为变性人争取权利就是为健康而战.
特朗普时代的一个关键主题是倒退，看到多年来来之不易的进步突然受到威胁或逆转。 From 环境保护, to 生育权, to 投票 and 公民权利, recent years have shown how fragile societal advances can be. 在跨性别者权利方面尤其如此。 In 2016, 我写了一张纸条 about public health’s responsibility to fight for transgender equality. At that time, there was indeed progress to celebrate, from the Obama administration’s 决定 to direct US schools to let students use restroom facilities that correspond with each student’s gender identity, to, here in Massachusetts, Boston Medical Center’s plan to launch 跨性别医疗中心, and the state senate’s passage, 以压倒性的优势, of 跨性别者权利法案, which prohibits discrimination against transgender people in many areas of public accommodation, including restrooms.
今天，这一进展面临危险。 The Trump administration has shown 敌意 to transgender populations in actions like its 推动禁止跨性别军人, and in the Department of 教育’s announcement that it would 驳回 complaints from transgender students barred from using the restroom that corresponds with their gender identity. 然而，白宫并不是唯一一个考虑取消变性人权利的地方。 在马萨诸塞州，一项呼吁废除变性人权利法的投票倡议将于今年11月出现在选民面前，每一票“反对”都将被视为废除。 As of recent polling, while a majority of voters are in favor of keeping the law, that majority is 令人担忧的是苗条的.
这项法律的未来不仅关系到跨性别人群的尊严，也关系到他们的健康。 的确，尊严和健康是相互联系的； 没有前者，后者就不可能存在。 边缘化群体，如LGBTQ社区，由于他们经常面临歧视，面临着独特的健康挑战。 A precise estimate of the prevalence and health burden of transgender, gay, lesbian, bisexual, or queer individuals is 困难, given that the Census and many other official surveys 不要明确地问 about sexual orientation and gender identity. 此外，我们的估计可能由于少报而有偏见； 一项新濠影汇线上赌场研究 发现71%的跨性别者为了避免歧视而隐瞒了自己的性别。 Transgender people are also sometimes “lumped in” with other populations—for example, HIV studies have 特征 transgender women as “men who have sex with men.” An analysis by the 威廉姆斯学院 in 2011 compiled different databases to estimate that about 8 million, or 3.5 percent, of Americans identify as gay, bisexual, or lesbian, with another 700,000 identifying as transgender.
As I discussed in a previous 迪安的注意, discrimination and marginalization of the LGBTQ population is associated with a range of health conditions, including 物质使用，焦虑和情绪障碍. Additionally, LGBTQ populations may have 更少的访问 to health care. On a larger scale, we know that discrimination in general is significantly associated with negative health outcomes as broad-ranging as 抑郁症，心脏病，肥胖症, 高血压和药物使用, and we are in need of better data on the health effects of being transgender specifically. Globally, transgender women are 近50次 more likely to get HIV than the general population, and transgender individuals who are also members of an ethnic or racial minority are at 更大的风险 of discrimination and harassment.
那么，当我们面临进一步边缘化这一已经脆弱的人群的努力时，今天公共卫生的作用是什么？ 在我看来，我们在这里的责任很好地映射了我们作为大学公共卫生学院所做的工作。
首先，我们的核心责任是教育我们的学生，为下一代人口健康领域的思想家、新濠影汇赌场和实干家铺平道路。 这一责任包括使我们整个社区了解主导公众谈话的问题，以及正在改变影响公众健康的社会、经济和文化条件的问题，特别是当这些问题可能不在我们的直接经验范围内时。 在这方面，我们的任务不仅仅是填充思想，而是打开思想，这在跨性别权利领域是最重要的。 This 迪安的注意 is perhaps part of that attempt, as is the ongoing work of our 多样性和包容性副院长伊维特·科齐尔, our 激进的实验室, student groups like 奇怪的联盟, and our collective efforts to promote the use of pronouns that reflect the gender with which members of our community identify and to create 更多性别平等的教室.
We also seek to educate through our events, like our September 12 迪安的研讨会. 这次活动将重点关注马萨诸塞州跨性别者权利斗争的利害关系。 It will be moderated by Professor 苏菲无趣, and will feature as speakers Mason Dunn, executive director of the Massachusetts Transgender Political Coalition and co-chair of the 全马萨诸塞州的自由 Campaign; 波士顿医疗中心跨性别医学和外科中心的医学主任詹妮弗·西格尔； 还有Iris Olson，她是我们活动分子实验室的同事，参与了马萨诸塞州全民自由组织的“赞成3号”运动。 全马萨诸塞州的自由 is a bipartisan coalition of communities, businesses, faith leaders, safety advocates, and other stakeholders who have come together to encourage state residents to vote 第3题是 of the November ballot, to stop the repeal of the transgender rights law and safeguard the dignity and health of this population.
其次，当面对一个对健康有影响的问题时，比如跨性别者的权利，作为一个学校，我们必须不害怕集体站队。 我以前写过 关于选择何时学校应该在一个特定的问题上用一个声音说话的过程。 在这篇文章中，我提出了决定是否持有头寸的两个关键标准。 首先，学校的核心价值必须受到威胁；其次，我们应该只在能够产生实质性影响的情况下采取立场。 从这两个方面来看，为挽救这项法律而进行的斗争都是有条件的。 To strip the state’s transgender population of needed protections would violate our 核心价值观 of empathy and inclusivity, to say nothing of the disastrous effect it would have on health. 很明显，我们将做出实质性的改变。 As primaries and special elections have shown across the country, political outcomes are shaped by community mobilization, especially when the polling is as close as it is on Question 3 (对政治和公共卫生的想法). 的确，本周的研讨会将有助于表明我们在这场斗争中是多么需要继续努力。 For these reasons, it strikes me as both necessary and natural for our school to endorse 投票 “yes” on Question 3 this November.
在这个争取跨性别平等的关键时刻，重要的是要记住，全国的目光都在关注我们在马萨诸塞州所做的事情。 Just as this state took the lead on marriage equality 15年前, we have the chance to show the way forward on transgender rights. 2016年，我们朝这个方向迈出了一步。 今年11月，我们必须确保我们不会走回头路。
我希望每个人都有一个美好的一周。 下周见。
温暖的问候,
桑德罗
桑德罗 Galea, MD, DrPH
Dean and Robert A. Knox Professor
波士顿大学 公共卫生学院
推特: @sandrogalea
Acknowledgement: I am grateful to Laura Sampson, Michelle Samuels, Meaghan Agnew, 艾米丽Barbo, Iris Olson, and Eric DelGizzo for their contributions to this 迪安的注意, and to Professor Ulrike Boehmer for a critical read.
以前的院长笔记存档于： /sph/tag/deans-note