During the month of June, I had two root canals, a filling and a tooth extraction. Only the first root canal was planned, the rest were either emergency events (the tooth extraction for a broken canine tooth) or urgent events (the filling and the second root canal).
Ouch.
In August, I’m currently scheduled to receive two crowns and a bridge; still to be scheduled is a dental implant.
The Veterans Health Administration (VHA), part of the Veterans Administration (VA), is covering my dental care. This is because I’m a disabled Persian Gulf War veteran; this is because when I was evaluated by the VA, I received a 100 percent VA Disability Rating – Service Connected.
Because I’m a Navy, 20-year retiree and disabled veteran, I fell into a huge safety net. I’m grateful for that safety net.
I’m not unique in being a transgender veteran accessing health care through the VHA.
So questions I’m sometimes asked are, “How many transgender veterans are accessing the VA health care system?” and, “What kind of health care are transgender veterans accessing?”
Nobody really knows. There has been no systematic, mandated collection of health care assessment data related to sexual orientation or gender identity of patients.
On Wednesday, June 29, Secretary of the Department of Health and Human Services Kathleen Sebelius announced that the department is going to begin collecting data on lesbian, gay, bisexual and trans people. For trans people! To begin counting and collecting data on trans people. This is in accordance with SEC 4302. (Understanding Health Disparities: Data Collection and Analysis) of the Affordable Healthcare Act.
The National Center for Transgender Equality (NCTE) described how this is going to impact transgender people in this way:
• Public health data has never really been collected by the federal government.
• Federal public health data is the gold standard in public health data.
• Without such data, getting the federal government to focus on a public health problem is extremely difficult or impossible.
• Soon (or at least in a few years), we will have good public health data we can use to advocate with the federal government for programmatic focus on trans health disparities.
Mara Keisling, the executive director of NCTE, added, “In other words, if there is no federal population-based study data identifying and quantifying a public health issue, there will be no governmental focus to solve it. Because of the HHS announcement (on June 29), there will soon be federal population-based public health data on a variety of trans public health issues.”
NCTE reports that the timeline, as it currently stands, to collect data related to gender identity and sexual orientation is:
• June – December 2011: Continue cognitive testing and begin field testing of sexual orientation data collection.
• Summer 2011: Conduct first roundtable on gender identity data collection. Development. Complete initial development of sexual orientation data collection questionnaire.
• Winter 2011: Conduct follow-up roundtable on gender identity data collection.
• Spring 2012 Conduct and complete initial field testing of sexual orientation data collection. HHS Data Council presents a strategy to include gender identity data collection in HHS surveys.
• Winter 2012: Conduct and complete large scale field test of sexual orientation data collection.
• 2013: If the field test is successful, implement new data collection on sexual orientation into the full NHIS data collection.
NCTE identified who was instrumental in getting this initiative started: “NCTE and our allies have been working with the administration for several years to get to this point. We especially thank the Coalition for LGBT Health, the Center for American Progress, the Williams Institute, the Network for LGBT Health Equity and a lot of individual researchers for this important work.”
NCTE also thanked Secretary Sebelius.
I wholeheartedly agree with Mara Keisling’s conclusion about this HHS initiative: “This is a big deal.”
I have no idea if the VA will follow suit in collecting data on lesbian, gay, bisexual and transgender patients, but it is something that this HHS data collection plan could easily spur discussion about data collection within the VA. Frankly, I believe that it would also be extremely helpful to collect data on actual trans people accessing health care, and what health care outside of transgender specific care (specific care such as endocrinology and mental health services related to hormones and transition) they are actually accessing.
Who knows, my teeth might even be interesting to health care data collectors.
There is no doubt that the Obama Administration has been the most forward thinking and action oriented presidential administration, ever. I’m personally looking forward to what comes next from this administration. It seems to me to be just one “big deal” after another for trans people. It’s as if we’re being considered to be American citizens.
