof accounts for our dog, Oh Henry spaniel, the dog’s name is Henry and one of the posts that we like in that is Henry saying that because she doesn’t put him on a leash, he sometimes almost falls into a lake and has hurt his toenails as a result, and this is a picture of him hurting his toenails. And of course speaking of this particular Haha, this isn’t a meme nor gif, but for general purpose, we’re just putting up a picture of Christian Cooper because, of course, why not? I mean, looking at him, doesn’t it lift your mood? Doesn’t it lighten your load during these dark times? That’s me.

And lastly on the gif and new friends is this YouTube video spoofing the on going series of versus, the latest this week was between RNB groups 112, and Jagged Edge, straight through for the 1990s for you people who were not born yet. But they continue to have all of the whites involving them for some reasons, sound problems. So she talks about why that is and all the distress that’s causing her and these people who were famous in the 90s not knowing how to work technology, that 10 year olds love.

And lastly, we also wanna give a shout out to HBO Max, their new show debuted yesterday. It’s a ball competition series called “Legendary”; make sure you check it out and support. We are so proud of everyone who worked on that show and helped to bring it about. And so check it out. And if you’re competing, you know you can get $100,000.

Before we turn to the heart of our program, let me also give a few program notes. I want to be sure to underscore the fact that not everyone who is trans decides to undergo medical interventions, specifically surgeries or hormones, and whether or not one does or does not, does not mean that they’re any more or less trans, but for those of us who choose to or need to, here’s a video of me being wheeled out of surgery myself almost two years ago, it can be life saving. We’ll unpack all the nuances around that as we move forwards.

One other thing that we wanted to ask your help with, just with our program overall, is that we wanna make sure that this program is accessible and that means making sure that people who are hearing impaired can engage in this program, so we are looking for someone, preferably a freelancer who is from a marginalized community to work with us on providing American Sign Language during the program. If you know someone, please ask them to send us a note or tag them in the timeline, we’d love to make sure that our next program is able to be American sign language accessible in real time, however for now, tomorrow at seven pm on all of our various channels this program will be subtitled and therefore will be accessible and that way we know that’s not good enough and we’re working on it and we need your help.

On to the heart of our program, focusing on the impact of COVID-19, on trans healthcare, this is Lives At Stake and I am Imara Jones. Dr. Asa Radix is Senior Director for education and research at Palomar community health. They are also Chair of the Standards Committee of the world’s professional association of Transgender Health, helping to set global standards for Transgender Health. Asa is also a pioneer in quotes I guess, Asa, I mean Transgender Health starting in the 1990s before there was such a thing. So clearly, this is a person that we need to talk to today. And Asa I am so thrilled and honored that you are joining us today. Thank you so much.

DR. ASA RADIX: Hi. Thank you so much Imara. It’s always nice to be on a on a program like this, to get to talk about some of the issues that are really important for trans people. But did you have a specific question for me?

IMARA JONES: I have many specific questions for you. I’m just spotting you up front, just shouting through your roses. So all right, we’re all about business. So specifically, I’m wondering if you can start us out by talking about the impacts that you can see so far on Transgender Health for COVID, and if you can wrap in that just a synopsis of where you think we are on transgender healthcare overall in the US right now?

DR. ASA RADIX: So, great question. I think anytime you’re in, I would say this is very similar to an environmental and natural disaster, right? In that people have had their access to health care become incredibly limited in a very short period of time. If you can imagine, I mean, it’s just been, what, eight weeks and life has changed so much for us. So for trans people who are used to accessing medical care, gender affirming health care in any form, that’s just been cut, I mean, very few providers are doing in person visits at the moment. So we’re very lucky, I work at Callen-Lorde, where we serve about 5,000 plus trans and gender non binary folks, and that’s headed by an amazing woman, Joan Goldstein. And people got very worried right away because, where am I going to get my hormones? Because often they picked up medication in the clinic. Who’s gonna write my prescriptions? I can’t get hold of my provider. It can be any medical issue, I have back pain, where am I gonna go? And I think for trans people especially this is very difficult. If you’re used to accessing healthcare in a place that’s welcoming and all of a sudden you’re maybe having to think about going to place that’s closer to home, and while you don’t know if they’re going to be welcoming, so perhaps you don’t go, perhaps you stay at home, you stay at home sick and you stay at home in pain, or you stay at home with COVID symptoms. So I think that the access issue is probably the biggest. But like I said, access to medication. Maybe you can’t pick it up, maybe your prescriptions were written every 30 days and you’re out of medication now, not just gender affirming hormones or medications, but anything else that you need. Perhaps you were considering having or you were scheduled for gender affirming surgery, and you’re supposed to be getting hair removal or other preparation, and now you can’t get it or even the medical visit that’s usually a month before your surgery so that you can get cleared for the procedure, that’s not available to you anymore. So I think there’s so many issues, right? But I think from what we’re hearing from clients, those who’ve had their surgeries postponed, it’s really been devastating for them.

