Reading Trans-Health/Reading Race War

I had saved this article in my archives and just recently re-read. I am posting here for others to read. Piece is by michelle o’brien

Reading Trans-Health/
Reading Race War
Trans health organizing and neocolonial capital
Michelle O’Brien, May 2003
Thanks goes out to the organizers of Philadelphia’s 2 nd Annual Trans Health
Conference, especially Jaci Adams and Rick Feeley. Gratitude to Dean Spade
for much of my analysis. And serious props to the girls working the streets,
from San Salvador to London, Bangkok to Philly.
Recently I was involved in the organizing of Philadelphia’s 2 nd Annual
Trans-Health Conference this May of 2003. Drawing about a hundred and
fifty people, the one-day free conference offered a space for transgender
people, health care providers, social service workers and trans allies to
share knowledge, develop relationships and address the ongoing
concerns of affordable, respectful and accessible healthcare for trans
communities. The small conference organizing committee reflected a
mixed, cross-racial and cross-class group of trans people and close
community allies. Several of us had worked closely together in organizing
a memorial for Nizah Morris, a trans woman murdered in Philadelphia in
December.
In this article I situate this conference across multiple political and social
contexts. This event is located in ongoing struggles in Philadelphia over
healthcare and survival in trans communities. These ongoing struggles, in
turn, are embedded in the restructuring of transnational capital and
intensifying white supremacist, transphobic violence globally. Tracing
across the conference battles over power, domination and survival, I’m
trying to articulate a vision of healthcare possible within the emerging
grounds of revolutionary struggle.
transient possibilities
The success of this trans health conference reflects three major
developments in recent Philadelphia politics: the growing interest in trans
issues among social service providers, the momentary and localized
increase in federal funding available for trans-focused health care
programs and the developing solidarity between trans communities in the
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city.
The first two are closely related. Our conference was comparatively well-
attended. Several social service and health care agencies in Philadelphia
have been restructuring policies to promote trans inclusion and trans
awareness in their work. Due to both community pressure and new
funding, there is a small growth in trans health programs around the city.
We were able to make this conference free due to funding from Ryan
White Funds - Federal money allocated for social service and healthcare
for people living with HIV/AIDS. Within Philadelphia, it’s rumored that
trans issues are ‘hot’, and worth incorporating into some agency plans.
While few to none of these agencies are trans run, or substantively
accountable to trans communities, there are a few new programs on the
horizon.
Why, then, is the federal and regional governments and these agencies
supporting trans healthcare? We are living in a culture of hatred and
ongoing violence against trans people. Medical and social service
agencies have decades of neglect, disrespect and exclusion of trans
people behind them. And in its rapid right-wing plummet, our federal
government has increasingly reflected the ultraconservative linking of
rabid transphobia, white supremacy, homophobia and anti-poor polices.
The obvious answer to the question of funding for trans programs is that
it doesn’t really exist, and that the government doesn’t really care about
trans people. Our conference and a handful of new programs aside,
overwhelmingly most trans people in the U.S. continue to face extreme
poverty, rampant levels of HIV infection among trans women, grossly
inadequate healthcare and a wide range of social injustices actively
supported by federal and local government regimes. In many cities I have
heard of a drastic reduction of funding available for trans programs; this
funding is strictly local and regional in scope. Here in Philly several trans-
related health programs were underfunded in the most recent round of
grants.
But this limited amount of local money available is worth looking at more
closely. On a more optimistic note, these new resources reflect advocacy
work pushed over the last decade by trans activists, service workers and
community members working within agencies and out in the streets.
These activists have drawn attention to the ongoing social crises of
inadequate healthcare and social oppression of trans people in
Philadelphia. Needs assessments, tireless street outreach, endless
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meetings and a whole range of strategies deployed outside of any
bureaucratic infrastructure have slowly pushed agencies and funders to
take trans health care seriously.
