[PASSED] Access to Transgender Hormone Therapy

[Goobergunchia]

Hey there guys, gals and non-binary pals!

After being repulsed by some transphobic BS earlier today (edit for clarification: not on NS), I remembered that I had this draft. You may think you’re suffering from déjà vu rn, and ask "don’t we already have a resolution on hormone therapy??" Yes. However, there are two key differences in this one:

• it includes non naturally occurring hormones as part of "hormone therapy", which was not included in 467,
  
• free drugs lol

The one problem that will arise from this of course would be potential illegality due to duplication with 467. So if any quick witted commentators believe I should accompany this proposal with a repeal, please let me know! (In addition to other feedback)

Now, without further ado...

The World Assembly,

Heralding the efforts made by GA#467 "Affordable Transgender Hormone Therapy" which ensured that transgender individuals could easily access hormone therapy for medical transition,

Recognising, however, that the resolution does not go far enough in ensuring that transgender individuals receive the medication they need, such as through the exclusion of puberty blockers from the definition of "hormone therapy",

Totally believing that a supplementary resolution is required to resolve these issues, hereby:

1. Defines "hormone therapy" as any medical treatment using hormones or chemicals that reduce their effect which is carried out on a person effectively and with minimal risk to their health for the sole purpose of aligning their sexual characteristics with their gender identity (or lack thereof),
   
2. Requires member nations to allow their inhabitants to seek and obtain hormone therapy with their free and informed consent, and ensure that those inhabitants face as few barriers as possible when seeking hormone therapy,
   
3. Mandates that the process of seeking and obtaining hormone therapy cost no more than the fees absolutely necessary for the manufacturing and distribution of hormone therapy, and very strongly urges member nations to waive any and all costs inhabitants may have to pay when seeking and obtaining hormone therapy,
   
4. Forbids any entity from:
   
   
   1. denying hormone therapy to any person, except where a legitimate danger to their health would arise as a result,
      
   2. requiring any person to seek or obtain hormone therapy,
      
   3. coercing anyone to seek or obtain hormone therapy, and further forbids entities from coercing people to not seek or obtain hormone therapy.

(Title is tentative btw)

[Berhakonia]

Would section 1 include anabolic steroids and other general testosterone-enhacing drugs that would be considered contraband in certain nations?

Also, regarding sections 3a and 3b, am I reading those provisions wrong or did you just write them to contradict themselves? It reads as if WA nations are to be forbidden from denying hormone replacement procedures AND reccomending them to patients.

[Honeydewistania]

Would section 1 include anabolic steroids and other general testosterone-enhacing drugs that would be considered contraband in certain nations?

Also, regarding sections 3a and 3b, am I reading those provisions wrong or did you just write them to contradict themselves? It reads as if WA nations are to be forbidden from denying hormone replacement procedures AND reccomending them to patients.

Hormone therapy in the definition is to align your gender identity, not for getting jacked. But I guess a little extra clarification won’t hurt.

Also, I think you did read them wrong, because its forbidding nations from forcing people to go for it, which does not contradict allowing willing people to go for it

[Bananaistan]

"Removing hormone therapy from the realm of healthcare is bad policy. You'd literally be forcing us to allow any quack, qualified only in woo, to "treat" already vulnerable people and profit from it at the taxpayers' expense. Opposed."

[Berhakonia]

Would section 1 include anabolic steroids and other general testosterone-enhacing drugs that would be considered contraband in certain nations?

Also, regarding sections 3a and 3b, am I reading those provisions wrong or did you just write them to contradict themselves? It reads as if WA nations are to be forbidden from denying hormone replacement procedures AND reccomending them to patients.

Hormone therapy in the definition is to align your gender identity, not for getting jacked. But I guess a little extra clarification won’t hurt.

Also, I think you did read them wrong, because its forbidding nations from forcing people to go for it, which does not contradict allowing willing people to go for it

What's to prevent an individual from citing gender dysphoria as grounds to purchase steroids? Would this be left to state legislators to decide? And if the matter is left to state legislators, what's to prevent them from declaring all hormone treatments as contraband?

[Honeydewistania]

"Removing hormone therapy from the realm of healthcare is bad policy. You'd literally be forcing us to allow any quack, qualified only in woo, to "treat" already vulnerable people and profit from it at the taxpayers' expense. Opposed."

My sincere apologies. I have hopefully corrected the mistake, and have had the intern in question responsible for the oversight flogged at the stake

[Bananaistan]

"Removing hormone therapy from the realm of healthcare is bad policy. You'd literally be forcing us to allow any quack, qualified only in woo, to "treat" already vulnerable people and profit from it at the taxpayers' expense. Opposed."

