Neumannesque

Time to counter the U.S. attack on the transgender community:

From: Alena Neumann [mailto:neum0184@umn.edu]
Sent: Tuesday, August 02, 2011 7:06 PM
To: 'ASKPRI@state.gov'
Subject: Renunciation
Sensitivity: Private

If I were to travel of out of the country and sign an oath of renunciation due to transgender persecution experienced within and by the United States would that be considered duress or would it be honored?

Alena E Neumann
1780 130th Ave NE
Blaine, MN 55449
p: (415) 424-4967
m: (612) 991-4292
f: (701) 526-3358
e: neum0184@umn.edu

From: Alena Neumann [mailto:neum0184@umn.edu]
Sent: Tuesday, August 02, 2011 3:18 PM
To: 'Kathleen.Sebelius@hhs.gov'; 'COS_info@hhs.gov'; 'William.Schultz@hhs.gov'
Subject: WPATH SOC Compliance
Importance: High

Dear Secretary Sebelius:

HHS and operating divisions are out of compliance with current generally accepted standards of medical practice. The World Professional Association for Transgender Health (WPATH), recognized by the American Medical Association as the authority in this field, has published Standards of Care (SOC) for many years that must be observed under mandated insurance. Medicare's policy based in 1981 findings, standing by as states discriminate in Medicaid, very anemic or totally lacking research programs (e.g. NIH/NIMH), and so on can no longer be ignored. Recent data collection efforts, while appreciated, fall direly short of law. Please act immediately, as this case is highly actionable. The next correspondence is scheduled for September.

Sincerely,

Alena E Neumann
1780 130th Ave NE
Blaine, MN 55449
p: (415) 424-4967
m: (612) 991-4292
f: (701) 526-3358
e: neum0184@umn.edu

Alena Neumann
1780 130th Avenue NE
Blaine, MN 55449-4905
August 3, 2011

CMS FOIA Officer
Centers for Medicare & Medicaid Services
Mailstop N2-20-16
7500 Security Boulevard
Baltimore, MD 21244
Dear CMS FOIA Officer:

Under the Freedom of Information Act, 5 U.S.C. subsection 552, I am requesting access to all information/sources used to arrive at National Coverage Determination (NCD) for Transsexual Surgery (140.3).

In order to help you determine my status for the purpose of assessing fees, you should know that I am an individual seeking information for personal use and not for a commercial use.

I request a waiver of all fees for this request. Disclosure of the requested information to me is in the public interest because it is likely to contribute significantly to public understanding of the operations or activities of the government and is not primarily in my commercial interest. Digital documents/documentation are/is preferred, and can be sent to me at neum0184@umn.edu. Information will be made public through social media, human rights and social justice advocacy groups, blogging, etc.

If you have any questions about handling this request, you may telephone me at:

• home: (415) 424-4967
• mobile: (612) 991-4292
• fax: (701) 526-3358

Sincerely,

Alena Neumann

1. Revise policy and procedures (e.g. RM 10212.200 Changing Numident Data for Reasons other than Name Change) that effect transgender Americans so they are based on standards and recommendations of the World Professional Association for Transgender Health (WPATH), recognized by the American Medical Association as the authority in this field.
2. Immediately revise policy RM 10212.200 to be continuous with the US Department of
   State's policy guidelines regarding gender/sex change in passports and Consular Reports of Birth Abroad.

No reasonable explanation has been given as to why the policy conflicts with the Department of State's, so we also ask that a review of federal policy and procures be conducted across all federal agencies to make them continuous in this regard. Our pleas have been falling on deaf ears at the SSA, and legal action backed by national advocacy groups is close at hand. Please save everyone a great deal of aggravation with this nominal act of solidarity.

Our SINCEREST thanksl

Continuation of: Brain Banking

It seems to me you are saying that the Netherlands has more resources to research gender identity. This obviously isn't due to their higher GDP, so this calls out obvious discrimination. Is NIH, HHS, and the Obama administration saying it would be better for members of the transgender community to live and die in the Netherlands until the U.S. can muster equality? Why can't NIH even address possible agreements with the Netherlands Brain Bank?

