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06/10/2019

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John Schwenkler

While these matters are immensely fraught in a way that surely makes it impossible to leave everything just to our ordinary ways of enforcing collegial behavior, I find the level of power being granted here to administrative bodies and written policies to be frankly terrifying. There is so much contested territory regarding what inclusion and support require in these cases, and inviting administrators to adjudicate these decisions seems like a sure way to weaponize policy in order to stifle disagreement or carry out personal vendettas. I would be happy to be corrected if that is not what's going on here, or to be given assurance that these policies haven't been weaponized in the way I've suggested, and that there are appropriate safeguards to prevent this from happening.

Daniel

John:

"I find the level of power being granted here to administrative bodies and written policies to be frankly terrifying. There is so much contested territory regarding what inclusion and support require in these cases, and inviting administrators to adjudicate these decisions seems like a sure way to weaponize policy in order to stifle disagreement or carry out personal vendettas."

I can't access the policies themselves (the documents won't download), so maybe there's a lot of troubling stuff there which I'm ignoring, but on the face of it I'm not sure I understand the concern (and especially not concern rising to the level of terror!). It seems like either the department or administrators could adjudicate the decisions. Having the department adjudicate the decisions strikes me as MUCH more liable to being "weaponized" in order to "carry out personal vendettas," because the same people involved in adjudication would be the people caught up in the conflict. The administration, meanwhile, presumably is no more likely to side with the person who has a personal vendetta than they are to side with the target of the vendetta. I can't think of any obvious reason for the administration to be on the side of vendettas, and in fact if I had to guess, I'd imagine a relatively neutral third party would be more liable to side against personal vendettas than someone involved in the vendetta themselves (i.e. a member of the department).

John Schwenkler

@Daniel: My intuition was just the opposite given my general distrust of administrators, so the observation that departments could use the policy to carry out internal vendettas makes me feel even worse about the prospects here!

Daniel

I think I might have miscommunicated a bit. I was suggesting the policies would not be particularly vulnerable to misuse by department members with personal vendettas, because the policies are implemented by the administrators, who would have no reason to go along with the vendetta. If you are picturing administrators using the policy to carry out their personal vendettas, I'm having trouble picturing how that works, but again maybe I'm just missing some obvious issues because I haven't been able to read the actual policies.

In general I'm still not sure I understand the potential issue. All policies, of course, are subject to misuse. Nothing is foolproof. But of course a lack of policies would also be subject to misuse, as it would allow people to mistreat others without there being adequate means for the mistreated people to remedy this mistreatment. Nothing's perfect, but I think I prefer a world with policies that protect the vulnerable to a world without these policies, at least in most cases. So I'm not sure what the particular issue is here.

Jules Holroyd

I'm reposting a reply from an exchange with John on fb, in case it is helpful here:
Given the power dynamics in play, and given what we know about how hesitant students are to make formal complaints about discrimination etc, I find it hard to imagine such a case materialising.
Since these are self-legislated commitments, any complaint would, I expect, be dealt with by attempting to work out what we could do better. The policy does not come with punitive sanctions attached.
However, as specified in the policy, there are bits of law that we are constrained by (specifically, against hate speech and discrimination, and concerning privacy of trans staff and students specifically). If a colleague did violate these constraints, then it is already dealt with by those laws.

John Schwenkler

My original concern was not about administrators trying to carry out their own personal vendettas. It was rather about others trying to use these policies as a way to go after those they disfavor, with those charged with having violated a policy like this then having great trouble defending themselves against what would likely be quite unspecific allegations, and in response to administrative bodies whose usual concern is to cut troublemakers in order to save face.

To be clear, I would support policies guaranteeing time off for transition, etc. My concern is about these guidelines insofar as they are supposed to govern teaching and everyday interactions. Whether that's a real concern is of course an empirical matter, as Jules and I discussed earlier on Facebook, so I'll just repeat here my sincere hope that policies like these have many the desired effects and few of the undesired ones, in which case my view of them would shift.

Unionized US State School Grad

Thank you for starting this discussion. I am eager to share notes with other trans grad students about improving our working environments. At my state university in the US, we do indeed let students enter their preferred name and pronouns into the student database such that they appear on all automatically generated student rosters. Sometimes students enter goofy names (e.g. “Your Royal Highness”), but in general this system works very well. Maybe ~30 percent of my students opt-in and fill out this additional information. I think this was an undergraduate-led, campus wide reform. Maybe it would be strategic to team up with undergrads if you want to see this happen on your campus as well.

