Category Archives: Transgender

Health Care for Trans People Gets Better in MA!

“The new MassHealth guidelines will cover more services and remove some onerous requirements that have kept trans and gender-diverse communities from receiving services.”  D.  Ducar, The Boston Globe,  September 7, 2021

ESL Voices Lesson Plan for this post with Answer Key

Philip Steury- Adobe

Excerpt: Massachusetts leads the way in caring for the health needs of trans and gender-diverse people. By Dallas Ducar, The Boston Globe,  September 7, 2021, 

“The coronavirus pandemic has made it clear that Americans need better health care access, especially for those who are most marginalized. States should reassess what is considered medically necessary to expand equitable coverage and access — including for transgender and gender-diverse people.

On Sept. 3, MassHealth took that next step forward. It updated the state’s Guidelines for Medical Necessity Determination for gender-affirming care. MassHealth uses these guidelines to determine what care is deemed necessary and paid for. Gender-affirming services currently include services such as hair removal, surgery, pubertal blockade, and hormone therapies.

Expanding access to these services will improve mental health and save lives…These advances are landmark examples of how the government has led by example in advancing care for trans and gender-diverse individuals. The new MassHealth guidelines will cover more services and remove some onerous requirements that have kept trans and gender-diverse communities from receiving services… MassHealth has made a move in the right direction by recognizing the variability in gender-affirming care. It’s time for private payers to follow this same path. To be sure, there are concerns that individuals will join MassHealth or other insurers strictly for gender-affirming care and then leave. These arguments are scarecrow arguments and advance the idea that gender-affirming care is a lifestyle choice. The fact is, gender-affirming care is life-saving care.”

ESL Voices Lesson Plan for this post

NOTE: Lessons can also be used with native English speakers.

Level: Intermediate – Advanced


Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.


Time: Approximately 60 minutes.


Materials: Student handout (from this lesson) and access to news article.


Objective: Students will read and discuss the article with a focus on improving reading comprehension and improving oral skills. At the end of the lesson students will express their personal views on the topic through group work and writing.

I. Pre-Reading Activities

KWL Chart

The K-W-L chart is used to activate students’ background knowledge of a topic in order to enhance their comprehension skills.

Directions: Have students use the KWL chart to list the information they already know about the current  health care situation for Trans and gender-diverse people.  Later in the Post- Reading segment of the lesson, students can fill in what they’ve learned about the topic.

II. While Reading Activities

Word Inference

Directions: Try to infer the meanings of the words in bold taken from the article. You use a dictionary, thesaurus, and Word Chart for assistance.

  1. The coronavirus pandemic has made it clear that Americans need better health care access,
  2. Especially for those Americans who are most marginalized.
  3. States should reassess what is considered medically necessary.
  4. Medical coverage  should include transgender and gender-diverse people.
  5. *These arguments are scarecrow arguments and advance the idea that gender-affirming care is a lifestyle choice.
  6. MassHealth uses guidelines to determine what care is deemed necessary and paid for.
  7. Unfortunately, coverage for gender-affirming services has been trailing behind the needs of the trans communities.
  8. These advances are landmark examples.
  9. MassHealth guidelines will cover more services and remove some onerous requirements.
  10. Private insurers have attempted to apply a more restrictive model.

Grammar Focus: Word -Recognition

Directions: Students choose the correct word to complete the sentences taken from the article. They are to choose from the options presented.

Gender-affirming care/caring is only the first steps/step. When we cared/care for our most/more marginalized, we provide/providing better health cares/care overall. We all have/having some/any relationship to gendered/gender. We know that caring/care for the whole person allows four/for better health and decreases the overall costs.

Reading Comprehension

True /False/NA-Statements

Directions: Review the following statements from the reading.  If  a statement is true they mark it T. If the statement is  not applicable, mark it NA. If the statement is false  mark  it F and provide the correct answer. 

