Trans/plant/portation

Roughly 72 percent of commencement speeches by graduating students begin with, “Here we are, we made it,” so I am wary of beginning there. Okay, I just made that statistic up off the top of my head. But congratulations are in order! Remember to take time to thank all of your people who supported you these last 18 months, because we all relied on someone for guidance, strength, ad hoc pep-squadding, and more. So thank you, Emile and Lucas, for being patient with me whenever I ran off to work on another school assignment, and thank you so much, Susanne, for always encouraging me and for all the extra labor you had to do while I was in this program.

Meanwhile, the public health sector is in the midst of many crises affecting individual, community, and population health. We are entering into these crises as professionals now, and we will be working in this chaotic environment, in a sector which is challenged by competing mental health needs, substance use disorders, infectious diseases, the rampages of climate change, and persistent health disparities. In listening to everyone’s final ILE presentations this week I was struck by how much the literature talks about system transformation but how little of it is actually happening.

I was working in public health before I entered this program, but I had previously felt like an outsider or an interloper. Now that I can put MPH after my name, and trust me, I already ordered new business cards, I’m not sure I feel very different about my location to the field. You may feel similarly, that you are too small to change large-scale outcomes around type II diabetes, maternal health for Black women, opioid overdose rates among unstably housed people, improving cancer diagnosis, increasing hepatitis B vaccination rates for Asian Amerians, or cleaning up neighborhood soils or particulate matter as industry just chugs more waste into the environment.

But there are more than two dozen of us in our cohort. We are not one person, we are many. Some of us will create new interventions and will show that they are more efficient at improving health than the last interventions, or as my older son would say, “take that, previous science!” Some of us will apply our training around prioritizing racial justice to our current professions, and that commitment will create ripple effects in our areas of influence. Others are moving into policy, and may re-orient the state or their region so that many lives at once will have better access to health care. None of us, in other words, are actually in this alone.

At our after-class toast on Thursday night, I asked those in attendance if the reasons you applied to the program were still your motivators at the end of the program. I was surprised to see unanimous agreement, although we talked about how much we’d learned, or we mentioned the new ideas we were incorporating into our vision of public health and how we wanted to interact with those visions. Enrolling in this program was a good thing we all did! I grant you permission, although of course you don’t need my permission, to reflect back from time to time on what called you to this field, whenever you think you need a reset. Depending on what part of the field you’ll work in, you might need to reflect more or less often. (As someone who works in HIV and substance use, I reflect quite OFTEN.) Or as my younger son said in the midst of COVID-19, “I just build LEGOs to reduce stress.”

If the work might be at times stressful, public health is also a brilliant conduit for opening up vital discussions around the consequences of unchecked privilege and their specific effects on population health. I can hardly think of a more relevant example than the extreme greed of the Sackler family. In their successful attempts to become billionaires, they manufactured a nationwide opioid dependence by promising they had created a non-addictive narcotic, Oxycontin, that would cure us all of pain forever, which led us directly annual to the 100,000 overdose deaths we see today. This week research was released showing that fully ten percent of Americans have a close familial relation who has died of an opioid overdose. That is just staggering.

This periscope into the whys of our health challenges is a fundamental strength public health work. Public health practitioners have sounded alarm bells on toxic waste sites like the Love Canal, they’ve called out cancer clusters, they routinely work through individual stories of trauma to identify the patient zero when tracking down infectious disease in a community, they assess unsafe food handling practices in the marketplace, and we all know, post-pandemic, that they quarantine people when needed to keep a community safe. My family and I were quarantined in 2013 when I brought pertussis to Walla Walla County after getting coughed on for two hours on a flight from LA, but that’s another story for another day. But the point is, public health has this history, not completely unproblematic history, of course, of linking A to B and of beginning important conversations around association and causation, in an effort to improve health, lives, and systems. And now we are a part of that history and practice. If we have critiques of those problematic elements, we also have the capacity to do the future work in public health differently, with those limitations in mind.

