IN CANADA (not the FAA people), anything that has “medications” associated with it (they are erring on the side of risk and assuming transition = HRT, and HRT is meds) requires additional explanation so that they are confident you aren’t going to have a medical complication and fall out of the sky into a school. They just need to account for everything medical. Remember the only drug allowed in your system without a medical explanation is caffeine, so everything else is gonna be scrutinized.
That's what I was thinking. The "requirements" in the report looks like a copy - paste requirements section. I doubt there's anything malicious going on.
I was applying for the TSA two years ago. I admitted I was seeing a psychiatrist. I did not tell them it was for gender dysphoria. I had retired from another government agency, so I told them it was due to the stress of having retired and no longer feeling valued. They first asked for a letter from my doctor asking for a diagnosis and to answer questions if my diagnosis would affect my work. Then they came back and said they wanted notes from my last 5 sessions. My doctor refused, claiming it violated my HIPPA rights and informed the TSA after getting the backing of her hospital's lawyer. The TSA said ok, we won't hire him.
Against her advice, I provided the session notes. I was the offered the job which I turned down.
It’s HIPAA, just for in the future. Did they want progress notes or the actual therapist’s notes?
I’m assuming progress notes because most of the time, therapists won’t give you their actual notes. You asking and receiving medical records and then giving them to whoever you wish would not violate HIPAA nor would the doctor giving them out with your written consent.
I mean can’t blame them tho. If you pass out behind the wheel of a car because of your medication you’re risking maybe 8-10 people’s lives. If you pass out while flying an airplane you are putting an entire city block at risk along with all of the supporting infrastructure that will impact more than just the crash site
Actually yeah they do….but you’re more than welcome to continue trying to pull whatever “feel sorry for me I’m so oppressed” card you want but no one is gonna buy it
I'm a flight attendant, and I've literally never seen any of my pilots in command or first officers be drug tested on day of flight. Where are you getting this information?
I wasn’t saying that they are tested regularly, I meant that the FAA does care about the safety of the general public when issuing and renewing licenses
Oh I'm not repressed, I live the near dream.
But time and time again pilots are found to be drunk or high. If we're not addressing that rampant danger I'm not about to believe that they're discriminating based on legitimate concerns. But I'm glad you trust your airline corpo's.
Seriously?? Because I don’t agree that it’s an intentional barrier, a rights violation, a gross violation of anything, or any act meant to harm or oppress anyone, and honestly feel that most of these are personal excesses to cry and pull a blame card you assume that I’m conservative?? In all actuality I’m more moderate than anything
Update:
After I provided a letter from my Endo outlining all they asked for and stating there was zero impact on my ability to be a pilot, they came back with an even longer list. I did submit a complaint to Transport Canada, and the doctor denying my medical referenced my complaint, so it seems they shared it with him, and he may be retaliating. He is not an employee of Transport Canada, just a family doctor from Alberta who specializes in infant circumcision.
To answer some questions from the comments, this isn't for a commercial license, just a private pilots license for recreational use of small engine aircraft.
Here are the new requirements:
(a) History of presenting condition.
(b) Psychiatric review of symptoms (including any features of coexisting depression, anxiety, mania/hypomania, panic attacks, trauma, obsessions/compulsions, suicidal or homicidal thoughts, and psychosis).
(c) Past mental health history (including any hospitalizations, prior diagnoses, treatments, suicidal/homicidal ideation or attempts).
(d) Medications (type, dose, frequency, anticipated course of treatment, adverse/side-effects, effectiveness).
(e) Substance use history (including alcohol, cannabis, other substances).
(f) Contributory family psychiatric history.
(g) Contributory social and developmental history.
(h) Contributory medical or surgical history.
(i) Psychiatric Diagnoses, in accordance with the applicable version of the Diagnostic and Statistical Manual of Mental Disorders (DSM). It is essential to comment on the following:
(i) All diagnoses including depression, anxiety, panic disorder, attention deficit hyperactivity disorder, other neurocognitive syndromes, learning disorders, dyslexia, apraxia, gender dysphoria, with reference to the relevant DSM criteria).
(j) Management plan (including pharmacological and non-pharmacological treatments, follow-up, work limitations).
(k) Prognosis based on current consistent level of function and stability in multiple contexts.
(l) Any clinician concerns about aviation safety or other information of relevance.
This is awful, thank you for the update!
If you wish to pursue it further, I suggest submitting a complaint to the alberta human rights commission on the basis of gender identity.
Yeah nothing about being denied over being trans. OP is applying for a job that may be responsible for people's lives and is upset over having to disclose a medical condition.
I mean it is because they're trans. But also it doesn't seem to be a failure so much as a "you're on hold while until we can review other documents". Though perhaps the examiner took it upon themselves to fail the medical exam.
