Transgender Awareness Week & Remembrance Day

Transgender Awareness Week falls between November 13-19 every year and is meant to help raise visibility of a vulnerable and underserved community.  ‘Transgender’ is an umbrella term for people whose gender identity is different from the sex assigned at birth; ‘gender identity’ is one’s innermost concept of self as male, female, a blend of both, or neither.

 

Transgender Pride Flag

Transgender/gender non-conforming people experience gender dysphoria, a clinically significant distress recognized by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) caused by a person’s assigned birth gender differing from the one with which they identify. This leads to increased depression among the transgender community, which can be exacerbated by being rejected by family and friends, abuse/violence, or experiencing discrimination. Gender-affirming operations have shown to yield long-term mental health benefits for transgender people.

Transgender and gender-nonconforming people can face significant problems with accessing health care. Finding a healthcare provider who is knowledgeable of transgender health issues can be a hurdle itself; some healthcare professionals may believe that there is something wrong with someone because they are transgender — these practitioners  are wrong. Even after finding a knowledgeable and sympathetic doctor, insurance may not cover the cost of treatment. Many transgender people are on a dosage of hormones which can affect one’s blood pressure, blood sugar, or in rare cases contribute to cancer. Some cancers found in transgender people can appear atypical — trans men are at risk for ovarian and cervical cancers, and trans women can be diagnosed with prostate cancer.

 

According to the U.S. Department of Health and Human Services, the Affordable Care Act (ACA) protects against discrimination based on gender identity. Despite these protections, over 27% of transgender/gender non-conforming people report having been denied healthcare. Even paperwork can be a barrier to access for transgender individuals as standard forms often only list “male” or “female.” Nearly 21% of transgender people in the US report being subjected to harsh or abusive language from a healthcare professional, and an almost equal amount say healthcare providers have blamed them for their own health conditions. Transgender people report the highest rates of discrimination and barriers to care among the LGBT community. To avoid discrimination, nearly a third (31%) reported in a survey that none of their healthcare providers knew they were transgender and an additional 17% reported that only some of their providers knew.

 

Transgender rights and protections have been diminished by the Trump administration. Early in 2017, the Department of Education rescinded Obama’s guidance on Title IX of the Civil Rights Act for transgender/gender non-conforming people in schools. The Department of Justice announced months later in October 2017 that civil rights laws do not protect transgender people in the workplace, reversing a guideline instituted by President Obama on Title VII. The case for Title VII was brought before the U.S. Supreme Court just last month (October 2019), and could have life-altering ramifications if the Court decides the Civil Rights Act doesn’t protect transgender individuals. Advocates for an already vulnerable population call the guidelines “license to discriminate” while others claim it is their “religious liberty” to deny services or access to individuals based on belief.

Transgender Awareness Week ends on November 20, known as Transgender Day of Remembrance, which is observed as a vigil commemorating the transgender people lost to violence. This year, the American Medical Association is extending efforts to curtail what it calls “the epidemic of violence against the transgender community, especially the amplified physical dangers faced by transgender people of color.” At the time of writing, over twenty transgender/gender non-conforming individuals have been killed in the United States — nearly all of whom were trans women of color — from violence ranging from gunshots to immolation to a transgender woman in ICE custody being denied healthcare. Awareness is vital for the stigma and misconceptions surrounding transgender/gender non-conforming individuals can be eliminated and allow all to be able live safely and in peace.

 

Human Rights Campaign (HRC) has information on finding insurance for transgender-related healthcare. To further help those in need, NeedyMeds has a growing list of programs in our Diagnosis-Based Assistance database for transgender/gender non-conforming people that offer various forms of assistance such as financial aid or legal services. We also have listings for recreational camps/retreats and academic scholarships for LGBT youth and their families. NeedyMeds’ unique crowdfunding platform HEALfundr is also available for individuals trying to raise funds for their transition. If you know any programs assisting transgender/gender non-conforming people that we don’t have listed on our site, leave a comment and let us know about it.

