The South Dakota House of Representatives has passed a bill that would ban teaching about transgender people in public schools.

Lawmakers in the state gave the green light to HB 1108, which seeks to block teachers from acknowledging the existence of transgender people to young people in classrooms, on Tuesday (February 12).

The bill says: “No instruction in gender dysphoria may be provided to any student in kindergarten through grade seven in any public school in the state.”

The proposal passed by a vote of 39-30 in the 70 seat chamber, where the Republican Party has a large majority.

South Dakota anti-transgender bill ‘harmful’ to young people

LGBT+ campaigners hit out at the proposal, warning that it could prevent teachers from providing any support to young transgender people.

Cathryn Oakley of LGBT+ campaigning group Human Rights Campaign said: “The intent of this legislation is clearly to discriminate against transgender and gender non-conforming South Dakotans.

“If HB 1108 were to become law, it would send a strong message to LGBTQ youth that they are less than their peers.”

Oakley added: “South Dakota was the first state to introduce anti-transgender legislation that would bar trans kids from accessing facilities consistent with their gender identity, and it seems intent on being on the forefront of discrimination yet again, at the risk being out of step with the rest of the country.

“We implore the Senate to vote against this harmful legislation.”

Libby Skarin of the American Civil Liberties Union (ACLU) of South Dakota added: “[We are] disappointed that South Dakota’s representatives voted to pass House Bill 1108.

“It is this type of hostility toward young transgender people from adult leaders that contributes to the high rates of depression and even suicide among transgender young people in our state. But the fight is not over.

“Our commitment to ensuring that transgender South Dakotans can live openly without discrimination remains strong and urges South Dakota lawmakers to stop hurting transgender youth.”

South Dakota anti-transgender bill would be on ‘forefront of discrimination’

The bill will now head to the South Dakota Senate, which is also controlled by Republicans.

If it clears the legislature, the bill would then head to the desk of South Dakota’s Republican governor Kristi Noem.

And, if passed, the state would become the first to explicitly restrict teaching on trans issues, though wider laws restricting teaching about LGBT+ issues are not a new battle in the US.

Seven states still maintain ‘no promo homo’ laws, which actively restrict schools teaching about homosexuality.

Alabama, Arizona, Louisiana, Mississippi, Oklahoma, South Carolina and Texas maintain laws barring the “promotion of homosexual relationships” in schools.

Some of the laws have been criticised for being damaging—with Arizona explicitly restricting teaching about “safe methods of homosexual sex.”

Study suggests that increased hours of education related to caring for transgender patients may not correlate to more competent care

People who are transgender face many barriers in the health care system - from intake forms that use non-inclusive language, to challenges finding providers who are knowledgeable about their health care needs.

But more training may not be the answer to improving competent care, a new Michigan Medicine-led study suggests. Surprisingly, more hours of education in the field was not associated with improved knowledge of transgender care among physicians and other providers, according to a new study in the journal Medical Education.

Nearly half of providers in the study said they had cared for a transgender patient, but as many had received no training on the topic.

What distinguished knowledgeable providers from those who were less so, however, appeared to have little to do with their medical education. Transphobia, or a prejudice against people who are transgender, was the only predictor of provider knowledge.

"We were surprised to find that more hours of education about transgender health didn't correlate with a higher level of knowledge about this topic among providers," says lead author Daphna Stroumsa, M.D., MPH, an obstetrician gynecologist at University of Michigan's Von Voigtlander Woman's Hospital and a National Clinician Scholar at the U-M Institute for Healthcare Policy and Innovation.

"Transgender and gender diverse individuals often face discrimination in health care settings and many are unable to find competent, knowledgeable and culturally-appropriate health care," Stroumsa adds. "Lack of provider knowledge is a significant barrier, but our findings suggest that simply increasing training may not be the solution.

"Medical education may need to address transphobia and implicit bias in order to improve the quality of care transgender patients receive."

Researchers surveyed 389 attending physicians, advanced practitioners and residents from the departments of internal medicine, family medicine and obstetrics and gynecology in a large urban health system.

While the study did not evaluate the content or format of the education providers were exposed to, it is likely that educational efforts that address unconscious bias would be more effective.

Stroumsa notes that even in educational programs that address transgender health, the topic is usually presented as a separate section of provider education, rather than as an integral part of general medical education and training - a distinction which may further fuel "othering" of transgender patients.

According to the 2015 United States Transgender Survey, a third of transgender people who saw a healthcare provider over the past year had a negative experience with the provider related to being transgender, such as being verbally harassed or refused treatment because of their gender identity.

Twenty-four percent reported that they had to teach their medical providers about transgender care in order to receive the care they needed and 23 percent avoided medical care they needed because they were worried they would be mistreated due to their gender.

That's why Stroumsa developed and produced training modules (hosted on the Michigan Ob/Gyn website) to prepare Ob-Gyns and other providers to better care for transgender and gender diverse people. The modules were developed in collaboration with physicians and transgender health activists across the country, and the Council on Resident Education in Obstetrics and Gynecology.

Meanwhile, another series of videos created by U-M's Halley Crissman, M.D., M.P.H., intend to help train frontline staff on the same topic.

Many providers - especially those traditionally considered "women's health" professionals - likely need to be better prepared to care for transgender patients, Stroumsa notes. People who identify as transgender and non-binary may require many of the services provided by Ob/Gyns and other "women's healthcare" providers, including prenatal and fertility care, cervical cancer screening, menstrual cycle management, as well as gender transition-related care (i.e. hormone therapy), and other routine Ob-Gyn care.

