Sometimes we have choices about who to seek services from, and sometimes we don't. The degree of choice we have often depends on what we can afford, what language the services are offered in, how easy it is to get from where we live or work to the location of the service, how confident we are that a service will be respectful of our cultural heritage, and other issues relating to accessibility. Our choices are also affected by the bureaucratic restrictions of different systems of health and social care.

The listings in our resource area and other sites on our links page list some ideas of service providers in the US that have expressed an interest in working with the gender community. That does not necessarily mean all (or any!) of these listees will have an approach that works for you. When you have a choice about who to go to, there are many things you can to do try and find someone who fits what you are looking for.

Before choosing a service provider, consider:
·- What qualities am I looking for in a service provider? One way to think about this is to think
about experiences you've had that have been positive as well as those that have been
negative. What did the service provider do or say that made it so positive/negative?
·
- What are my expectations? Consider whether you're looking for something immediate,
short-term, or long-term. It is also helpful to consider whether you're looking for a service just
for your own needs, or also to satisfy a bureaucratic requirement (e.g., psychiatric
assessment to get approval for hormones or surgery).
·
- What can I afford? Do you have any kind of medical coverage  MSP, extended health benefits
through work, or private insurance  that could help pay for some or all of a service?
·
- What have other people's experiences been? If you know other trans people, intersexed
people, or family members, ask them if there is anyone they would recommend or if there is
anyone they had negative experiences with.
·
- Do I want another perspective? Sometimes it is difficult to make decisions when you are in a
crisis. It can be helpful to ask friends, family, peers, or other professionals to help you sort out
what your options are and determine what would help you to make a decision.

Finding a Service Provider That is Right for You: Asking Questions

Even among service providers who charge fees, many people will provide a free initial interview or consultation by phone or in person. This gives you a chance to ask the service provider questions about their experience, expertise, and attitudes relating to intersexuality and trans issues, as well as find out more about the practical logistics such as fees and waitlist for services.

The types of questions you ask depend on your personal preferences and needs. When we asked participants in our community focus groups what they would need to know about a service provider to feel confident and comfortable about going to them, responses included:

Logistics & Policies

- What kinds of resources, services, or programs do you offer?
·
- Are you open to everyone, or are there limits on who is eligible for your services?
·
- Do I need to get a referral from another service provider to see you? Do you have an intake
process?
·
- How long is your waiting list?

- What are your fees? Do you have a sliding scale? Are any of your fees covered by
government health plans or insurance?

·- Are there stairs into your office? Is the bathroom wheelchair accessible?
·
- What are the limits of your services and powers? What can/can't you do? Are you in a
position where your assessment of me will determine my access to other services?
·
- How much privacy do I have in accessing your services? If people see me walk into your
office, will they know I'm ___ (HIV+, gay/lesbian, a person with a mental illness, etc.), or do
you see people for all sorts of reasons?
·
- Who are you accountable to? What level of responsibility will your agency take for an
individual staff/volunteer's actions?
·
- What are your policies or standards around working with intersexed and trans people and
their family members?

Training & Experience
·
- What is your background and training? What kinds of education and experience do you
have?
·
- Have you ever worked with trans and intersexed people or their family members? Have you
worked specifically with (MTFs, FTMs, intersexed people, transsexuals, crossdressers, etc.)?
·
- Have you had any training or participated in professional development sessions? Is there a
specific person at your agency who has experience with intersex and trans issues?
·
- Are you familiar with the language used to talk about gender issues, physical sex, and
sexual orientation?
·
- What kinds of expertise do you have that you think I might find useful?
·
- Do you know how to find other resources?