IMARA JONES: Right, I mean, we have actually an audience comment from someone in Atlanta, who mentioned that her husband has had his surgeries canceled several times, this is a big issue, we’re gonna be talking about it later with Toxic, can you talk about why gender affirming surgeries are classified as quote elective close quote, when there’s research that shows that in many cases they can be life saving and life improving?

DR. ASA RADIX: Right, I mean, you’re so right about that. I mean, first of all, gender affirming surgeries are essential and medically necessary. And there’s robust research, as you said, like showing that having access to these procedures for those who want them, results in much better health outcomes overall, reduction of mood disorders. I mean people talk about the joy that they experience after accessing these procedures, of course it’s incredibly important. And I think part of the issue is the language that we’re using, right, because we’re calling these procedures elective, and when someone hears elective, what they’re hearing is that this is not necessary. And so I think, predominantly, this is an issue of language. And I think what we should remember is that this is basic critical surgery, incredibly important surgery, and what the hospitals and healthcare facilities, what they should really be saying to us is that, yes, we understand how important this surgery is, that it is part of something that you’ve been waiting for for two, sometimes three years. You were saving up money, you were waiting to get that job to get this scheduled and now you’re being told it’s on hold and we understand the fear and we understand all the uncertainty at this time. But the reason that procedures aren’t being done is not because they’re unnecessary, it’s because right now, every health care provider in the hospital, whether it’s the respiratory therapist, the anesthesiologists, the intensive care providers are working with people who have COVID infection. There is not an ICU bed open. They’ve been running out to ventilators in some facilities, they’ve been running out of oxygen, right? This is not a situation where you want someone to come in and have surgery when the healthcare system is under so much strain. So, that’s really the reason. And it’s not only gender affirming surgeries that have been put on hold, it’s anything that’s not imminently life threatening. So I don’t know if that helps put things in perspective a little bit. I think we need to do a far better job of explaining the reasons and also understanding where people are at and providing them with support. Whether it’s behavioral health support or additional support, because this is really hard to get through. And something that you talked about right at the beginning, that really impacts people of trans experience is the fact that for many people, their jobs, their insurance is tied to their employment. And we have one in four Americans now filing unemployment, and I can guarantee it’s probably higher among trans folks. So you’ll be waiting for the surgery for two years, it’s gonna be covered under your insurance that you get through your job, and you might be on the verge of losing your job. I think these are the really uncertain times, and of course, the issues around, the attempts to strip gender identify, non discrimination from healthcare.

IMARA JONES: Yeah, yeah, let me ask you another question before we return to that, ’cause that’s a really important one, which is one of the things that a lot of trans people are experiencing right now is a delay in going in when symptoms appear, not only because of access, which is real and which it is, I mean, given our system, easily quote an area for improvement. But beyond that, you don’t have a fear because not everyone has been trained in gender affirming care. And so I’m wondering, is that a part of the discussion right now in terms of how that providers are talking about and one of the things that the Governor, for example here in New York has spoken about, is the need to expand health care and health sensitivity to populations that are particularly vulnerable to COVID, because that’s one of the reasons why the rates of infection are so high and it seems to me that for trans people this would be a key initiative.