In a separate publication in the American Journal of Obstetrics and Gynecology, Stroumsa and Michigan Medicine family physician Justine Wu, M.D. M.P.H., urge expanded language around "women's health" to be more inclusive. This may include everything from using gender neutral terminology on intake forms to subtle differences in labels, such referring to "well-person" care instead of "well-woman visit."

Many services are "less specialized that we may think," the authors write.

"The Ob-Gyn field has traditionally centered on serving the health and needs of women. But our approach and language may unwittingly alienate a vulnerable population in need of our services," Stroumsa says.

"We obviously have a lot of work to do in improving health outcomes for gender diverse people," Stroumsa adds. "We need to take a close look at our healthcare environments, practices and approaches to medical education. These are just beginning steps in reducing wide health disparities.

"Creating a safe, knowledgeable, trustworthy care environment will help us expand the care we provide to a broader more diverse patient population."

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According to one of the highest-ranking officers in the California National Guard, Maj. Gen. Matthew Beevers, California will defy Trump’s wishes and not discharge transgender service members from the troops.

The Advocate reported that Beevers spoke to the Assembly Veterans Affairs Committee about the decision.

“As long as you fight, we don’t care what gender you identify as,” he said. “Nobody’s going to kick you out.”

This comes only a month after the Supreme Court ruled that Trump’s transgender military ban can proceed until lower courts make a decision about its legality. Beevers said that, despite the ruling, he believes “the ban will be lifted again.”

While the state’s National Guard, according to Beevers, doesn’t track its number of transgender soldiers, the National Center for Transgender Equality has estimated that 17,763 transgender service members could face dismissal nationwide."

Equality California, an LGBTQ organization who’s suing the president over the ban, showed their support of the California National Guard’s decision.

“What the California National Guard said, and what we’ve said in our lawsuit, is that the military ought to treat them just like every other service member,” said Samuel Garrett-Pate, communications director of Equality California. “California will always champion the values of freedom, equality, and fairness – even when the president fails to.

After a rough period in 2017, the Trump Administration’s anti-transgender ban for the armed forces came back in force in January right on the heels of the government shutdown.

Director of the LGBT Resource Center Kaitlin Legg shared her observations of the ban’s return and its fallout for LGBT members in the armed services.

“There’s estimates that between 13,000 and 15,000 transgender people are currently openly serving in the armed forces,” Legg said, “So the reason this is on the news again is that on Tuesday, the Supreme Court decided that they were going to put some of those injunctions on hold, which would mean, again, transgender people cannot serve.”

For the time being, though, the Supreme Court has not made any further decisions over the case. For the LGBT community this means that thousands still risk losing their jobs. For Legg, who mentioned a prior study by the Department of Defense that found no major negative consequences for transgender people to openly serve, it also means more polarization in an already charged political climate.

“The only answer [to why this is coming back] I can think of is that transgender people’s lives have become incredibly politicized,” Legg said, “So there’s often two camps: there’s the one side of the fence that says we need trans inclusion now, this is fine, and the other side of the fence, which I think are the people President Trump is trying to appeal to, believe that trans folk shouldn’t have equal access to those rights.”

With this and the government shutdown in mind, Legg also mentioned that this is the first time that a president reversed a decision to integrate a minority population into the military.

“If you think back historically, to the integration of black troops within a predominantly white – at the time – military, the integration of women as well as the integration of lesbian and gay folks when ‘Don’t Ask, Don’t Tell’ was repealed, none of those things were reversed. So, this is a big move.”

However, Legg remains optimistic that in the long term, people will move in support of the LGBT community and deny the ban.

Days after the Supreme Court backed a Pentagon ban on transgender troops serving openly, an active-duty transgender sailor will appear as a guest of honor at President Donald Trump's State of the Union address in Washington, D.C.

Petty Officer 2nd Class Megan Winters will be the guest of Rep. A. Donald McEachin, D-Virginia, at the State of the Union on Feb. 5, according to a release from the congressman's office. Winters, 30, was a plaintiff in a lawsuit by the organizations Lambda Legal and Outserve-SLDN challenging the ban.

The policy approved by then-Defense Secretary Jim Mattis last year was not the across-the-board prohibition proposed by Trump via Twitter in 2017, but would keep most openly transgender individuals from enlisting and limit the ability of currently serving transgender troops to come out and transition.

Winters, now assigned to the carrier George H.W. Bush in Norfolk, Virginia, is a constituent of McEachin's who has been vocal about her position, giving interviews to PBS and The Associated Press, among others, about her position.

"I do my job to the best of my ability every single day and will do that as long as I'm able to," she told the AP in January. "I recall how I felt the first time I put on the uniform. I genuinely wish that upon any American who wishes to serve."

In a release, McEachin said he wanted to recognize Winters for her service in the Navy and give more visibility to other transgender service members.

"As many as 15,000 transgender individuals currently serve in the U.S. military, and they deserve our utmost respect and gratitude," he said in a statement. "Unlike our current commander in chief, I will always support and defend the brave members of our military."

On Jan. 22, the Supreme Court released a 5-4 decision that it would not take up three cases challenging the proposed ban. Several lawsuits continue in lower courts, however. The Pentagon has yet to begin enforcing its transgender policy as one nationwide injunction against it remains effective, tied to an ongoing case in Maryland Federal District Court.

Winters told the AP she would abide by the Pentagon's transgender policy if enacted, but hoped for the opportunity to remain in uniform.

"I want to tell you I stand steadfast and hold my head up high, but it is a little difficult," she said in the interview. "The president of the United States is my commander in chief. If they called for the end of transgender service, if it's a lawful order, I would have to obey it. But I truly want to continue serving my country."

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