The potential good lifting a ban like this could cause is momentous. There is a large number of people living in poverty who would otherwise be unable to receive such care that would benefit from this change in policy. The Catholic Church should show its support for Health and Human Services. Unfortunately, we can all easily expect that this will become another hill to die on with respect to religious liberty. Many bishops may well be afraid that, like birth control before it, this sort of decision could become precedent to mandate coverage of transition related healthcare to all insurance companies. There is already an example in the city of San Francisco where all health plans have this requirement. Still, such bishops fail to understand the core of the Church’s tradition and fail to see that access to necessary medical care and bodily integrity are human rights. Thus it is incumbent on Catholics (and the Catholic Church, though they may shirk this duty) to support decisions like this and demand equal coverage for transition related medical procedures.
Thanks to the Affordable Care Act, transgender patients are protected from discrimination and are able to file complaints with Health and Human Services against any doctor that takes medicare, medicaid, or receives federal funding. This sort of protection is an act of justice which the Catholic Church should support fully if it is to follow its own principals laid out in its social teaching. While complete protection for transgender patients so that they can receive the care they need from their doctors without worrying about discrimination may not be immediate, this is an extremely important step towards that goal.
Once again, turning to the national transgender survey and its report, Injustice at Every Turn, when transgender people are injured 28% postponed treatment due to discrimination and 48% because of an inability to afford it. 19% of respondents reported that they were refused care because of their transgender identity, and 28% were victims of harassment within medical settings. The report even states that “2% were victims of violence in doctor’s office.” The report also says that, “If medical providers were aware of the patient’s transgender status, the likelihood of that person experiencing discrimination increased.” Additionally, half of respondents had to educate their doctors on what transgender care entails.
What we can see is, in addition to the same hurdles to care that Americans face in general, transgender people also face discrimination and harassment when it comes to receiving medical care. This clearly interferes with transgender people’s ability to access health care and negatively affects our health over time. This is without even discussing access to transition related care, an area that has been a thorny issue among transgender people for years. Regardless, it is clear that some reform is necessary on the part of the medical community when it comes to understanding and respecting transgender people. Greater care is needed in studying and understanding our basic health needs in order to allow us adequate preventative care.
The Catholic tradition also upholds these values. In the encyclical “Pacem in Terris,” St. John XXIII wrote, “[People have] the right to live. [They have] the right to bodily integrity and to the means necessary for the proper development of life, particularly food, clothing, shelter, medical care, rest, and, finally, the necessary social services. In consequence, [they have] the right to be looked after in the event of illhealth….” In the encyclical, “Economic Justice for All,” the United States Council of Catholic Bishops writes, “internationally accepted human rights standards are strongly supported by Catholic teaching. These rights include the civil and political rights to freedom of speech, worship, and assembly. A number of human rights also concern human welfare and are of a specifically economic nature. First among these are the rights to life, food, clothing, shelter, rest, medical care, and basic education. These are indispensable to the protection of human dignity.”
The Catholic Church upholds the rights of all people to have access to health care. It seems natural then that the Catholic Church would also desire barriers like discrimination and ignorance to be removed, creating an environment in which health care can be freely accessed. What is interesting also is that people have “a right to bodily integrity,” as St. John XXIII wrote. This right to health care is not only a reflection of the inherent dignity of the human person (a dignity which, necessarily, extends to transgender people) but also a reflection of the right to bodily integrity. In that sense, considering that access to transition related health care is not only a matter of human dignity, but also of bodily integrity, it makes sense that the Catholic Church should support not only the rights of transgender people to access health care in general but also specifically related to transitioning. It might seem contradictory, considering some of the statements bishops and popes have made either directly referencing transition related care or making obtuse statements that can be interpreted that way. They have made their case that transition related health care is considered “mutilation.” However, much like how the Catholic Church has spoken out against protections for transgender students and against transgender employment, this is simply a failure of the Catholic Church to live out its own principles. It is necessary then for Catholics and the Catholic Church to realize that access to health care for transgender people means access to an environment free of discrimination and harassment, as well as access to transition related health care. Thus it is necessary for Catholics and the Catholic Church to support reforms within medical associations when it comes to sensitivity and promoting universal access to health care (including access to transition related health care.)
Here transgender people, specifically trans women, have sought to create a space for homeless trans women that will offer services that they might otherwise be unable to receive. The correct response from Catholics and the Catholic Church would be to support such endeavors while also trying to change the systemic problems that require trans women to have their own shelters in the first place.
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Referring again to the survey report “Injustice at Every Turn,” when it comes to housing, “The various forms of direct housing discrimination faced by respondents included 19% being denied a home or apartment and 11% being evicted because they were transgender or gender non-conforming. Nineteen percent (19%) of respondents became homeless at some point because they were transgender or gender non-conforming, and 1.7% of respondents were currently homeless.” Those who were homeless were more likely to be incarcerated and/or engaged in sex work. Of those who attempted to access homeless shelters, “29% were turned away altogether, 42% were forced to stay in facilities designated for the wrong gender, and others encountered a hostile environment. Fifty-five percent (55%) reported being harassed, 25% were physically assaulted and 22% were sexually assaulted.” We can see then that access to housing can be a difficult thing for transgender people, and that facilities designed for the homeless are often not capable of housing and protecting transgender people. What is needed is laws which protect transgender people from discrimination and guidelines/regulations in place for homeless shelters on the treatment of transgender clients, or perhaps even housing specifically focused on homeless transgender people.
