Trans activist wants to legally change status .........

Neish McLean, a Jamaican, who was born a woman but now identifies as a man, wants the Government to allow transgender persons to change the gender on their legal documents to match the one they have identified with.

McLean, executive director of the transgender organisation, Transwave, wanted to be deemed a man despite being born with female genitalia.

McLean told THE WEEKEND STAR that it is imperative that transgender individuals be given this opportunity to reduce the likelihood of them being exposed to violence.

Violence and discrimination

"I wish to navigate the world as I see myself, so if my ID does not match as I see myself, then that exposes me to violence and discrimination," McLean said. "For example, going through the airport, that can expose people of tran-experience with undue scrutiny and discrimination and when receiving services at different spaces because my ID is reflecting who I say I am."

McLean competed at the Sagicor Sigma Corporate Run in February as a male.

"I didn't identify with the gender I was assigned to. I just didn't feel as if I fit in. I didn't know how to term it," McLean said. "It is not a matter of changing, it's just a matter of internal feeling. I just felt fully accepted into my adulthood and felt comfortable expressing my gender as I do."

Identifying myself

Now 32, McLean told THE WEEKEND STAR that feelings about gender have never been an issue.

"I was never afraid to share how I felt with my family. It was really more a matter of me accepting who I was and who I was comfortable being. For my family, it is more so of my safety that they were more concerned about than my gender identity," McLean said.

McLean said that apart from wearing a tunic to school, pants and shorts were the preference.

"I didn't grow up in an environment that was very strict in terms of me identifying myself as a girl. My gender wasn't policed. It was a few years back when I actually told them that I wanted to be identified as a man. They are not very expressive, so I don't know how they are truly feeling," he said.

McLean said Transwave is currently arming itself with the necessary information to place a solid argument before the Government.

McLean also said the group has had discussions about engaging medical professionals to provide a framework for transgenders to undergo medical transitions in Jamaica.

meanwhile 

Outside of the Star News report older folks such as Laura Garcia of Aphrodite's PRIDE Jamaica already got her identity papers after much fight and trips to the Registrar General's Department RGD in order to change her birth papers and by extension her driver's license. The RGD has always had a reputation of Pentecostal nepotism in hiring staff so gender non-conforming persons with sometimes harsh transphobic language in the customer service experience was a problem. I hope the younger folks engage well experienced folks and resources to good use.

Peace & tolerance

H

Breasts right but down there!

So the business of genitalia confusion if not error during sexual negotiations has come up again. A transgender commercial sex worker found herself in exactly such a position over the Christmas/New Year’s holidays as she plied her trade in New Kingston; more commercial sex workers or persons who rely on it to make some money come out to pound the pavement. She reportedly met a man where they left the hip strip to handle business but the man after fondling her breasts went further, the victim tried the old ‘I am having my menstruation’ excuse to avoid the man going too far physically via fondling but he would have none of it. The man while not assaulting the trans woman did eventually got his hands at her genitalia area only to discover a bulge instead of an expected flat surface. 

Transsexual people experience a gender identity that is inconsistent with, or not culturally associated with, their assigned sex, and desire to permanently transition to the gender with which they identify, usually seeking medical assistance (including hormone replacement therapy and other sex reassignment therapies).

Things got tense as the man reacted violently but thankfully the young tranny (the friendly version of the word) being petite in body was able to elude her raging attacker as she was not wearing her shoes in the form of a six inch pump. She made her way along the eastern section of Grenada Crescent judge a couple hundred yards from the infamous Shoemaker Gully where the homeless transgender/MSM reside. That part of town has always had some issues over time from shots fired at persons to men pretending to be clients but who unleash an attack when they get close in proximity to the intended target(s). How does transgender sex workers navigate this problem if you will?

Using the menstrual cycle excuse is the oldest trick in the book and is a little unethical if you ask me as it is not the truth but then again the client is seeking a fantasy to be fulfilled in the real world so the seller has to try to conform to the needs of the paying customer. Oral sex is usually the way out to avoid too much body contact and fondling, trouble with that based on engaging some persons is that some men are turned on via touching and exploration to strengthen their arousal and such. It was only December 17 this blog observed International Day against Violence towards Sex Workers and it was subjects like this that came up in an online social media group call. The ins and outs of this came out quick loudly.

I am reminded of the murder of transgender vogue queen in the US Amy Mizrahi whose body was found days later under a bed in a motel, as the news spread locally many were disturbed at the murder then in the nineties and the subject came up in terms of safety for street workers. Then the stabbing incident in 2003 of the popular and well liked “Browning” who was killed by a soldier who was a client of hers on the night in question, she too used the menstrual cycle excuse as part of negotiations to guide the client towards oral sex but the attempt failed based on the word allegedly of the perpetrator who was said to be bragging that he killed a ‘battyman’ dressed in women’s clothes. Browning managed to escape from the car and ran and scaled a fence but he pursued her until he got her. Being a soldier with a stronger frame he was able to overpower her and then stabbed her repeatedly and left the body. She was discovered by other walkers and cruisers of the day.

Folding ones penis under between the legs is not necessarily an option that works especially if the genitalia is of a larger size of 8 inches, with walking and so on things can shift and a thong or a similar clothing apparatus may not guarantee a vaginal appearing presentation to supposedly ‘fool’ or trick male clients. “Coming out” as pre-operative transgender is not an option in Jamaica just yet as the level of knowledge is simply not there when compared to our counterparts per say in Cuba. They already have a national program via CENESEX that hosts serials and TV PSAs and so on highlighting transgender issues long before the wave came in the United States and eventually worldwide. They also offer some reassignment surgery services for free essentially for qualified persons but the longstanding problem in that department is the quality of the healing and other post surgery treatments, many prefer Thailand as the place of choice for transitioning.

The US has been reaping some better success since the challenges in the eighties where breast implants would have ruptured from poor silicone gels encasements and leakage into the body causing more disastrous complications, they experts alongside manufacturers of implants have since improved the products from the shape from egg-shape or elliptical to tear drop types that hang better for nipple placement post the surgery. Vaginoplasty has also seen some leaps and bounds with better formed vaginas as it were complete with sensitive areas that act as a clitoris as the tip of the penis is reshaped to attain that. While some local efforts are being done to educate doctors and surgeons one gets the feeling some are not condoning or are receptive to the information. Surgeries locally are not available at this time in as far a vaginoplasty are concerned, breast implants are already here via plastic surgeons but some locals are not too impressed especially the ladies in the dancehall arena who have now taken on enhancement activities to enhance the optics for their careers. 