I’m so excited for the work we all will do. I know our contributions will not be small. They mostly won’t be easy, either, although I am here for the quick wins whenever they show up. Public health has been politicized, and I have been struck by the uneasy realization that there is no public health intervention that takes place outside of the political sphere. So dig in, you know why you want to do this work, and you are ready to tackle these big challenges. The cohorts of students ten, twenty years from now, ought to be looking at a robust history of declining disparities, because people like you and made a real difference. That’s what I wish for us all, brilliant ideas among servant leaders in public health who built relationships and made our lives better. Congratulations, colleagues! I’m proud of every single one of us.

Well, the last four years have been an adventure, I suppose. I ran for office in 2018 for the state house in my legislative district, and came in a distant second, but the experience itself was life-affirming. My kids got older and I no longer have any diaper duty. Susanne went through the tenure process and has settled in as an Associate Professor, and is working on her next book.

My book projects, on the other hand, are a bit . . . quiet. I have a full draft of the Unintentional sequel, but I have a POV issue to resolve, and an improved ending to write. I stopped trying to sell short stories when work got busy.

My work, well, that has grown, which makes sense, as it has been my focus these last four years. It’s no longer a sleepy little nonprofit with a tiny caseload. When I walked in the door in July 2010, I literally wiped up the dusty keyboard to a then 11-year-old iMac. Its memory was half-filled with photos and music files of Yanni, for no discernible reason. I mean, I guess some people really like Greek air flute music, or whatever. There were four employees, two of whom were extremely part-time, I was slotted for 20 hours a week, and one full-time case manager. We ran the whole deal on $180,000 a year.

These days the agency has an annual budget of $3.4M, 27 employees, 3 of whom are part-time advisory board members, 3 staff who are part-time, and the rest of whom are full-time. We’ve got somewhere on the order of 200 clients across half a dozen programs, and a vehicle fleet, which still blows my mind. Nobody’s computer is older than 3 years. But along with this growth has been a shift in the time I have to dedicate to writing, and that is a cost I am willing to bear a while longer. At some point though, I want to get back to it.

In the interim of 2018 and now my mother passed away, from appendix cancer that spread to her lungs. I spent roughly two-and-a-half months with her in that last year of her life. It was time well spent, but saying goodbye to her was the hardest thing I’ve ever done, by far. Double mastectomy and sex changes, and catching Lucas at his birth, and hearing that my Dad had died after the fact, saying goodbye was excruciating. And then she didn’t die, and I got to see her again! But when I left in early January 2019 (as opposed to leaving shortly before Christmas 2018), was the last time. Saying goodbye again was also painful, although somehow, slightly less so. I’m grateful she is no longer in pain.

The pandemic could be a great reason I stopped blogging, but of course that wouldn’t explain the first two years of my absence. I just ran out of time in the day as work became more involved. Years ago I jokingly said that my goal was to make the agency too complicated for me to run it anymore. Now I realize what a stupid thing that is to say. It’s definitely more complicated, and I’ve driven away at least one bookkeeper in the process, but I am still hard at the work, as is the staff.

But to be clear, the pandemic has been a trying time, as I know it has been for nearly everyone. I like many others try to mediate my risk on a daily basis, but I’m not wearing my mask as vigilantly as I once was. I do watch the transmission rates, for what that’s worth (I’m sure we are missing a lot of data and that the accuracy of the published transmission rates are no longer great). I get my boosters and last week the boys got their boosters. I still don’t get on a plane or run through the grocery store open-faced (like a sandwich). But I’d be lying if I said I wasn’t fatigued by it.

Once upon a time this blog was to communicate with my social fabric of friends as Susanne and I made our way across the continent from DC to Walla Walla. It became my lifeline to sanity as I faced two years of unemployment because nobody in Walla Walla would hire me (or Portland, or Seattle, for that matter) in the wake of the 2008 Great Recession. Now I am the job creator, a fine twist of fate. When I was writing, jobless, and looking to get noticed as an author this blog was a requirement oft-referred to by agents, none of whom contracted with me. Somehow I published two books anyway, and army-crawled my way through the publishing industry. Then this blog was part of my writerly persona.

Now? What now? I think time will tell. Speaking of time, I don’t have a lot of it, between work, a master’s program in public health, two tweens, and a beautiful spouse, but I will commit to at least one post a week, and see how it goes. I’ll have some unpublished stories on here, thoughts about the work I do, reflections on speculative fiction, and possibly some political posts, but honestly I’d like to focus on other topics for a while.

I hope you are well, and if you made it this far, welcome back.