  1. The coronavirus pandemic has made it clear that Americans need better health care access.
  2. States do not have to reassess what is considered medically necessary to expand equitable coverage and access.
  3. On Sept. 3, New York Medical Center took that next step forward. It updated the state’s Guidelines for Medical Necessity Determination for gender-affirming care.
  4. Gender-affirming services currently include services such as hair removal, surgery, pubertal blockade, and hormone therapies.
  5. Coverage in Massachusetts has continued to advance over the years:
  6. In 2021, the attorney general’s office reminded providers that MassHealth gender-affirming surgeries are not covered.
  7. Private payers, on the other hand, have traditionally relied on the World Professional Association for Transgender Health Standards of Care 7 to determine necessity.
  8. According to WPATH, every trans and gender-diverse person has the same types of gender-affirming care needs.
  9. According to WPATH, every trans and gender-diverse person has specific types of gender-affirming care, and types of social transition needed. There’s no one size fits all model.
  10. MassHealth has made a move in the right direction by recognizing the variability in gender-affirming care.

 

III. Post Reading Activities

WH-How Questions

Directions: Have students use the  WH-question format to discuss or to write the main points from the article.

Who or What is the article about?

Where does the action/event take place?

When does the action/event take place?

Why did the action/event occur?

How did the action/event occur?

Discussion Questions for Comprehension /Writing

Directions: Have  students discuss the following questions/statements. Afterwards,  students share their thoughts as a class. To reinforce the ideas, students can write an essay on one of the topics mentioned.

  1. How does MassHealth determine what care is necessary for gender-affirming care?
  2. What new services are included for gender-affirming patients?
  3. Name several advances that have occurred in Massachusetts Healthcare coverage over the years.
  4. What gender-affirming healthcare advances have occurred on the national level?
  5. Why is the Supreme Court’s 2020 Bostock decision so important?
  6. What does WPATH stand for and what function does it serve?
  7. Explain three new ideas that you have learned from reading this article. Was there anything that you did not understand? Was there any information left out of this article?

ANSWER KEY

Category: Culture, Education, Social Issues, Transgender | Tags:

Supporting the Use of Non-Binary Pronouns in Schools

“Transgender and nonbinary students are urging educators to use inclusive language, but not everyone is on board.” L. K. Wertheimer,The Boston Globe September 28, 2021

ESL Voices Lesson Plan for this post with Answer Key

Alia Cusolito, a sophomore at Old Rochester Regional High School in Mattapoisett. Credit- Harry Scales. The Boston Globe

Excerpt: ‘A very scary thing to tell someone’: The debate over gender pronouns in schools, explained By Linda K. Wertheimer September 28, 2021, The Boston Globe

“On the first day of school at Old Rochester Regional High School in Mattapoisett, Alia Cusolito donned cool, 3-inch, dangling sword earrings. The sophomore also pinned a circular black button with ‘they/them’ in silver letters onto their shirt and a pink ‘they/them’ pin to their backpack. The buttons were a plea for respect and for acknowledgement from teachers and peers of Alia’s identity and preferred pronouns. The teen identifies as nonbinary.

‘The language we use to describe ourselves is a choice, but the gender I am is not a choice,’ says Alia, who switched from she/her pronouns to gender-neutral ones in ninth grade. ‘Nonbinary fits me. My identity isn’t a choice.’

As president of the school’s Gender and Sexuality Alliance club, Alia, who is 16, wanted to attend class and walk the halls without the worry that someone, teachers included, might misgender them…Before the school year began, school librarian Allison Barker, adviser to the Gender Sexuality Alliance club (known around the country as GSAs), slipped sample get-to-know-you forms in every teacher’s mailbox. The forms, which students would be asked to fill out, included a blank space to fill in their pronouns and preferred names. Barker has distributed such forms for the past three years to help teachers ease the way for students who may feel anxious to announce their names and pronouns in front of the class.

But Alia’s first two days of school this year were a disappointment. Only three of their nine teachers gave students a way to provide pronouns and names of choice…Many teachers and school administrators I interviewed, including the principal at Old Rochester Regional, say they’re listening and making changes… While asking for pronouns has become routine in some school systems, it isn’t at all commonplace at others.