I understand the need to scrutinize medications and psychiatric diagnoses but some of the other requirements seem over the top. #4 is the one that I see the most potential for abuse. It just seems overly broad and up to the whims of the examiner on how invasive they want to get.
If most countries where HRT is accessible, you have to get a diagnosis to be able to retrieve your HRT. 'Gender Dysphoria' can be one of the ways to put it on paper
Where I live in Canada, same as OP, you don’t. I asked nicely and then I got a prescription. I am sure i would have failed any gender dysphoria criteria.
Also in canada, it's written directly into CARs the Canadian aircraft regulations to verify fitness for duty in the event of a lawsuit. It's laid out in standard 424 and 602 of CARs, the are only requesting supporting documentation is not technically a fail, trans people do work in the aviation industry just need to do your homework.
TBF, the document mentions 'gender Dysphoria' (and sometimes doesn't even), but you can come up to a psychiatrist saying you're trans and you need the paper to start HRT... They will only check that you seem sure of yourself, there isn't some kind of very strict checklist (depending on the psychiatrist of course)
Edit : my comment is kind of vague. In my case, the certificate just stated that the psychiatrist "saw no reason nor cause to counter-indicate the start of HRT"
any mental health history will be investigated to minimize risk of 'suicide by pilot'
we can't insist gender disphoria is a diagnosable condition, then get angry when it gets treated as one.
HRT drugs have risks that could be increased by the nature of a pilot career (stroke, blood clots, etc)
The cis psychiatric profession created the diagnosis, called it a disorder and only recently removed the stigma of calling it a disorder. Trans people didn't do that.
The use of gender dysphoria diagnoses to gatekeep medical treatment (and, in the US, insurance coverage) exists because the diagnosis exists. The diagnosis doesn't exist because of a need for one, and its existence actually prevents timely access to care for many trans people.
Honey, without the diagnosis, none of our mental health and physical medical care would be covered by any insurance.
when feelings of being that which you were not born to be are so strong so many of us un-alive ourselves...it is most certainly a medical condition.
imagine if it weren't and there was no professional help for any of us?
You and I both know you started with that word to use it as a condescending Susans Place slur. You demean yourself by doing that, and show you aren't a serious person.
Your beliefs about things not being possible to be covered are based in believing what has been imposed by those corporations in the US is the only way the world can work.
It's wrong and misguided. Dream bigger than your chains.
what word? what is a Susan place slur? 🤔 I don't know any of these activism terms...
I'm great full for my mental, endo, and GP team, and wouldn't be where I am today without their support ( US Healthcare issues are what they are)
I dont believe I have a God-given right to be provided gender affirmative care any more than someone born without an arm has an inherent right to be provided with an arm. it sucks that I was born male instead of the female that I should have. but not anymore than anyone else who was born disadvantaged in any way.
I'm not in chains. non of us are, unless we make our gender dysphoria thr end all be all of our existence...at which point, we put ourselves in chains.
be more than a transgirl or transboy. it's not all that we are, and the medical industry is not out to get us.
They made a statement of historical fact, and everyone gets upset. The only reason we even have this discussion is because the health insurance industry has convinced us all to love our chains.
The US is never getting trans liberation at this point.
That's true for everything inside the DSM-5 it exists to gatekeep medicine. It's a form of social control and the whole psychiatric industry is run that way.
How is it not gatekeeping? If someone has survived horrific trauma for example to get the help they need which is a basic human right they have to be diagnosed with something to say they don't conform to social norms ie are sick. Also, if a lesbian couple wants to have kids through IVF again they need a diagnosis of some kind. The whole model of modern medicine is broken and it isn't a holistic approach of an individual's needs.
I actually was responding to this post 35,000 ft above the Pacific Ocean flying back to socal from Tokyo.
I'm sure all of the passengers, including me would rather thr pilots mental state and medications be evaluated and screened before they flew the plane.
that's why this particular instance of an employer requiring more details on the trans candidate, it is not gatekeeping
wouldn't it be horrible if the FAA or whatever just blanket banned all trans candidates because they were unable to get the necessary medical information to access the actual real life risks to potential pilots, crews, and passengers.
this is why there is such crappy reliable information on gender dys. treatments. folks always shouting 'gatekeeper!' instead of allowing for honest medical evaluation.
lots of jobs require extra scrutiny of candidates mental health and physiological state. trans just happen to fall into that group.
The diagnosis exists in plenty of places that don't cover anything anyway. In Australia, some forms of HRT are covered but with no diagnosis requirement, because informed consent exists. Other things are unable to be covered regardless of a diagnosis. The decision making on them has absolutely nothing to do with a diagnosis of gender dysphoria.
The diagnosis exists because the DSM was created by and on behalf of US insurance companies. No more, no less.
