Advocacy

On February 22, 2022, Governor Greg Abbott defined “gender-affirming care” as “child abuse” under Texas Family Code Sec. 261.001(1)(A)-(D) and issued an order for the Texas Department of Family and Protective Services (DFPS) to investigate these instances of “child abuse.” This order effectively criminalizes any gender-affirming care, preventing families from seeking said care and licensed professionals from providing it. Although the Honorable Judge Amy Clark Meachum issued a temporary injunction to these investigations on March 11, families trying to keep their transgender and nonbinary children safe are already feeling the impact. Many say they have been encouraged to leave the state, but more than half of Americans cannot afford even a $1,000 emergency expense, much less an interstate move. Even if they have the means, parents should never be forced into a situation to decide between their child’s safety and uprooting the family from their community. 

Texas is one of several examples of recent anti-trans and anti-queer legislation denying individuals the right to exist in their authentic gender and sexual identity. Similar bills have been passed or are under consideration in Arizona, Indiana, Tennessee, Kansas, Kentucky, Utah, Alaska, Idaho, and New Hampshire. In Florida, the Parental Rights in Education Bill – better known as the “Don’t Say Gay” Bill – seeks to outlaw all discussions on LGBTQIA+ content in kindergarten through third grade and restrict discussions in other grade levels to content deemed “appropriate.” It also requires educators to inform parents about LGBTQIA+ youth’s identities, “outing” the student even without their consent. This bill has passed in the Florida House (February 24) and Senate (March 8) and currently awaiting Governor DeSantis’ signature.

Last year, the Asian Pacific American Medical Students Association (APAMSA) released a statement of solidarity with the trans community and a call to action following anti-trans legislation in Arkansas and other states. Not even one year later, new anti-trans and anti-queer legislation continue to target a vulnerable population. Withholding or delaying gender-affirming care can lead to significant psychosocial distress and is not a neutral option. Nearly 1 in 5 LGBTQ youth and 1 in 3 trans or nonbinary youth attempt suicide in a given year, with discrimination – both individual and political – as a strong risk factor. 

In contrast, studies show that gender-affirming care can reduce emotional distress, improve their sense of well-being and reduce the risk of suicide. Numerous professional societies, including the American Medical Association, the American Psychological Association, the American Psychiatric Association, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Endocrine Society, espouse the efficacy of gender-affirming care for trans youth and adults.

The effects of anti-trans and anti-queer legislation are also felt keenly in our AANHPI communities. The Trevor Project, a non-profit addressing suicide prevention in LGBTQ youth, alone cared for approximately 9,000 AAPI LGBTQ individuals in 2020. Compounded by cultural and religious stigmas against discussing sex and sexuality, AANHPI youth are significantly less likely to disclose their LGBTQIA+ identity to their parents than the youth of other racial/ethnic backgrounds. They are also much more likely to experience feelings of isolation in predominantly white LGBTQIA+ spaces. 

Because anti-trans and anti-queer legislation like those in Texas and Florida particularly harm LGBTQIA+ youth, including those of AANHPI identity, APAMSA stands firmly against these discriminatory bills. We also support in solidarity with the Medical Student Pride Alliance (MSPA) and the broader LGBTQIA+ community.

As part of APAMSA’s mission to promote the health of the AANHPI community, we urge our members to take action in support of our LGBTQIA+ friends, colleagues, and patients. At our institutions, we can advocate for education on gender-affirming care and increased recruitment and retention of trans and gender-diverse students and faculty. In research, we can investigate understudied issues at the intersection of AANHPI and LGBTQIA+ identities. On a policy level, we can push for local, regional, and federal policies that recognize trans rights as human rights. We must also acknowledge that the ongoing injustice and discrimination against trans and nonbinary individuals do not exist in a vacuum; it coincides with numerous attempts to restrict access to abortion care and discussion of race and racism in schools. 

APAMSA reaffirms its opposition to discriminatory policies that undermine the health of marginalized individuals in AANHPI communities and beyond.

In solidarity,

Your APAMSA National Board

In the early hours of February 13th, Christina Yuna Lee, a 35-year-old Korean American woman, was followed into her New York City Chinatown apartment and stabbed to death by a stranger. Last month, Michelle Alyssa Go, a 40-year-old Asian American woman, was pushed to her death while waiting for a southbound R train at Times Square (1). APAMSA grieves these recent tragedies and recognizes them as the latest in a painfully long list of attacks against Asian Americans even as they have not yet been officially charged as hate crimes (2).

Just as we have in our previous statement, APAMSA denounces these horrifying crimes and all such senseless acts of violence, regardless of their legal designations (3). Anti-Asian hate crimes have been on the rise since the start of the COVID-19 pandemic, with New York City alone experiencing a 361% increase over this past year, leaving Asian Americans across the country fearful for their safety (4). APAMSA firmly and unequivocally opposes every racist act, and we call all our allies to stand in solidarity with the AANHPI community.

