Street roots., May 20, 2016, Page 9, Image 9

News
P age 10
S tre e t R o o ts • M ay 2 0 -2 6 , 2 0 1 6
HEALTH, from page 9
“measurable outcomes,” a way of measuring
effectiveness, eh. Do you think anything is lost when
we talk about health care like that?
3-JLai It does matter. It has to do with the
quality of those services. A lot of the focus of the
ACA is on padenl-centered medical homes. That's,
what we have been doing for 30 years now. We
haw been developing medical homes for people
who are pretty much excluded anywhere else,.
(homes) that are compassionate and respectful, g
We look to what is achievable within the patient’s
own frame of reference. When we make a referral,
we fully recognize the Last* management (needed)
to help make that referral really work - that there
are warm handoffs, careful care transitions,
discharge planning so that one person moves
S o m one sort of provider to another.
A.W.:IWw#/foyoMf/unA»wrfitodi««#?ixiAis
twnhy - socially, politically -fo r the United States
to create universal health care?
J X ; ff’s thejMrfitical
companies and the for-profit health care ■
Igbviders. That's dear and simple, I think, to
anybody who looks at it. They command
somethinglike17o r 1 8 percentofthenation’s
economy. Somewhere between 20 and 30 percent
f i their profit goes into shareholder profit and
K h er wasteful administrative costs. Health
people in the country; It’s the 1 percent
defending itself.
A.W.: 7%a ntfemuy mte i# Tbrf/sW,
ndharWfesfCoast«fees,isfoiaerthan2 /wflreni.Jibe
rents/martefisintTEdi&/yfwHandfand/oiifsoreH
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capitalism
JJL: Absolutely. It’s capitalism run amok. Our
(Jconomy treats housing and health care as
commodities, as things to be bought or sold for -.
profit, not as the fundamental human right that
we. understand they are. They are necessary for
our survival. They’re so basic. I try to talk about
I Abraham Maslow’s needs hierarchy, Shelter, food
and clothing are right there at the bottom, before
you can advance economically or psychologically.
It’s a fundamental need that the capitalist system ;
does not accommodate willingly.
The McKinney-Vento act got passed in 1987 | | | j
because Mitch Snyder was starving himself to
death (in Washington, D.C.). Many people were
expressing a lot of outrage of this sudden influx of ’
hometesanesB when Reagan cut the HUD budget
by 75 percentWhatwe lack now is that sort of
powerful grassroots movement We need to see
: more on that political front around huusing. I
Rally for health care and housing
What: Rally for housing, supportive services and health
care, organized by the National Health Care for the
Homeless. The rally is open to the public.
When: 4:30-5:30 p.m. Thursday, June 2
Where: Directors Park, downtown Portland.
Portland's low-income clinics
pioneer safe health care
for transgender patients
BY AM ANDA WALDROUPE
Town Clinic, have been some of the first organizations
in Portland to adopt practices that make their clinics
safe and affirming for transgender people.
ours after the Obama administration’s May 13
Transgender people are disproportionately
announcement that public schools must allow
represented in the homeless population, especially
transgender students to use bathrooms
among homeless youth, where up to 40 percent of
corresponding to their gender identity, the
homeless youths identify as transgender or gender fluid
administration announced a second directive making it
- a mix of both traditional genders.
illegal for insurance companies to deny insurance
Rieke and others say that the basic
coverage and services based on their
mission of the Old Town Clinic - serving
gender identity.
"Inst like other
low-income people and people
The directive will make it easier for
traditionally un­
marginalized from society - made
transgender people to have the medical
dertreated groups,
changing the way the clinic’s staff
services and surgeries necessary to
transgender people communicates with transgender patients,
transition - including hormone
need to feel like the and some aspects of how care is
replacement therapy and sex
provided, a no-brainer.
reassignment surgery - covered by their system is consider«
“Just like other traditionally
insurance companies.
ing their existence/' undertreated groups, transgender people
Some insurance providers in Oregon
E O W Y N R IEK E, need to feel like the system is
already provide coverage for
A S S O C IA T E D IR E C T O R t i p
considering their existence,” Rieke said.
M E D IC A L C A R E A T O L D
transgender-related health care,
T O W N C L IN IC
Outside In opened Portland’s first
including the Oregon Health Plan, which
primary care clinic specifically designed
began offering transgender benefits last
to serve transgender people in 2004.
year.
Executive Director Kathy Oliver said
“Oregon has always been a leader and a state that
Outside In always made serving LGBT youths a
spearheads the health and wellness of transgender
priority since they made up such a large percentage of
people,” said Jazz McGinnis, the trans services
the homeless youth population. After a few years, she
coordinator for Outside In, a homeless youth service
noticed that “clients were focused more on gender
agency.
identity than sexual orientation.”
When McGinnis, who is transgender, heard the
She said she also noticed it “was a continually
Oregon Health Plan would cover transgender services,
growing
and expanding group.” Over time, the clinic,
he was overcome with a feeling that “my state felt like
which was operated by volunteers twice a month,
my life was important.”
began attracting a bigger client base.
“That was not a message I received from a
“Outside In was positioned in a place where we were
government agency before,” McGinnis said.
seeing a lot of marginalized folks for care,” McGinnis
Acceptance of transgender people and transgender
said. “Low-income, uninsured people or people living in
rights remains elusive in America, but nowhere can it
poverty (who were not homeless youths) began to
be more apparent - and heartbreaking for a
come to us. No one was doing trans-inclusive care.”
transgender person - than in the country’s health care
The effects of not receiving adequate care can be
system, where transgender people routinely face
devastating. Transgender people may not get the
discrimination, harassment, poor medical care or none
hormones or surgeries they need and they may avoid
at all.
receiving health care altogether, letting other diseases
“Very often, our health care system sticks with a
and illnesses go untreated.
gender binary and very little understanding of people
McGinnis said the problems transgender people
who experience a different gender identity than their
experience in trying to access care and develop a
sex assigned at birth,” said Eowyn Rieke, the associate
patient provider-relationship with a primary care doctor
director of medical care at Central City Concern’s Old
are “institutional as well as individual.”
Town Clinic.
The discomfort, discrimination and barriers to
It is all the more paradoxical given that transgender
accessing health care can start the moment a
people need the health care system to transition - a
transgender patient walks into a provider’s office.
step fundamental for transgender people to have an
Hospitals and clinics may prohibit people from using
identity and sense of self that reflects who they are.
bathrooms or changing rooms that correspond with
That critical intersection has prompted the National
their chosen gender.
Health Care For the Homeless Council to specifically
Medical forms ask patients to check a box that labels
address the issue during its national convention in
them as male or female. There is no place for a person
Portland at the end of May. Both Rieke and McGinnis
to say that they are transitioning or are gender fluid.
will speak before health care and homeless
“It’s uncomfortable for some people to answer that
professionals across the country.
question because their physical anatomy may not match
Social services in Portland that provide health care
to homeless people, such as Outside In and the Old
STAFF W R ITER
H
See TRANSGENDER, page 11