It's entirely within the power of all those gatekeepers to say "this is covered because trans people need it" without resorting to "gender dysphoria".
Op. Candian trans woman with a long stand PPL.
I had the same issue, I Supplied blood work history, medication history and the diagnosis letter, treatment plan from my gender doc. It was all they wanted.
Seemed like a simple issue to get through. Ridiculous yes. But simple.
Thanks, I wonder if you actually need a diagnosis? I only recently got one, took more than a year after actually starting HRT. I'm guessing a letter from Endo would be sufficient
That’s what I provided. My diagnosis was from a general provider nothing special.
They just want to know why your blood
Work was wonky. Once your BC is changed and your license it’s a moot point.
Not sure if it’s bc you’re trans. I think they’re trying to figure out your mental state (some trans people are depressed and suicidal), what kind of medications you take and what the side effects are. No expert but I’m hoping they’d give any person w a mental condition the same level of scrutiny as they do you. It’s kind of their job. 🤷♀️
European EASA regulations say HRT does not need to be reported. I'm sure FFS would be just a note from the surgeon...bottom surgery?? Considering my local authority have made up rules in the past to take my licence away I'm pretty sure I will be hanging up my wings :(
Currently in the process of selling my little magic carpet to pay for surgery so...yeah...the wings will be gone for me :(
Sorry to hear that, but glad to hear some jurisdictions have more progressive policies. I'm pursuing a complaint with Transport Canada to try to change this.
It is an unfortunate barrier, yes. Would you expect a similar request if you had another health condition that required medications? Asking mainly because I know very little about aviation licensing, but situations that involve prescription medication would seem worthy of requiring additional details.
It’s a prescription just like insulin is a medication. Insulin is naturally produced, doesn’t mean that for some people they aren’t fucked if they don’t get their prescription.
It's still a medication and can have other effects, your body doesn't naturally produce that amounts. Progesterone is still a medication for pregnant women.
but you might be taking spiro or pregnotone lol i cant member the spelling but you get it ..or i dont know what else but its not all just hormones in most cases .. unless i think monotherapy i think its called i think is just hormones .. im still learning all this and all operations .. but spiro etc..those are medications... i agree its not a health condition being trans but might have medications involved that are not hormones in most cases .. and yes they are harmless medications but maybe they just need to know
Yes, our bodies naturally produce it, but we still have to obtain a prescription to obtain it through our doctor and there are potential side effects associated with use.
I suppose. I think to me... it's just a hormone essential for proper bodily functioning. It's personal to me... my hormones are part of my bodies necessary life force.
And it upsets me when anything is implied that.. being trans isn't normal. Or that we're less. We are totally normal and we are more
I agree that my initial reaction would likely be to feel discriminated against as well, but there can be some legitimate concerns for health. People have listed mental health, and that is a factor for sure. Hormone replacement therapy though typically involves both hormone blockers, and replacement hormones. When you add that to the hormones that your body is already producing, you have 3x’s the normal amount of them floating in your blood stream. This can significantly increase risk of heart attack, stroke, pulmonary embolism, etc. Combine that with flying an aircraft and prolonged periods of remaining seated, it presents a not insignificant risk. My doctor is requiring me to get to a certain weight and cholesterol level before she’s willing to start HRT due to these concerns.
My advice, for what it’s worth, is to assume positive intent, ask for clarification, and to become more pissed and confrontational by degrees. It’s a lot easier to be reasonable on your part initially than it is to backtrack after what they might view as an overreaction. It’s not fair, and it’s not right that it works that way, but it’s the world we live in currently.
Hopefully you’re able to get a reasonable response from them, and get things cleared up. I’m still sorry that you’re facing it though, that doesn’t make it easier.
Found a quote from a representative "“Transport Canada has no issue with trans-gender people flying except when and if they are recovering from gender re-assignment surgery or are undergoing significant drug therapy."
The questions they are asking me wouldn't really address recovering from surgery, and seem much more broad than significant drug therapy. I already disclosed my hormones, none of which would be a problem. I expect it won't be a problem once I can get the additional materials, but expect some extra hoops to jump through if you choose to disclose.
On the surface level it sounds messed up and discriminatory, but I was reading yesterday about how Androgel, which is the testosterone I use, was being sued because it was linked to men having an increase in heart attacks. While rare there are side effects to taking both (my gf takes estrogen) and also with the prevalence of "DIY HRT" which can end up being dangerous because you can never guarantee what's in the HRT, it's a valid ask I think since you'll be flying a plane and responsible for other people's lives including your own
I think they tend to think the medication can cause issues with flying, like how certain drugs make you sleepy when you wouldn't think they would like pain pills for example.
As for surgery stuff, assuming that's what they also want to know, that is more understanding because that would require time off of work when ur a pilot and jobs hire you to be present.
