March 20th, 2020
Office of Governor Gavin Newsom
Department of Public Health
Department of Healthcare Services
Department of Social Services
California Department of Corrections and Rehabilitation
Dear Governor Gavin Newsom and Related State Departments,
The coronavirus (COVID-19) pandemic has increased rapidly, which has left community members alarmed far and wide. As a coalition of transgender-led organizations working to provide much needed services and resources, we represent a community most impacted by COVID-19. As a state, it is important for California to acknowledge and advocate for one of the most marginalized and underrepresented communities: the transgender, gender non-conforming, and intersex (TGI) community. What coronavirus has revealed to the wider public is what is already experienced by the TGI community, which is a lack of resources. In a time that we are met with emergency and scarcity, we are seeing the effects of a society that has historically failed to address the many-specific needs of TGI people.
TGI people experience significant barriers in society that have only been exacerbated by the coronavirus. Houselessness, economic instability, and difficulties in accessing health care are only a few of the barriers that have been deepened during the world’s response to the pandemic. Discrimination runs rampant in the lives of trans people regularly, especially for those that identify as people of color. Navigating society, TGI people are often met with ridicule and ignorance, attributed to a lack of understanding and deeply rooted stigma toward gender identities other than cisgender identities. Because of these discriminatory mindsets, this often leads to a lack of access to many of the social determinants of health for TGI people. COVID-19 is not only impacting the literal medical and physical health of trans people, but the financial, spiritual, and mental health as well. What COVID-19 means for trans people is uncertainty and scarcity, in deeper ways than are felt on a daily basis.
The Williams Institute estimates that in the state of California, approximately 220,000 individuals identify as Transgender. TGI people, especially transgender women of color, experience unemployment and poverty at higher rates than the general population. The report The State of Transgender California conducted by The Transgender Law Center in 2008 highlights that “transgender Californians surveyed experience unemployment and poverty at twice the state average. One in four earn wages below the national poverty level. Almost half report some loss of employment as a result of their gender identity.” This report also states that 30% of transgender Californians reported that they have postponed care for illness or preventive care due to disrespect or discrimination from doctors or other health care providers. Over 40% did so because of economic barriers.
In the United States Transgender Survey (USTS) where nearly 28,000 transgender individuals in the United States participated, nearly one-third (29%) of respondents were living in poverty and almost 50% reported have been victims of sexual assault. Many members of the TGI community find ourselves in dire economic situations due to the combination of discrimination accessing life saving and supportive services in emergency and permanent housing, workforce and economic development, health care, mental health, education and spiritual and religious places. Due to these disparities that our community constantly faces in our society, we are forced to engage in underground work which is necessary and vital means of survival, . Gaining income and ensuring financial stability is difficult as a TGI person, which only creates more barriers to society, especially in the midst of COVID-19.
As cities, counties, state, and national governments implement emergency policies to combat and prevent the spread of Coronavirus, we must be intentional and critical about how these policies address the needs of all people. The structural and institutional change that must occur to counter these barriers means an investment in trans-led organizations and services, those that are tailored to address the specific needs of TGI people, that take into account gender identity and expression in the ability to access resources, and celebrate the dissidence and variance in these identities and experiences. Because of a lack of services tailored to serve the trans community, this makes this moment especially isolating and difficult. Our coalition proposes the creation of an Emergency Transgender Wellness and Equity Fund, that would help address the immediate needs of TGI people in the midst of COVID-19, but would also help to create long-term services that would prevent the drastic impact on our community in the midst of crisis in the future.
In order to address these disparities in our community, there must be opportunities facilitated by our Governor’s administration, provided in these recommendations below:
Housing:
Housing is a major worry for TGI people and brings light to larger issues of tenant rights, land ownership, and need for resources to address intersecting determinants of health. TGI people, especially Trans Women of Color, are pushed to living in the streets by discrimination, family and social exclusion or an unsafe mental health environment. Emergency housing shelters or transitional living homes are one option for support. However, many facilities are sex segregated or hold religious beliefs against TGI people. This makes accessing housing and shelter during quarantine difficult.Fund trans-led organizations to Provide financial assistance vouchers designated for TGI people to access motels, hotels, and to address the need for safe emergency housing options.
Create emergency housing options entirely for TGI people during quarantine, such as repurposing abandoned buildings or empty property. California can allocate state owned properties and lease these to trans led organizations create emergency housing options.
In the long-term, there is a need for trans-led organizations to have opportunities to create TGI-designated land projects with clean energy, water, and resources, which will address the many barriers TGI people face in attempting to achieve stability. These projects would provide emergency housing, permanent housing assistance and beds, medical and mental health services, legal services, workforce development, substance use treatment, re-entry assistance, anti-violence programs, and peer support groups.
Employment and Economic Stability
For TGI people—many of whom face significant challenges in the workplace and are unemployed, are freelancers, and are constantly seeking work as independent contractors—the widespread cancellations of conferences, speaking engagements, and other related events have left many TGI people with lost income. This makes it difficult to pay rent, pay for care, and most importantly to survive.