Trans people are not the only hated and marginalized population
momentarily benefiting from highly limited social service care. A friend
working at the local needle exchange commented on programs for
intravenous drug users. Widespread bans on needle exchanges and the
baring of all federal and state funds for needle exchange work aside,
there are a handful of cities where needle exchanges are funded. This
funding is not due to the ruling class caring about poor drug users - they
are funded to the limited extent they are because HIV has become so
politically charged, such an immediate reference of social justice, that for
the moment it makes political sense to not completely write off all people
facing HIV infection.
The recent small growth of trans health programs is due, in part, to this
same history. Activists and social service workers have documented the
high rates of HIV infection among poor trans women. Through direct
action, mass mobilization, media campaigns, advocacy and grassroots
organizing AIDS activism through the 80s and 90s was able to force AIDS
into public attention. Despite facing deep transphobia, homophobia,
racism and hatred of the poor and drug users, AIDS activists were able to
link HIV/AIDS to social justice, creating the political pressure to force
limited federal and regional funding of services for communities facing
AIDS.
It’s worth emphasizing, however, both the tentative nature of these
resources and their cost. Trans health and education programs that
depend on an extreme right government regime and the beneficent of
transphobic bureaucracies could lose their funding anytime. Further,
these relationships of financial dependency create relationships of
accountability to government agencies that rarely understand or care
about the well-being of poor trans communities. A few years ago several
Philadelphia health service workers embezzled a substantial sum
allocated for Black trans youth. The story is just now coming out, a
scandal in the gay press. Like several programs today that are
notoriously ineffective in meeting their stated objectives of serving trans
people, these examples underscore the dire consequences when
accountability goes up to the government, and not down to the poor
communities themselves. Accountability to government agencies runs
directly counter to meeting the real needs or substantively empowering
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trans people themselves.
developing relationships, confronting brutality
Philadelphia’s Trans-Health Conference was not only possible because of
this hard-won wrinkle in funding, but also because of the specific
character of the organizing committee. Philadelphia trans politics have
been long characterized by extreme racial and class division - deep,
insurmountable splits between suburban white heterosexual cross
dressers and center city African-American trans sex workers, between
young white punk transmen and femme queen vogue dancers, between
successful professionals and trans people in prisons, in inpatient facilities
or on the streets. While we certainly grappled (and failed to grapple) with
racism and classism within the group, the organizing committee reflected
a mix of trans people from a range of very different trans communities.
This was possible, it was clear to all of us, from organizing a few months
before. Just before Christmas in center city Philadelphia Nizah Morris was
murdered. Nizah was well known as a performer, loved member of her
family, and as a mentor for other African-American trans women. While
the circumstances are far from clear and I won’t go into detail about them
here, there is a great deal about the police stories from that night that
are extremely dubious. These suspicions of police culpability are
buttressed by less deniable truths: the media and police response to
Nizah’s death reflected extreme racism, transphobia and negligent
hatred.
Weeks later the police still refused to investigate Nizah’s death, or to
classify it as a murder. Media coverage horribly misidentified Nizah as a
male prostitute, and made repeated unsubstantiated accusations of
illegal drug use. Nizah family, and many throughout trans and gay Black
communities in Philadelphia, were offended and outraged with the media
and police.
We put together a coalition of individuals and groups to organize a large
memorial for Nizah. The organizing was extraordinary. Trans people
managed to maintain consistent leadership, with a working-class African-
American trans woman from Nizah’s community taking the main leadership
role. It was the first time anyone remembers Black and White trans
people working effectively together in Philadelphia. With the participation
of Nizah’s family, we drew from the support of many communities and
organizations around Philadelphia and put together a widely-publicized
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and powerful memorial drawing over 300 people.
The event had a major impact on the police and media response to her
death. News coverage improved dramatically, with one gay newspaper
which had previously run offensive articles started taking on the story
and critically challenging police around Nizah’s murder. Police finally began
an investigation of sorts, classifying the death (six weeks later) as a
homocide. Now the District Attorney is involved with an investigation of
their own.