Sincerely,

Alena E Neumann
1780 130th Ave NE
Blaine, MN 55449
p: (415) 424-4967
m: (612) 991-4292
f: (701) 526-3358
e: neum0184@umn.edu

From: Kaucher, Christine (NIH/NIMH) [E] [mailto:kaucherc@mail.nih.gov]
Sent: Monday, July 11, 2011 8:36 AM
To: 'neum0184@umn.edu'
Subject: RE: Brain Banking

Dear Alena:

Thank you for your e-mail to the National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH).

We appreciate the challenges for people with Gender Identity Disorder in getting the treatment they seek, but all of the U.S. brain banks that we are aware of only accept brain tissue from people with diagnosed major mental disorders. One of the challenges is getting a large enough number of donors to make it statistically powerful enough to do research. Banking tissues is very expensive and so resources have to be alotted where there is the best chance of collecting from enough donors to have statistically meaningful data. Gender Identify Disorder is an important area of research, but historically it has been difficult to attract large numbers of donors.

Regarding the health of people along the continuum of Gender Identity Disorder and those identified as Lesbian, Gay, Bisexual and Transgender, the Department of Health and Human Services has begun efforts to improve data gathering about the health of LGBT individuals, in response to the recommendations of the Institute of Medicine (IOM) Report on LGBT health. The IOM report was commissioned by NIH and can be found at http://www.iom.edu/Reports/2011/The-Health-of-Lesbian-Gay-Bisexual-and-Transgender-People.aspx. While we have a long way to go until data-gathering is up-to-speed and includes all relevant areas, such as the one you are concerned about, the effort has begun to recognize and address health disparities in this population. NIMH and NIH are also aware that there are individuals in categories beyond those named, as well as those who are questioning. You may be interested in recent announcements by the White House and HHS about these issues. Links to these announcements are below.

U.S. Department of Health and Human Services Recommended Actions to Improve the Health and Well-Being of Lesbian, Gay, Bisexual, and Transgender Communities
http://www.hhs.gov/secretary/about/lgbthealth.html

LGBT Pride Month at The White House
http://www.whitehouse.gov/blog/2011/06/29/lgbt-pride-month-white-house

Improving Data Collection for the LGBT Community
http://www.healthcare.gov/news/factsheets/lgbt06292011a.html

While we are aware that this does not directly address your concerns, we hope that these efforts will result in more health care attention paid to these issues, and more help becoming available. We hope this information is helpful.

Sincerely,

Christine Kaucher Cooper
Office of Science Policy, Planning and Communications
National Institute of Mental Health
National Institutes of Health
6001 Executive Blvd., Room 8184
Bethesda, MD 20892-9663
Phone: 301-443-4058
Email: kaucherc@mail.nih.gov

From: Alena Neumann [mailto:neum0184@umn.edu]
Sent: Tuesday, July 05, 2011 11:02 AM
To: 'NIHinfo@od.nih.gov'; 'nimhinfo@nih.gov'; 'info@minorityhealth.hhs.gov'
Cc: 'info@glma.org'
Subject: Brain Banking

I'm really tired of clinicians and physicians telling me they don't consider Gender Identity Disorder a mental illness, but won't take in off of the DSM until it's recognized as a medical condition so people are still able to get treatment. The Harvard Brain Tissue Resource Center says they cannot accept a tissue donation from me for transsexual research due to NIH. Why not, and is there any U.S. brain banks that I can designate the tissue be used for that purpose primarily or exclusively? I have contacted the Netherlands Brain Bank, who is leading in this research, but they say they cannot accept my brain due to lack of lack of agreements with pathologists in the U.S. If there are not any U.S. brain banks perhaps facilitating such agreements would be more practical. It seems to me this would be an obvious priority in health disparities for HHS and the current administration.