Many go overseas of pump up via Botox injections and so on. The ugly business of underground pump up actions by some is here with us in ever increasing reports, they do so by using non traditional methods and ingredients such as cooking oil, olive oil, estrogenic laced concoctions, illegally obtained syringes or burrowed/shared ones and so on which can be risky in terms of HIV transmission. Then there is the cross population concerns as gay friends may also be in the presence of some of this at pump parties or so and may also experiment in a desire to conform construct and not feel left out. Then there is the psychology of some of this as I expressed some concern recently to a leading transgender activist that some persons professing transgender may not be so, seeing that it is easier to escape homophobia in a sense by physical appearance adjustments or aesthetic but they may not feel ‘born in the wrong body’ many times after a psychological analysis they are found not to be transgender but gay and effeminate. Besides not everyone’s body can handle hormones either even transgender individuals, that all important pre-surgery physical examinations are so crucial to determine that.

Unless and until the powers that be locally allow more reassignment surgery opportunities for transgender folks who may otherwise cannot afford it fully we may have challenges such as this genitalia mishap, the young transperson has since been on the low hoping she does not come across the man again in case he decides to exact some follow up. Such are the realities of pounding the pavement; a girl has to earn her coins.

Peace & tolerance

H

GLMA Calls for End to Nonconsensual Surgeries on Intersex Minors!

As GLMA states on their website: In what is believed to be a first for a US-based health professional association, GLMA recently revised its position statement on care for children with differences of sex development (DSD) to call for delay in any medically unnecessary surgical intervention until the patient can provide consent/assent to the treatment. The revised policy statement is being released to coincide with activities related to the 20th anniversary of Intersex Awareness Day.

GLMA was also among a host of organizations, including the Intersex Campaign for Equality, that signed a joint resolution this past Intersex Awareness Day, October 26th. The resolution reaffirmed the following three demands of the Third International Intersex Forum, in Malta, co-organized by ICE founder and director Hida Viloria:

1) All intersex people have the right to make their own decisions affecting their bodily integrity, physical autonomy, and self-determination.

2) Medically unnecessary treatment, surgeries, and sterilizations of intersex people should not occur without said intersex person’s full informed consent.

3) Intersex people and the families of children born with intersex traits should have access to non-pathologizing psychosocial and peer support.

We thank and commend GLMA for supporting intersex activists and people everywhere in our quest for self-determination and bodily integrity, and for being the first medical association in the United States to do so!

also see:

Jamaican Intersex (ambiguous genitalia) baby case a cause for concern

Despite opposition, EU Parliament votes for LGBTI rights/trans identity depathologization 

Peace & tolerance 

H

Call to Action: International Day of Action for Trans Depathologization 2016

This year's International Day of Action for Trans Depathologization is approaching, taking place on Saturday, October 22, 2016.

As in previous years, on this day and in the course of October activist groups throughout the world will organize demonstrations and other actions demanding trans depathologization.

The slogan of the 2016 Call to Action is:

Stop Pathologizing Gender and Bodily Diversity

If you would like to participate in the International Day of Action for Trans Depathologization 2016 and organize an action in your city, please send us a message.

In order to view STP's Call to Action published on August 9, 2016:
http://www.stp2012.info/old/en/news#call_to_action2016

The main objectives of STP are the removal of the classification of gender transition processes as a mental disorder from the diagnostic manuals (DSM of the American Psychiatric Association and ICD of the World Health Organization), access to state-funded trans health care, a change of the trans health care model, from an assessment towards an informed consent approach, legal gender recognition without medical requirements, depathologization of gender diversity in childhood, as well as protection from transphobic violence.

This website aims to visibilize the objectives, manifestos and actions of this Campaign, as well as the list of collective and individual supporters.

Since 2009, STP launches each year the Call to Action for the International Day of Action for Trans Depathologization, with activities being organized in cities all over the world throughout the month of October.

In October 2016, more than 120 actions took place in 47 cities worldwide within the International Day of Action for Trans Depathologization 2016.

Furthermore, at the moment (October 2016), STP counts on the support of 410 activism groups and networks, public institutions and political organizations from Africa, Asia, Europe, Latin America, North America and Oceania.

Apart from the annual call for action in October, during the year STP carries out information, networking and lobbying activities for trans depathologization.

Currently, trans depathologization activism continues to focus on the revision process of the

International Statistical Classification of Diseases and Related Health Problems

(ICD), which is published by the World Health Organization (WHO). The expected approval

date of ICD-11 by the World Health Assembly is 20184

.

As noted in previous press releases5,6,7

, we believe that the removal of trans-specific categories

from the ‘Mental and behavioural disorders’ Chapter and the inclusion of a trans-specific

 1 STP, International Campaign Stop Trans Pathologization. STP launches the Call to Action for the

International Day of Action for Trans Depathologization 2016, August 9, 2016. Available at:

http://www.stp2012.info/old/en/news#call_to_action2016 2 STP, International Campaign Stop Trans Pathologization. Acciones Octubre 2016 / October 2016 Actions.

Available at: http://stp2012.info/old/en/press#october2016_actions

3 STP, International Campaign Stop Trans Pathologization. Support. Available at:

http://stp2012.info/old/en/supports 4 WHO, World Health Organization. The International Classification of Diseases 11th Revision is due by

2018. Available at: http://www.who.int/classifications/icd/revision/en/ 5 GATE, Global Action for Trans* Equality, STP, International Campaign Stop Trans Pathologization. GATE

and STP Press Release: New Developments in the ICD Revision Process, August 19, 2014. Available at:

http://www.stp2012.info/old/en/news#information_ICD_revision_process

6 STP, International Campaign Stop Trans Pathologization. STP Press Release: International Day of Action

for Trans Depathologization 2014. 

Available at:

http://www.stp2012.info/STP_Press_Release_October_2014.pdf

7 STP, International Campaign Stop Trans Pathologization. 

STP Press Release: International Day of Action

for Trans Depathologization 2015. Available at:

http://www.stp2012.info/STP_Press_Release_October2015.pdf

Implicit Transphobia or sheer ignorance .......

both perhaps

So Dr Glenville Ashby had a piece he penned published in the Sunday Gleaner dated September 25, 2016 entitled “Transgender: denying reality” where he insidiously went off on Transgenderism and so near effortless displayed sheer ignorance on the subject(s). He was quite prepared to conflate transgender with intersex and committed the ultimate infraction when it comes to the latter that of using a now well accepted stigmatizing term as ‘hermaphrodite’ and the faux pas of transgender(ed) as if to suggest someone can be a past participle of who one is, the ‘ed’ at the end is still a problematic issue in terms of designation prior to or after re-assignment surgery or feels.

‘Hermaphrodite’ has been removed from the LGBTQI toolkit in as far discourse surrounding such physiological issues attends since 2005. The word is seen as a stigmatizing terms as it conjures up mental images of someone with merely two sex organs when the issues attendant to such matters are not ones of sexual orientation and or gender identity in as far as psychological considerations are concerned. While Dr Ashby has used the correct term ‘Intersex’ he has misdirected it to mean something else and ends up concluding some sort of abnormality or as the article is subtitled ‘denying reality’

For example he wrote:

“Transgender should not be confused with transvestite

Then he both Transgenerism and intersex as one, he wrote:

“Transgender is invariably referred to as intersex (a person that has non standard genitalia), or transsexual (a person who expresses a gender identity that is different to his or her gender at birth).”