DR. ASA RADIX: Yeah, you’re absolutely right. I mean, even before COVID we know that about a third of trans people delay care, delay necessarily care and delay preventive care, right? I mean, working in a clinic like Callen-Lorde, it’s every day there are patients who refuse to go to the emergency room, because they’re so afraid of encountering discrimination. So you can imagine what things are like now. I mean, people are sitting at home with COVID symptoms, maybe getting worse and absolutely petrified of going into an emergency room to encounter providers they’ve never seen before. They could be discriminated against by the patients who are in the emergency room. It’s a very, very scary time for people to be trying to access emergency care.

IMARA JONES: I personally had a situation where I had stomach infection. My primary care physician had diagnosed it, told me to go to an emergency room, and when I went to an emergency room the doctor who treated me, in a major hospital in New York City, insisted that I was, in reality, a sex worker and that I had an STD and ended up giving me the wrong medication and extending my infection because it was for something that wasn’t treating the thing that I needed. And the questions were incredibly invasive, they were all about what I did for work, when was the last time I worked, what type of sex that I had and it had nothing to do with what I actually went in for. So I know that that’s something that I’ve experienced myself. One of the things that you touched upon is this move by the Trump administration, it’s very close to being issued a rule that essentially rules back the Obama administrations, mandate that there be equal access for trans people under health care, and we can understand or imagine based on how everything that we spoke about, what that would mean for actual trans people. But one of the things that you spoken about is that the fear that it puts on providers, particularly some of the moves by the states as well, to penalize treatment of trans teens. Can you just talk about the impact of that rule systemically?

DR. ASA RADIX: Right, well, I mean, these are two different movements, I should say that. The issue around the trans adolescence is really difficult. We know that trans youth especially, face so much bullying and discrimination, alienation from their parents, there’s so much that’s happening, so on top of that we’re now seeing states saying that medical providers are not allowed to provide gender affirming hormone care or blockers to youth and if they do, they run the risk of losing their medical license and it’s actually that the states that are trying to push this legislation through are also making it a felony. So many people don’t know this, but for a medical provider to have a felony conviction means that they really cannot work in almost any state. So it is very, very scary, and I don’t know what’s gonna happen so far at least, even though the legislation has been proposed, it really hasn’t gone any further, so we’re really hoping that continues to happen. As far as the HHS rule, this is a really terrible time for this to be happening, on top of COVID now we have to worry about losing rights to healthcare. So, I don’t really know what it will mean, perhaps nothing will happen for a few months. So I’ll say to everyone, if you’re eligible to vote, please register, but I don’t really want to think about the near future.

IMARA JONES: Right, well, lastly, let’s end on a notion of hope, you don’t want to talk about in the near future, but long term future, how do you feel about the prospects of trans healthcare?

DR. ASA RADIX: We’re slowly but surely getting more and more research showing the importance of gender affirming care, and I think that will go a long way. I mean, often, insurance companies will try to say, well, we’re not going to cover a procedure, for example, facial surgery because there are no data to show that this particular procedure results in good outcome. But we’re starting to see more research showing the benefits, we’re starting to see more providers who are being trained in gender affirming care. I was just part of a webinar and we have people from all over the world participating. So that was wonderful. We’re also starting to see more surgeons getting trained, there’s more interest, the coverage has improved. I think this will continue and also WPATH, which you alluded to, The World Professional Association of Transgender Health, is releasing new guidelines within the next six months that really improve on assessment of people and really encourage providers to get the training to provide this care. I think things will be better and I am optimistic, in a global way, I should say. I just hope that we continue to see improvements in the United States as well.

IMARA JONES: Well, on that note, tenuous hopefulness, it’s better than no hope, we will end this program and hope that the data driven approach that you all are having will have an impact. And just thank you so much for taking the time and for everything that you do and have done.

DR. ASA RADIX: Well, thank you so much Imara, for inviting me on to your program.

IMARA JONES: Of course, of course. That is Dr. Asa Radix, who is Senior Director of Research and Education at Palomar Community Health Center in New York. You are watching Lives at Stake, I’m Imara Jones and we’re focusing tonight on the impact of COVID-19 on Transgender Health Care. Well, one of the issues that we spoke about was the reality of cancellation of gender affirming surgeries for trans people.