My sincere apologies. I have hopefully corrected the mistake, and have had the intern in question responsible for the oversight flogged at the stake

"So then. What does this now do that GAR#467 doesn't already?"

[The Hazar Amisnery]

I don't like section 3 subsection D. Transgender hormone therapy is an expensive, lengthy and complicated process. In The Hazar Amisnery, we make all non and semi elective medical procedures free and hormone therapy is elective. You don't need it so we shouldn't have to pay for it.

[Honeydewistania]

I don't like section 3 subsection D. Transgender hormone therapy is an expensive, lengthy and complicated process. In The Hazar Amisnery, we make all non and semi elective medical procedures free and hormone therapy is elective. You don't need it so we shouldn't have to pay for it.

"Need" is very subjective. We disagree.

Hormone therapy in the definition is to align your gender identity, not for getting jacked. But I guess a little extra clarification won’t hurt.

Also, I think you did read them wrong, because its forbidding nations from forcing people to go for it, which does not contradict allowing willing people to go for it

What's to prevent an individual from citing gender dysphoria as grounds to purchase steroids? Would this be left to state legislators to decide? And if the matter is left to state legislators, what's to prevent them from declaring all hormone treatments as contraband?

Fair. What do you suggest we should do with regards to amendments of this proposal to address your concerns? I was thinking of allowing people to block the sale of hormones to people who are doing it because they want drugs and not because they're transitioning, but that seems like a huge can of worms

My sincere apologies. I have hopefully corrected the mistake, and have had the intern in question responsible for the oversight flogged at the stake

"So then. What does this now do that GAR#467 doesn't already?"

GA#467 does not cover synthetic drugs used in HRT (OOC: examples include https://en.m.wikipedia.org/wiki/Leuprorelin and others). As they can be very costly, we feel that legislation ensuring greedy pharmaceutical companies do not overcharge for these drugs.

Also, now everything is free. Which GA#467 does not guarantee. Plus some other minor stuff.

[The Hazar Amisnery]

I don't like section 3 subsection D. Transgender hormone therapy is an expensive, lengthy and complicated process. In The Hazar Amisnery, we make all non and semi elective medical procedures free and hormone therapy is elective. You don't need it so we shouldn't have to pay for it.

"Need" is very subjective. We disagree.

What's to prevent an individual from citing gender dysphoria as grounds to purchase steroids? Would this be left to state legislators to decide? And if the matter is left to state legislators, what's to prevent them from declaring all hormone treatments as contraband?

Fair. What do you suggest we should do with regards to amendments of this proposal to address your concerns? I was thinking of allowing people to block the sale of hormones to people who are doing it because they want drugs and not because they're transitioning, but that seems like a huge can of worms

"So then. What does this now do that GAR#467 doesn't already?"

GA#467 does not cover synthetic drugs used in HRT (OOC: examples include https://en.m.wikipedia.org/wiki/Leuprorelin and others). As they can be very costly, we feel that legislation ensuring greedy pharmaceutical companies do not overcharge for these drugs.

Also, now everything is free. Which GA#467 does not guarantee. Plus some other minor stuff.

Transgender people won't die if they don't get hormone replacement.

[Berhakonia]

I don't like section 3 subsection D. Transgender hormone therapy is an expensive, lengthy and complicated process. In The Hazar Amisnery, we make all non and semi elective medical procedures free and hormone therapy is elective. You don't need it so we shouldn't have to pay for it.

"Need" is very subjective. We disagree.

What's to prevent an individual from citing gender dysphoria as grounds to purchase steroids? Would this be left to state legislators to decide? And if the matter is left to state legislators, what's to prevent them from declaring all hormone treatments as contraband?

Fair. What do you suggest we should do with regards to amendments of this proposal to address your concerns? I was thinking of allowing people to block the sale of hormones to people who are doing it because they want drugs and not because they're transitioning, but that seems like a huge can of worms

"So then. What does this now do that GAR#467 doesn't already?"

GA#467 does not cover synthetic drugs used in HRT (OOC: examples include https://en.m.wikipedia.org/wiki/Leuprorelin and others). As they can be very costly, we feel that legislation ensuring greedy pharmaceutical companies do not overcharge for these drugs.

Also, now everything is free. Which GA#467 does not guarantee. Plus some other minor stuff.

I'm naturally going to be against this legislation, so take my suggestions with a grain of salt. You can either specify an exhaustive blacklist of certain hormone-altering drugs that run the risk of infringing on being contraband, modify your initial definition of hormone therapy to refer to previous WA legislation (if such a legislation exists) defining hormone therapy in greater detail that doesn't run you into trouble with the law, or mandate that each country under the WA set up agencies to discern hormone replacement medication from illegal substances. None of these options are super great imo, but I hope they gave you some ideas.