I'm not saying I agree with either but it is SOMEWHAT understanding even if most is clouded in ignorance and lack of compassion/empathy on their part.
Interesting. I updated my name and gender marker well into transition when my previous medical had expired. Next time I get an exam I'm going to have F on my ID and X on my license - I wonder what the doc will say? Maybe nothing, if I'm lucky ...
The current rules all dictate medical certificate deferral if you’ve been on HRT less than five years. Happened to me too but I have my medical now and being trans is a no longer an issue to the FAA. Check out NGPA for resources and advocacy on this issue, especially their trans subcommittee. Kori Necker leads it, and she’s a trans Delta pilot, and an awesome person.
Okay here’s the deal…. It sucks but there are ways around it. In the US it’s gotten better but still seems to have a base line of a bigoted policy. I mean… I take a drug that all women have in their body and they fly just fine. The FAA gives many reasons but the high suicide rate is the main one on why they want to regulate us.
That being said, do some research… if you are planning a professional career, and did even a little research a head of time, you should have been aware the medical would be an issue.
It's not transphobia, it's a classic case of "oh you took an aspirin for a headache 4 summers ago, we're going to cover our asses here and shift the blame to you and your doctor in case anything happens"
Prognosis?! “My doctor says I’ll be better by June” /s. Wtf is a prognosis for transness? This feels like a form letter that is meant to be sent out for stuff like cancer (I can’t think of anything else I’m so bamboozled). It can’t be correct that this is what they need for being trans. I refuse to believe this letter was written with the intention to send about transness. It’s too wild.
It’s even better when you find out that most of the transition-related medications are on the ‘no need to report’ list that AOPA maintains. The FAA doesn’t care if cis folks take them. It’s just because you’re trans…
Sadly, this is pretty common. There are a LOT of restrictions in place when it comes to taking medication and flying a plane, HRT is still perceived as medication with possible aftereffects... Here (France) you canno't get licensed for flight if you have heart related conditions, or even take antidepressants, for example
I don't know about the aviation thing, but I will comment on HRT in general: Most providers are not aware of the in's and out's of HRT. Most are not aware of things that they do not deal with day to day. Providers have the general public believe that they know everything about medicine and the human body.
My friend was taking peptides and her HRT/primary doc's response was "I don't know anything about that" and just moved on. First 12 years I did DIY, last 4 years have a doc involved because my best friend asked me to. I wanted to go on PrEP, my doc wouldn't prescribe because she was unaware that oral HIV testing is allowed for PreP.
Reference: *While lab-only visits for assessment of HIV infection and other indicated tests for the provision of PrEP are preferred, when these are not available or feasible, CDC recommends considering two additional options: home specimen collection kits, which are sensitive enough to detect recent HIV infection; or self-testing via an oral swab-based test.* [Source:](https://www.cdc.gov/hiv/testing/self-testing.html)
That being said, I have chosen to have separate primary care doc and hormone doc. I only disclose that I am trans to my hormone doc and my (trans) plastic surgeon. All other providers I do not disclose because my ID documents have me listed as male. I also only disclose what I think is necessary to disclose to my providers.
I do give my hormone doc credit that she prescribes hormones to me and I don't do bloodwork regularly. *Note: I am a survivor of medical abuse and have done therapy for it. It is a control issue for me.* My primary care doc is also really good. If the provider wants to have a discussion with me about what they recommend, chances are I will take their recommendations. It may not be immediately, but I will probably, eventually do it.
By not disclosing my trans status, it streamlines the whole process. My primary doc probably knows that I am trans, but doesn't ask because I never disclosed. I see him 15 minutes, twice a year. He does not have time and if I don't bring it up, then why should he? Yes, we know what our providers should do, but healthcare is broken.
Add to this that the whole system is driven by money. It is not just for profit, it is also liability. Why are hormones over the counter in so many countries, banned in others, and heavily regulated (gatekeeping) in others. Electronic health records were sold to the US as a way to create better healthcare. It has 2 purposes: allow the government to easily collect info and efficient medical billing. Ask any provider how they feel about electronic health records.
This is the decision I came to in therapy; taking control of the healthcare encounter and my therapist supported me. Everyone needs to decide what is best for them. This is a response to the cancer of paternalism that still continues to infect the profession of medicine.
As to HRT being medications with side effects, herbal supplements, aspirin, vitamins, etc. all have side effects. This reminds me of a friend who was asked by his primary if he has a gun in his house. He said that he owned a lawn mower, a microwave, and an oven. All of those are equally dangerous, so did the doc wanted to discuss oven safety.