Our next guest, Tati Bellamy Walker has had that experience and wrote about it in an article for their publication, Business Insider, where they are a fellow. That article is entitled, My Gender Affirming Surgery Isn’t Optional, It Is Life Saving, and to talk about the emotional and human aspects of things that we’ve been talking about from a policy standpoint is Tati Bellamy Walker. Tati, thanks so much for joining us.

TATI: Thank you so much for having me Imara. So when I wrote the piece, I think that initially, it felt like I was smacked in the face with this reality that COVID-19 is really taking everything. And I had this initial feeling of like, Oh, maybe things will be okay. But when I headed to the doctor’s office, and the psychiatrist was not there because they were social distancing, I don’t know, that was just a very disappointing time for me.

IMARA: Yeah, let’s just take a step back ’cause I think it’s really important for people to be able to contextualize and understand what you’re talking about. So going to the psychiatrist office is one of the necessary hikes in order to be able to get gender affirming surgery. And as I understand that what happened is that you literally went to that doctor on the day of the lockdown because they said that they were open and so available, and then when you got there they said they weren’t there. And so wondering if you can just take us into that day? And emotionally, what was that like when you have this roadblock?

TATI: Yeah, so for me, it’s been a while for me to try and find a psychiatrist that is actually gender affirming. And luckily, through the aperture community health center that I go to, the psychiatrist is gender affirming, but before that, I encounter a lot of discrimination in that setting, and to finally get to a point where, okay, I can access this letter and access from a provider that is more affirming and then not have that happen. It’s not just disappointing, but, it just makes you feel like you can never really stop fighting. I think especially as trans people, we’re always in this scenario where we constantly have to fight for everything, and so to kind of get very, very close to something once again, and then be told that the person was not there because of social measures, are all safety measures that are in place to keep people safe, it’s just, I don’t know, it’s just a very depressing moment, it was a very depressing moment for me.

IMARA: I think one of the things that people don’t understand is that you can’t, when you’re right at the point of getting gender affirming surgery, that’s not something that you just can walk into a surgeon’s office with a referral and get. Can you just talk about kind of the full range of things that you had to do? How long had you been in the process of even getting to the point of getting that necessary letter so that you can move forward? How long had the process been?

TATI: It’s been since about September of 2019, and I wasn’t seen until probably about November of last year, because of just the way I guess, wait times are and you have to see multiple counselors, you have to get letters from multiple providers, and then at the same time, if your weight is, if you have a BMI that’s over, I think 33 or 34, you can’t get scheduled for the surgery. And for me, that’s something that happened. First I’m like, wow, I got this far, I’m at the clinic, I’m talking to the social worker, talking to the psychiatrist that they have in house, and then the last step, I remember of that day is to get weighed and to make sure that you’re healthy and everything and when I was told that your BMI is a couple of percentages off, and you can’t be scheduled to see the doctor just for a consultation. I’m like, it feels like every step of the way, I encounter some sort of barrier. So now weight, that’s a barrier and then now it’s COVID that’s my barrier. So I think it’s hard that every step of the way of this process there’s something that’s constantly pulling you back.

IMARA: That’s right, that’s right. What would gender affirming surgery mean for you and why? Can you just talk about why for you as a person, as an individual, it’s really critical?

TATI: Yeah, so for me, it’s just like, it’s a combination of the gender dysphoria and the trust that I feel, and then there’s also that point of feeling like, I feel like for a long time I’ve tried to manage as best as I could manage with the gender dysphoria that I have, and I just kind of gotten to the point over many years since I was a child and now a grown person, is that I don’t think I can come to a point where I can have some sort of acceptance or so over that part of my body, and I think it could be very harmful to try and get somebody to come to some sort of acceptance that just is not really there for them. And for me, that’s kind of my case where it’s just the distress is just something that is very heavy on my mind all the time and I wanna kind of just know what it’s like to not have all that fuzz in the background. What it would be like for me to kind of just live my life, just live my life and not live my life with bottom dysphoria constantly in the back of my head. So it’s like I imagine for me, I’m thinking being able to just exist in public space, especially locker rooms and not have to be so worried, ’cause for me I’ve had issues in bathrooms before where people tell me I’m not I’m not in the right place. So that’s really my reality of constantly not feeling safe in certain spaces. So, this is feeling of wanting to feel safe just for myself and feel comfortable in my body, but also to just kind of really exist safely in the world and in different public spaces. So it would mean a lot for me, yeah.