More importantly, we managed to build some strong relationships
between divided trans communities. A number of us who had worked
together on Nizah’s death came together again to plan the trans health
conference.
race, class and violence
Nizah’s death was far from an isolated instance. Philadelphia have a long
history of extreme police brutality focused against the city’s poor African-
American residents. The more publicized police terror against Black
liberationists Mumia Abu-Jamal and the M.O.V.E. family are just a part of
the larger violent war that has been waged over decades against poor
Black Philadelphians by the police department.
This war is particularly vicious for poor trans and gay people of color in
Philadelphia. Nizah is one in a long, long list of trans and gay Black people
who have died either at the hands of police, or died under circumstances
that the police have been unable or unwilling to effectively respond to. In
‘the gayborhood’ - the neighborhood of Philadelphia known for gay
people - police harassment of poor Black gay and trans people, especially
sex workers, is constant. As a social service worker and support group
facilitator, I’ve heard more than my fair share of stories of trans people
raped repeatedly and otherwise brutalized by police.
Given the scale of the brutality, there is remarkably little public, above-
ground anti-police brutality organizing. In planning the memorial for
Nizah, at one point someone proposed taking our march to the 6 th
Precinct, a police station notorious for anti-trans violence. In a few
minutes of discussion, though, it became clear that many people in the
room, especially African-American trans women, couldn’t personally afford
the inevitable fall-out of harassment that would result from such a
protest. While some White residents might disagree, it is a taken for
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granted that you don’t organize against the police in Philadelphia
because if you do they will just kill you.
There are two organizations in Philadelphia that have been extremely
successful in linking the racist wars within our city to a broader regional
and global context: International Concerned Family and Friends of Mumia,
and Philadelphia AIDS Coalition To Unleash Power (ACT-UP). Intl.
Concerned has spearheaded a massive global movement to free death
row political prisoner and activist Mumia Abu-Jamal. They’ve been
successful at linking Mumia’s struggle for freedom and survival to a
broader context of white supremacist violence globally and to a wide
range of other social justice struggles and oppressed communities. I
remember from years back Italian autonomous Communists explaining to
me in a squatted social center why they took Mumia’s plight seriously.
They saw it as inseparable from their own struggles against neoliberalism
and state terrorism in Italy.
Philadelphia ACT-UP has successfully linked the struggles faced by poor
people living with AIDS in Philadelphia, especially African-Americans and
people in prisons, with the global struggle over access to AIDS drugs in
developing countries. With protests on the streets of Philadelphia, or
sending activists to international trade conferences in Quatar, Philly ACT-
UP has made it clear that what is happening on the ground here is part of
a much deeper, much bigger global struggle over health, power, race and
sexuality.
I locate Nizah’s murder and the police and media response to her death
in a similar understanding of the transnational interconnections of white
supremacy and transphobia. The current United States building of right-
wing puppet corporate governments in post-invasion Afghanistan and
Iraq and the U.S.-funded wars in the Philippines, Columbia and Palestine
are just the more visible manifestations of a much deeper war. We are
witnessing a massive consolidation of global wealth linked to a dramatic
intensification of U.S. white-supremacist imperial violence across the
world. The economic, cultural and social survival of hundreds of millions of
poor people of color around the globe is in crises, as the empire of global
capital is restructuring economies, governments, and societies with rapid
ferocity.
reorganizing neocolonial capital
The needs of transnational capital and profit have placed high demands
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on the organization of governments throughout the world. The new
neoliberal states that are forming through IMF restructuring have actively
pushed racist and classist polices, including mass incarceration, forced
consolidation of peasant land, crushing of labor and social justice
movements and a hyper-militerization of society. These polices also have
especially profound and terrifying consequences for transgender and
gender variant people. Trans people are among the most swiftly
displaced and terrorized in the economic disintegration and political
brutalization of neoliberal society in many countries across the globe.