In some cases, administrators say they’re moving slowly because for many teachers the concept of gender-neutral pronouns is relatively new. And community backlash is a realistic fear. Gender identity, as well as anything to do with the LGBTQ community, used to be a hush-hush topic in schools and elsewhere…In Virginia, a gym teacher sued the Loudoun County school system, contending that his free speech rights were violated when he was suspended for saying at a school board meeting that he wouldn’t refer to transgender students by their preferred pronouns. In August, a judge ruled in his favor… Advocates say the pronoun/name forms are necessary for health and safety reasons. ‘Simply respecting a student’s chosen name and pronoun is the single most important thing you can do to prevent suicide and mental health issues,’ says Kimm Topping, program manager of the Massachusetts Safe Schools Program for LGBTQ Students.”

ESL Voices Lesson Plan for this post

NOTE: Lessons can also be used with native English speakers.

Level: Intermediate – Advanced


Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.


Time: Approximately 60 minutes.


Materials: Student handout (from this lesson) and access to news article.


Objective: Students will read and discuss the article with a focus on improving reading comprehension and improving oral skills. At the end of the lesson students will express their personal views on the topic through group work and writing.

I. Pre-Reading Activities

KWL Chart

Directions: Have students use the KWL chart to list the information they already know about transgender or non-binary terms. Later in the Post- Reading segment of the lesson, students can fill in what they’ve learned about the topic.

II. While Reading Activities

Word Inference

Directions: Try to infer the meanings of the words in bold taken from the article. You use a dictionary, thesaurus, and Word Chart for assistance.

  1. Some people identify as Transgender.
  2. Many teens identify as non-binary.
  3. Alia was president of the school’s Gender and Sexuality Alliance club.
  4. Many students feel anxious saying their names and pronouns in front of the class.
  5. I’ve seen  a new trend myself as a parent.
  6. My son is an eighth-grader in a suburban Boston middle school.
  7. Those who oppose the distribution of pronoun forms, include parents and conservative Christian groups.
  8. At Old Rochester Regional, a collaboration is taking place  between students and the school educators.
  9. Some teachers still called students by their dead names on the first day and some were misgendered.
  10. Students upset about teachers who didn’t distribute the forms expressed their angst on an Instagram site.

Vocabulary Cluster By Learnnc.org

 

Grammar Focus: Identifying Prepositions

Directions: The following sentences are from the news article.  For each sentence choose the correct preposition from the choices listed. Note that not all prepositions listed are in the article.

Some Prepositions: at,  as, across, around,  by, during,  for, from, in, into,  of, on,  to, over,  off, through, up,  with, since,

Devoll, the school’s principal___13 years, wanted___ know how they could fix it. Barker believes consistency is the key. She gave Devoll a copy___ a form that’s gone viral, created___ a Pennsylvania middle school science teacher who runs an Instagram site called Teaching Outside the Binary. Barker praised the form’s inclusion___an option ___students___decide who should know their new identity, including whether guardians and parents should be___ the list. “That’s ___their safety,” Barker says. “They don’t feel comfortable being out ___their parents, but___school, they have found safety___being able ___express their true selves.”

Reading Comprehension Identify The  Speakers

Directions: Read the following quotes from the speakers in the article. Then identify the speakers.

  1. “I think it’s not asking very much to simply ask a child what they would like to be called.”
  2. “I think everyone who cares about children is on a learning curve. Our understanding of gender identity has evolved in the last decade.”
  3. Advocates say the pronoun/name forms are necessary for health and safety reasons. “Simply respecting a student’s chosen name and pronoun is the single most important thing you can do to prevent suicide and mental health issues.”
  4. “Expanding the curriculum and letting students be called what they want in school are both part of making schools safer.”
  5. “What other emotional and mental labor do queer and trans kids need to put in before we’ll be shown basic respect?” 

III. Post Reading Activities

WH-How Questions

Directions: Have students use the  WH-question format to discuss or to write the main points from the article.

Who or What is the article about?

Where does the action/event take place?

When does the action/event take place?

Why did the action/event occur?

How did the action/event occur?

Discussion Questions for Comprehension /Writing

Directions: Have  students discuss the following questions/statements. Afterwards,  students share their thoughts as a class. To reinforce the ideas, students can write an essay on one of the topics mentioned.