IMARA: Yeah, and one last question, 20 seconds way for you is the update on your situation, wanna try to end on a positive note. So is there a positive update?

TATI: I wish I had a positive update. It’s wild ’cause last week was supposed to be my pre-op appointment, but because of COVID it was canceled. But so far I have been able to get the letters, which is a good thing, and those letters were sent off, so, I don’t think I’m as hopeful as I was before, but I’m definitely seeing the statistics and everything in terms of COVID cases, things are improving in the city. So, I’m still hopeful for my July, 20 surgery date, hopefully that could still happen.

IMARA: Well, we are wishing you all the best and I really appreciate you coming on to talking about something that’s so personal and appreciate your journalism and your writing about this in a really important way. I also wanted to let you know that many of our audience members have been sending you the best and expressing their sadness of your situation and hoping that you’re able to get the care that you need, so please leave with that and keep us posted.

TATI: Okay, well, thank you, thank you so much Imara.

IMARA: Thank you, thank you so much. That is Tati Bellamy Walker who is a fellow at Business Insider, their article, My Agenda Affirming Surgery is Not Optional, it’s Life Saving, is a piece that they wrote about their experience with gender affirming surgery. You can link to that in our timeline. I also wanted to say that we also have through our website, that’s also posted a website link, resources to trans health care that was provided to us by Callen-Lorde as well, so make sure that you pay attention to that, dig into that if you need resources and help and share that with others.

Before going on to our next guest, I know this is public television so, no, actually Public Radio, and so we have a pitch on behalf of the Green Space, of course this program that you’re seeing is free, it is open to all but as you know, all legends right now are coming under stress, so the Green Space is asking that if you are in a position to, we know that many people are not, that you text to let me drum roll the information here, to be able to make sure that you send if you can, a donation and to text the word Live to 70101 and it’ll text you back and tell you how you can make a donation, anything that you can get will be appreciated to help keep this program going and to make sure that we’re able to be here.

So onto our next guests. Our next guest is Evan Urquhart who is contributor at slate. Evan wrote a piece about their experience with having fear of going to emergency rooms during the COVID-19 crisis, so we are asking them on today, to ask them on to be able to talk about that experience, that article, which you can see on your screen, is also one that you can link to at our site. A link is provided in our feed where you can read that at your leisure, make sure that you share that as well. This issue of fear that people have had out of discrimination is having a real impact on access to care and so Evan, thank you so much for coming on and talking to us today.

EVAN: Thank you so much for having me.

IMARA: Of course. Can you just talk about one of the things that you mentioned in your article is something that Dr. Radix mentioned in their talk, which is one of the things trans people have faced some sort of discrimination in the healthcare system and therefore are more reticent to seek care. But that’s a statistic, you wrote about the emotionality of it, can you talk about the fear that you have had in the past that you think would impact on your seeking care in COVID-19 and other people, other trans people as well?

EVAN: Yeah, absolutely. In my article, I talked about passing, which I’m lucky enough to go around my day to day life with people don’t really know that I’m trans, and that’s actually even included medical settings. And over time, I have noticed very distinctly that I’m treated really differently by nurses, by administrative staff and by doctors if maybe they don’t know that I’m trans and so I go in for an ingrown toenail and I’m like, you know what, this doctor probably doesn’t really need to know that I’m transgender at the urgent care to treat my ingrown toenail. And, lo and behold, I have a very normal, relatively painless, except that it’s a painful thing, experience where I’m not being asked my pronouns five different times by different people, I’m not having people make a mistake and then apologize or over apologize, I’m not being asked probing questions about my personal life that I’m not really interested in and that aren’t really relevant. And I wrote the piece because COVID-19 is a much more serious illness, and if I was very seriously ill, who knows if I could even get away with not disclosing that I was transgender and it would be quite dangerous to go into an emergency situation and not give the doctors all of the relevant information. But as someone who has experienced discrimination who my primary care doctor I go to because the guy will prescribe hormones and it’s the only person within three hours who will prescribe hormones for me, but he’ll do it and he’ll be like, oh hey, what’s your cup size. Objectifying my body in this really gross and frightening and dehumanizing way, and treating me much more like a specimen or an interesting case than just a human being. And so because of these experiences I have a lot of fear that any time I’m interacting with medical professions, they’re not gonna be seeing me as worthy, as valid as their other patients. And so even in a very extreme situation, my fear that I’m just gonna be a little bit less valid, I’m just gonna be a little but less worthy or important or my life is less worth saving, maybe I’m gonna take that risk and try to have them maybe not know that I’m transgender because it is really terrifying that my care isn’t going to be as good as someone who they think is more valid.