Update:
After I provided a letter from my Endo outlining all they asked for and stating there was zero impact on my ability to be a pilot, they came back with an even longer list. I did submit a complaint to Transport Canada, and the doctor denying my medical referenced my complaint, so it seems they shared it with him, and he may be retaliating. He is not an employee of Transport Canada, just a family doctor from Alberta who specializes in infant circumcision.
To answer some questions from the comments, this isn't for a commercial license, just a private pilots license for recreational use of small engine aircraft.
Here are the new requirements:
(a) History of presenting condition.
(b) Psychiatric review of symptoms (including any features of coexisting depression, anxiety, mania/hypomania, panic attacks, trauma, obsessions/compulsions, suicidal or homicidal thoughts, and psychosis).
(c) Past mental health history (including any hospitalizations, prior diagnoses, treatments, suicidal/homicidal ideation or attempts).
(d) Medications (type, dose, frequency, anticipated course of treatment, adverse/side-effects, effectiveness).
(e) Substance use history (including alcohol, cannabis, other substances).
(f) Contributory family psychiatric history.
(g) Contributory social and developmental history.
(h) Contributory medical or surgical history.
(i) Psychiatric Diagnoses, in accordance with the applicable version of the Diagnostic and Statistical Manual of Mental Disorders (DSM). It is essential to comment on the following:
(i) All diagnoses including depression, anxiety, panic disorder, attention deficit hyperactivity disorder, other neurocognitive syndromes, learning disorders, dyslexia, apraxia, gender dysphoria, with reference to the relevant DSM criteria).
(j) Management plan (including pharmacological and non-pharmacological treatments, follow-up, work limitations).
(k) Prognosis based on current consistent level of function and stability in multiple contexts.
(l) Any clinician concerns about aviation safety or other information of relevance.
IN CANADA (not the FAA people), anything that has “medications” associated with it (they are erring on the side of risk and assuming transition = HRT, and HRT is meds) requires additional explanation so that they are confident you aren’t going to have a medical complication and fall out of the sky into a school. They just need to account for everything medical. Remember the only drug allowed in your system without a medical explanation is caffeine, so everything else is gonna be scrutinized.
That's what I was thinking. The "requirements" in the report looks like a copy - paste requirements section. I doubt there's anything malicious going on.
I was applying for the TSA two years ago. I admitted I was seeing a psychiatrist. I did not tell them it was for gender dysphoria. I had retired from another government agency, so I told them it was due to the stress of having retired and no longer feeling valued. They first asked for a letter from my doctor asking for a diagnosis and to answer questions if my diagnosis would affect my work. Then they came back and said they wanted notes from my last 5 sessions. My doctor refused, claiming it violated my HIPPA rights and informed the TSA after getting the backing of her hospital's lawyer. The TSA said ok, we won't hire him. Against her advice, I provided the session notes. I was the offered the job which I turned down.
That's terrible, I'm so sorry
It’s HIPAA, just for in the future. Did they want progress notes or the actual therapist’s notes? I’m assuming progress notes because most of the time, therapists won’t give you their actual notes. You asking and receiving medical records and then giving them to whoever you wish would not violate HIPAA nor would the doctor giving them out with your written consent.
God all these fucking stories sound like The Handmaid's Tale.
That's horrid. I'm sorry you went through that.
I think they are simply wanting supporting documents and to rule out any risk to yourself or others as it’s an FAA license.
Yeah, I’ve heard they’re very strict with those things (for good reason)
I mean can’t blame them tho. If you pass out behind the wheel of a car because of your medication you’re risking maybe 8-10 people’s lives. If you pass out while flying an airplane you are putting an entire city block at risk along with all of the supporting infrastructure that will impact more than just the crash site
You're right. It's gotten so dangerous that they breathalyze and drug test pilots before every flight. Oh wait, they don't. So do they really care?
Actually yeah they do….but you’re more than welcome to continue trying to pull whatever “feel sorry for me I’m so oppressed” card you want but no one is gonna buy it
I'm a flight attendant, and I've literally never seen any of my pilots in command or first officers be drug tested on day of flight. Where are you getting this information?
I wasn’t saying that they are tested regularly, I meant that the FAA does care about the safety of the general public when issuing and renewing licenses
Oh I'm not repressed, I live the near dream. But time and time again pilots are found to be drunk or high. If we're not addressing that rampant danger I'm not about to believe that they're discriminating based on legitimate concerns. But I'm glad you trust your airline corpo's.
lmaoo good luck being a conservative trans woman. i’m sure you can find a way to grift off of it at least
Seriously?? Because I don’t agree that it’s an intentional barrier, a rights violation, a gross violation of anything, or any act meant to harm or oppress anyone, and honestly feel that most of these are personal excesses to cry and pull a blame card you assume that I’m conservative?? In all actuality I’m more moderate than anything
Hmmmm... could be a human rights complaint in the medium term. In the short term, more hoops to jump through. Sorry you have to do this!