Sincerely,

Alena E Neumann
1780 130th Ave NE
Blaine, MN 55449
p: (415) 424-4967
m: (612) 991-4292
f: (701) 526-3358
e: neum0184@umn.edu

Continued at: RE: Brain Banking

Equal Opportunity Letter - 03 25 2011

I don't know what to do. The University has violated its own Equal Opportunity Statement, and the Office of Equal Opportunity and Affirmative Action has handed down a verdict that they have not. What do you think?

The University of Minnesota shall provide equal access to and opportunity in its programs, facilities, and employment without regard to race, color, creed, religion, national origin, gender, age, marital status, disability, public assistance status, veteran status, sexual orientation, gender identity, or gender expression.

The 2010-2011 Comprehensive Student Health Benefit Plan excludes:

Services for or related to sex transformation/gender reassignment surgery, sex hormones related to surgery, related preparation and follow-up treatment, care and counseling.

The American Medical Association says:

Whereas, Many health insurance plans categorically exclude coverage of mental health, medical, and surgical treatments for GID, even though many of these same treatments, such as psychotherapy, hormone therapy, breast augmentation and removal, hysterectomy, oophorectomy, orchiectomy, and salpingectomy, are often covered for other medical conditions; and

Whereas, The denial of these otherwise covered benefits for patients suffering from GID represents discrimination based solely on a patient's gender identity; and

Whereas, Delaying treatment for GID can cause and/or aggravate additional serious and expensive health problems, such as stress-related physical illnesses, depression, and substance abuse problems, which further endanger patients' health and strain the health care system; therefore be it

RESOLVED, That our American Medical Association support public and private health insurance coverage for treatment of gender identity disorder (New HOD Policy); and be it further

RESOLVED, That our AMA oppose categorical exclusions of coverage for treatment of gender identity disorder when prescribed by a physician. (Directive to Take Action)

While the failure to cover sex reassignment surgery in the Plan does not amount to a violation of University policy, it hinders the perception of the University as a place that supports all of its students. Additionally this exclusion could have a negative impact on the University's ability to promote itself as a welcoming and open community. This concludes the investigation into this matter.

Am I the only gopher embarrassed by that? Not only does it contradict all reason, but they contradict themselves!

Furthermore, I have been advised that the General Counsel's office for the U doesn't think there is a violation of the law. I cite Minnesota Statutes:

363A.03 DEFINITIONS.

Subd. 44. Sexual orientation.

"Sexual orientation" means having or being perceived as having an emotional, physical, or sexual attachment to another person without regard to the sex of that person or having or being perceived as having an orientation for such attachment, or having or being perceived as having a self-image or identity not traditionally associated with one's biological maleness or femaleness. "Sexual orientation" does not include a physical or sexual attachment to children by an adult.

363A.11 PUBLIC ACCOMMODATIONS.

Subdivision 1. Full and equal enjoyment of public accommodations.

(a) It is an unfair discriminatory practice:
(1) to deny any person the full and equal enjoyment of the goods, services, facilities, privileges, advantages, and accommodations of a place of public accommodation because of race, color, creed, religion, disability, national origin, marital status, sexual orientation, or sex, or for a company to discriminate in the access to, full utilization of, or benefit from service because of a person's disability.

Whether Gender Identity Disorder can be considered a disability is controversial in the transgender community, but the Minnesota Human Rights Commission has clearly stated that it can be. Minnesota law broken on two accounts: discrimination based on "sexual orientation" and discrimination based on disability.

The GLBTA office has gotten me to back off for now b/c they think this can be resolved through a joint committee, approved by the Vice Provost, between Boynton employees and members appointed by the GLBTA office to resolve the issue. On the other hand I'm getting legal advice from OutFront Minnesota saying I have a case that would stand up in court.

My gut is telling me this means war! What should I do? My health and possible survival is at stake here...