Trans Lifeline (transgender crisis support): (877) 565-8860

Open Enrollment for Healthcare Coverage

The Affordable Care Act (ACA; aka Obamacare) Health Insurance Marketplace begins its seventh Open Enrollment period today. American healthcare consumers can sign up on the federal insurance exchange at healthcare.gov or through their state marketplaces. In recent years there has been increased confusion surrounding Open Enrollment due to changes (and attempted changes) made to the ACA under the Trump administration, leading to the U.S. uninsured rate to rise for the first time since 2014 and the largest single-year increase since 2008.

 

When Obama was president and launched the ACA, Open Enrollment period ran 90 days beginning November 1 and running until the end of January. Open Enrollment was cut by President Trump to 45 days in 2017 unless you qualify for the Special Enrollment Period which extends enrollment by an additional 60 days. Advertising and outreach budgets for Open Enrollment have faced cuts, limiting the people able to access assistance or appropriate information that can help them.

New rules put out by the Trump administration allow ACA subsidies to be used for short-term, low-benefit insurance plans that can deny coverage based on pre-existing conditions. These plans often have lower premiums than those that offer Obamacare’s Essential Health Benefit but they set annual or lifetime payment limits, don’t cover prescription drugs, and have fine print excluding some conditions or treatments. Consequently, insurers providing short-term plans don’t have to pay as many medical bills, so they have more money left over for profits. The Affordable Care Act requires 75% minimum of premiums be spent on medical care. Trump’s junk plans are not subject to the same requirements and spend an average of 39% of your premium on actual medical care — some are as low as 9%. Junk short-term plans often lead to “surprise bills” for patients unaware of their coverage gaps.

Since federal resources are refraining from outreach, organizations such as Get America Covered are reaching out to combat misinformation and encourage enrollment. There is no longer a penalty for not having health insurance, but even healthy people can be faced with extraordinary costs for unforeseen health reasons — especially those without insurance. For those who have applied through insurance exchanges in previous years, they have to update their information and compare their options for 2020. If you have questions about signing up or want to talk through your options with a trained professional, free assistance can be reached by calling 1-800-318-2596 or visiting http://localhelp.healthcare.gov/.

 

NeedyMeds will continue to provide information as the need for assistance navigating the often expensive landscape of healthcare rises. The NeedyMeds website has databases of Patient Assistance Programs (PAPs), Diagnosis-Based Assistance (DBAs), and Free/Low-cost/Sliding-scale Clinics to help those in need. The NeedyMeds Drug Discount Card can save users up to 80% off the cash price of prescription medications for those without insurance or choose to use the card instead of insurance. In addition to the plastic card, the card is available in a printable form or a smartphone app for Apple and Android devices. For more help finding information, call our toll-free helpline Monday-Friday 9am-5pm Eastern Time at 1-800-503-6897.

Breast Cancer Awareness Month 2019

For more than 30 years, October has been National Breast Cancer Awareness Month in the U.S. Breast cancer is the second most common cancer among women, second only to skin cancer. With more than 240,000 women diagnosed each year, awareness can save lives through early detection and lowering risk.

 

The main risk factors of breast cancer include being a woman and being older, which means almost any woman can be diagnosed with no family history or other known risk factors. The Centers for Disease Control and Prevention (CDC) recommends healthy living habits such as maintaining a healthy weight, regular exercise, getting plenty of regular nighttime sleep, avoiding carcinogens, and encourages women to breastfeed their children. These steps may help to reduce one’s risk for breast cancer.

The US Preventive Service Task Force recommends that women between the ages of 50 to 74 should have a breast cancer screening called a mammogram every two years. Women in their 40s should begin consulting with a doctor about when to start and how often to get screened, often influenced by any family history of breast cancer. About 10% of breast cancer cases are found in women younger than 45 years old. Men can also get breast cancer, though it is rare; less than 1% of breast cancer diagnoses are found in men.