We have different recommended practices with regard to pronoun sharing: At our teaching assistant training, we were encouraged by university staff to have every undergrad student share their pronouns with their names during introductions so that their classmates would be able to use each others pronouns in discussion. We were also told that students practice this during their orientation. To mitigate the chance of a student feeling like they must misgender themself, we were encouraged to ask “What pronouns do you USE?” rather than “What ARE your pronouns?” and signal that a student can let us know if some other pronouns better serves their needs later in the term.

Personally, I often suggest round-robining like this outside of the classroom as well. I use they/them. With no round-robining, I end up being the only one to share my pronouns along with my name in large groups. I share them because I prefer being ‘othered' to people failing to default to the neutral they/them and misgendering me. I now suspect I am letting my self-interest cloud my judgment at the expense of other trans people, since I don’t have anything to say in response to the real worry that as a result of round-robining people may be targeted. I can take that risk on myself, but I should not impose it on others.

***An additional recommendation: If your university has a graduate student union, then 1) honor those grad students responsible for that fact, and 2) consider joining or starting an initiative to better workplace conditions for trans people. In the US, fighting for better and more extensive health benefit coverage of affirming treatment means fighting for a better employment contract. Or fight for more gender-inclusive restrooms and facilities. Or, y’know, fight for a livable wage.

Jules Holroyd

Really useful point about how to frame any pronouns questions (in terms of use). Thank you!

Great point about the unions also. I hope it is widely known, but just in case it is not: in the UK graduate students can join the University and College Union (UCU) for free. https://www.ucu.org.uk/join

At least at Sheffield, we have had great liaisons between Union members about support for trans students: we coordinated a meeting of students and staff from student services who are redesigning the student records system, with a view to incorporating something like a name preference on the record, and to having (in fact, maintaining - they have been doing this a while) a system where changes of records, if needed, can be easily achieved via a single point of contact.
Working with union members has also been a helpful way of sharing what we are doing and learning from what others are doing beyond our department and faculty - since it emerges there are pockets of great practice around the university, but not necessarily shared or joined up!

Untenured UK philosopher

Having preferred names and pronouns on registers sounds like an eminently reasonable and easy thing to achieve. It would make things much simpler, instead of having awkward conversations with the students themselves about names and pronouns. Having also looked through Sheffield's policy, this all seems very sensible, and avoids the administrative overreach that many teachers might be concerned about.

UK Junior

Hello everyone,

I think the Sheffield philosophers have done an excellent job here. I've been teaching on a world-leading masters degree in policy-making and one thing a policy, and those commenting on any policy, need to sensitive to is the context in which that policy is going to implemented. The U.S. (where a number of commentators appear to be based) is different from the U.K. context. In addition, the confined context of a university in the UK, as opposed to anywhere else in the UK, is more nuanced again. Further, the context of a School or department is even more nuanced. I have full confidence in the Sheffield philosophers to be reliably competent enough to understand the context of their department and needs of their students in their university in their country to exercise their good judgment about what to do in a trustworthy manner. Best wishes to all of you commenting from across the water and well done Sheffield!

Amanda

Uk Junior: i'm very glad to hear you have such an efficient admin system at Sheffield. However, if the US is indeed quiet different than the UK, and even more different than Sheffield, then it seems we will need different solutions, given the distinct systems. Or at the least, US solutions should come with caveats that account for the challenges unique to US university bureaucracy.

Unionized US State School Grad

I'll describe the trans-related healthcare context at XYZ state school in the US in more detail so some of the potential differences become more vivid -- Some are surprised by the state of things even if they have lived in the US all their life:

Again, in the US, our health insurance coverage is often tied to our employment benefits packages and grad student worker packages are often severely limited with regard to covering trans-related health care. The only way to change that is to pray for the benevolence of our school administration or agitate — preferably through a graduate student worker trade union. For instance, any grad student worker would have to pay fully or mostly for non-emergency medical procedures if they went out-of-state. In-state, non-university-affiliated care fees are also only partially covered. This alone is not good, but these restrictions are particularly bad restriction for people who seek medical transition-related care in certain parts of the country. There might be some procedures *technically* fully covered by university insurance, but university facilities may not have enough staff trained to perform them. And those staff they do have are frequently booked up for months or years in advance.