IMARA: Right. This particular issue is taking place against the backdrop. So we know that trans people have this fear, and this reticence because of the very real discrimination that people have faced and you detail that, in some ways that are really stomach churning and as human being, I’m so sorry that you have to experience that and have experienced those just to be able to get the health care that you need to be a human being. But, of course, all of this is taking place against the backdrop which you also write in your article about the move by the Trump administration to deny equal access to trans people to health care. And so, what would be the role do you think of passing this discriminatory rule and adding to this overall atmosphere of fear and discrimination that people are facing?

EVAN: The Trump administration wants the law to say, not just trans people are invisible and don’t matter, that we’re not gonna protect them, they want to go a step further and say, you can discriminate, you have a right to discriminate against a transgender patient. And that’s frankly terrifying, I think that doctors, people take messages, they take the climate of the administration, and it impacts how they treat people. The desired law would go well beyond saying that someone can’t discriminate if they don’t wanna prescribe hormones which obviously that is needed care, just like toddies, and I mean, I’m not saying that that should be treated differently but I think a lot of cisgender people don’t realize that what they want is for doctors to have a right to refuse any kind of medical care however basic, however life saving, just because they want to discriminate. They want to protect the right to discriminate against us. And, yeah, in that environment, how can you not consider maybe it’s better they don’t know?

IMARA: Right, and also this separate move by this 20 across the country to allow people to deny equal access to trans teens, specifically prescribing hormones after they’ve gone through a process of evaluation, is also contributing to this as a backdrop, and you’ve spoken about the fact that you as a foster parent to trans teens, this is among your worst nightmare.

EVAN: Yeah, absolutely. I’m not a scholar on the law but as I understand it, they want to criminalize people who help teams get trans affirming medical, medically necessary care. And so, in my actual life, I take in kids who are being neglected or abused or mistreated by their parents sometimes because of their gender identity, so they come from a home where they’re not affirmed and they come into a safe place, and now the law wants to mess with my ability as a foster parent to affirm this child, to get them the medical treatment that they need and want, and to give them a different environment from their home environment where they’ve been unable to thrive when they’ve been maybe treated really badly or maybe just couldn’t get access to what they need.

IMARA: Right. And lastly, what do you think, from our entire experience with COVID-19, would be some important takeaways as important building blocks for improving healthcare for trans people, what are some of the things that we need to learn?

EVAN: So, I think that, I have two different kind of messages for cisgender people and for transgender people. I think cisgender people really need to learn that this is life or death, that it’s real. I often say every single piece of journalism I do about being trans is just really reiterating over and over again I’m a real human being, and it gets tiring to just say that every time but we have very modest needs to be able to be treated equally in society and we do not have that now and just hammering it into cis people every which way that this is real medical care that is necessary that goes beyond whatever fantastic thing they think is going on about genitals or whatever. And then what trans people need to do is we need to network with each other to find out who the affirming providers are and to make sure that people can figure out where to go, how to get what they need, planned parenthood in particular is often the best resource for a rural area like mine, so look into that and, make it easier for us to figure out where to go and how to get medical care without discrimination, while also of course, pushing as activists to improve the picture everywhere.