He could have simply done some basic research on this just as how he was able to site opinions of the likes of neuroscientist Tad Pacholcyzk or Dr Paul McHugh. We have been subjected to a series of very deceptive writings and outward transphobic pronouncements by some persons pointing to Transgenderism as madness of some kind; the leader in the wave of the intellectually driven hatred is Dr Wayne West of Jamaica Coalition for a Healthy Society, JCHS fame. He has been given support by sociologist and radio show host of Everywoman on the sometimes progressive Nationwide News Network, NNN Radio one Miss Georgette Crawford.

Here is the Gleaner article in question:

The highly publicised sexual transformation of United States Olympian Bruce Jenner (now Caitlyn Jenner) has ignited a bruising political and cultural debate on gender dysphoria and 'transgenderism'.

Academicians, scientists, theologians and laypersons have weighed in on a phenomenon that is as old as civilisation.

With a shift in the cultural paradigm, transgender rights are slowly being accommodated. Federal laws prohibit discrimination against transgender individuals, and bathrooms at most public places in the United States are required to accommodate new 'gender realities'.

Not surprisingly, political, academic, and judicial activism has advanced a new confrontational liberal zeitgeist that has made it difficult to have a dissenting opinion for fear of being maliciously labelled. The same held true when conservatism was universally dominant.

There are key questions surrounding this debate. For example, is surgery appropriate in dealing with somatic dysphoria? Also, is being transgender a psychopathology? What is needed is a sober discussion based on measurable arguments and not malleable evidence fashioned by individual and social leanings.

Transgender should not be confused with transvestite (a man having pleasure in dressing like a woman), homosexuality (having sexual feelings for the same sex), bisexuality (having sexual feelings for both sexes), or hermaphrodites (a person having male and female genitalia).

Transgender is invariably referred to as intersex (a person that has non-standard genitalia), or transsexual (a person who expresses a gender identity that is different to his or her gender at birth).

In many of these cases, gender transition is made possible through surgery.

Orthodox religions have long expressed paradoxical views regarding abnormal sexual identity, not unlike its position on homosexuality. The actions of the so-called sinner are vehemently condemned, although love is professed for the perpetrator.

Russell D. Moore, president of the Ethics and Religious Liberty Commission of the southern Baptist Convention, said: "The transgender question means that conservative Christian congregation must teach what's being handed down to us, that our maleness and femaleness points us to an even deeper reality, to the unity ... of Christ and the Church.

"A rejection of the goodness of those creational realities, then, is a revolt against God's lordship, and against the picture of the gospel that God is embedded in His creation."

In marginal cases, pastors have been accused of fomenting a climate of hatred and violence towards transgender people who are deemed morally bankrupt and evil.

James Dobson, president of Focus on the Family, declared: "If you are a dad, I pray that you will protect your little girls from men who walk in unannounced, unzip their pants and urinate in front of them ... . If this happened 100 years ago, someone might have been shot."

WORSHIPPING IN CHURCHES

 

Sensing and experiencing slight from mainstream Christianity, many in the LGBT (lesbian, gay, bisexual and transgender) community have begun worshipping in churches and temples where sexual orientation is inconsequential.

Secular society, though, has pushed back forcibly against what they call intolerance and bigotry. Prominent businesses are boycotting states, such as Georgia, Indiana, and North Carolina that uphold the Religious Freedom Restoration Act that is arguably discriminatory and unconstitutional.

While battlelines are drawn, some are critically measured, preferring to understand the sexual dynamics and overall psychological profile of the transgender community.

Among those is priest and neuroscientist Tad Pacholczyk, a Yale and Harvard graduate and education director at the National Catholic Bioethics Center in Philadelphia. His scientific and theological background offered a unique insight into this highly charged subject.

In the article, 'Seeing through the intersex confusion,' he acknowledged that confounding physiological (hormonal) triggers and cultural forces lead to psychological discordance.

Comparing somatic disorders to other developmental disorders that should never "be subjected to bias or mistreatment", he argued that "while a newborn's 'intrinsic maleness' or 'intrinsic femaleness' may be difficult to access in certain more complicated intersex cases, the point remains that there is an 'underlying' sexual constitution that we must do our best to recognise and respect and act in accord with".

Equally important is his far-reaching assertion that "wilfully (denying this reality) is a prescription for disillusionment and dishonesty".

Pacholczyk has oftentimes referred to the work of the eminent Dr Paul McHugh, the former psychiatrist-in-chief at Johns Hopkins Hospital, who has been in the cross hairs of liberal professionals.

His detailed study of transgenderism and sex-reassignment surgery has produced some explosive assertions.

McHugh observed that after transitioning, individuals are still plagued by psycho-emotional and identity problems; that there is an absence of maternal characteristics and desires in transgendered individuals; and that despite haute couture over compensation there remains definitive, irreversible indicators of their maleness or femaleness.

Writing for the Wall Street Journal, McHugh likened the transgendered to "anorexia nervosa patients who believe that a drastic physical change will banish their psychosocial problems".

"At the heart of the problem," he argued, "is confusion over the nature of the transgendered."

McHugh continued: "Sex change is biologically impossible (and) people who undergo sex-reassignment surgery do not change from men to women or vice versa. Rather, they become feminised men or masculinised women."

He concluded that the transgender issue "is not a civil rights matter and encouraging surgical intervention is in reality to collaborate with and promote a mental disorder".

VERY REAL PROBLEM

 

McHugh has always emphasised that a diagnosis of mental illness should be met with the most appropriate means to address a very real problem.

Lending support to McHugh is the conservative American Association of Paediatricians.

Featured on its website is the article, 'Gender Ideology Harms Children', in which we read that "gender (an awareness and sense of oneself as male or female) is a sociological and psychological concept (and) not an objective biological one".

It also highlighted the disproportionately high rates of suicides among those who use cross-sex hormones and undergo sex realignment surgery, "even in Sweden which is among the most LGBT- affirming countries".

As both sides of the debate harden their position, the words of Pacholczyk invite reflection: " ... allowing people to 'define their identity' ignores the crucially important truth that numerous aspects of our identity, especially those related to our bodily and sexual identity, are predetermined, objective goods that we are called upon to recognise and respect in the choices we make".

I am sure as we wade through the sea of ignorance and the bliss that accompanies it we are going to see more nonsense such as this article so worded to give support but the true reasons becomes clear.

Peace & tolerance

H

also see:

Jamaican human rights advocate uses the "H" word in submissions on intersex/lgbt issues a ..... 2014

Five Myths that Hurt Intersex People 2010

Intersexuality, Ambiguous Genetalia & Psycho-social issues Discussion on Nationwide Radio 2009

Uncomfortable with Endocrinologist explanation of the case of the intersex infant

In a previous post (Jamaican Intersex (ambiguous genitalia) baby case a cause for concern part 2 ) I mentioned the push by a certain endocrinologist on early surgery of an infant who was featured on CVM TV some time ago. He has been interviewed since and has seemingly steered clear of suggesting surgery on a baby as an option, but I am not comfortable at all.