Donald Trump and Hillary Clinton, from Wikimedia under a reuse license.

We began this week with the now-usual, unhelpful conversation about whether Donald Trump is a jerk for going on about a former Miss Universe and her weight and ethnicity. Lost in the noise around Alicia Machado’s value as a human being (Mary Matalin called her a “tart”), was the leering, grotesque womanizing personality of Trump, which Hillary Clinton framed for 100 million Americans in the first debate when she said:

And one of the worst things he said was about a woman in a beauty contest. He loves beauty contests, supporting them and hanging around them. And he called they woman “Ms. Piggy.” Then he called her “Ms. Housekeeping,” because she was Latina. Donald, she has a name.

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This is the transcript of my piece said during the vigil.

I’m sorry. I’m sorry that 47 years since the Stonewall Inn riots, 43 years since being gay was no longer listed as a mental disorder, and 13 years since the Supreme Court decriminalized being gay, that this tragedy at The Pulse nightclub in Orlando has occurred. I’m sorry that in the many years since Brandon Teena’s murder and Matthew Shepard’s murder and since Tyra Hunter was refused life-saving medical care, we are here tonight, mourning the loss of so many good people. I’m sorry because I thought that after the AIDS crisis where tens of thousands of gay men passed away while our leaders made inappropriate jokes, that we were moving through the worst of this hatred for us. I thought that the quiet anti-discrimination legislation enacted by more than twenty states, and that seeing marriage equality become the law of the land meant we were entering an era of acceptance. I thought my generation would be the last to face disparate levels of depression, suicide, unemployment, and harassment.

I was wrong. I am sorry.

I stand here tonight shocked—again—at how easy it seems to take away dozens of lives in the manner of a few minutes to a few hours. I stand here, wondering which of the hateful things I’ve heard over the past two decades may have lead to this moment. Was it the refusal by extremists to sign marriage licenses for gay and lesbian couples? Was it the preacher who interprets scripture to mean that killing LGBT people is a holy mission? Was it the lawyer who argues that discriminating against gay, lesbian, bisexual, and transgender people is simply an act of religious freedom? Was it the national organization that insists transgender people in bathrooms are a danger to the public and to our children? Was it the candidate who called immigrants rapists and refugees a threat to national security?

I am angry and inconsolable that people who expected they could be themselves in the confine of a nightclub, traditionally a space where LGBT people could find temporary sanctuary, died there. And yet we see triumph even in that hell—the mother who, dancing with her gay son, saved his life with a final gift by blocking bullets with her body. The Indian American former marine who helped 70 people survive by breaking open an exit door. The young Latino man who used a bandana to staunch a neck wound of his friend. Stories will continue to emerge about our strength in the midst of tremendous pain, and this is how I understand our collective journey.

All of us are stronger than hate. All of us are more resilient than a lobbying organization. We reject the false narrative of abomination and perversion and we embrace our pride, our community, and our shared journey.

We are determined. We insist on ending garbage pronouncements about what LGBT lives mean for our society or our morality. We are determined to make this world better for our youth. To our youngest LGBT members: your elders and your allies sincerely care about you. We see you and we know there is a lot of chaos and pain that comes your way. We are here for you, just as we are here to honor the people we have lost. We will find our way together, in solidarity. Peace to you all.

Vote NO on Initiative 1515!

In just the last two months we’ve gone from the hurried lawmaking that pushed through North Carolina’s HB2 that halted Charlotte’s city ordinance against discrimination of transgender people, to a moving speech by the Attorney General suing the Governor over the law. But just to recap, here is a quick overview of the moments between those points:

