Which Box Do You Check? Some States Are Offering a Nonbinary Option

nonbinary

As nonbinary teenagers push for driver’s licenses that reflect their identity, a fraught debate over the nature of gender has arrived in the nation’s statehouses.

Ever since El Martinez started asking to be called by the gender-neutral pronouns “they/them” in the ninth grade, they have fielded skepticism in a variety of forms and from a multitude of sources about what it means to identify as nonbinary.nonbinary

There are faculty advisers on El’s theater crew who balk at using “they” for one person; classmates at El’s public school on the outskirts of Boston who insist El can’t be “multiple people”; and commenters on El’s social media feeds who dismiss nonbinary gender identities like androgyne (a combination of masculine and feminine), agender (the absence of gender) and gender-fluid (moving between genders) as lacking a basis in biology.

Even for El’s supportive parents, conceiving of gender as a multidimensional sprawl has not been so easy to grasp. Nor has El’s suggestion that everyone state their pronouns gained much traction.

So last summer, when the Massachusetts State Legislature became one of the first in the nation to consider a bill to add an “X” option for nonbinary genders to the “M” and “F” on the state driver’s license, El, 17, was less surprised than some at the maneuver that effectively killed it.

Beyond the catchall “X,” Representative James J. Lyons Jr. (he/him), a Republican, had proposed that the bill should be amended to offer drivers 29 other gender options, including “pangender,” “two-spirit” and “genderqueer.” Rather than open the requisite debate on each term, leaders of the Democratic-controlled House shelved the measure.

“He articulated an anxiety that many people, even folks from the left, have: that there’s this slippery slope of identity, and ‘Where will it stop?’” said Ev Evnen (they/them), director of the Massachusetts Transgender Political Coalition, which is championing a new version of the bill.

As the first sizable group of Americans to openly identify as neither only male nor only female has emerged in recent years, their requests for recognition have been met with reservations that often cross partisan lines. For their part, some nonbinary people suggest that concerns about authenticity and grammar sidestep thornier questions about the culture’s longstanding limits on how gender is supposed to be felt and expressed.

“Nonbinary gender identity can be complicated,” said Mx. Evnen, 31, who uses a gender-neutral courtesy title. “It’s also threatening to an order a lot of people have learned how to navigate.”

And with bills to add a nonbinary marker to driver’s licenses moving through at least six legislatures this session, the expansive conception of gender that many teenagers can trace to middle-school lunch tables is being scrutinized on a new scale.

NYTimes.com, May 29, 2018 by Amy Harmon

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Both Parents Are American. The U.S. State Department Says Their Baby Isn’t.

state department

James Derek Mize is an American citizen, born and raised in the United States. His husband, who was born in Britain to an American mother, is a United States citizen, too.  Now the State Department is dictating the citizenship of their child.

But the couple’s infant daughter isn’t, according to the State Department.

She was born abroad to a surrogate, using a donor egg and sperm from her British-born father. Those distinct circumstances mean that, under a decades-old policy, she did not qualify for citizenship at birth, even though both her parents are American.

“It’s shocking,” said Mr. Mize, 38, a former lawyer who lives in Atlanta with his husband, Jonathan Gregg, a management consultant. The couple received a letter denying their daughter’s citizenship last month.

“We’re both Americans; we’re married,” Mr. Mize said. “We just found it really hard to believe that we could have a child that wouldn’t be able to be in our country.”

Their case illustrates the latest complication facing some families who use assisted reproductive technology, like surrogacy and in vitro fertilization, to have children. For years the techniques have set off provocative legal and ethical debates about what defines parenthood. Immigration and citizenship are the latest frontier in those debates.

At issue is a State Department policy, based on immigration law, that requires a child born abroad to have a biological connection to an American parent in order to receive citizenship at birth. That is generally not a problem when couples have babies the traditional way, but can prove tricky when only one spouse is the genetic parent.

The policy has come under intense scrutiny in recent months amid lawsuits arguing that the State Department discriminates against same-sex couples and their children by failing to recognize their marriages. Under the policy, the department classifies certain children born through assisted reproductive technology as “out of wedlock,” which triggers a higher bar for citizenship, even if the parents are legally married.

In one instance, a married Israeli-American gay couple had twin sons in Canada using sperm from each of the fathers. The biological son of the American received citizenship, but his brother, the biological son of the Israeli, did not. In February, a federal judge sided with the couple, calling the State Department’s interpretation of the immigration law “strained.” The department is appealing.