IMARA: Right, right. Thank you so much for that, one of our audience members, is asked how to necessarily go about spotting people and providers who are affirming in trans health. I mean one we put up some of those resources in our timelines so you can be able to identify that, but I think quite clearly early signs of whether or not they are objectifying your body as you’ve experienced or whether or not they’re using the right pronouns I think. The other thing is that so many of this is about basic respect, right? You’re training people to be respectful in so many ways. But I wanted to thank you for coming on, your article, if I get sick with COVID-19, do not tell my doctor that I am transgender is an article that people should check out and we link to it in our timeline. Thank you so much for joining us and all the best to you as we move through this incredibly difficult moment and thank you for sharing these incredibly personal stories and feelings, I really appreciate it.

EVAN: Thank you Imara, great show.

IMARA: Thank you.

So, because these issues are really tough, and tough on us emotionally, a lot of times we like to end this show with something that is a work of art. And our last but definitely not least guest has done just that, Miss Mojo is an artist in New York City. She has transformed her experience, a deeply personal moment with regards to giving herself a hormone injection into an incredible work of art. These moments are ones that can be affirmative and beautiful and uplifting and we want to end our program and to share her art with you, and her insights as to why she created it so that we can hold on to our humanity as we move through these tough times. Mojo, thank you so much for joining us.

MOJO DISCO: Hey my baby.

IMARA: Why are you twisted?

MOJO DISCO: Am I twisted?

IMARA: I mean, you might be twisted but you know what I mean, you’re sideways in this. I’m gonna look to my technical people really tell me, are they sideways. Maybe it’s just me, maybe I’m sideways and you’re normal. But any of it, sideways, upside down, right side up, you look stunningly beautiful.

MOJO DISCO: Thank you my love.

IMARA: I wanted to start off tonight with why did you decide to transform a moment that’s extremely intimate, extremely personal, one that is generally not shared in this way, I mean on YouTube you can see people giving themselves a shot, but it’s still a moment that many people don’t share publicly. Why did you decide to transform that into a stunningly beautiful work of art?

MOJO DISCO: For me it was a choice of one, creating something that I’ve never seen before. I’ve never seen a Black trans woman administer a shot in a way that was teachable, but also poignant in its art, in its reality. And I wanted to create something that would show the future Mojo, and the future Imara’s, what it is we actually go through in this journey versus the end result because a lot of people see the glamor, they see the glitz, they see all those things, but they don’t really see, I know I didn’t see the reality of what it is to walk in this existence. – Right. That’s right. One of the things I’ve just gotten to know about is that you need to turn your phone, I guess horizontal so that we can capture you. Yes, tada , okay.

MOJO DISCO: That’s better?

IMARA: Perfect. That is totally perfect. I mean, you look hot the other way too, I’m not even going to complain about it.


IMARA: Can you talk to us about, in this piece, what’s one of your favorite moments in it and why? This video piece, called “Lady Shot.”

MOJO DISCO: One of my absolute favorite moments in it, literally, well first of all let’s talk about the fact that I couldn’t watch it without crying for the first week I released it, let’s just start there. ‘Cause emotion is just so strong. I’m very sensitive about my look in the public eye and gaze. So for me it was so crucial that I was projecting me in a way I actually saw myself, but I will say my favorite part of the film is just the little piece of sass, moments in which I put back my dress to get myself together, and definitely it was a moment where I put a clip in my hair to let you know, she’s a lady.

IMARA: And then the moment I think that you, one of the ones that you like that you focus on is, I think you’re injecting the shot, right, and it’s going into your leg, and then after you do there is this moment of satisfaction after pulling down your dress and you’re looking kind of at the audience with this sense of fulfillment. What were you trying to convey in that moment of delivering this shot?

MOJO DISCO: That it wasn’t in vain. That it wasn’t in vain. And my humaneness in doing this is my reality. And this, I wanted to convey choice, I wanted to convey purpose, I wanted to convey black woman queen, any other words you can think of that just represents me in that moment.

IMARA: And I’m wondering what after someone watches this video short, “Lady Shot” which they can find in our feed it’s also on YouTube, very easy to find, what after they see the video do you want them to be able to be a takeaway? And is there a difference between someone who’s trans, and someone who is cis in terms of what you’re hoping that they get?