Breast cancer can present with a wide variety of symptoms or none at all. Symptoms can include a change in size or shape of one’s breast, pain in the area, nipple discharge other than breast milk, or a lump in the breast or underarm. These symptoms can be serious and a doctor should be consulted immediately. Mammograms cannot prevent breast cancer, but it is much easier to treat when detected early. More than 40,000 women die from breast cancer in the U.S. each year.

 

The Title X federal grant program is dedicated to family planning and preventative health services for low-income families and uninsured people — including cancer screenings. The Trump administration enacted a gag rule this year, forbidding healthcare providers to offer or even refer patients to abortion services, forcing Planned Parenthood and other sexual and reproductive healthcare providers out of the program. Planned Parenthood has served up to 40% of Title X recipients, providing contraceptive care, cancer and sexually transmitted infection (STI) screenings, prenatal care, and other crucial health services. It will be nearly impossible for other health centers to fill the gap being created, with patients in underserved states seeing longer wait times for appointments or going without care. Abortion services will be largely unaffected by the change.

A majority of Title X patients are people of color or low-income. Most patients in the Title X program don’t even realize they’re getting care through this program. For many women, the Trump administration’s gag rule will prevent them from being able to access breast exams and cancer screenings, which can impact the mortality rates from breast cancer. Without cancer screenings and other reproductive health services provided through the Title X program, low-income women are unable to access preventive health care.

 

NeedyMeds has over 200 national, state, and local programs that help individuals diagnosed with or at risk for breast cancer. These Diagnosis-Based Assistance programs provide financial assistance, mammogram screenings, medical equipment, prostheses, and more. We have a Diagnosis Information Page for Breast Cancer, a collaborative effort between NeedyMeds and the American Breast Cancer Foundation (ABCF). We also have records on more than 4,500 free, low-cost, or sliding scale medical clinics including nearly 500 Planned Parenthood clinics that offer women’s health services. Search your ZIP code and check for “Women’s Health” listed by Services to find locations near you. For assistance finding help near you, check the NeedyMeds website or call our toll-free helpline at 1-800-503-6897.

Talk About Your Medicines Month

October marks the BeMedWise Program at NeedyMeds’ 34th Talk About Your Medicines Month (TAYMM). This is an annual opportunity to focus attention on the value that enhanced provider-patient communication about medicines can play in promoting safe and appropriate medicine use and improved health outcomes. Communication is a two-way street: consumers benefit from being proactive in asking questions and seeking information about their medicines, and healthcare providers in turn must be able to share medical information in a meaningful way that their patients are able to understand and act on.

 

This year’s theme for TAYMM is Preventing Opioid Misuse and Abuse Across the Ages. Opioids are a class of drugs that act on certain receptors in the central and peripheral nervous system and are often prescribed to relieve acute moderate to severe pain. Opioids are used recreationally for their euphoric effects and long-term use can build a tolerance, meaning that increased doses are required to achieve the same effect, and physical dependence, meaning that abruptly discontinuing the drug leads to unpleasant withdrawal symptoms. A person with an addiction and  a growing tolerance is at risk of experiencing an opioid overdose. Opioids were involved in 47,600 overdose deaths in 2017 (67.8% of all drug overdose deaths).

The opioid epidemic persists, whether you live in a large city, affluent suburb or rural community. On average, 130 Americans die every day from an opioid overdose. The dedicated TAYMM website features tips, fact sheets and a library of resources for patients, healthcare providers and caregivers, focused on preventing the misuse and abuse of opioid medications

Tips include:

  • How and why you should keep all of your medicines up and away and out of reach of your toddlers 
  • The important conversations you should have with your kids, teens, and college students about responsible medicine use
  • How to recognize and resolve problems that may occur when an older adult you are caring for is prescribed an opioid medication. 

 

Help protect your family and learn about the risks, responsibilities, safe use, storage and disposal of opioids. Responsible use includes learning about other treatment options and non-opioid alternatives that may be a better choice for either you or a loved one who are experiencing pain from an injury, medical condition, or surgery.