• Wednesday, March 23: HB2 is introduced in the chamber, debated for approximately 90 minutes, voted on and passed, and that evening, signed into law by Gov. McCrory. [Eleven Democratic representatives voted for its passage; all of the Democratic senators walked out of the chamber refusing to vote at all, so it passed the senate chamber 32-0.]
• Friday, March 25: The NBA releases a statement saying it may move future playoff games from the state if HB2 is not reversed or voided.
• Monday, March 28: The ACLU of North Carolina, Lambda Legal, and Equality NC file a lawsuit on behalf of three transgender and queer people who are employed by the state government, against HB2. The Governor goes on local news outlets to support the new law.
• Thursday, March 31: The list of businesses and organizations coming out against HB2 grows to more than 300.
• Wednesday, May 4: The Department of Justice sends a letter to Gov. McCrory telling him not to enforce HB2 or face further action from the federal government. The letter gives North Carolina until Monday, May 9, to show it will not enforce the law.
• Monday, May 9: The Governor’s office sues the DOJ, in North Carolina’s eastern district of Federal Court, insisting that its interpretation of “sex” (e.g., sex assigned at birth) is correct, and not the federal government’s interpretation (gender/sex identity and expression)
• Monday, May 9, about six hours later: Attorney General Loretta Lynch and head of the Civil Rights Division, Vanita Gupta announced that they had filed a federal civil rights lawsuit against the Governor Pat McCrory, the North Carolina Department of Public Safety and the University of North Carolina.

Much of Ms. Lynch’s remarks spelled out not just the legal foundation of the government’s case, but also the Obama Administration’s stance on ensuring civil rights for all transgender Americans, a series of sentences that had never been so clearly expressed in the history of any country towards the transgender community:

Let me also speak directly to the transgender community itself.  Some of you have lived freely for decades.  Others of you are still wondering how you can possibly live the lives you were born to lead.  But no matter how isolated or scared you may feel today, the Department of Justice and the entire Obama Administration wants you to know that  we see you; we stand with you; and we will do everything we can to protect you going forward.  Please know that history is on your side.  This country was founded on a promise of equal rights for all, and we have always managed to move closer to that promise, little by little, one day at a time.  It may not be easy – but we’ll get there together.

There is much to unpack in this part of her statement, not the least of which is whether the rule of law is adequate to support an emancipatory or even radical politic for transgender people. I wouldn’t ever expect a federal institution to call for radical change, because that would be like expecting a snake to eat itself. What this statement does do, however, is make direct reference to earlier civil rights struggles, a tumultuous legal and social history that depending on one’s textbook, might not be covered in primary or secondary school. It’s a government looking at itself and its role in supporting all Americans, and in a polarized, political environment like we have right now, in which the Republican Senate leader can somehow decide to not do his constitutional duty to confirm a Supreme Court justice, in which all it takes is one senator to decide Flint residents shouldn’t get the federal emergency funding they need to remedy their catastrophic municipal water problem, and in which more than twenty states have come out with legislation that basically calls transgender women sexual predators despite all evidence to the contrary, such a statement is incredibly important. If we can agree that a law like HB2 puts trans people who are on the edge at risk of suicide and harassment, then what do we make of a statement, bald and assertively pronounced, that the government is standing behind those vulnerable people?

I make of it that it is life-saving. I really do. I have known—I have been—people who needed a sign that they weren’t an incarnation of wrecked evil or humanity. That they, we, have a purpose. That being trans isn’t a horrible disease. That it can in fact, be wonderful, or mundane, or present us with fascinating opportunities, or help us become better people because we are more us.

It is a commonly held belief within the broad LGBT contingent that these anti-trans bills are an intentional backlash and attempt by the far right that is still licking its wounds over losing the same-sex marriage fight. It’s easy to call this fight intentional, as it is clearly financed by the same organizations that fueled the push against marriage equality. And while the reactionary push against trans civil rights is well funded (even if it turns out to ultimately be futile), several LGBT equality groups shut their doors after the SCOTUS ruling. This has left much of the support for trans rights to transgender groups and to non-LGBT allies who work on civil rights. But what work they’re doing—with today’s two events shoring up even more support for the trans community.

This morning, the Obama Administration made two announcements: first, the President sent a letter to every public school district in the country (wrap your mind around THAT mailing) that they must let transgender students use the rest room and locker room that comports with their gender identity, or face a revocation of federal education funding.

BOOM.

There are more than 14,000 school districts in the United States today.

The scale of that statement boggles my mind. But then later this morning, another declaration came out. The Administration directed health insurers across the country that they could no longer reject coverage for people simply because they are transgender.

CRASH.