Paying out of pocket for certain procedures would wipe out my ~$29,000 USD yearly income and then some. We often talk about graduate students sacrificing opportunities for higher earning jobs by pursuing a PhD, but one of the biggest potential sacrifices for trans students in the US is the sacrifice of adequate gender-affirming healthcare (if one is not independently wealthy or willing to go into *significant* medical debt). To learn that I am making such a sacrifice in order for a chance to join an academic field that is relatively callous towards the expressed pain of trans people has been… uh... not fun to say the least.

(Obviously, HRT or affirming medical procedures are not relevant to all trans people. But they can be very, very important — life-saving even — for some trans people.)

I am not sure what philosophy department faculty could do about this other than be supportive of students working for better contracts. Ideally, departments would also be able to answer prospective student questions about healthcare or know who to ask about these questions. And, again, be aware that some procedures can be unaffordable even if technically covered because in-network facilities are inadequate when it comes to providing affirming care. I am sure this is relevant when it comes to people who need other types of specialized medical care as well.

Unionized US State School Grad

I forgot maybe the most stunning difference on the horizon: if federal gender identity-based anti-discrimination regulations are rolled back in the US, then healthcare workers will be able to refuse to give medical care for trans people based on their personal beliefs as long as there are no local gender identity-based protections in place. This includes refusing to provide transition-related care, routine check-ups or even medical care during emergency situations.

See, for instance, coverage here:

https://www.vox.com/identities/2019/5/29/18643022/trans-health-care-rule-discrimination-trump-hhs
and here

https://www.buzzfeednews.com/article/emaoconnor/trump-rule-religious-doctors-refuse-abortion-sex

International trans students looking to go to conferences or to study or get jobs in the US should be made aware of this possible policy change. Departments aiming to court prospective students should also know their local anti-discrimination laws and regulations or know who would know. If this policy change goes into effect, philosophers organizing an event in a city or state with no such local protections for trans people should make potential attendees aware that of this fact — by attending, we would be taking on a higher risk of being refused potentially life-saving care in a medical emergency.

No matter what happens policy-wise, philosophers interested in the idea of ‘gender identity' should know of this term’s central role in US anti-discrimination protections for trans people (they can know the stakes and be indifferent, of course).

Not Foolish Enough to Put my Name Here

"If this policy change goes into effect, philosophers organizing an event in a city or state with no such local protections for trans people should make potential attendees aware that of this fact — by attending, we would be taking on a higher risk of being refused potentially life-saving care in a medical emergency."

The linked articles did not seem to say anything about this. The issue was routine and transition-related care, not emergency medical services. Is there any law or regulation (current or proposed) which would make it legal to refuse emergency medical care to someone on the basis of their gender identity? Are there documented instances of this happening? It seems that EMTALA covers these cases and legally requires emergency medical providers to care for everyone without any possible exception.

Unionized US State School Grad

I withdraw that statement regarding emergency care completely. And it is a very, very serious thing to get wrong given that it perpetuates the well-known public health issue of trans people aggressively avoiding emergency rooms or avoiding contact with emergency services. A friend beat you to this correction, but I want to thank the above comment from Not Foolish for publicly setting it right.

It is worth re-stating: Emergency care providers cannot refuse care whether or not gender identity-based protections are rolled back. Emergency care is protected under separate federal law, so transgender people will retain their right to emergency care. People holding philosophy events that last only a few days need not research local gender identity-based anti-discrimination policy in the event that federal-level protections evaporate.

Healthcare providers would be able to refuse routine care and affirming care for trans people. Regular access to non-emergency care can still be life-saving, of course, but is less time-sensitive.

Difficult-to-read content ahead: There are many pivotal moments in trans political consciousness — the death of Tyra Hunter is one of them. This death has, unfortunately, contributed to a general distrust of emergency care personnel among some trans people in the US.* Tyra Hunter was in a serious car accident and as the EMS was disrobing her in order to administer aid, the emergency medical team stopped administering aid when they saw her genitalia. Ms. Hunter was left to lie by the side of the road as emergency workers mocked her appearance, referred to her as “it” and called her racial slurs. Eventually she was seen by a hospital where her treatment was further delayed. Staff failed to see that she needed emergency surgery and she passed away. The court ruled that her death was preventable and her treatment was in violation of the D.C. Human Rights Act, a local law which prevents discrimination based on gender identity or expression.