Comprehensive anti-racist policies that improve upon the reporting and prevention of all racist hate crimes must be implemented. We will continue to demand that our politicians and legislators acknowledge the tragedies of Lee and Go’s deaths, as well as their broader context of the pandemic of anti-Asian hate that persists.

APAMSA offers its support to all of its members during these difficult times. We have listed below several helpful resources for your reference, and we invite you to reach out with any specific ways we can further assist your chapters.

APAMSA Applauds Return of White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders to Health and Human Services 

On December 9th, the Biden-Harris Administration announced the relaunch of the White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI), housed within the U.S. Department of Health and Human Services (HHS).

Like other communities of color, AANHPI communities have been disproportionately impacted by the COVID-19 pandemic. In addition to the exacerbation of long-standing health inequities, we have seen a spike in racist rhetoric, xenophobia, and violence. This public health crisis highlights issues our leaders must address: anti-Asian bias and violence, data disaggregation, the model minority myth, language barriers, and health equity. 

APAMSA applauds the Initiative’s return to HHS and the expansion of its name to explicitly include Native Hawaiians–a significant step in reinvigorating this historic endeavor. We look forward to seeing how the Biden-Harris Administration will address the vital concerns of everyone in our communities.

Current events in Afghanistan and the impending humanitarian crisis with the likelihood of increased number of displaced people

Facing crisis and emergency levels of needed humanitarian assistance, Afghanistan’s needs have risen sharply because of conflict and COVID-19. Since the end of May 2021, the number of people internally displaced because of conflict and in need of immediate humanitarian aid has increased by 550,000, adding to the already 3.5 million internally displaced people before this year (1).

As future medical professionals, we are deeply concerned about the people of Afghanistan and the threat posed to their rights, safety, and ability to access health care. We support the World Health Organization’s call to ensure access to health care during this turbulent time (2-3). 

Many members of the Asian Pacific American Medical Student Association are descendants of refugees that have fled past conflict, famine, and poverty. Southeast Asian refugees represent one of the largest refugee communities to resettle in the United States after being forcefully displaced by war and its aftermath in the 1970s. While there are differences regarding the context of what’s happening in Afghanistan vs. Southeast Asia, the desire to pursue safety and opportunity are shared between both groups regardless of time and place (4-7).

We urge our government to take swift action to ensure the safety of refugees, including but not limited to: keeping borders open to those fleeing from violence and persecution, permitting permanent resettlement in the United States, and ensuring refugees feel safe and supported by ending the ongoing deportations of all undocumented immigrants regardless of country of origin (8-9).

APAMSA has long supported providing culturally and linguistically relevant resources, including but not limited to financial assistance and mental health support. Government and nonprofit entities, especially those involved in healthcare, must commit to Afghanistan refugees for years to come.

Saturday marks the 20th anniversary of the horrific terrorist attacks on the World Trade Center. Nearly 3,000 people lost their lives on that fateful day. Let’s honor their memory by committing to being a country inclusive of diverse backgrounds committed toward building mutual respect and support that can resist hate and divisiveness in all of its forms.

On September 1, Texas law SB8 went into effect, outlawing virtually all abortions 1. By allowing third-party lawsuits against clinicians that provide abortions and restricting access to vital components of reproductive healthcare, SB8 creates a coercive environment for patients and clinicians. Additionally, it would escalate the financial and logistical barriers many abortion patients already have to confront regarding their care 2.

SD8 is an example of a “heartbeat bill 3.” In 2019, APAMSA opposed the passage of “heartbeat bills” in several states 4. We continue to oppose efforts to undermine patients’ ability to access a necessary component of their health care, recognizing that these discussions and decisions ought to remain at the discretion between patients and their health care providers without undue external interference.

SD8 will likely inspire attempts to pass similar restrictions in other states 5. APAMSA encourages its members to stay informed on local state laws, and to use accurate information from verified sources, such as the American College of Obstetricians and Gynecologists, to guide their patients 6.

On August 29th, Hurricane Ida made landfall on the Gulf Coast. Its impact was particularly felt in Louisiana, making it the second most intense hurricane to hit the state after Hurricane Katrina of August 2005. More than a million people in Louisiana currently have no power. There have been reports of infrastructural damage and heavy flooding in coastal areas. This is more apparent within healthcare, as local hospitals’ capacities to admit victims of Hurricane Ida are being pushed to near full capacity from the ongoing COVID-19 surge.

As the storm progressed north, devastation has also been felt throughout the East Coast, particularly New Jersey, New York, and Philadelphia. As of September 3rd, about 4.5 million people on the East Coast remain under flood warnings.

National APAMSA has been in contact with the local chapters to offer support to those impacted by the hurricane. In addition, we encourage everyone to support the local organizations in helping those affected. 