The state government should enact emergency policies that prevent evictions and provide flexibility in paying bills until quarantines are lifted and the effects of COVID-19 subside.
Due to the high unemployment rate, an emergency fund should be made available to provide financial assistance to unemployed, houseless, and disabled TGI people to address barriers to employment. This should be made available to TGI people with recent and non-recent work history, those in the entertainment industry, and those living below the poverty line.
For those that are employed, paid sick leave and paid time off should be available and should be extended to all employees, including those with temporary/part-time employment status.
Financial relief should especially be provided to undocumented trans people who have layered difficulties in accessing employment. There are many barriers faced when attempting to gain a work permit, especially when released from immigration detention. Given the COVID-19 pandemic, undocumented people are among the most impacted by a lack of financial stability.
Healthcare
On top of the structural and institutional barriers that TGI people are continually facing, there are are transition-related reasons that make transgender people particularly susceptible to the coronavirus. Because of the lack of access to the institutions that are crucial in people’s survival, transgender people often are at higher risk and experience higher rates of cancer and HIV, both of which can compromise a person’s immune system and make someone more vulnerable to COVID-19.Prescriptions for transition-related care or medical care for TGI people should stay available during COVID-19 restrictions under essential health care and should be discounted or free of cost to ensure that the health needs of TGI people are addressed in COVID-19.
There have also been widespread cancellations of Gender affirming surgeries due to COVID-19. Cancellations of life-saving gender affirming surgeries should be a last resort, and if needed, postponed with the intent of rescheduling within the next 30 days.
Incarceration and Re-entry
Transgender, Gender non-conforming, and Intersex (TGI) people experience encounters with the criminal justice system at significantly high rates, particularly for reasons related to their identities. Primarily due to racial profiling, the criminalization of poverty, and lack of public awareness about trans identities, TGI people are frequently incarcerated. TGI people being held in incarceration settings, who are even further at the margins, are particularly susceptible to catching coronavirus. Jails and prisons already do not provide adequate medical care to TGI people, especially in regard to gender affirming medical care. Because of the inadequate care provided in jails and prisons, TGI people are suffering in overcrowded facilities and without the needed resources to combat the virus. Organizations across the country are calling for the release of incarcerated people in the midst of COVID-19 to prevent the virus from spreading, and amongst the population that is in need of decarceration, TGI people in custody are at a tremendously high risk.
The following TGI populations should be released with all haste:
People over the age of 50
Vulnerable populations according to CDC, including people who have serious chronic medical conditions like:
Asthma
Cancer
Heart disease
Diabetes
Lung disease
People living with HIV
Pregnant people
People with less than 6 months left on their sentence
Anyone else who does not pose a serious safety risk to the community upon release.
The prison population should be reduced so that there is no unnecessary threat to the health and safety of incarcerated TGI people who remain in the facility. A sufficient reduction requires capacity is such that cells are not shared and there are sufficient medical beds. Similar populations of non-TGI people should be released to reduce the number of people in the facility, unless there is clear evidence that release would present an unreasonable risk to the physical safety of the community.
Phone calls, video calls, and other forms of communications should be made available free of cost for people to stay in touch with their loved ones.
Prisons should provide soap, CDC-recommended hand sanitizer, comprehensive sanitation and cleaning of facilities, and other safety measures as recommended by the CDC for those who remain incarcerated. Water must not be shut off and soap and other sanitizers must not be denied to anyone for any reason. Sanitization products should be provided at no cost to the people incarcerated in the facility.
People should not be held in isolated confinement as an alternative for adequate medical care.
Quality health-care to all persons in custody should be provided, including transferring to a hospital any person who is too ill for medical staff to effectively treat.
Prison employees should immediately be tested for COVID-19, and those employees who test positive or whose family or household members test positive should be placed on paid sick leave. Any prison employees who were unable to maintain a safe social distance from those who test positive due to the nature of their work (shared offices, etc.) must be placed on paid sick leave, as well. Any incarcerated people exposed to those who test positive should be given access to testing and quality medical care.
California should invest in creating a long term gender-responsive re-entry programs for TGI people coming out of jail and prison.
California should release to the public the existing plan and procedures in place to address COVID-19 within its prisons.
Many TGI people are being held in detention centers as Immigration and Customs Enforcement (ICE) continues to arrest TGI people and place them in dangerous conditions. We call for California to demand an end to ICE arrests and call for the release of all TGI people in ICE custody.
COVID-19 has only enhanced the difficult realities for many TGI people, in both rural and urban areas. We must ensure that all of these efforts take into account TGI people, especially TGI people of color, and how this virus is impacting this community the most. These recommendations will save lives in both the short- and long-term and California must make an investment in supporting it’s most marginalized communities.
We hope to receive a response from you in the week of March 23rd and we assure to follow up to ensure action is taken.
Signed,
TransLatin@ Coalition
Unique Women’s Coalition
Transgender, Gender Variant, Intersex Justice Project
Transgender Health and Wellness Center
Gender Justice LA
Transgender Law Center
El/La Para TransLatinas