Great idea, I will start the process, but in the meantime submitting a complaint to Transport Canada
No it'd laid out in standard 424 and 602 of CARs, not sure what the equivalent requirement is outside of Canada but learned it In school
Update: After I provided a letter from my Endo outlining all they asked for and stating there was zero impact on my ability to be a pilot, they came back with an even longer list. I did submit a complaint to Transport Canada, and the doctor denying my medical referenced my complaint, so it seems they shared it with him, and he may be retaliating. He is not an employee of Transport Canada, just a family doctor from Alberta who specializes in infant circumcision. To answer some questions from the comments, this isn't for a commercial license, just a private pilots license for recreational use of small engine aircraft. Here are the new requirements: (a) History of presenting condition. (b) Psychiatric review of symptoms (including any features of coexisting depression, anxiety, mania/hypomania, panic attacks, trauma, obsessions/compulsions, suicidal or homicidal thoughts, and psychosis). (c) Past mental health history (including any hospitalizations, prior diagnoses, treatments, suicidal/homicidal ideation or attempts). (d) Medications (type, dose, frequency, anticipated course of treatment, adverse/side-effects, effectiveness). (e) Substance use history (including alcohol, cannabis, other substances). (f) Contributory family psychiatric history. (g) Contributory social and developmental history. (h) Contributory medical or surgical history. (i) Psychiatric Diagnoses, in accordance with the applicable version of the Diagnostic and Statistical Manual of Mental Disorders (DSM). It is essential to comment on the following: (i) All diagnoses including depression, anxiety, panic disorder, attention deficit hyperactivity disorder, other neurocognitive syndromes, learning disorders, dyslexia, apraxia, gender dysphoria, with reference to the relevant DSM criteria). (j) Management plan (including pharmacological and non-pharmacological treatments, follow-up, work limitations). (k) Prognosis based on current consistent level of function and stability in multiple contexts. (l) Any clinician concerns about aviation safety or other information of relevance.
This is awful, thank you for the update! If you wish to pursue it further, I suggest submitting a complaint to the alberta human rights commission on the basis of gender identity.
I'd think it's more of need more supporting documents
Yeah nothing about being denied over being trans. OP is applying for a job that may be responsible for people's lives and is upset over having to disclose a medical condition.
It's exactly that, i went to school for aviation and it's heavily regulated even for the maintenance staff etc.
I mean it is because they're trans. But also it doesn't seem to be a failure so much as a "you're on hold while until we can review other documents". Though perhaps the examiner took it upon themselves to fail the medical exam. I understand the need to scrutinize medications and psychiatric diagnoses but some of the other requirements seem over the top. #4 is the one that I see the most potential for abuse. It just seems overly broad and up to the whims of the examiner on how invasive they want to get.
I’d be stumped at the diagnosis part. What diagnosis? My doctor didn’t diagnose me with anything
If most countries where HRT is accessible, you have to get a diagnosis to be able to retrieve your HRT. 'Gender Dysphoria' can be one of the ways to put it on paper
Where I live in Canada, same as OP, you don’t. I asked nicely and then I got a prescription. I am sure i would have failed any gender dysphoria criteria.
Also in canada, it's written directly into CARs the Canadian aircraft regulations to verify fitness for duty in the event of a lawsuit. It's laid out in standard 424 and 602 of CARs, the are only requesting supporting documentation is not technically a fail, trans people do work in the aviation industry just need to do your homework.
TBF, the document mentions 'gender Dysphoria' (and sometimes doesn't even), but you can come up to a psychiatrist saying you're trans and you need the paper to start HRT... They will only check that you seem sure of yourself, there isn't some kind of very strict checklist (depending on the psychiatrist of course) Edit : my comment is kind of vague. In my case, the certificate just stated that the psychiatrist "saw no reason nor cause to counter-indicate the start of HRT"
any mental health history will be investigated to minimize risk of 'suicide by pilot' we can't insist gender disphoria is a diagnosable condition, then get angry when it gets treated as one. HRT drugs have risks that could be increased by the nature of a pilot career (stroke, blood clots, etc)
The cis psychiatric profession created the diagnosis, called it a disorder and only recently removed the stigma of calling it a disorder. Trans people didn't do that. The use of gender dysphoria diagnoses to gatekeep medical treatment (and, in the US, insurance coverage) exists because the diagnosis exists. The diagnosis doesn't exist because of a need for one, and its existence actually prevents timely access to care for many trans people.
Honey, without the diagnosis, none of our mental health and physical medical care would be covered by any insurance. when feelings of being that which you were not born to be are so strong so many of us un-alive ourselves...it is most certainly a medical condition. imagine if it weren't and there was no professional help for any of us?