We encourage patients everywhere to talk to their doctors and/or their pharmacists about the medications they are taking, especially if they are taking prescribed opioid medications, about any questions or concerns they have. Be sure to take your medications as directed by your doctor and do not hesitate to discuss any side effects you may experience. 

World Mental Health Day

For over 25 years, the first full week of October has been Mental Illness Awareness Week. World Mental Health Day falls on October 10. This year, our blog has observed Mental Health Month in May, Minority Mental Health Month in July, and Suicide Prevention Month/Week/Day in September. We continue to discuss mental health because it is crucial to public health.

 

Twenty percent of the population — as many as 65.9 million Americans live with some kind of mental health condition, with nearly 5% living with a serious mental illness that substantially limits their life activities. Those living with mental illness fight stigma while trying to survive under intense  internal duress. Awareness is important so that resources are made available to those who need them and the stigma and misconceptions surrounding mental illnesses can be reduced.

 

Everyone has stress and difficult emotions on occasion, and this is completely normal. Mental illness, however, is any condition that makes it difficult to function in daily life. It can affect relationships or job performance, and is caused by any number of complex interactions within the human brain. Mental illness can range from anxiety or mood disorders like depression, psychotic disorders like schizophrenia, to eating disorders or addictive behaviors.

Depression is the leading cause of disability in the world and includes 16 million American adults living with major depression. Eighteen percent of adults in the US experience anxiety disorders such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and/or specific phobias ranging from a fear of spiders to a fear of pickled vegetables.

Mental illness is prevalent in homeless populations, with an estimated 26% of adults staying in shelters living with serious mental health conditions and approximately 46% with both mental illness and/or substance abuse. One in five state prisoners have a recent history of mental illness. Mood disorders such as depression or bipolar disorder are the third most common cause of hospitalizations in the US across ages 18-44. Serious mental illness costs America $193.2 billion in lost earnings per year.

 

Contrary to scientific evidence, Americans are increasingly viewing people affected by mental illness as potentially violent due to media coverage of mass shootings and the political language used to explain such events as aberrations that cannot be foreseen or effectively avoided. The truth is the vast majority of people with mental health problems are no more likely to be violent than anyone else. Most people with mental illness are not violent; only 3%–5% of violent acts can be attributed to individuals living with a serious mental illness. In fact, people with severe mental illnesses are over 10 times more likely to be victims of violent crime than the general population.

The effects stigma has on people with mental illness and their families can be extensive. Stigma comes from a lack of understanding of others’ experience, and can be invalidating and painful to those already struggling. This can lead to further isolation and unnecessary shame. Stigma can also lead to harassment, bullying, and violence towards those affected. People with mental illnesses continue to face discrimination in seeking employment and housing. Stigma also prevents people from seeking help or getting treatment, causing symptoms to become worse and more difficult to treat.

 

NeedyMeds has Diagnosis Information Pages for various mental illnesses including depression, obsessive-compulsive disorder, and schizophrenia. We also have information for over 5,000 free, low-cost, or sliding-scale clinics throughout the country that offer counseling or mental health services. Search your ZIP code for clinics that may offer Counseling/Mental Health Services near you, or call our toll-free helpline for information at 1-800-503-6897 (open Monday through Friday, 9am to 5pm ET).

 

We encourage everyone to educate themselves, strive to understand the difficulties people around us live with, and to replace stigma with hope and support. If you or someone you know is thinking about suicide, it is important to know that no one is alone in their struggle. Call for assistance, whether help is needed immediately or long-term.

Samaritans 24/7 Crisis Services via call or text: (877) 870-HOPE (4673)

The Trevor Project (LGBTQIA crisis support): 1-866-488-7386 or Text “Trevor” to 1-202-304-1200

Trans Lifeline (transgender crisis support): (877) 565-8860

The Steve Fund Crisis Text Line (crisis support for people of color): Text STEVE to 741741

Photo by Dan Meyers