In Guatemala in the mid-90s, for instance, the U.S. began to deescalate
the war it had been waging with the help of a military dictatorship against
the country’s social justice movements and indigenous peasant
populations. After decades of scorched earth, death squads and mass
concentration camps, it became politically expedient to make Guatemala
into a more stable society that could support the construction of
maquiladoras - ultra-exploitative industrial manufacturing centers for
clothing - in a previously predominantly agrarian economy. So the
government signed a few peace treaties, disarmed the guerrilla groups,
and hired most of its army as security guards. Meanwhile the only death
squads that continue to operate in Guatemala City are not targeting
social justice activists or ex-guerrilla politicos (although both could face
such violence if there were again political movements threatening capital
in the country); instead these death squads are primarily targeting trans
sex workers. Like several other central American cities - San Cristobal de
Las Casas, San Salvador, Panama City - the last few years have been
marked by a dramatic escalation of paramilitary violence against the city’s
poor trans people.
Here in the United States such links are obvious to anyone looking. In the
agendas of the New Right, whether we are talking about Ronald Reagan
or George W. Bush, transphobia, homophobia and racism are intimately
linked. Extreme sexual and gender normativity, enforced throughout the
state’s policies, are deeply interwoven with the intensification of white
supremacy through the prison system, in exclusions from higher
education or in the gutting of social services. To take one example from
many, trans people face discrimination in immigration policy - bars to
immigrants living with HIV, wide personal discretion given to transphobic
immigrant officials, inadequate asylum rights to trans people and
systematic violence against trans people in INS detention facilities — all
are embedded in a structure that is racist to its core, targeting immigrants
of color.
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Nizah’s death is deeply wrapped up in this ongoing reality of racist and
transphobic violence institutionalized on all levels of state and corporate
policy. Perhaps a bit more subtly, so was our Trans Health Conference.
Returning to the work of ACT-UP Philadelphia and AIDS activism more
broadly, state violence doesn’t just take the form of death squads and C4
bombs dropped from police helicopters. It also manifests as institutional
neglect, poverty and poor healthcare. While many trans women have died
at the hands of Philadelphia police, far more have died of AIDS in a city
with grossly inadequate resources to address the health crises in poor
trans communities.
At its worse moments, our Trans Health Conference was just another
step in social services consolidating more resources for institutions that
are structurally transphobic and racist; another space for professionals
developing new strategies to document, trace, absorb and exploit a
community that has no say in the actual development, administration and
management of agencies that can virtually run our lives. But at its best
moments the Conference was also a site of this broader and deeper
revolutionary challenge to an institutionalized hatred of trans people that
is a component to a neocolonial capitalism waging wars against poor
people of color across the globe; a space for trans people to organize to
claim self-determination in a society that works to systematically rob of us
of control over own bodies.
social services and accountability
In closing I want to focus a bit more on the difference between these two
characterizations of this Conference and health organizing - as
oppressive and as liberating. Social services occupy a particular position
in post-1960s capitalism. Capitalism consistently produces large numbers
of poor people. Up until recently, ruling classes in industrialized countries
mostly recognized that overall capital could benefit from the proper social
management and social control of the poor. Some of the institutions
charged with this task are obviously coercive - police, military, prisons.
Others have a far more complex effect, tracking and financially supporting
the lives of poor people. Through the 1960s a whole class of social
workers took on new prominence. Largely middle class professionals,
social workers were called on to work closely around understanding,
managing and benefiting the lives of poor people. This increases overall
social stability, cuts down on violent social uprisings that marred the
1960s and is significantly cheaper than its close compliment of
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incarceration.
Social workers also occupy a specific ideological position - advancing an
understanding of liberalism that has had a major impact in defining and
limiting the terms of the American political Left. It has been decades since
a substantive revolutionary, or even working class, politics had held sway
on the national US political terrain. Instead the most progressive side of
policy debates has been held by a form of liberalism the reflects a great
deal of the positioning of social workers: concerned with the plight of the
poor, but unaccountable, privileged and patronizing.