The government is also fighting a similar suit from a lesbian couple in London, who did not use a surrogate. One is American and one is Italian. They took turns conceiving and carrying their two children. Only the child born to the American mother was granted citizenship. Last week, a federal judge allowed the case to proceed, calling the family’s predicament “terrible” and “outrageous.”

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Transgender dads tell doctors: ‘You can be a man and have a baby’

transgender dad

Transgender dads say they face misinformation, bias and a lack of understanding from the medical establishment when they decide to start a family.

When transgender dads, like Jay Thomas, 33, decide to get pregnant in 2016, he spoke to his physician.transgender dad

Thomas, a cook who lives in Louisville, Kentucky, explained to his doctor that he and his wife, Jamie Brewster, 33, a bank employee, are both transgender, and that he had been on testosterone for more than two years. The physician said Thomas had likely gone through early menopause, and that if they were able to conceive at all, he would have to go off the hormone for at least 18 months.

But none of that turned out to be true, according to Thomas, who gave birth to the couple’s son Dorian, 2, less than a year after that doctor’s appointment.

“We got pregnant in three months,” Thomas said.

One of the most persistent myths transgender men and nonbinary people hear from doctors is that testosterone has sterilized them, experts say. While testosterone generally blocks ovulation, trans men can get pregnant while taking it, particularly if they are not taking it regularly.

It’s just one example of the misinformation and discouragement transgender men say they face from the medical establishment when they decide to get pregnant — a problem advocates and experts blame on a lack of training and research around transgender health care, as well as doctors’ biases.

There is no data on how many transgender men and nonbinary people give birth in the United States each year, because medical systems track them as female, but experts believe the numbers are likely higher than many would expect. The number of people who identify as transgender is growing: A 2016 study from the Williams Institute found that 1.4 million adults in the U.S identify as transgender, which was double the estimate based on data from a decade earlier.

In Australia, where government agencies began tracking both sex and gender in official records in 2013, 54 transgender men gave birth in 2014, according to statistics from the country’s universal health care system. And a Dutch study published in the journal Human Reproduction in 2011 found that a majority of trans men reported wanting families.

But doctors, nurses and medical office staff are still adjusting to the idea that those who are pregnant may not identify as women. Transgender and nonbinary people describe gaps in medical professionals’ understanding ranging from an ultrasound technician calling them by the wrong name to doctors who tell them hormone therapy probably ruined their fertility. The consequences can be dire. A recently published case study described a transgender man who went to an emergency room with severe abdominal pain — but doctors were slow to realize that he was pregnant and in danger. The man delivered a stillborn baby several hours later.

nbcnews.com, May 19, 2019 by Julie Compton

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2020 Democrats Slam ‘Cruel’ Trump Administration Policy Denying Citizenship to Kids of LGBT Couples

2020 Democrats

Mayor Pete Buttigieg, one of the 2020 Democrats running for president, the first presidential candidate to be in a same-sex marriage, wrote on Facebook the policy is ‘a sober reminder that we must continue to fight for equality.’

From the 2020 Democrats ‘ campaign trail to the halls of Congress, Democrats condemned a State Department policy that withholds American citizenship from some children of U.S. citizens who are born abroad.2020 Democrats

Their reactions came after a story by The Daily Beast highlighted the damage the policy has done to the families of same-sex couples.

The policy deems children born abroad via assisted reproductive technologies as having been born “out of wedlock,” even if their parents are legally married, creating legal hurdles to obtaining birthright citizenship that threaten to keep parents permanently separated from their infant children.

On Thursday evening, House Speaker Nancy Pelosi (D-CA) released a statement aggressively condemning the policy, which she called “unconscionable attack on American families” that “violates our Constitution.”

“Once again, the Trump Administration is demonstrating just how far they are willing to go to undermine our core values and advance their hateful agenda,” Pelosi said. “The State Department must uphold our laws, end this cruel and inhumane policy and treat every family with the dignity and respect that they deserve.”

Leading Democratic presidential candidates, too, called for the State Department to reverse the policy.

“If you are born to U.S. parents, you are entitled to U.S. citizenship, full stop,” said Sen. Elizabeth Warren (D-MA). “This is just another example of the Trump administration’s shameful attacks on LGBTQ+ families.”