The Catholic Church has similar guidance for issues of housing as it has for education and employment. In Gaudium et Spes, paragraph 26 states that, “At the same time, however, there is a growing awareness of the exalted dignity proper to the human person, since [they] stand above all things, and [their] rights and duties are universal and inviolable. Therefore, there must be made available to all [people] everything necessary for leading a life truly human, such as food, clothing, and shelter….” In the same vein, Living the Gospel of Life paragraph 22 says, “ Any politics of human dignity must seriously address issues of racism, poverty, hunger, employment, education, housing, and health care. Therefore, Catholics should eagerly involve themselves as advocates for the weak and marginalized in all these areas.” Thus the Catholic Church has made it clear that access to housing and shelter is a human right, one that Catholics and the Catholic Church should prioritize, especially for the weak and marginalized.
Looking at these statistics, it is difficult to think of housing for transgender people as anything but an issue of the weak and marginalized. Not only is there a fairly high rate of discrimination in housing, those who are homeless are actively preyed on. It is necessary for the Catholic Church and the Catholic laity to understand better the needs of transgender people in order to provide the kinds of services that they need in housing situations. How many transgender people have died on the street who might otherwise have lived had they been able to access homeless shelters? How many transgender people have been raped or assaulted because they were not properly cared for when they were allowed in a homeless shelter? The Catholic Church should advocate on behalf of transgender people the need for the state to pass laws protecting transgender people from discrimination in housing and for better regulations for homeless shelters.
Here we can see the Catholic Church (or at least the United States Conference of Catholic Bishops) privileging its teachings on sexuality and gender over its teachings of economic justice. While in the statement the bishops may give lip service to economic justice, it is clear that they consider employment to not be a universal right but a privilege for those whose sexuality and gender are far more acceptable to the bishops. The fact that they specifically write as an objection that the law, “rejects the biological basis of gender by defining “gender identity” as something people may choose at variance with their biological sex” shows a profound unwillingness to even consider the issues that trans workers face.
It is difficult to really expect any Catholic to uphold the traditions of the Catholic Church when its representatives fail. If work is a fundamental human right, then LGBT people should be able to fully participate in the economy. Poverty is a greater threat to the human family and to human lives than same sex marriage or transgender/gender non-conforming identities. The representatives of the Catholic Church need to be more compassionate and understanding in order to truly protect the rights of workers.
Referring to Injustice at Every Turn, the 2011 report on a national survey of transgender people, the topic of employment is an extremely important one. Keeping in mind that the numbers were gathered as the recession began (and thus likely have gotten worse rather than better in the years following), the rate of unemployment for survey respondents was twice that of the national average. 90% of those surveyed had either been the subject of harassment at work or had taken steps to prevent it. According to the report, “Forty-seven percent (47%) said they had experienced an adverse job outcome, such as being fired, not hired or denied a promotion because of being transgender/gender non-conforming; 26% of respondents said that they had lost a job due to being transgender or gender non-conforming.” These negative outcomes are often doubled or tripled among transgender people of color. 15% of respondents also reported a household income that was less than $10,000 a year. 16% engaged in underground economies, with 11% turning to sex work.
Clearly we can see that bias in the workplace prevents transgender people from being able to fully take part in the economy. Workers are harassed, abused, underpaid, and often completely shut out of legal work and pushed into things like sex work in order to sustain themselves. Currently, there are no federal protections for transgender workers. Only a few states have laws in place protecting transgender people from workplace discrimination. In the majority of states that have no protections in place, the laws could easily vary from county to count and from city to city. While there has been some protections from discrimination on the basis of legal interpretation of protections against sex discrimination applying to transgender people, there is still no set guidelines for what business owners and human resources managers must do to protect trans workers from discrimination. Things like wrongful terminations still exist, and transgender people are often overlooked for many positions (especially ones requiring face to face contact with customers or clients). What does the Catholic tradition have to say about these issues?
In Centesimus Annus, St. John Paul II wrote that, “The obligation to earn one’s bread by the sweat of one’s brow also presumes the right to do so. A society in which this right is systematically denied, in which economic policies do not allow workers to reach satisfactory levels of employment, cannot be justified from an ethical point of view, nor can that society attain social peace.” On a similar theme, St. John XXIII wrote in Pacem in Terris, “The government is also required to show no less energy and efficiency in the matter of providing opportunities for suitable employment, graded to the capacity of the workers. It must make sure that working men are paid a just and equitable wage, and are allowed a sense of responsibility in the industrial concerns for which they work.”
What we can see from these two popes and saints is that it is the responsibility of the goverments to provide ethical work for ALL citizens. There are no exceptions made here. It does not say “for the heterosexual worker” or “not for transgender workers.” Instead universal employment, fair wages, and the ability to provide for oneself is the standard to which the law should aspire. Thus, it is the obligation of all Catholics and the Catholic Church to uphold these principles as they apply to transgender people. It is necessary to support laws that would provide a framework for employers to understand how to treat their transgender employees, and to protect transgender people from being fired or not hired due solely to their transgender status. It can be shown conclusively that the current state of employment for transgender people fails to meet the standards of justice that these saints laid out, and it is the responsibility of the church and all faithful Catholics to promote these protections.