Here is an excerpt of the article involving the gentleman:

For thousands of years children have been born with what’s called ambiguous genitalia — a condition in which there is incomplete development of the external genitals, and at birth doctors are not able to clearly define a sex. Last week, Dr Leslie Gabay, consultant paediatrician and paediatric endocrinologist, addressed the biology of the condition. This week, he speaks of stigma and social repercussions.


WITH regard to the social repercussions, the sex of a baby is usually the first question friends and family members have after a birth, Dr Gabay said.

“Generally, I recommend that the parents say the infant is undergoing tests to clarify the sex due to incomplete development of the genitals,” he advised.

“If we do this, then there is no stigma. Stigma occurs only when the child goes home with one sex and this is subsequently changed. Hence the importance of early diagnosis.”

Dr Gabay said stigma has to be dealt with by family support, parental education and counselling, where necessary.

He pointed out that it is important to note that the physical development of infants (sex) has nothing to do with the psychological development (gender).

“When we’re looking at the conditions, we’re looking at developmental disorders of sexual maturation. That can give us various issues. When you talk about gender, you talk about how people feel about themselves,” he said. “I may have testes, I may have XY chromosomes, but psychologically I feel like a female. When there’s a disconnection between the physical and the psychological, we call that gender dysphoria where somebody is feeling one way, but has a phenotype that is opposite to how they feel.”

A paediatric endocrinologist looks at what can and can’t be corrected, which is whether your hormones have the capacity to complete your development as a male or female.

“So, for example, we will have an XY male who has testes and is actually making male hormones but he doesn’t have the receptors for them to work on, so he can’t get a complete development into male external genitalia. We sometimes have those same individuals with XY and testes, but their genitals look like females because the testosterone they’re making cannot work to convert the genitals into a male. So there are a number of different medical conditions which all fall under the disorders of sexual maturation, which can give you a disconnect in terms of your chromosomal sex, your gonadal sex and your phenotypic sex,” he said.

He added: “The difference between Caitlyn Jenner’s case, for example, which is a psychological disconnect between the psychology and the physicality of sex, versus when a child has a disorder of development, is vast. So, for example, if you are a boy you have XY, you have testes, you make testosterone but your tissues can’t respond to testosterone — you look like a girl. There’s nothing that I or anybody can do to make you into a boy. So you’re a girl by how you look, except that you won’t have a womb to have babies and therefore you may be able to get some sperm to do IVF, but you’re not going to carry a baby.”

Dr Gabay said most people don’t know what their chromosomes are, so definition of sex is mostly phenotypic — how you look.

“Until you have a baby or get pregnant you don’t know that your ovaries can make eggs, but all along you’re walking through school as a girl. Your chromosomes don’t make you a girl, the fact that you can make eggs or have a womb doesn’t make you a girl,” he said. “When I met you I thought you were a girl and that’s because of how you look. That’s how people walk around looking at individuals. So how we socialise in the world is based on how we look — our phenotype.”

He added that when we want to reproduce and move forward for another generation, that’s when our chromosomes, sperm and ovaries become important.


“I can’t say at six weeks of age how you will feel at five years old. But I can say at six weeks whether your hormones have the capacity to complete your development as a male or complete your development as a female,” he explained.

ENDS

Intersex activists have been advocating to delayed surgery decision making on the pat of impacted individuals with proper engagement in terms of education.

Also see:
Jamaican Intersex (ambiguous genitalia) baby case a cause for concern part 1

Treating transgenderism ..............

I would have preferred a different title from the Observer but for what it is worth

Dr Derrick Aarons

WITH increased evidence over the past 20 years pointing to the biological underpinnings of gender identity, a paradigm shift is occurring in the health care offered to transgender individuals in some countries.

In some settings, transgender medicine is a fully fledged subspecialty, and treats transgenderism as a medical and biological issue, rather than as a psychological matter.

At a recent Endocrine Society Hormones & Health: Science Writers Conference at the Boston University School of Medicine in Massachusetts, USA, the director of endocrinology education reported that gender identity is a durable biological phenomenon that, even from birth, we cannot change. In that setting, the best treatment option involved treating transgenderism medically, and this was reportedly very successful.

BIOLOGICAL EVIDENCE FOR GENDER IDENTITY

In the past, numerous attempts were made by the medical community to manipulate gender identity to align with the sex organs that were perceived at birth. For example, a research study conducted at Johns Hopkins University in the USA and published in the

New England Journal of Medicine, examined 16 children born with ‘XY’ chromosomes but with ambiguous genitalia (uncertainty in appearance, whether male or female) who underwent surgery to create female genitalia. They were all subsequently raised as girls, with the exception of two individuals whose parents raised them as boys.

When these children reached the age of puberty (around age 10-11 years), eight of them felt like boys despite being raised as girls, and the two that were raised as boys identified with being male, despite them all having female genitalia.

Other biological evidence comes from research studies dating back to the 1990s in which researchers attempted to locate brain structures that correlate with gender identity. In one classic study, published in the journal

Nature, an area of the brain (the bed nucleus of stria terminalis) was thought to correspond to gender identity, and to be involved in homosexuality. At autopsy, however, slices of this area of the brain were stained to match gender identity, and revealed instead that the area was actually smaller in women and in male-to-female transgender women, compared to that in heterosexual men.

Further, in contrast to those so reared during early childhood, a Dutch study published in the journal

Archives of Sexual Behaviour revealed that of 1,285 individuals who voluntarily changed their genders hormonally and/or surgically to match their own perceived gender identity, 99 per cent of them were satisfied with their decision.

GUIDELINES FOR CARE

Consequently, in 2009, the US Endocrine Society recognised the issue and published formal guidelines on the medical care of transgender patients. The specific treatment follows three basic steps. First, the onset of puberty is postponed by using a gonadotropin-releasing hormone analogue (a chemical which acts like the hormone), the effects of which are reversible. These analogues delay the development of the permanent, secondary sexual characteristics until a child is secure in his or her gender identity and is ready to start hormone therapy.

This approach is necessary as hormonal therapy can cause potentially irreversible changes. Patients transitioning from female to male will receive testosterone, while male-to-female individuals will receive androgen (male hormone) blockers and be given oestrogen hormone.

The specialists recognise that some young children who present as transgender may not be so as adults, and as a consequence, these professionals would not want to effect permanent changes at that first stage of puberty.

The final step may include surgery, if so desired. For female-to-male individuals, mastectomy (surgical removal of the breasts) is done to create a ‘male’ chest. In male-to-female transitions, surgery includes removal of the testicles, breast augmentation if desired, and feminisation of the face. The creation of a penis (phalloplasty) or removal of the penis and the creation of a vagina (vaginoplasty) will occur last.