Attitudes & Sensitivity
·
- What approach do you take to health care? Are you open to complementary therapies?
·
- What is your approach to gender, sex, and to gender/sex diversity? Do you perceive
transgenderism as a mental illness? Do you perceive intersexuality as a physical abnormality?
·
- How do you think gender oppression and other types of social justice/equity issues play a
role in affecting people's health and well-being?
·
- Do you act as an advocate for your clients if they are having difficulty with other service
providers?
·
- How would you deal with examining a gendered body part (e.g., breasts)?
·
- How comfortable are you with talking explicitly about gender and sex issues? How
comfortable are you being around trans and intersexed people or dealing with our bodies?
·
- How do you show that you value diversity and honor the client's perspective?
·
- How do you deal with it when clients bring up concerns? How do you deal with conflict that
occurs in working with a client?

What If I Don't Have a Choice About Who to Go to?

We don't always have choices about which service providers we would feel most comfortable with. If you need income assistance, you have to deal with the welfare system the way it is, whether it works for you or not. Government bureaucracies such as Vital Statistics all have rules and regulations that are relatively inflexible.

Although we often don't have choices about who we get to see or how the service is provided, we still have human rights that must be respected in every interaction with an individual service provider, agency, or government system. Even when we are part of a system that doesn't meet our needs, there are things we can do to advocate for ourselves and for our loved ones, to encourage service providers to become more respectful of sex and gender diversity and to deal with discrimination when it does occur.

Advocating for Yourself or for Someone Else

Advocacy can involve any of all of the following strategies:

·Ask the service provider to explain all steps of a procedure or process, and check back with them to make sure that your understanding of it is accurate. For example, "If I've understood you right, you want to see me for a minimum of five hour-long sessions before you'd feel comfortable deciding whether or not I qualify for hormone therapy."

- Interrupt discriminatory behavior and respectfully challenge stereotypes. Sometimes it can be
as simple as saying, "I think you're basing your assumptions on a stereotype. What you're
describing does not fit my experience."
·
- Ask for access to all written materials in your file, and read over documentation alone or with
the service provider. If documentation is incorrect, you can ask that a note be made to that
effect (it is rare that a service provider will be willing or able to alter their original
documentation, even if it is incorrect). Some service providers are willing to discuss what they
are recording and to hear your suggestions on what would be the most accurate way to record
the information.
·
- Request a second opinion or appeal a decision.
·
- Suggest resources for education.
·
- Bring a friend, family member, or professional with you to offer you support, act as a witness,
and help you to advocate for yourself.
·
- Set limits on what types of questions you are willing to answer, and only share information
that you feel is relevant, necessary, and fair to ask about.
·
- For example, "I'm wondering why you think my sexual practices are relevant to getting a root
canal. I'm happy to provide you with information you need to know, but my privacy is important
to me and I don't want to discuss my personal life beyond what is necessary for the success
of this treatment."
·
- Ask if the service provider is a member of a professional organization. If they are, ask them or
their association for a copy of the organization's code of ethics and complaints procedure.
·
- If you are seeing a service provider on an ongoing basis, ask for regular evaluations  time set
aside for you and your service provider to talk about what is working well and what changes
need to be made. You can ask for an evaluation at any time, and/or for evaluations at regularly
scheduled intervals (e.g., every 3 months).
·
- Express your feelings and thoughts about the quality of service provision you are receiving. If
you are comfortable with the service provider knowing you have made a complaint, you can
talk in person, on the phone, or by letter. If you prefer to remain anonymous, you can write an
anonymous letter, make use of an agency's complaints processes, or make a complaint to the
service provider's professional association. If you want the service provider to meet with you to
discuss your concerns, you have the right to bring someone you trust for support (friend, family
member, or another professional). In an agency, you can ask that a service provider's
supervisor be present as well.


I Think My Service Provider (or anyone else) Violated My Rights...

It's not always clear what happened in a negative interaction with a service provider. Sometimes it's hard to know if they just didn't understand your concerns, if they were having a bad day, if they generally have a bad bedside manner, or if they are acting in a discriminatory way that violates your human rights.

You may feel angry, confused, or disgusted. You may feel like you did something wrong. These feelings are all normal. But no matter what you did or didn't do, there is no justification for violating your human rights.

It's important to get whatever you feel would be supportive. Some people want to talk to friends, family members, peers, or other service providers. Other people want to hide from the world for a while.