Ms. Hunter's case and Robert Eads’ (of "Southern Comfort" fame) were a big wake-up call to many trans people and allies in the US. Examples from the news of the refusal of adequate medical care to trans people from this year include the on-going insurance battle of Dashir Moore, the exciting victory in court of Jessica Sunderland and the horrific, unjust death of Johana Medina Leon -- and this is with Obama-era protections still in place!

Thank you for letting me publish this correction even if it is not on-topic. I am sorry if I have de-railed the thread with my mistake.

*Since the avoidance of emergency rooms by trans people is a well-known problem, there are currently on-going health initiatives to try to better train staff to meet the needs of trans people. So all is not lost. People are working to rebuild this trust.

Not Foolish Enough to Put my Name Here

Hi Unionized, thanks for the examples. I didn't know them and I'm sure lots of others didn't as well.

It does seem clear that legislation which removes protections for things like routine care is likely to have the effect of suggesting to some healthcare workers that refusing or delaying care in other, e.g. emergency, situations is legally permissible as well. It's a mess.

Amanda

Unionized Grad: Thanks for all the information. I have a couple of clarification questions:

1. You said that, in reference to transition related treatments, "university facilities may not have enough staff trained to perform them..." I'm curious what you mean by "university facilities." When I was a grad student, we did have a student health center, but what could be done there was very limited. For almost everything I had to get a referral to outside facilities. I guess I thought this was typical, but perhaps not. Are you saying that in your university health care system the only treatment covered was that which could be actually done at the university facility itself? This would indeed be very hard on trans students, but also it seems, on any student that needed any type of atypical care. Unless you had an unusually expansive university facility.

2. From what I gather, academia isn't unique in the US as far as difficulty getting these healthcare services is concerned. I know some trans friends outside of academia who would love to get HRT. They have decent jobs with decent health insurance, but HRT isn't covered. Those that seem to have had the most luck are trans friends who are under 26 (or were under 26) and covered under their upper-class parents coverage. But again, I have no idea if this is typical or just my idiosyncratic experience. And if it is typical, that of course still means philosophers should fight for better health insurance for trans colleagues. I guess it just wouldn't follow that leaving philosophy is the best way to get transition care covered.

3. Along the lines of 2, unfortunately I don't think the US is unique in not covering trans-care. Lots of "liberal democracies," including those with universal healthcare (I'm thinking of many countries in Europe) also don't have the best coverage for transition care. People sometimes forget that as long as it took for the US to legalize same-sex marriage, many European countries did this after, like Germany, for instance. Italy just recognized same-sex "unions" in 2016, and still does not have same sex marriage. I guess my point is countries outside the US are actually not as LGBT friendly as they are portrayed to be in the media.

Unionized US State School Grad

Thank you for your questions, Amanda.

1. As you suggested, we have an out-patient only student health center as well as a large university hospital system that serves the surrounding community. I was calling the entire thing “university facilities”, but this was too vague. I could see people seeking other types of specialized care falling through the cracks even though the hospital system is relatively extensive.

2. Prior to grad school, I had insurance that covered transition-related care in a region where there were many available providers. When choosing which grad school to go to, I made sure that I continued to have such coverage. However, I did not anticipate how little availability there would be. This isn’t a fact a quick google search is likely to reveal — it took me many phone calls and office visits to figure this out. I hope I didn’t imply that "leaving philosophy is the best way to get transition care covered”. It is likely true in my case that I could have much better care if I left given what part of the world I am from and given I would be able to find a job comparable to the one I had before grad school. But geographic location and employment alternatives are considerations that factor into any calculation of the opportunity costs of grad school.

3. I am sorry if I came off as making light of the difficulties trans people have accessing affirming care in other contexts. I tried to describe my experience with the private health insurance system and, thinking globally, I don’t doubt for a second that I have it relatively good. I am also fairly certain I have it good even in comparison to other trans grad students in the US based on the few others I know. I hope others chime in and we can discuss how to make it better for everyone!

Amanda

Thanks Unionized Grad Student, that is helpful. We have a long way to go with these things, but, to look at things positively for at least a bit, the changes that have happened in just the last 10 years are really incredible. Hopefully we will keep going along at this pace.

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