Posting on Facebook, Vermont Sen. Bernie Sanders called the policy “completely outrageous.”

“The Trump administration’s bigotry seems to have no limit,” Sanders said. “When we are in the White House this kind of discrimination will have no place in our government.”

Sen. Kamala Harris (D-CA), who counts both the Kivitis and the Dvash-Bankses as constituents, tweeted that the policy is “a cruel attack on LGBTQ* families.”

DailyBeast.com, May 15, 2019 by Scott Bixby

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Which Partner in a Male Couple Provides the Sperm in Gay Family Planning?

If you’re a male couple, your sperm-related issues are primarily focused on which partner should provide the sperm.

After all, only one man in a male couple can be the sperm contributor to one egg. Similarly, if you are a female couple, you’ll be deciding which of you will be inseminated. Admittedly, technology is changing rapidly, and at some point gene splicing may progress to the point where DNA from two men could be combined and used to fertilize one egg, or DNA from two women could be spliced and then fertilized by one sperm. But for now this is not an option.

Sometimes the choice of a male couple of whose sperm to use is an easy one — one of you may really want to use yours and the other doesn’t care. Or maybe there is a family history of health issues, addiction, or mental illness on one side so you use the other. It is also possible to take sperm samples from both partners, mixing the semen together so you and your partner each have an equal chance of being the biological father. However, doctors typically don’t like this approach and I don’t recommend it either, as it’s a bit more complicated medically, ethically, and legally.

In cases where both of you want to be a biological father, you can “take turns.” Essentially, when you get a batch of eggs from your donor (usually around ten or twenty are harvested), you can fertilize half of the eggs with one partner’s sperm and half of the eggs with the other partner’s. Then you take a fertilized egg from one of you and put it in the surrogate, freezing the rest of the embryos for later use. After you have your first child, you can have another, this time using an embryo from the other father. Or, if you want twins (much more on twins later), you can use one embryo from each of you, transferring them at the same time. If one takes but the other doesn’t, you can go back when you are ready and use an embryo from the other dad.

In cases where there will be two moms who both want to be genetic parents the idea is the same, although the logistics are different. You can use the donated sperm to inseminate one of you first, and then for a second child you can inseminate the other.

Advocate.com, by Kim Bergman, May 1, 2019

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Legal Basics for LGBTQ Parents

lgbtq parenting

It’s never been easier for LGBTQ people to become parents.

We can now adopt and serve as foster parents in every state in the country. Thanks to advancements in assisted reproductive technology, otherwise known as ART, and innovative co-parenting and known-donor arrangements, we’re also having biological children in greater numbers. llgbtq parentingDespite this progress, a complex network of state laws, regulations and restrictions affect many of our most common paths to parenthood, meaning would-be LGBTQ. parents can face a far more complicated legal landscape than our straight counterparts. 

Legal concerns for LGBTQ people are generally impacted by three factors: the state you live in, your preferred path to parenthood and your relationship status. To gain a better understanding of each, I interviewed four experts at some of the country’s top LGBTQ legal and policy organizations.

THE GIST

  • Know the laws in your state; your legal outlook can vary widely depending on where you live. 
  • Your preferred path to parenthood (donor arrangements, adoption or fostering) will present you with a specific set of legal considerations. 
  • Other legal concerns arise depending on your relationship status: whether you’re single, in an unmarried relationship or married.
  • If you are not biologically related to your child, legal experts recommend taking steps to protect your legal status as a parent, even if you’re married to your child’s biological parent. 
  • Parenthood for LGBTQ people doesn’t always come cheap — but there are some ways to offset the costs. 
  • If you encounter obstacles, don’t give up. An experienced family lawyer is often familiar with legal workarounds, even in states with unfavorable laws for the LGBTQ community.

NYTParenting.com by David Dodge, May 7, 2019

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Parental Rights In New York To Graduate From The Dark Ages, Hopefully

New York parental rights

The changes, if they go through, will significantly improve the state of New York law, and protect parental rights and donors’ rights.

New York parental rights

Many New York parents are currently in a very scary legal environment, and they may not even know it. Did you know that a hopeful single parent who turns to a known sperm donor to conceive in New York has no way to sever the donor’s parental rights? That’s right. And that means that a sperm donor can, at any time, seek parental rights to the child. Vice versa, the parent can seek child support from the sperm donor. That’s concerning! The situation is also true for egg and embryo donations.