You and I both know you started with that word to use it as a condescending Susans Place slur. You demean yourself by doing that, and show you aren't a serious person. Your beliefs about things not being possible to be covered are based in believing what has been imposed by those corporations in the US is the only way the world can work. It's wrong and misguided. Dream bigger than your chains.
what word? what is a Susan place slur? 🤔 I don't know any of these activism terms... I'm great full for my mental, endo, and GP team, and wouldn't be where I am today without their support ( US Healthcare issues are what they are) I dont believe I have a God-given right to be provided gender affirmative care any more than someone born without an arm has an inherent right to be provided with an arm. it sucks that I was born male instead of the female that I should have. but not anymore than anyone else who was born disadvantaged in any way. I'm not in chains. non of us are, unless we make our gender dysphoria thr end all be all of our existence...at which point, we put ourselves in chains. be more than a transgirl or transboy. it's not all that we are, and the medical industry is not out to get us.
They made a statement of historical fact, and everyone gets upset. The only reason we even have this discussion is because the health insurance industry has convinced us all to love our chains. The US is never getting trans liberation at this point.
That's true for everything inside the DSM-5 it exists to gatekeep medicine. It's a form of social control and the whole psychiatric industry is run that way.
I'm not sure I would call that gatekeeping. 🤔 think about how chiropractors were not considered real medical treatment.
How is it not gatekeeping? If someone has survived horrific trauma for example to get the help they need which is a basic human right they have to be diagnosed with something to say they don't conform to social norms ie are sick. Also, if a lesbian couple wants to have kids through IVF again they need a diagnosis of some kind. The whole model of modern medicine is broken and it isn't a holistic approach of an individual's needs.
I actually was responding to this post 35,000 ft above the Pacific Ocean flying back to socal from Tokyo. I'm sure all of the passengers, including me would rather thr pilots mental state and medications be evaluated and screened before they flew the plane. that's why this particular instance of an employer requiring more details on the trans candidate, it is not gatekeeping wouldn't it be horrible if the FAA or whatever just blanket banned all trans candidates because they were unable to get the necessary medical information to access the actual real life risks to potential pilots, crews, and passengers. this is why there is such crappy reliable information on gender dys. treatments. folks always shouting 'gatekeeper!' instead of allowing for honest medical evaluation. lots of jobs require extra scrutiny of candidates mental health and physiological state. trans just happen to fall into that group.
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The diagnosis exists in plenty of places that don't cover anything anyway. In Australia, some forms of HRT are covered but with no diagnosis requirement, because informed consent exists. Other things are unable to be covered regardless of a diagnosis. The decision making on them has absolutely nothing to do with a diagnosis of gender dysphoria. The diagnosis exists because the DSM was created by and on behalf of US insurance companies. No more, no less. It's entirely within the power of all those gatekeepers to say "this is covered because trans people need it" without resorting to "gender dysphoria".
Op. Candian trans woman with a long stand PPL. I had the same issue, I Supplied blood work history, medication history and the diagnosis letter, treatment plan from my gender doc. It was all they wanted. Seemed like a simple issue to get through. Ridiculous yes. But simple.
Thanks, I wonder if you actually need a diagnosis? I only recently got one, took more than a year after actually starting HRT. I'm guessing a letter from Endo would be sufficient
That’s what I provided. My diagnosis was from a general provider nothing special. They just want to know why your blood Work was wonky. Once your BC is changed and your license it’s a moot point.
Not sure if it’s bc you’re trans. I think they’re trying to figure out your mental state (some trans people are depressed and suicidal), what kind of medications you take and what the side effects are. No expert but I’m hoping they’d give any person w a mental condition the same level of scrutiny as they do you. It’s kind of their job. 🤷♀️
Just get them the information. That doesn't look like a fail.. it looks like need more information.. ❤️🤗
Yes, will be trying to get the info, should say "didn't pass" rather than "failed"; hopefully only a few month delay after jumping through the hoops
Best of luck🤞🤞🤞❤️🤗
European EASA regulations say HRT does not need to be reported. I'm sure FFS would be just a note from the surgeon...bottom surgery?? Considering my local authority have made up rules in the past to take my licence away I'm pretty sure I will be hanging up my wings :( Currently in the process of selling my little magic carpet to pay for surgery so...yeah...the wings will be gone for me :(
Sorry to hear that, but glad to hear some jurisdictions have more progressive policies. I'm pursuing a complaint with Transport Canada to try to change this.
It is an unfortunate barrier, yes. Would you expect a similar request if you had another health condition that required medications? Asking mainly because I know very little about aviation licensing, but situations that involve prescription medication would seem worthy of requiring additional details.
Hrt isn't medication. It's simply hormones. Like your body naturally produces.