LIFELONG CARE

After surgery, patients will require lifelong hormonal therapy for the health of their bones, as the latter is normally dependent on the sex steroids. Transgender women will continue to need oestrogen, and transgender men will need natural levels of testosterone.

However, we know that long-term use of steroids may carry risks, which could include blood clot (thrombosis) with the use of oestrogen, and a possible slightly increased risk for cardiovascular disease with the use of testosterone. Testosterone may also have unknown effects on tumour formation.

An example of this research was reported in the Medscape Medical News, where 3,240 women were examined over a course of 13 years, with the finding that women with high levels of testosterone at midlife were 1.33 times more likely to develop uterine fibroids, compared with women with low levels of testosterone. However, despite such occurrences, when all considerations are made, hormone therapy in humans is considered relatively safe even with the concern regarding the risk of clotting with oestrogen use. The occurrence of the latter is very uncommon.

The way forward

Evidence-based research has been greatly beneficial, but in some societies access to transgender treatment still hinges on legal and social issues, and around moral issues and religious beliefs. All these issues notwithstanding, this matter should go deeper to that of our common humanity and one’s basic right to self-expression, self-actualisation and self-fulfilment.

Derrick Aarons MD, PhD is a consultant bioethicist/family physician, a specialist in ethical issues in medicine, the life sciences and research, and is the ethicist at the Caribbean Public Health Agency – CARPHA. (The views expressed here are not written on behalf of CARPHA)

Jamaican Intersex (ambiguous genitalia) baby case a cause for concern part 2 #learning moment

See part one HERE

A reminder - What is the difference between a TRANS, transsexual or transgender person & an intersex person? INTERSEX is not a part of transgender because intersex is not about gender. Intersex is about anatomical differences in sex. Also the word ‘hermaphrodite’ is no longer an acceptable term in discussing such issues since 2005. Sadly a sociologist who hosts a show on Nationwide had fun using the term disparagingly. She is the same sociologist who featured in this previous post: Aphrodite’s P.R.I.D.E Jamaica, APJ tackles gender identity, transgender misconceptions & an ignorant sociologist ......

now to pressing matters:

So part two of the series regarding little baby ‘Angel’ and the associated ambiguous genitalia issue garnered several comments on social media where it was shared on CVM TV’s Inspire Jamaica Facebook page. The feature has been growing on the minds of Jamaicans as the stories carried therein as very positive and host Kerlene Brown has certainly grown since her appearance on television several years ago; Miss Brown obviously did some research on the matter as she also raised the issue of the timing of the surgery whether it should occur at puberty or not; my beef is not with the show itself but the decision by the goodly consulting gynaecologist & endocrinologist Dr Gabay to rush to surgery as he suggests when baby ‘Angel’ get to 18 months after the birth. Bear in mind the mother though while seemingly obedient to the suggestion has not said a full yes based on the interview. This entry is in no way questioning the competencies of persons such as Dr Gabay but the principle if not ethics regarding addressing sex and gender specific to ambiguous genitalia.

There seems to be mixed positions on whether to take the early surgery route versus waiting until after puberty. Some experts suggest it maybe too late in some cases as developmental trends may preclude such reassignment surgery or post hormonal treatment courses.

also see: Chilean officials oppose “normalization” surgery for intersex children! 2016 (OII)

The push by intersex activists worldwide but especially in the United States, Australia and Canada have all pushed that early surgery is not the way to go and that issues to do with chromosomal changes can occur even after initial tests may shoe XX as in this case and a uterus but no undescended testicles suggesting male features or the lack thereof. I still suggest that no surgery be done to little ‘Angel’ and allow the baby to develop to puberty (age 18 as our age of majority) and then allow the adult person to make a decision based on more test now that they have matured.

Intersex Issues and the International Classification Of Diseases

The ICD revision and reform process has a key relevance for the intersex movement. Diagnostic categories play a central role in expressing scientific understandings, establishing medical approaches, informing clinical protocols, defining surgical, hormonal and other treatments. Diagnostic categories defining intersex bodies reify differences between stereotypical female and male bodies on the one hand, considered to be healthy, and bodies that vary from female and male standards on the other hand, considered to be “disordered”, Or “abnormal”. Current Classifications therefore contribute to stigma and discrimination against intersex people; they endow appropriateness to medical attempts to “fix” Or “normalize”

Intersex bodies through surgical and hormonal means. They play a direct role in determining how intersex bodies are treated in society at large.

Everywhere in the world, people born with intersex traits are subjected to “normalizing” procedures, including clitoridectomies, labioplasties, vaginoplasties, gonadectomies, hypospadias “repair”, and treatment with steroids or sex hormones.

Many of these procedures are performed during infancy and early childhood when intersex individuals cannot provide their informed consent. Intersex babies, infants, children and adolescents are also subjected to related practices in medical settings, such as continued exposure. In different parts of the world, treatments also include socio--‐legal measures, including a lack of birth certificates; at least in this case according to part 1 of the video the mother explained the process she was told that she could get the changes made at the Registrar General Department, RGD. Most of these treatments have lifelong consequences: they produce sterility, genital insensitivity and impaired sexual function, chronic pain, chronic bleeding, and chronic infections, post--‐surgical depression, and trauma (in many cases associated with the experience of rape), massive internal and external scarring, metabolic imbalances.

These procedures have been internationally denounced as institutionalized forms of genital mutilation.

They reproduce and reinforce the cultural sense of intersex bodies as disordered and shameful; they produce coercive social environments. Such a hint came through loudly when the goodly doctor spoke to the possible embarrassment by the parent(s) and inquisitive family members where lies are told to cover up or deflect the scrutiny. Given what we now know I believe persons can be allowed to mature with the right psycho-social interventions and some medical monitoring but not medicalizations as seen before.

Vaginoplasties are another common feminizing treatment, performed on girls affected by CAH, by complete or partial Androgen Insensitivity Syndrome, or by Mayer Rokitansky Kuster Hauser Syndrome.

Vaginoplasties, as well as other associated genitoplasties, seems to be the recommended course in this specific case and which are also performed to feminize intersex bodies when an infant has been assigned female at birth –for example, in cases of penile agenesis. Early surgical interventions are known to have significant negative consequences:

In children with ambiguous genitalia assigned female, vaginoplasty is commonly performed during the first year of life even though the child will not menstruate for a further 10 or so years and is unlikely to be sexually active until after puberty.

High rates of introital stenosis of up to 100% have been demonstrated as well as frequent requirements for repeated reconstructive surgery in adolescence before tampon use or intercourse. Given that there is no available data to suggest early infant vaginoplasty has a better long-term outcome than a later delayed surgery, vaginoplasty in infancy is, then, chiefly to create a reassuring appearance for parents and clinicians’.