New York attorney and adoption and assisted reproductive technology powerhouse, Denise Seidelman, spoke to me about the current problematic legal environment, as well as her ongoing efforts to fix the situation, and to protect parents and children. Seidelman and her law partner, Nina Rumbold, are among those in New York zealously advocating for the passage of the Child-Parent Security Act (CPSA).

Even The Governor Wants It!

The CPSA was introduced in 2013 by Assemblymember Amy Paulin and State Senator Brad Hoylman. Hoylman is himself a parent of two children born through surrogacy. Hoylman and his husband were forced to go outside of New York to have their children through surrogacy because, in addition to the bleak donor situation, compensated surrogacy is illegal in New York.

The CPSA has undergone a number of revisions since its initial proposal, and is still undergoing a few finishing touches. But not until this year did anyone have as much hope that this legislation could pass. Key among factors giving New Yorkers newfound optimism is the vocal support of New York Governor Andrew Cuomo. The Governor has publicly supported the bill, explaining that “New York’s antiquated laws frankly are discriminatory against all couples struggling with fertility, same sex or otherwise.” Even more exciting, the Governor initially included the CPSA in his executive budget plan. However, it was removed in the last few weeks — possibly out of an interest in letting the legislature pass the bill with the latest updates.

What’s So Special About This Bill?

It protects children, for one! No kid should be stuck in the middle of a legal battle questioning who his or her legal parent is, merely because New York’s laws are decades out of date. Specific protections for families and those who help them include:

  • Clarifying and protecting parental rights when a sperm donor, egg donor, or embryo donor assists with conception. About time! Seidelman explained that while the surrogacy aspects of the bill are getting most of the attention, she is especially excited about the positive impact of the donor-related provisions. The bill provides that those who turn to a donor can be assured that they are the legal parents of their child, and that a donor can’t claim parental rights to the child. And, on the other side, that donors can rest easy that their good deed of helping another family no longer opens them to the risk of later being sued for child support for the child. This protection could encourage more couples to donate remaining embryos to others to form their families, rather than destroying them or donating them to research.
  • Legalizing compensated gestational surrogacy. At the moment, New York is among a small minority of U.S. states which dictate that a woman is not permitted to receive compensation if she chooses to act as a gestational surrogate for another. In fact, it’s criminal.

AboveTheLaw.com, by Ellen Trachman, April 10, 2019

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Making Babies in the Year 2045 – Genetic Data

genetic defect

Huge pools of Genetic data collected over the past generation allow you to pick many of your child’s genetic traits. Are you comfortable with that?

genetic defect

The year is 2045. The genomes of four billion humans have been sequenced, creating a huge pool of genetic information accessible to researchers. This process had been well underway in 2019, but accelerated rapidly once many countries realized that understanding human biology was the ultimate big data problem and a key to reducing health care costs and enhancing national competitiveness. Widely sharing deeply personal health information had alarmed privacy advocates. But supporters of sharing genetic data argued convincingly that the benefits to society outweighed the privacy concerns of individuals. The debate may have once seemed abstract. But now you are in a fertility clinic and the issues are fast becoming real.

The cascade of numbers overwhelms you as the doctor splashes the spreadsheet across the digital walls of her office.

“I hope you can see the wonder and possibility in these figures,” she says, trying to put you at ease.

As you sit in the spa-like clinic, it’s hard to imagine it was just last week when your assistant placed the miniature device on your arm that painlessly suctioned out a small amount of blood and started you on this journey. The spark of life that used to begin in bedrooms and the back seats of cars was now migrating out of the human body and into the lab.

“Take your time,” the doctor continues. “You need to first select the early- stage embryo optimal for you. The numbers across the top list the 300 options for you that we’ve prescreened from the initial 10,000. The column down the left lists all the disorders and traits influenced by genetics that we have some ability to predict. The numbers populating the chart are our best predictions for how the genetic component of each trait would be realized if we selected based on that trait alone. We’re looking for high composite scores emphasizing the qualities most important to you.”

You scan the lists on the walls wondering if a human being can really be reduced to numbers. “Can you really predict all of these traits?” you ask.

“These are all probabilities, not certainties,” the doctor says. “Not all traits are equally genetic. And genetics is a trade-off, so we can’t choose to optimize every trait. Thirty years ago we could mostly just identify disorders determined by a single genetic mutation, but in 2018 we started using what we call ‘polygenic scoring’ to make better predictions about diseases and traits influenced by hundreds or thousands of genes. 