Sometimes the people we go to for support pressure us to take action. Deciding what you want to do (if anything) is a very personal decision. The following are not suggestions for what you should do, but an explanation of strategies that will help if you decide you do want to take action of some kind.

Document what happened
·
- Document the details as soon as possible, even if you don't intend to proceed with any kind
of informal or formal complaint. This is one way for you to get clearer about what happened.
·
- Record as much as you remember of what happened  what the service provider said and did,
what you said and did, conversations you had with others about the incident, how you felt, and
anything else that will help give a full picture of what happened from your perspective.
·
- If you are not able to write down the information, you can tape record yourself talking, or ask
a friend, family member, or supportive professional to take notes as you talk.
·
- If you do decide at a later time to proceed with a complaint, this documentation will be
critical.

Contact the provider's professional association
·
- Find out how to file a complaint, what the possible outcomes of a complaint process are, and
what kinds of disciplinary action the organization can take when a complaint is made.

Take legal action
·
- It is often helpful to seek as advice from a lawyer before making a decision about legal action.
·
- Legal options include civil suits, criminal charges, and the Human Rights Commission.
·
- Legal action can be very stressful. If you are thinking about legal action, consider what types
of support you could make use of (family, friends, peers, service providers, etc.).


How Do I Know if I Have Grounds for a Human Rights Complaint?

Some of the reasons you might file a complaint are:
·
- you are being sexually harassed at work or school
·
- a restaurant will not serve you because you are trans or intersexed
·
- a landlord will not rent an apartment to your family because one member of the family is
intersexed and/or trans, because you have children, because you and your partner are both
women or both men, or because you are receiving income assistance
·
- you are refused a job or fired because you are trans or intersexed

The BC Human Rights Commission rulings clearly state that transsexuals who are in transition cannot be refused access to gendered space. MTFs who are in transition and presenting as women, and intersexed women who live as women, have the legal right to access women-only organizations and services, and to use the women's washroom.

If you're not sure if you have been discriminated against, you can contact the Human Rights Commission in your area and describe what happened. A human rights officer will tell you if you have grounds for a complaint.

Are There Time Limits?

In most situations, a complaint must be filed within a year of the incident. In special cases, the Human Rights Commission may extend this time limit.

It can take up to two years for a case to be heard before the tribunal. If a settlement is reached without a hearing, the case will not take as long to be resolved.

How Do I File a Human Rights Complaint?

Stage 1: Contact the Commission

- See Below some contacts
·
- A human rights officer will tell you if you have grounds for a complaint under the BC Human
Rights Code, and provide you with the necessary paperwork.
·
- If your complaint is outside the grounds of Human Rights Commission guidelines, staff may
be able to refer you to another organization that can help.
·
- There is no cost to file a complaint.

You and your witnesses are protected by law from any retaliation once you have laid a human rights complaint. You cannot be fired, evicted, or otherwise penalized for filing a complaint. Any harassment or intimidation is grounds for a separate human rights complaint, and possibly other legal action.


International Gay and Lesbian Human Rights Commission (IGLHRC) 1375 Sutter Street,
Suite 222  San Francisco, CA 94109  USA Telephone: +1-415-561-0633  http://www.iglhrc.org/

Human Rights within the USA and International http://www.globalissues.org/HumanRights/Abuses/USA.asp#HumanRightsWithintheUnitedStates

Canadian Human Rights Commission Commission http://www.chrc-ccdp.ca/

Ontario Human Rights Commission Web site  http://www.ohrc.on.ca/

Asian Human Rights Commission http://www.ahrchk.net/

Australian Human Rights and Equal Opportunity Commission Website  http://www.hreoc.gov.au/

Saskatchewan Human Rights Commission's Website: http://www.gov.sk.ca/shrc/default.html

South African Human Rights Commission Website: http://www.sahrc.org.za/

New Zealand Human Rights Commission Website: http://www.hrc.co.nz/




Organisation Intersex International
How Do I Pick Who to Go To?
Things you should know about caregiver selection