Vaginoplasties usually require regular follow--‐up treatment through dilation, a procedure that has been repeatedly identified as an experience comparable with rape by intersex people forced to undergo it after non--‐consensual interventions, or following interventions where consent was not fully informed. The latter cases are characterized by inadequate or incomplete access to proper information regarding follow up treatment and long--‐lasting consequences.

Dense scarring and the closing of the vagina opening are common complications [in addition to] chronic pain during intercourse, excessive vaginal secretion and total closure of the vagina”, complicated by other factors “including poor communication, inadequate follow--‐up, humiliating encounters with health professionals including medical photography, poor treatment outcome, and inadequate psychological support.

Given the occurrence of long term failures, long--‐term follow up is rare, for example, because pediatric urologists do not follow patients into adulthood, and because patients “have been shown to be reluctant to seek further medical advice despite significant distress”; clinicians acknowledge that such data are necessary “to provide an honest and meaningful account” of results.

Given the limitations of such data, a “common weakness of the existing literature is that most studies have been based on surgeon impressions of outcome, as opposed to patient satisfaction”

Other concerns
Prenatal Treatment

Dexamethasone, a steroid, is used to prevent homosexuality and physical “virilization”in infants with CAH assigned female. This is defended as a means of preventing post--‐natal elective surgical treatments, and is considered to be of greater benefit than established cognitive and physical risks to the children exposed to such treatment. Dexamethasone treatment does not address the more critical issue of salt wasting associated with CAH, an issue which may necessitate urgent medical attention to ensure the health of an infant. Genital variation is seen as a social emergency.

Sterilization

Sterilization is a consequence of treatment rationales related to tumor risk. The fertility of persons with intersex variations is not valued in the same way as that of other persons – and sterilizations may not be viewed as such if a child’s capacity for fertility does not match a gender assignment or reassignment removing a person’s only route to biological parenthood.

I hope some gentile persuasion can be brought to bear on this and a rushed decision is not enter into on the part of the mother for this baby; Dr Gabay did say in the video that the department which he is a part sees on average five to six cases per year.

What isn’t intersex ?

A point from OII Australia with whom I totally support:

INTERSEX is not a sexual orientation. Although nearly all intersex have a sexual orientation, we are no different to other people in this. It is unknown if our intersex influences our sexual orientation and intersex resist efforts by researchers who seek to link the two. We do this because we hold the view that it is a back door way to find the gay gene. We hold the view that this effort is essentially homophobic.

Peace & tolerance

H

IOC rules transgender athletes can take part in Olympics without surgery

Female-to-male athletes can compete ‘without restriction’, while male-to-female athletes must undergo hormone therapy, according to new guidelines

Source: Guardian

Transgender athletes should be allowed to compete in the Olympics and other international events without undergoing sex reassignment surgery, according to new guidelines adopted by the IOC.

International Olympic Committee medical officials said on Sunday they changed the policy to adapt to current scientific, social and legal attitudes on transgender issues.

Rio 2016: hopes high that Games can reacquaint world with sport’s good side

The guidelines are designed as recommendations – not rules or regulations – for international sports federations and other bodies to follow and should apply for this year’s Olympics in Rio de Janeiro.

“I don’t think many federations have rules on defining eligibility of transgender individuals,” IOC medical director Dr Richard Budgett said. “This should give them the confidence and stimulus to put these rules in place.”

Under the previous IOC guidelines, approved in 2003, athletes who transitioned from male to female or vice versa were required to have reassignment surgery followed by at least two years of hormone therapy in order to be eligible to compete.

Now, surgery will no longer be required, with female-to-male transgender athletes eligible to take part in men’s competitions “without restriction”.

Meanwhile, male-to-female transgender athletes will need to demonstrate that their testosterone level has been below a certain cutoff point for at least one year before their first competition.

“It is necessary to ensure insofar as possible that trans athletes are not excluded from the opportunity to participate in sporting competition,” the IOC said in a document (pdf) posted on its website that outlines the guidelines. “The overriding sporting objective is and remains the guarantee of fair competition.

“To require surgical anatomical changes as a precondition to participation is not necessary to preserve fair competition and may be inconsistent with developing legislation and notions of human rights,” it added.

The guidelines, first reported by Outsports.com, were approved after a meeting in November 2015 in Lausanne, Switzerland, of Olympic officials and medical experts.

Budgett said there were no plans for the guidelines to be sent for approval by the IOC executive board.

“This is a scientific consensus paper, not a rule or regulation,” he said. “It is the advice of the medical and scientific commission and what we consider the best advice.”

Former IOC medical commission chairman Arne Ljungqvist, who was among the experts involved in drafting the new guidelines, said the consensus was driven by social and political changes.

“It has become much more of a social issue than in the past,” he told Associated Press. “We had to review and look into this from a new angle. We needed to adapt to the modern legislation around the world. We felt we cannot impose a surgery if that is no longer a legal requirement.

“Those cases are very few, but we had to answer the question,” he added. “It is an adaptation to a human rights issue. This is an important matter. It’s a trend of being more flexible and more liberal.”

Under the new rules, an athlete transitioning to a woman must undergo hormone therapy and demonstrate that the total level of male testosterone in the blood has been below 10 nanomols per litre for at least a year prior to competing.

The previous rule stated that, in addition to reassignment surgery, the athlete required a minimum of two years of hormone treatment. How long it will take the athlete to reach the new cutoff limit will depend on individual cases, Ljungqvist said.

“If you change sex, you will have to have a hormone level below 10 for 12 months,” he said. “That does not mean a one-year guarantee. You don’t go below 10 from day one. It takes quite some time. It can take more than one year or two years.”

The issue gained extra prominence after former Olympic decathlon champion Caitlyn Jenner announced last year that she had transitioned to a woman.

The IOC document also cited the case of hyperandrogenism, or presence of high levels of testosterone in female athletes.

Indian sprinter Dutee Chand was suspended by the IAAF in 2014 due to hyperandrogenism and missed the Commonwealth games and Asian games.

But the court of arbitration for sport (CAS) suspended the rule last year, saying the IAAF had failed to prove that women with naturally high levels of testosterone had a competitive edge. Chand was cleared to compete, and the court gave the IAAF until July 2017 to present new scientific evidence.

The IOC statement urged the IAAF and others to go back to the CAS with arguments in favor of reinstating the rule.

“To avoid discrimination, if not eligible for female competition, the athlete should be eligible to compete in male competition,” the IOC said.

The issue of gender verification gained global attention after South African runner Caster Semenya was ordered to undergo sex tests after winning the 800m world title in 2009. She was eventually cleared to compete by the IAAF and won silver in the 800m at the 2012 London Olympics.

The IOC used to conduct gender verification tests at the Olympics, but those chromosome-based screenings were dropped before the 2000 Sydney Games because they were deemed unscientific and unethical.