• Mutual Aid Louisiana https://www.gofundme.com/f/hurricane-ida-mutualaidlouisiana
• Imagine Water Works https://donorbox.org/imagine-water-works
• WC Kitchen https://donate.wck.org/give/355034/#!/donation/checkout?c_src=ida-homepage
• Cajun Navy Relief www.cajunnavyrelief.com
• Hands on New Orleans https://www.handsonneworleans.org/
• New Orleans Musician Clinic https://neworleansmusiciansclinic.org/
• Second Harvest Food Bank https://no-hunger.org/

On April 6th, 2021, Arkansas overrode a veto from the governor to pass Act 626–which banned gender-affirming treatments for transgender youth. Arkansas was only one of 33 states in 2021 that have altogether introduced over 100 bills intended to interfere with the rights of trans individuals. These bills aim to ban gender-affirming treatment, forbid trans students from participating in sports, require teachers to refer to students using their biological sex, and prohibit discussion of LGBTQ issues at school.

Proponents claim that gender-affirming treatments are dangerous and not evidenced-based. Alan Clark, the state senate sponsor of the Arkansas bill, criticized that puberty blockers and hormone treatments are “at best experimental and at worst a serious threat to a child’s welfare.”

However, medical expert groups and studies say otherwise. Most professional societies—the American Medical Association, the American Psychological Association, the American Psychiatric Association, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Endocrine Society—espouse the efficacy of these treatments at improving the wellbeing of trans youth. A National Institute of Health (NIH) prospective study that began in 2015 found that earlier gender-affirming treatment leads to better overall mental health. Given that nearly 1 in 3 trans youth attempt suicide in a given year, this new wave of anti-trans legislation poses an increased threat to an already marginalized community.

Our AAPI communities would also be devastated by these laws. Research from the Trevor Project, a non-profit addressing suicide prevention in LGBTQ youth, demonstrates that AAPI trans and non-binary youth are at 3 times the risk for attempting suicide compared to their cisgender peers. In 2020 alone, the organization served around 9,000 AAPI LGBTQ individuals. Another study reported that 54.7% of AAPI LGBTQ students have experienced harassment or assault due to their gender expression, and 82.3% have heard negative remarks about transgender people at school.

These chilling statistics remind us that there is more work to be done. APAMSA opposes these discriminatory laws that would severely undermine the well-being of trans individuals and their loved ones in AAPI communities and beyond. In medical education, we can advocate to our school leaders for more curricular resources and educational events concerning the foundational importance of gender affirming care. At our various institutions, we can work to establish clear, confidential pathways for transgender individuals to report mistreatment and discrimination. On a policy level, we can fight for local, state, and federal governments to recognize trans rights as human rights. We stand with the trans and nonbinary members of APAMSA and urge all our members and allies to show solidarity and advocate for the trans community in this ongoing fight against injustice and discrimination.

In solidarity,

Your APAMSA National Board

APAMSA mourns the senseless murders of Amarjeet Johal, Jaswinder Kaur, Jaswinder Singh, and Amarjit Sekhon, alongside Matthew Alexander, Samaria Blackwell, Karlie Smith and John Weisert. This massacre in Indianapolis took place exactly one month after eight other lives, including those of six Asian women, were taken in Atlanta.

We cannot separate these events from the current climate of racial violence. 90% of the workers at the FedEx center in Indianapolis were members of the Sikh community – a community that has endured hatred from the days it first settled in America in the 19th century. From the Bellingham massacre of 1907, to attacks and discrimination post-9/11, to the Oak Creek gurdwara massacre in 2012, our Sikh American siblings have been targeted over and over again. To deny that this crime was racially motivated is to deny the historical and personal experiences of our colleagues, patients, and loved ones.

To our Sikh American family: we see your resilience, your dedication to justice, and most deeply in this moment, your grief. We stand with you. We fight for you. And we mourn with you.

On March 29th, Adam Toledo, a 13-year-old Latino boy, was brutally shot to death by a white policeman in Chicago, IL while he was trying to comply with the officer’s orders to raise his hands. A few days later on April 11th, Daunte Wright, a 20-year-old Black man, was fatally shot in Minneapolis, MN after being pulled over for driving with an expired license plate–only ten miles from where Derek Chauvin is on trial for the murder of George Floyd.

APAMSA mourns for these unnecessary deaths, and we condemn these acts of police brutality. As discussed in a previous statement, APAMSA stands firmly with the Black and Brown communities during these heartbreaking times. We will not forget the pain from the murders of George Floyd, Breonna Taylor, Tony McDade, and Ahmaud Arbery; from the murders of Angelo Quinto and Christian Hall from our own communities; and the suffering that white supremacy has caused us all. We recognize that systemic racism is a public health threat, pledge to learn more about these issues that threaten the well-being of marginalized communities, and will continue to fight against all forms of racism.

Black Lives Matter.

In solidarity,

National APAMSA