Conservatives are ranting across hyperspace, in social media and on right-wing media outlets, but they do not have the force of law behind them. This ally work from the highest office in the land means something very important even if it is not revolutionary. It is still affirming, validating, critical, systemic, and a clear kick in the pants to the wave of legalized harassment that we’ve seen in the way of “religious freedom” and “bathroom bills.” It means something huge that the trans civil rights movement has had these broad statements made three times in three days, in a time when the top court in the federal system is missing a deliberator.

I cheer these moves from the President and his staff. And I turn to our allies within the LGBT coalition and say, what will you do now to help the trans community?

One of the more atrocious things the Walla Walla City Council did, after the brouhaha with the toy store’s mural faded away, was to pump in classical music at Heritage Square, a little strip of grass between storefronts on the downtown Main Street shopping district. At one point there was a playground structure, some limestone boulders to climb on, and a shelter like you would fine in a regional park; now only the shelter remains. As the city’s heroin epidemic grew, so did the numbers of drug dependent people in Heritage Square, hanging out on the toddler slides, or perched up against the wall of a building grotesquely painted to look like a Wild West-era trading post. We were perhaps not ready for the “two Wallas” to intersect right in the heart of the tourism office’s territory. Legal alcohol consumption as part of local wine industry, everyone can get behind. Illicit heroin use, on the other hand, is not to occur in the open. To drive away injection users, the city began streaming classical music to Heritage Square, as if the melodies of Mozart and Brahms were naturally antagonistic, like slipping on high frequency bracelets to keep mosquitos at bay. In its essence, the move was problematic.

Next came a fight between a group of citizens who wanted to set up a half-circle of tiny homes for homeless people to use, and the city and county governments who thought this plan would interfere with the work they’d been doing to create a comprehensive response to homelessness here. There have been many town hall-style meetings, angry online debates, motions and amendments to motions, and it so far has amounted to neither the construction of tiny homes nor the effective roll out of broad policy (although I keep hearing the latter is just about to happen). When I moved to town with Susanne in August 2008, mental health was handled somewhere between a few charity organizations, the county-run service for people in poverty, and the willingness of Main Street business owners to find their common interest—one gentleman really enjoyed taking cardboard to the Whitman College recycling center, so he would collect it all morning along the downtown strip before walking with his wagon to the campus.

Those verbal agreements and informal relationships have faded, giving way to evidence-based analysis and polarizing approaches to a worsening issue. We are too rural for many large grants or cooperative agreements to take interest in us, yet we are not rural enough to qualify for many federal programs. Whatever our political leanings, it is becoming clear that we only have ourselves to sort through the vulnerabilities of our local economy.

I keep wondering when we will focus on community connectedness and move past antagonizing people who oppose our ideas.

Dear Friends and Readers—

My publisher, Booktrope, is folding as of May 31, 2016, and my books will be (hopefully temporarily) out of print. I do have two works in progress: a follow up to my memoir with the working title of Bumbling into Baby, and the second in the Time Guardians trilogy, Intermediate Time Travel. The latter is further along than the former. I’ll be speaking with some colleagues in the publishing industry about my options for these two new titles and when I have an approach for them I will let everyone know.

I have no ill will toward Booktrope and I have to say I am honored to have worked with some very fine people, especially the senior team at the hybrid publisher, my editors Jennifer Munro and Danika Dinsmore, who are incredibly talented writers in their own right. (Right? Or rights? See, I need good editors.) Thanks also to Christy Price for helping to publicize Bumbling into Body Hair; I’m sure I’m still a nobody author but I was REALLY a supremely nobody author in 2012.

My plan is to republish the memoir with perhaps an author’s forward and a new cover. Expect that later this summer. Regarding the novel … well, I have to talk to a few people in the industry and see what my options are. I don’t want to leave readers hanging from the first book, although perhaps it could stand alone.

Yes, I have other projects. They’ve been on the back burner for the last six months as I’ve been working on Intermediate. If you could put in a word to the universe for something like a MacArthur Fellowship for me, feel free. (I know, it’s never going to happen. *cough cough GENIUS GRANT cough cough*) But my time is limited; I’ll discuss possibilities and then do my best.

Often, it’s all we can do. Be well, friends, fellow authors, editors, publicists, proofreaders, and cover designers extraordinaire. See you in the pages of the next project.

It was a good idea, Ken and Katherine. I’m sorry it didn’t work out.