Sex reassignment surgery may protect metabolic health of transgender women

Transgender women who undergo sex reassignment surgery and hormone therapy may be less likely to develop metabolic disease than those who receive hormone therapy alone. This is according to new research recently presented at Cardiovascular, Renal and Metabolic Diseases: Physiology and Gender - a conference of the American Physiological Society, held in Annapolis, MD.

Sex reassignment surgery combined with female hormone therapy may protect the metabolic health of transgender women, researchers suggest.

Previous research has suggested that transgender women are at greater risk for cardiovascular disease and type 2 diabetes, compared with men and women among the general population.

Some studies have put this increased risk down to female hormone therapy; therapy with the female hormoneestrogen, for example, has been linked to high blood pressure and increased risk of stroke and heart attack.

For this latest study, lead author Michael Nelson, PhD, of the Cedars-Sinai Medical Center in Los Angeles, CA, and colleagues set out to determine whether this metabolic risk varied depending on the type of therapy used make the male-to-female transition.

The team enrolled 12 transgender women to their study, four of whom were receiving female hormone therapy and eight of whom received a combination of female hormone therapy and bilateral orchiectomy - in which both testicles are surgically removed.

The researchers measured the insulin resistance and the accumulation of fat in the liver of each participant. They explain that insulin resistance is a key sign of poor metabolic health, and build-up of fat in the liver can cause nonalcoholic fatty liver disease - which studies have suggested can increase heart disease risk.

Bilateral orchiectomy may benefit metabolic health

Compared with transgender women who received female hormone therapy alone, those who received both female hormone therapy and bilateral orchiectomy were found to have better metabolic health.

Specifically, the team found that transgender women only receiving hormone therapy had greater insulin resistance and greater accumulation of fat in the liver than those who received both surgery and female hormone therapy.

Transgender women who had the highest levels of testosterone were found to have the poorest metabolic health, according to the researchers.

In addition, the team found that the amount of fat build-up in the liver was linked to the level of insulin resistance; whether the two are associated is an ongoing subject of debate in the medical world.

Overall, the researchers say their findings indicate transgender women who undergo bilateral orchiectomy may be protected against insulin resistance and fat build-up in the liver, while the two conditions are more likely to develop among those who receive hormone therapy alone.

Earlier this year, Medical News Today reported on a study that found transgender children do not have a hormone imbalance. - udy published in the Journal of Adolescent Health has revealed that the hormone levels of transgender youth are consistent with the gender they were assigned at birth.


A transgender symbol.

The term transgender is typically used to describe individuals whose gender self-identification does not match their birth-assigned gender.

"We've now put to rest the residual belief that transgender experience is a result of a hormone imbalance," says study author Dr. Johanna Olson of Children's Hospital Los Angeles (CHLA). "It's not."

The study conducted by Dr. Olson and colleagues is concerned with assessing the safety and effectiveness of treatments to help transgender patients bring their bodies closer in alignment to their gender identity.

Children who have reached puberty can be treated with gonadotrophin-releasing hormone (GnRH) analogs - synthetic hormones that suppress those produced by the body during puberty in order to delay physical changes to the body.

Such treatment is sought following the development of gender dysphoria - a sense of distress and anxiety that can occur when an individual feels dissonance between their gender identity and the sex they were assigned at birth. More and more young people are seeking treatment for this condition every year.

"Although transgender youth are known to be at high risk for depression, anxiety, and suicidality, there are no data available describing the physical and psychosocial characteristics of transgender adolescents seeking sex reassignment in the United States," the authors of the study write.

To amend this, the researchers have enrolled 101 transgender participants aged 12-24 years old for their prospective study. Of these, 51.5% were assigned "male" at birth and identify as transfeminine and 48.5% were assigned "female" at birth and identify as transmasculine.

After measuring a number of physiological parameters, the researchers discovered that the participants' hormone levels were in line with the normal ranges of the same assigned sex nontransgender youth population. Transmasculine participants had the same average hormone ranges as cisgender females and transfeminine participants had the same as cisgender males.

The researchers noted that many of the participants were overweight or obese, leading them to hypothesize that transgender individuals might use increased body fat to hide undesirable physical features.

Transgender youth aware of gender identity at early age

On average, the participants identified a discrepancy with their assigned gender at the age of 8. They did not tell their families until reaching, on average, the age of 17 years.

Alongside this, the researchers found that 35% of the participants reported symptoms of depression and that more than half had thoughts about suicide - significantly higher than the prevalence among general youth.

"Considering that transgender youth in this sample did not disclose their authentic gender to their families until 10 years after discovery on average, it might not be surprising that many are using maladaptive coping mechanisms to manage such a profound undisclosed element of their core selves," the authors write.

The prevalence of these mental health problems among transgender youth indicates that timely and appropriate intervention could be hugely beneficial to this group.

Having now established the baseline characteristics of the transgender participants, the researchers will continue to assess them over time, tracking the safety and efficacy of any medical interventions they receive as well as their impact on quality of life.

"My goal is to move kids who are having a gender-atypical experience from survive to thrive," Dr. Olson states. "With this study we hope to identify the best way to accomplish that."

The researchers will continue to publish follow-up data as they collect it, and they recommend that other medical centers providing care to transgender should consider collecting information and publishing their experiences as well.

A study published earlier this year demonstrated that the gender identity of transgender children is deeply held and consistent rather than the result of confusion as many people have previously maintained.

Finally Published in the Journal of Adolescent Health, the study of more than 100 transgender youths found that their hormone levels between the ages of 12-24 were consistent with the gender they were assigned at birth.

Dr Shelly Ann Weeks on Gender Identity & Sexual Orientation

When the Caitlyn Jenner matter first came to light and in the height of the euphoria Nationwide radio had a discussion on the issue with the present host of the show "Everywoman" Georgette Crawford who in essence made a mess of herself as a sociologist describing Caitlyn's journey and that of another panelist our own trans voice Satiba co-founder of Aphrodite's P.R.I.D.E Jamaica as mad.

see more on that here Aphrodite’s P.R.I.D.E Jamaica, APJ tackles gender identity, transgender misconceptions & an ignorant sociologist 

Thankfully the previous host of the same "Everywoman" radio show who happens to be a psychologist (maybe NNN needs to reconsider her hosting again) Dr Shelly Ann Weeks (her previous writing: Dr Shelly Ann Weeks on Homophobia - What are we afraid of?) has produced another simple but effective explanation of gender identity and sexual orientation which seems to be conflated in the reaction to the Jenner transition. Sadly we are not as highly exposed as let's say Cuba where their national public awareness programs on LGBT matters via the national TV station provide a steady feed of information, discussion and more.

Have a read of Dr. Weeks' piece as published in the Star today.

You would have to be living under a rock that's under the ocean to not have heard about Bruce Jenner's transition into Caitlyn Jenner.

"Call me Caitlyn" was the statement on the most recent cover of Vanity Fair magazine with a very feminine brunette who vaguely looks like Bruce Jenner in drag. This epic announcement has influenced passionate responses and a myriad of questions.