“Our biology is still about as complex as it’s been for millions of years but the technology we’re using to understand it is getting exponentially more sophisticated,” she continues. “There may be magic in humans, but we aren’t made of magic. Our DNA is a type of source code we’re learning how to read and write.”

The idea of humans as hackable data sets may be increasingly common but still unsettles you. The numbers on the wall seem to confirm the doctor’s words. “And this 60 means that embryo would be good at math?” you ask, pointing to one of the options on the list.

NYTimes.com, by Jamie Metzl, April 10, 2019

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The relationship between LGBT inclusion and economic development: Macro-level evidence

lgbt economic development

This study analyzes the relationship between social inclusion of lesbian, gay, bisexual, and transgender (LGBT) people and economic development.

gay money

It uses legal and economic data for 132 countries from 1966 to 2011. Previous studies and reports provide substantial evidence that LGBT people are limited in their human rights in ways that also create economic harms, such as lost labor time, lost productivity, underinvestment in human capital, and the inefficient allocation of human resources. This analysis uses a fixed effects regression approach and a newly-created dataset – Global Index on Legal Recognition of Homosexual Orientation (GILRHO) – to assess how these detriments are related to the macroeconomy. Our study finds that an additional point on the 8-point GILRHO scale of legal rights for LGB persons is associated with an increase in real GDP per capita of approximately $2000. A series of robustness checks confirm that this index continues to have a positive and statistically significant association with real GDP per capita after controlling for gender equality. In combination with the qualitative evidence from previous studies and reports, our quantitative results suggest that LGBT inclusion and economic development are mutually reinforcing. Also, a back-of-the-envelope estimate suggests that about 6% to 22% of the finding could reflect the costs to GDP of health and labor market stigmatization of LGB people. Results from this study can help to better understand how the fuller enjoyment of human rights by LGBT people can contribute to a country’s economic development.

ScienceDriect.com, April 11, 2019

Click here for access to the study.

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AI COULD SCAN IVF EMBRYOS TO HELP MAKE BABIES MORE QUICKLY

Embryos AI

Embryo AI

IF A WOMAN (or non-female-identifying person with a uterus and visions of starting a family) is struggling to conceive and decides to improve their reproductive odds at an IVF clinic, they’ll likely interact with a doctor, a nurse, and a receptionist, not an AI specialist. They will probably never meet the army of trained embryologists working behind closed lab doors to collect eggs, fertilize them, and develop the embryos bound for implantation.

One of embryologists’ more time-consuming jobs is grading embryos—looking at their morphological features under a microscope and assigning a quality score. Round, even numbers of cells are good. Fractured and fragmented cells, bad. They’ll use that information to decide which embryos to implant first.

It’s more gut than science and not particularly accurate. Newer methods, like pulling off a cell to extract its DNA and test for abnormalities, called preimplantation genetic screening, provide more information. But that tacks on additional costs to an already expensive IVF cycle and requires freezing the embryos until the test results come back. Manual embryo grading may be a crude tool, but it’s noninvasive and easy for most fertility clinics to carry out. Now, scientists say, an algorithm has learned to do all that time-intensive embryo ogling even better than a human.

In new research published today in NPJ Digital Medicine, scientists at Cornell University trained an off-the-shelf Google deep learning algorithm to identify IVF embryos as either good, fair, or poor, based on the likelihood each would successfully implant. This type of AI—the same neural network that identifies faces, animals, and objects in pictures uploaded to Google’s online services—has proven adept in medical settings. It has learned to diagnose diabetic blindness and identify the genetic mutations fueling cancerous tumor growth. IVF clinics could be where it’s headed next.

“All evaluation of the embryo as it’s done today is subjective,” says Nikica Zaninovic, director of the embryology lab at Weill Cornell Medicine, where the research was conducted. In 2011, the lab installed a time-lapse imaging system inside its incubators, so its technicians could watch (and record) the embryos developing in real time. This gave them something many fertility clinics in the US do not have—videos of more than 10,000 fully anonymized embryos that could each be freeze-framed and fed into a neural network. About two years ago, Zaninovic began Googling to find an AI expert to collaborate with. He found one just across campus in Olivier Elemento, director of Weill Cornell’s Englander Institute for Precision Medicine.

wired.com by Megan Molteni, April 4, 2019

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Source: Time for Families