More recently, social services have clearly become less crucial to
neoliberal capitalism, as such programs face drastic funding in most
industrialized and many developing countries. Welfare reform and similar
policies have shifted state’s role in poor people’s lives towards intensified
coercion, racism and violence. Still, however, social services place a crucial
political function.
As a social worker myself, I certainly don’t mean to overstate the politics
of individual people. The specific values, political commitments or
interpersonal graces of a particular case manager are not the point. This
is easily lost when I find coworkers taking critiques such of these
personally, acting offended because I am trying to talk critically about
class power as a structural and social system.
What’s key about social work as an institution comes down not to the
values of individuals, but to the structure itself: ultimately, nearly all social
workers and low-income health care workers are not accountable to the
communities they serve. We are structurally accountable solely to our
funders, usually the federal government and other ruling class social
institutions. Whatever my values, as a social worker at the end of the day
I answer to my boss, who answers to others up a hierarchy that leads
directly to the U.S. Center for Disease Control, the Bush administration
and the ruling class.
Like all structures, this organization of power and accountability is not
absolute - we have client feedback groups, we have complaining clients
who we might listen to. We are able to make some decisions of our own
within the terms the CDC provides. Sometimes we even break rules to
serve people we work with. But nevertheless the absence of any
structural accountability between social service or low-income health
workers and the marginalized populations they work with has profound
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and far-reaching consequences.
For trans people, these consequences are particularly dire. Many social
service providers are intensely transphobic, enforcing offensive,
exclusionary and discriminatory policies on trans people. Many others
grossly misunderstand the complexities, identities and experiences of
trans people lives. Few trans people end up in policy-making and
administrative positions in any agencies. The handful of trans people that
do make it into these institutions usually have very little clout, and come
from more privileged economic classes than most trans people accessing
social services. Further, many trans people are forced to access social
service and healthcare in disproportionately high rates due to
transitioning needs and HIV care. These factors all contribute to a large
number of trans people in desperate need of medical care and financial
stability, who then face systematic oppression when they turn to social
services to meet those needs.
There are many legitimate ideas challenging this situation presented at
the Trans Health Conference and among trans health activists in the city.
We are educating social service workers on trans issues; we are working
to build networks between trans allies in social service work and trans
people; we are trying to develop networks of interpersonal support
between trans communities; we are promoting an increase in trans-
specific social service care. All these things are great, and can be part of
significant and valuable changes.
serving democracy
Ultimately we need to situate these activities in a radical strategy of
transforming how accountability and control operate in our society. Rather
than just improve and fine-tune the machinery of capitalist social work,
we need to begin to push forward a vision of social services and
healthcare embedded in a commitment to a radically democratic and
economically just society. Doing so can’t just happen with the work of
well-intentioned professionals; it calls on broad movements led by poor
people radically transforming how power, wealth and control function.
We can begin, in part, by building structures of accountability in current
social service and health care institutions. Feedback groups that have
some teeth; working-class trans people making it onto executive boards
and into administration positions; advisory groups that are listened to
and substantively reflect the communities being served; grassroots
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organizing among diverse trans communities to put collective, strategic
pressure on agencies that are not meeting our needs or accountable to
our communities. These are all excellent steps in establishing limited
forms of accountability in the short-term within social service and
healthcare institutions.
In the long term, we need to radically restructure the social function of
social service institutions. We need to establish forms of overall structural
accountability where funding doesn’t come from a racist, transphobic
ruling class, where capital doesn’t produce systematic poverty and then
control the means to manage it. Across the globe poor people are fighting
a war for survival. This war ultimately calls on us to be committed to
abolishing the structures of capitalism, state violence, class-exploitation
and imperial white-supremacy that lie at the heart of all trans politics. Our
liberation, as trans people in Philadelphia from various classes crowding
into an empty high-school on a Saturday morning for a conference, is
intimately bound up with the survival and resistance of poor people
across this city and across the globe.
This text is posted on the author’s website, at www.deadletters.biz. The
author can be reached through her site.
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