Everett: Okay, Danika, first let me thank you for serving as the editor on my own novel which shall not be named—you did a great job, despite what reader Debbie said on Goodreads about there not being enough “pauses” in the story, which I suppose I should just be accountable and own as my personal failure, I mean honestly there was only so much you could do with that manuscript. I really appreciate your work!

Danika: It was a pleasure to work creatively with you, Ev. I really do enjoy story editing and wish I had more time for it. And to all possible future story editors of Ev’s out there – you would be lucky to work with someone as eager and amenable as he is. (The mutual admiration society now adjourns.)

E: So as a writer I on occasion have a story idea or a character or a scenario wander into my mind, and then an urge to explore it and write about it grows from there. Can you tell me how you came up with the idea for the faeries, or Narine, or the world they’re in? 

D: Characters definitely wander, pop, float, push, tickle, and cajole their way in. I like to fall in love with characters, especially if I’m going to spend any amount of time with them. To fall in love with them they have to feel real, which to me means complex.

About 13 years ago (previous to the MG/YA fantasy explosion), I was assisting in a lovely shop full of things like incense, divination tools, Renaissance wear, dragon statues, crystal balls… At one point I realized I was surrounded by faeries. I blame it all on them, because I suddenly had the urge to write a quest story featuring faeries. But I didn’t want a Tinkerbell story. I wanted the faeries to be as complex as humans are. I wanted them to be believable.

Steven DePolo under a Creative Commons license

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I admit it, I don’t really care for testosterone. Oh, I like the secondary sex characteristics and all, though my beard twelve years into this whole exploration of identity is still sparse and a bit laughable. But I don’t care for the skittishness that comes with taking T on a regular basis, even if it is preferable to the monthly bouts of increasingly despondent depression that I had on estrogen. I can get okay with a stable mood, especially if I’m no longer paying for a Lexapro prescription, but in all honesty I’d prefer to need neither of the sex hormone alternatives. At 45 my ovaries are still cranking out a little bit of estrogren and progesterone, and I can tell when I’ve missed a T shot the same way I can tell between shades of blue on a topology map…because that’s how gradients work to show a shift from one degree to another.

It’s been an intense few months—the final gear up for Susanne’s tenure file to be delivered to the provost was drama-filled with the kind of pettiness people often ascribe to academics. Emile and Lucas adjusted to a half-day schedule at a local preschool after only knowing life with a part-time nanny in their own home (or hers). I waded full Monty into the Affordable Care Act and Medicaid Expansion at work, trying to tie down new revenue streams for my nonprofit, even as I made slow headway on two book projects for which I supposedly dedicate ten hours a week. We made the hugely intelligent decision to stay home for the holidays so that gave us something of a breather, since holiday air travel is excruciating and expensive. Then this winter an old friend, a genuine, snarky, brilliant, generous, curmudgeon with emotional walls thicker than whatever Trump wants to put between us and Mexico, killed herself. I thought I would be better at handling her death, but I’ve been more on an emotional edge than I’d like to be. And whether I stay on top of my T shots or not, I keep thinking about her and all of the emotions that an unexpected, intentional death bring up. Thanks a lot, sex hormones, for not giving me any relief. Read More…

Let’s say it occurs to you that you can’t make it in this world living as the sex you were born with. It could be a big revelation, or a series of small ones, or something else entirely, like a haunting doubt, for a few examples. And let’s presume that you need some degree of connection to other people (YMMV, I know), so at some point, if you decide to transition to somewhere else on the gender spectrum, you’ll probably come into contact with another human being who notices you look/sound/etc different than you were before, even though (and this is not always a given for people observing someone’s transition) you’re still the same you in like 97% of other aspects of your identity and corporealness.

Now you have to tell some stranger–either through the health care system, mental health system, or gray market drug retail system–that you want hormones.

And you have to consider how to deal with the following:
• changing your name(s)–which means getting a judge in a court to authorize this change, and running your name change in a newspaper so you can ensure people you’re not trying to get out of a debt
• changing your gender marker and name on your birth certificate–which means petitioning the vital statistics group in the state where you were born, which all have their own rules around when/how/if they’ll make such a change, and if you’ll get a “clean” new birth certificate or one that says “amended” (or if you’re from Ohio, for example, not getting a new BC at all for ANY reason, forever and ever amen) Read More…