Bruce's transition to Caitlyn is possibly the most public declaration for a transgender person, and many persons seeing it for the first time were shocked. What made it even more traumatic is that Bruce was the ultimate alpha male. He's an Olympic star, father of six children and has been married three different times.

So how could he want to be identified as a woman? 

This is a very confusing idea especially for many persons who are already secure in how they identify themselves, so the thought of being so unhappy with the body a person was born with, is unbelievable. For some, the big question is about the sexuality, now that the transition has been made and Caitlyn will keep her penis. With all the questions, I found it important to make the distinction between gender identity and sexuality.

Gender Identity

Simply put, your identity is how you see yourself, and how you want to be seen by others. Gender can be masculine, feminine, intersex (having both male and female characteristics), or transgender (when a person's biological sex and gender identity don't match up). For some, gender identity is defined simply by the biological gender that they were born with. Culture and tradition also influence gender identity because there are defined gender roles that most persons conform to.

Sexuality

A person's sexuality is defined by the gender of the person that they are attracted to sexually. The spectrum can vary from asexual (no sexual attraction), heterosexual (opposite gender), homosexual (same gender), bisexual (male and female), pansexual (all genders).

It is important to note that while identity and sexuality are important aspects of human behaviour, they are not mutually exclusive.

Gender identity is very personal and though there are a lot of expectations placed on individuals because of their biology and so deviating from that is met with much skepticism. Butch women, for example, have become commonplace in Jamaica as quite a few young women choose not to express their identity in a stereotypically feminine way. While some of these ladies are homosexual, it's not always the case. While we continue to understand each other and persons express their identities, it is important that we are respectful of each other's choices whether we agree with them or not. 

Have fun and stay sexy!

ENDS

XXtraz here she is originally from her Youtube channel on Buggery and such:

Peace and tolerance

H

Caribbean tourism must reflect changing demands ....... pink $$$ anyone?

After years of idling in the doldrums, visitor arrivals to some parts of the region are increasing rapidly, travellers are spending more, and the yield for hoteliers is increasing. Moreover, as demand soars in Cuba, Jamaica, the Dominican Republic and some smaller Caribbean destinations like Aruba, it is getting much harder for visitors to find a quality hotel room at short notice. Recent figures by the tourism ministry reflect good increases but those only reflect a lower section of the US market in particular while the ever increasing and robust if not bold LGBT market is yet to be tapped into.

Gay marriage rights are almost covering the 50+ states in the US, The UK has already moved in that direction and the EU is quite clear as to such rights and state benefits. Correspondingly local travel interests in those jurisdictions have adjusted rapidly to meet their demands and while LGBTQ family goes mainstream they have more disposable income and on the face of it seeking relaxative environments outside their countries, honeymoons anyone?

The Business of Tourism - Caribbean tourism must reflect changing demands

Cuba apart, which is a special case following the virtual freeing of US travel restrictions late last year, this rapid increase in demand for a Caribbean vacation largely reflects the fact that disposable income in the main feeder markets in North America and parts of Europe is increasing as economic recovery occurs and travellers begin to feel more financially secure. It is also the case that some Caribbean destinations such as Jamaica have again become hot in the eyes of those who establish on social media and in print the image of an aspirational destination.

see this previous post:

Cuba Makes Progress in Sex Reassignment Surgery ... expects communist party to accept LGBT rights 2012

Cuban(s) enjoys new benefit of free sex-change operation 2011

Mariela Castro: “U.S government is concerned about LGBT movement in Cuba” 2012

Cuba Looking to Become Gay Travel Hotspot 2013

Cuba's already forward thinking treatment of LGBT matters especially transgenderism the recent changes of US foreign policy and courting by the federal government when the trappings are finally gone the flood gates will open. Medical tourism especially may grow there given the above posts hints to free reassignment surgery and their overall state healthcare.

But for the most successful Caribbean markets, there are also other factors at work.

The recent surge in visitor demand and indications that even the lower-cost coming summer season is building well reflect better marketing, product improvements, and new airlift that has resulted in improved access, for instance, from the countries of Latin America and from Scandinavia. It also in part, reflects the ability of lower-cost air carriers to pass on to the growing numbers of visitors using their services, the savings they are making as the price of aviation fuel falls.

What this means is that the industry in many Caribbean tourism destinations is not only making a significant contribution to national economic recovery, but again demonstrating its often-ignored significance to the wider Caribbean economy.

At its most basic, this is good news, but it also raises interesting questions as to where the region's product is headed now that sustainable growth again seems possible.

For some, renewed demand is simply about a return to business as usual, the end to heavy discounting of room rates, and the Caribbean again taking its 'rightful place' as the world's paramount warm-water destination.

Competitive marketplace

However, for those who are more thoughtful, it is about recognising that during the years of stagnation, the global marketplace for tourism has changed, becoming intensely competitive, and that the future will require adapting the product and the tourism offering so that present success is sustainable.

For those willing to look over the horizon, the issue now is about reorienting and developing the Caribbean tourism offering to reflect changing international demand for the authentic, quality service and cuisine; and even when the price is high, value for money. It reflects, too, an understanding that a significant part of the higher spending end of the market is looking for much more than just a luxury hotel and a beach in the tropics.

This will mean a sea change in the way that some in the industry and government in the region think. It is about more than the normal default position of rebranding. It requires a new approach involving both the industry and government reconceptualising tourism, hotels and the tourism product in ways that make it globally competitive and ensures that a visitor feels that the region and a destination is special and wants to return.

This will not be easy as it requires properties, restaurants, attractions, and if they are able to become better corporate citizens, the internationally branded chain hotels, to think in a vernacular way and come together to renew and develop the product in a manner that promotes the uniqueness of the Caribbean nations in which they are located.

The old practice of the LGBT market having to be engaged most discreetly as they do come but under most private arrangements often in ultra private villas for security reasons. Outward displays of affection is a no no even if you're a tourist (local culture may often overlook certain things) 

Tolerant industry

"Our hotels have always welcomed. We don't necessarily place ads advertising that we accept the LGBT, but we would never turn back persons because of their sexual preferences," said a Negril hotelier, who added that there is really no difference from how the LGBT market was treated by the average hotel 20 years ago.

"The industry has always been more tolerant than the rest of the society," said the hotelier, adding that there are many gays working in the tourism sector, so it's no big news.

Another hotelier says Jamaica is not ready for this market, which is a big mistake. "I have tried to target them in the past, but I have given up, because it's a hard sell, particularly because of our homophobic reputation," said the hotelier.

She said if members of the LGBT community were to turn up at her property they wouldn't be turned back. She admits that the market has huge potential of pumping foreign exchange into the island's coffers.

also see:

LGBT leisure travel market set to spike .................... LGBT "friendly" resorts are here

Jamaica missing out on gay billions, says J'can scholar 2008 from the Jamaica Observer

Peace and tolerance

H