[Jedinsto]

"Need" is very subjective. We disagree.


Fair. What do you suggest we should do with regards to amendments of this proposal to address your concerns? I was thinking of allowing people to block the sale of hormones to people who are doing it because they want drugs and not because they're transitioning, but that seems like a huge can of worms



GA#467 does not cover synthetic drugs used in HRT (OOC: examples include https://en.m.wikipedia.org/wiki/Leuprorelin and others). As they can be very costly, we feel that legislation ensuring greedy pharmaceutical companies do not overcharge for these drugs.

Also, now everything is free. Which GA#467 does not guarantee. Plus some other minor stuff.

Transgender people won't die if they don't get hormone replacement.

People would probably like to express themselves in how they look. If they want hormone therapy they should be given hormone therapy.

Support for the draft.

[Bananaistan]

GA#467 does not cover synthetic drugs used in HRT (OOC: examples include https://en.m.wikipedia.org/wiki/Leuprorelin and others). As they can be very costly, we feel that legislation ensuring greedy pharmaceutical companies do not overcharge for these drugs.

Also, now everything is free. Which GA#467 does not guarantee. Plus some other minor stuff.

"As a fairly characteristic of socialism, Bananaistan has single-payer, universal healthcare so it wouldn't be an issue - those who can afford to pay more into the system, do so through the tax system. But I can envisage it being an issue with other nations who might like to have those who can afford to do so, to make a contribution towards their care.

"Also, the proposal does not stick it to big pharma - it sticks it to the proletariat who always end up paying for everything anyway."

[Berhakonia]

Transgender people won't die if they don't get hormone replacement.

People would probably like to express themselves in how they look. If they want hormone therapy they should be given hormone therapy.

Support for the draft.

What I'm getting out of this is that the responsibility of hormone replacement will be placed on the shoulders of the taxpayer, and HRT will be treated as a health care issue. I shouldn't have to become a rogue state for not willing to allocate a decent amount of the national health care budget (which is already being used to prop up cancer patients, world-class surgical procedures and elderly and comatose care) on hormone replacement therapy at the demand of any given patient.

This brings me to my second point, aqusition of HRT seems to be dependent on the patient's personal judgement and not by an official diagnosis of gender dysphoria by a clinical psychologist or a behavioural examiner. This would go against traditional medical practice, and would set a dangerous precedent of cutting medical diagnosis out of the picture entirely and granting access to life-altering procedures at a whim.

[Honeydewistania]

OOC: I’m going to respond to other stuff more in depth tomorrow when I’m less tired, but if the free part is going to be too controversial, I may be persuaded to remove it. :c

[The Hazar Amisnery]

OOC: I’m going to respond to other stuff more in depth tomorrow when I’m less tired, but if the free part is going to be too controversial, I may be persuaded to remove it. :c

If you are referencing me, I don't see what is so controversial. The US makes life saving surgery cost money.

[Honeydewistania]

OOC: I’m going to respond to other stuff more in depth tomorrow when I’m less tired, but if the free part is going to be too controversial, I may be persuaded to remove it. :c

If you are referencing me, I don't see what is so controversial. The US makes life saving surgery cost money.

You’re not the only one here that has stated opposition for it being free to everyone.

Also, I believe life saving surgery should also be free, but that’s something for another day

[Sylh Alanor]

OOC: I’m going to respond to other stuff more in depth tomorrow when I’m less tired, but if the free part is going to be too controversial, I may be persuaded to remove it. :c

If you are referencing me, I don't see what is so controversial. The US makes life saving surgery cost money.

Perhaps we shouldn't look to the US as an exemplar of good healthcare choices.

[Hulldom]

“Support, and we ask you use the title of the thread as your submission title.”

[Jedinsto]

“Support, and we ask you use the title of the thread as your submission title.”

“This tbh.”
-James DuBois’ 14 year old daughter Alissa DuBois.

[Bears Armed]

“Support, and we ask you use the title of the thread as your submission title.”

OOC: If they do that, then I'd be tempted to mark it as illegal under the 'Understandable English' rule.

[Honeydewistania]

People would probably like to express themselves in how they look. If they want hormone therapy they should be given hormone therapy.

Support for the draft.

What I'm getting out of this is that the responsibility of hormone replacement will be placed on the shoulders of the taxpayer, and HRT will be treated as a health care issue. I shouldn't have to become a rogue state for not willing to allocate a decent amount of the national health care budget (which is already being used to prop up cancer patients, world-class surgical procedures and elderly and comatose care) on hormone replacement therapy at the demand of any given patient.

This brings me to my second point, aqusition of HRT seems to be dependent on the patient's personal judgement and not by an official diagnosis of gender dysphoria by a clinical psychologist or a behavioural examiner. This would go against traditional medical practice, and would set a dangerous precedent of cutting medical diagnosis out of the picture entirely and granting access to life-altering procedures at a whim.