  1. Do you consider yourself transgender  or non-binary?
  2. If so, how do you want others to address you?
  3. Do you know someone who identifies as transgender  or non-binary?
  4. In this article how does Alia identify?
  5. What was one of Alia’s fears going back to class?
  6. Which pronoun has been in use since 1375?
  7. What did the school librarian suggest students do before the school year began  to help teachers get to know them?
  8. Did all of the teachers comply with students’ preferences?
  9. What is a ‘dead name’ ?
  10. Why was Alia frustrated? How did they feel about the teachers’ support?
  11. How does Alia’s father feel about the situation at her school?
  12. Why are so many teachers and administrators afraid to use gender-neutral pronouns?
  13. Why would there be community backlash over using gender-neutral pronouns in schools?
  14. What incident occurred in the Loudoun County school in Virginia?
  15. How do opponents of transgender and non-binary pronoun forms view this topic?
  16. According to the recent Youth Risk Behavior Survey, what happens to youths who identify as LGBTQ in Massachusetts?
  17. What happened during the Stonewall riots in 1969?
  18. (Groups might research the riots and  share presentations with the class)
  19. After reading this article list three new ideas  that you’ve learned about the topic from the reading,  two things that you did not understand in the reading, and one thing you would like to know that the article did not mention.  Share your responses with your class.

ANSWER KEY

Category: Children/Teens, Culture, Education, Language, Transgender | Tags:

Helping Pediatrics Dispel Myths About Gender Identity

“We’ve all seen news stories about schools attempting to grapple with gender identity issues in children and adolescents, from name changes to restroom policies. In many cases, educators have found themselves making it up as they go along in trying to serve these children — and so has the medical system.” P. Klass, M.D., The New York Times

ESL Voices Lesson Plan for this post with Answer Key

New guidance for care of Transgender children and teens.Image credit Medscape

Excerpt: Helping Pediatricians Care for Transgender Children PerriKlass, M.D., The New York Times

“This month, the American Academy of Pediatrics put out its first policy statement to guide people providing medical care for children and adolescents who are transgender or questioning their gender identity. 

It arose in part as a direct response to queries from pediatricians, parents and patients, said Dr. Cora Breuner, a professor of pediatrics and adolescent medicine at Seattle Children’s Hospital…The goal of treatment is ‘understanding who each individual child is, and supporting them on that journey,’ said Dr. Jason Rafferty, a pediatrician and psychiatrist at Thundermist Health Center and Hasbro Children’s Hospital in Rhode Island, who was the lead author on the statement; he spoke of “creating a system where all children feel they have access to supportive and nonjudgmental care.’

Ellie, left, who is transgender, hugs her brother Ronnie. (Courtesy Ford family). Photo- Washington Post

Dr. Breuner said that ‘many times, when there are gender issues, we don’t have a road map.’ The statement puts forward a model of ‘gender-affirmative care,’ based in the idea that ‘variations in gender identity and expression are normal aspects of human diversity,’ and that mental health problems in these children arise from stigma and negative experiences, and can be prevented by a supportive family and environment — including health care. The term ‘gender diverse’ describes those whose gender identity does not match the sex they have been assigned, or the norms that are expected to go with that assignment.

Notes Blog – Boston Children’s Hospital

‘Gender identity is a brain thing, it’s your sense of whether you’re male or female in your head; it is independent of your body parts, it is independent of who are you attracted to,’ said Dr. John Steever, an adolescent medicine specialist and assistant professor of pediatrics at the Icahn School of Medicine at Mount Sinai.

‘People can have a sense of being male, female, both, somewhere in between, all of these are normal variations,” he said. ‘Just because they’re not very common doesn’t mean they’re abnormal, and my job is to help patients and parents understand all this.

The new A.A.P. statement tries to dispel a variety of myths about growing up with gender identity questions, Dr. Breuner said, such as the idea that parents should assume this is only a passing phase. ‘And still, colleagues look at me askance, say, ‘Isn’t this something they grow out of, I was taught that in medical school,’Dr. Breuner said. ‘So was I. It’s incorrect.’

And these issues sometimes emerge in relatively young children. Children may say that they don’t feel right in their bodies as young as 4 or 5, Dr. Breuner said, or may say more specifically something like, ‘even though I look like a boy, I feel like I’m a girl.’ Some adolescents will decide to pursue further interventions, medical or surgical, sometimes called transitioning.

