Bias, Buses, and Blood Pressure: Health of Trans Communities in the Face of Hate.

While I can happily wade into the waters of First Amendment rights, freedom of speech, and attempts at provocative messaging, I’m sure there are others out there far more qualified to host those conversations. Rather, I would take this opportunity to discuss the real-life implications this bus, and other efforts like it, have in our communities.

The trans and gender nonconforming communities have long been under attack in the modern Western world, from early media portrayals of trans people as deranged killers (see: Psycho), and the more modern sitcom tropes at the expense of trans people (see: just about any American sitcom in the past 10 years), to the increase in murders of trans people, more specifically trans women of color, and the rollback of federal guidance for trans youth in schools. The attacks against us are even happening locally: The hard-won protections for trans people to exist in public spaces without fear of discrimination in Massachusetts are under question and up for a popular vote in November 2018. Suffice to say: Trans people face marginalization, discrimination, and violence in far more numerous ways than many may realize.

But how does this all come back to health and wellness in our communities? From my perspective, discussions about how members of the trans community experience these attacks are now more essential than ever. More specifically, health professionals and providers must understand how acts of harassment and violence impact our health.

In 2014, the Massachusetts Transgender Political Coalition (MTPC) and the Fenway Health Institute released a report highlighting the health implications for trans and gender nonconforming people in Massachusetts. We found that 84 percent of surveyed community members who had experienced discrimination on the basis of their gender identity or expression faced increased risk of adverse physical symptoms (such as headache, upset stomach, tensing of muscles, or pounding heart). Knowing that well over one-half of the surveyed participants had experienced some form of discrimination, these numbers paint a stark reality: Discrimination has a very real, very dangerous impact on the well-being of a majority of the trans and gender nonconforming community.

Th

And I’m not alone. Recent surveys show similar fears as well as issues of discrimination faced in health care. In the 2015 US Trans Survey, conducted by the National Center for Transgender Equality, 24 percent of respondents report having to teach their providers about transgender identities in order to get adequate care. Fifteen percent were asked inappropriate or invasive questions that were unnecessary for their care. Twenty-three percent report avoiding necessary health care for fear of discrimination or harassment. What’s even more concerning are the increases in these numbers when broken down by race and ethnicity. While 33 percent of overall respondents reported negative experiences in health care in the prior calendar year, 50 percent of Native American trans and gender nonconforming people reported the same.

So, when a large bus rolls into town spreading messages of intolerance, and erasing the identities and experiences of those who are trans and gender nonconforming, this isn’t a matter of free speech. This is an outright attack on the health and wellness of our communities—and one we cannot assume is properly understood by the healthcare community.

Speaking to the current, future, or retired healthcare professionals out there, my ask for you today is simple: When you see bias, bigotry, hatred, or harassment against trans and gender nonconforming people, either outside or within your profession, responding with silence is an approach our community cannot afford. Our health and wellness depends on you standing up and speaking out against those who would do us harm.

Mason Dunn is executive director of the Massachusetts Transgender Political Coalition. He will be speaking Thursday, April 13, at the Dean’s Seminar “It’s Not About the Bathroom: The Fight for Transgender Equality.”