1. HRT is already treated as a health care issue, and is already ensured to be affordable under GA#467. This is just going one small step.

Also, becoming a rogue state just because you don’t want to pay an extra bit of cash to ensure people get hormones is embarrassing. Trans lives matter.

2. I feel like this could go under the ‘legitimate concerns for health’ section. I’m slightly reluctant to specifically require diagnosis of dysphoria since member nations could do all sorts of exploiting round that loophole that I don’t want.

“Support, and we ask you use the title of the thread as your submission title.”

OOC: If they do that, then I'd be tempted to mark it as illegal under the 'Understandable English' rule.

OOC:

[Araraukar]

I don't like section 3 subsection D. Transgender hormone therapy is an expensive, lengthy and complicated process. In The Hazar Amisnery, we make all non and semi elective medical procedures free and hormone therapy is elective. You don't need it so we shouldn't have to pay for it.

OOC: Just an OOC notice that that is only true in for-profit healthcare systems. It is not true in the majority of RL European nations, for example. Lengthy it is, as it's life-long, but so are many other such medications, including hormonal ones, such as thyroid hormone supplements. Complicated it is not, unless it is complicated for you to either take a pill or two daily (estrogen, and blockers) and/or slather your inner thighs with a gel (testosterone, though you can also get it in injections, but the gel you can apply yourself and it's cheap) once a day.

[Morover]

Darin Perise, President of the Morovian Department on the World Assembly and author of "Affordable Transgender Hormone Therapy".

"I'll forward you the number of our local therapist - following the thousands of death threats sent to our office during the voting and following the passage of the original, they are certainly experienced with dealing with the aftermath of trying to pass something like this."

"I have a few things to note about the draft: Firstly, I'm not entirely convinced that the lack of inclusion to synthetic hormones is necessarily a bad thing; either a reasonable, well-meaning nation realizes that synthetic hormone therapy necessarily needs to be included within the draft in order for it to be cheaper on their own wallets, or a transphobic nation who intentionally excludes synthetic hormones has to break the bank in order to comply with 467. And though I say this, if I had even thought about the implications behind unintentionally excluding synthetic hormones, I wouldn't have made that mistake - I just think it's not an end-of-the-world issue. Secondly, one of the reasons I opted for affordability rather than no-cost was in case a private organization wanted to pick up the business of hormone therapy, they could still make a profit without stretching the wallets of transgender people seeking therapy, which hopefully would extend into non-member-nations as well. This obviously becomes a lot more difficult and possibly burdensome on the nation itself, if it being perfectly free comes into play; it's not necessarily a deal-breaking issue, but it really is something to consider. Further, there is a slight ambiguity which says member-nations cannot make those who seek hormone therapy pay for it, while ignoring private entities - I am unsure if this is intentional or not, but I figured I'd point it out anyways."

OOC:

I really don't think this requires repeal of 467 (though I am obviously biased in that regard), if you can refocus the proposal to specifically cover non-biological hormone therapy for most of it, and if you insist on keeping the free-of-cost aspect of it (which OOC I support more than I do IC), expanding the scope to all forms of hormone therapy. I think that unnecessary repeals should be avoided if possible, and it is certainly possible in this circumstance.

One thing I will note is that the current definition within this proposal seems to have more significant overlap with 91 than 467, which could lead you to issues on that front.

[Honeydewistania]

Firstly, I'm not entirely convinced that the lack of inclusion to synthetic hormones is necessarily a bad thing; either a reasonable, well-meaning nation realizes that synthetic hormone therapy necessarily needs to be included within the draft in order for it to be cheaper on their own wallets, or a transphobic nation who intentionally excludes synthetic hormones has to break the bank in order to comply with 467.

I don’t quite follow with this, sorry. How is making synthetic hormones affordable cheaper for nations?

Further, there is a slight ambiguity which says member-nations cannot make those who seek hormone therapy pay for it, while ignoring private entities - I am unsure if this is intentional or not, but I figured I'd point it out anyways."

Thank you. I’ll amend that clause.

OOC:

I really don't think this requires repeal of 467 (though I am obviously biased in that regard), if you can refocus the proposal to specifically cover non-biological hormone therapy for most of it, and if you insist on keeping the free-of-cost aspect of it (which OOC I support more than I do IC), expanding the scope to all forms of hormone therapy. I think that unnecessary repeals should be avoided if possible, and it is certainly possible in this circumstance.

One thing I will note is that the current definition within this proposal seems to have more significant overlap with 91 than 467, which could lead you to issues on that front.

OOC: yeah, I’m trying to avoid a repeal as much as I can myself