‘I always tell parents I’m in no rush, I don’t have an agenda here,’ he said. Many kids, he said, feel much better after they start transitioning. On the other hand, ‘just because you start transition doesn’t mean it’s going to be always sunshine and rainbows — kids are going to need support.’

ESL Voices Lesson Plan for this post

NOTE: Lessons can also be used with native English speakers.

Level: Intermediate – Advanced


Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.


Time: Approximately 2 hours.


Materials: Student handout (from this lesson) and access to news article.


Objective: Students will read and discuss the article with a focus on improving reading comprehension and improving oral skills. At the end of the lesson students will express their personal views on the topic through group work and writing.

I. Pre-Reading Activities

KWL Chart

The K-W-L chart is used to activate students’ background knowledge of a topic in order to enhance their comprehension skills.

Advanced K-W-L chart.Intervention for Reading–Michigan State University

 

II. While Reading Activities: Word Inference

Directions: Students are to infer the meanings of the words in bold taken from the article. They may use a dictionary, thesaurus, and Word Chart for assistance.

  1. It  can be difficult growing up with gender identity questions.
  2. The American Academy of Pediatrics tries to dispel myths.
  3. The guidelines  were written in part as a direct response to queries from pediatricians, parents and patients
  4. Dr. Jason Rafferty is  a pediatrician.
  5. Dr. Rafferty wants to create a system where all children feel they have access to supportive and nonjudgmental care.
  6. The goal of treatment is understanding who each individual child is.
  7. Just because they’re not very common doesn’t mean they’re abnormal.
  8. Growing up gender-diverse means children and adolescents are much more likely to be bullied.
  9. Dr. Breuner agreed, It’s the environment that endangers the child, she said, not the gender issues.
  10. More adults are also identifying as transgender.

 

Word Map by Against the Oddstiff

 

Reading Comprehension: Fill-ins

Directions: Place students in groups and after they have read the entire article, have them complete the following sentencestaken from the article. They can use the words and terms from the list provided, or provide their own terms. They are to find the meanings of any new vocabulary

The biggest ___for doing a lot of this___is to try and ___ some of the traditional ___outcomes that ___or gender-nonconforming youth have ended up with,” Dr. Steever said. “We know that many of these___, if unsupported, have grown up and dealt with ___ ___ideation and attempts, substance use and abuse.

WORD LIST: suicidal, depression, people, transgender, horrible reason,work,prevent, 

 

Grammar Focus: Word -Recognition

Directions: Students choose the correct word to complete the sentences taken from the article. They are to choose from the options presented.

Growing up/out gender-diverse means child/children and adolescents are/is much more likely/likable to be bully/bullied and excluded, and their/they are at/on high risk for depression, suicidal thoughts and suicide. “The statistics are pretty stark,” Dr. Breuner said/say, “triple the/an rate of suicide, five times the risk of suicidal ideation, bullying, teasing, abuse. It’s just horror/horrific.”

 

III. Post Reading Activities

WH-How Questions

Directions: Have students use the  WH-question format to discuss or to write the main points from the article.

Who or What is the article about?

Where does the action/event take place?

When does the action/event take place?

Why did the action/event occur?

How did the action/event occur?

Discussion for Comprehension /Writing

Directions: Place students in groups and have them  discuss the following questions/statements. Afterwards, have the groups share their thoughts as a class. To reinforce the ideas, students can write an essay on one of the topics mentioned.

  1. What would your reaction be if  your best friend told you that they were transgender?
  2. If there are transgender members in your group see if they’s like to share their experiences. 
  3. The article states, “And these issues sometimes emerge in relatively young children. Children may say that they don’t feel right in their bodies as young as four  or five,  Dr. Breuner said, or may say more specifically something like, “even though I look like a boy, I feel like I’m a girl.”   In your opinion, can a young child really know and understand which gender they want to be? Provide reasons for your answer.

1-Minute Free Writing Exercise

Directions: Allow students 1 minute to write down one new idea they’ve learned from the reading. Ask them to write down one thing they did not understand in the reading.  Review the responses as a class.

ANSWER KEY

Category: Culture, Health Issues, Transgender