MOJO DISCO: I want people to take away silence. I want my film to leave you alone for just a second with your own thoughts, with your own bias, with your own experiences. And I want my film to convey a mood of calmness and reflection. I think, for the cis community, I do not create content for the cis community because they have enough. I create content for the trans community, the gender non conforming community, the non binary community because that’s just my place here. Also the black community, excuse me. So, for a cis people, I want you to feel generous after watching my video. I want you to feel very, come on, I want you to feel very open to donating to trans organizations, to people like Miss Mojo, because that stuff’s not cheap to just live our honest life. And we go through so much barriers with insurance and policy, it’s always a fight. As far as my trans community or anyone who falls under the umbrella of trans, I want them to feel hope, I want them to feel purpose, I want them to feel royal and be invited into that moment. And that’s that on that.

IMARA: Well, thank you so much for creating it. Thank you so much for joining us. I think that it is stunningly beautiful. An audience member also said the same thing.

MOJO DISCO: Thank you.

IMARA: People are apparently in our timeline saying that it is beautiful, as I told you. You should be very proud of it. And we look forward to seeing more videos from you. And thank you so much for coming on and for sharing your work.

MOJO DISCO: Thank you, I appreciate you so much sister and I just wanna say the light that you have brought into my life, no words can describe the joy that you bring to my heart Imara, so thank you for having me here.

IMARA: Thank you, thank you, thank you so much. I feel the exact same.

That is Miss Mojo. A New York based artist whose video piece, “Lady Shot”, is an intimate portrait into a moment of her injection with hormones and the result afterwards. Please be sure to check it out in our news feeds, on our website, you can also find it on, I think it is, and also on YouTube. Thank you so much for joining us.

As wrap tonight’s program, I hope that we have been able to take you, not only inside, or behind specifically the technicality of healthcare policy for trans people but to take you into the emotionality and the reality of it. There’s so many different aspects, we scratched the surface, but just the importance of having access to health care in a way that affirms our basic humanity is so essential, and it is a critical issue for trans people and one as you heard, will be on the ballot this year in so many ways, and so we hope that this goes a long way to educating you on that front.

We also wanna let you know that our next program is on June 24th, it will be our Pride show, I can guarantee you that it’s gonna be fine, unless the Supreme Court returns something negative, you know there’s that Supreme Court case that deals with whether or not trans people can be written out of the civil rights law of 1964, that the Trump Administration is advocating for. It’s just a fact. We should hear about that next month, if that’s negative, our show will have a different tenor but we’re planning on it to be fun.

So make sure that you mark your calendars, seven pm on June 24th. Our next Lives at Stake, that would be our Pride program. Thank you so much for joining us, please be safe and be well, take care of yourselves and take care of each other. Have a great night.


Take a stand. Join us for the next #LivesAtStake virtual town hall on June 24. Everyone is welcome! Subscribe for alerts:

[Heateor-SC style="background-color:#ffffff;"]

TransLash tells trans stories to save trans lives. As a trusted source for journalists, thought-leaders, movement activists, researchers, and those wanting to know about trans people, we produce narratives about and for the trans community—accurately and reliably. At a time when disinformation about trans people is being used to undermine democracy and human rights, TransLash Media serves as a beacon of hope through the voices that we share with the world.



TransLash tells trans stories to save trans lives. As a trusted source for journalists, thought-leaders, movement activists, researchers, and those wanting to know about trans people, we produce narratives about and for the trans community—accurately and reliably. At a time when disinformation about trans people is being used to undermine democracy and human rights, TransLash Media serves as a beacon of hope through the voices that we share with the world.


Coming Soon

The Glow UP

At TransLash, change is constant. We embrace our own process of collective transformation, and we honor every step of the journey. We’re getting ready to celebrate a pivotal point in our story, and we’re inviting you to be a part of it! 

Play Video

We’ve been working behind the scenes to launch a new brand for TransLash—one that honors our roots, reflects our growth, and leaves room for what’s to come. Over the next few months, you’ll notice fresh visuals and content as we bring our “glow up” to life across our digital channels. This summer, we’ll celebrate the culmination of that work: our brand new website! We’re building a new home for the journalism you love and trust, grounded in our deep commitment to the trans community.

We’re stepping into our own transition, and we want to share it with you. Join us!

Be the first to know when we launch the new site!


scroll to top