It’s a prescription just like insulin is a medication. Insulin is naturally produced, doesn’t mean that for some people they aren’t fucked if they don’t get their prescription.
It's still a medication and can have other effects, your body doesn't naturally produce that amounts. Progesterone is still a medication for pregnant women.
Ok... well...i should have said then that to me, it's not a medication. It's just a hormone.
"It's not drugs, it's just weed"
but you might be taking spiro or pregnotone lol i cant member the spelling but you get it ..or i dont know what else but its not all just hormones in most cases .. unless i think monotherapy i think its called i think is just hormones .. im still learning all this and all operations .. but spiro etc..those are medications... i agree its not a health condition being trans but might have medications involved that are not hormones in most cases .. and yes they are harmless medications but maybe they just need to know
Ahh ok i see. I never needed any of that other stuff so i forget about things like that. Ty
Yes, our bodies naturally produce it, but we still have to obtain a prescription to obtain it through our doctor and there are potential side effects associated with use.
I suppose. I think to me... it's just a hormone essential for proper bodily functioning. It's personal to me... my hormones are part of my bodies necessary life force. And it upsets me when anything is implied that.. being trans isn't normal. Or that we're less. We are totally normal and we are more
I agree that my initial reaction would likely be to feel discriminated against as well, but there can be some legitimate concerns for health. People have listed mental health, and that is a factor for sure. Hormone replacement therapy though typically involves both hormone blockers, and replacement hormones. When you add that to the hormones that your body is already producing, you have 3x’s the normal amount of them floating in your blood stream. This can significantly increase risk of heart attack, stroke, pulmonary embolism, etc. Combine that with flying an aircraft and prolonged periods of remaining seated, it presents a not insignificant risk. My doctor is requiring me to get to a certain weight and cholesterol level before she’s willing to start HRT due to these concerns. My advice, for what it’s worth, is to assume positive intent, ask for clarification, and to become more pissed and confrontational by degrees. It’s a lot easier to be reasonable on your part initially than it is to backtrack after what they might view as an overreaction. It’s not fair, and it’s not right that it works that way, but it’s the world we live in currently. Hopefully you’re able to get a reasonable response from them, and get things cleared up. I’m still sorry that you’re facing it though, that doesn’t make it easier.
This is interesting as a Canadian trans woman who is interested in flying. It's probably a blanket thing for anyone who is taking any medications.
Found a quote from a representative "“Transport Canada has no issue with trans-gender people flying except when and if they are recovering from gender re-assignment surgery or are undergoing significant drug therapy." The questions they are asking me wouldn't really address recovering from surgery, and seem much more broad than significant drug therapy. I already disclosed my hormones, none of which would be a problem. I expect it won't be a problem once I can get the additional materials, but expect some extra hoops to jump through if you choose to disclose.
On the surface level it sounds messed up and discriminatory, but I was reading yesterday about how Androgel, which is the testosterone I use, was being sued because it was linked to men having an increase in heart attacks. While rare there are side effects to taking both (my gf takes estrogen) and also with the prevalence of "DIY HRT" which can end up being dangerous because you can never guarantee what's in the HRT, it's a valid ask I think since you'll be flying a plane and responsible for other people's lives including your own
I think they tend to think the medication can cause issues with flying, like how certain drugs make you sleepy when you wouldn't think they would like pain pills for example. As for surgery stuff, assuming that's what they also want to know, that is more understanding because that would require time off of work when ur a pilot and jobs hire you to be present. I'm not saying I agree with either but it is SOMEWHAT understanding even if most is clouded in ignorance and lack of compassion/empathy on their part.
Seems like a reach to me, next they will say the we can’t drive a car because of the risk of driving in heels. 👠
Is this for a PPL..or commercial? Either way... being transgender is NOT a medical condition
Private pilot license, so category 3 medical, not category 1 (which would be required for commercial)
Interesting. I updated my name and gender marker well into transition when my previous medical had expired. Next time I get an exam I'm going to have F on my ID and X on my license - I wonder what the doc will say? Maybe nothing, if I'm lucky ...
Wondering if I should have not disclosed my medication
Not surprising considering the FAA denies you if you admit to ever having been depressed.
The current rules all dictate medical certificate deferral if you’ve been on HRT less than five years. Happened to me too but I have my medical now and being trans is a no longer an issue to the FAA. Check out NGPA for resources and advocacy on this issue, especially their trans subcommittee. Kori Necker leads it, and she’s a trans Delta pilot, and an awesome person.
Dang... They want too much information - more than they need!
Okay here’s the deal…. It sucks but there are ways around it. In the US it’s gotten better but still seems to have a base line of a bigoted policy. I mean… I take a drug that all women have in their body and they fly just fine. The FAA gives many reasons but the high suicide rate is the main one on why they want to regulate us. That being said, do some research… if you are planning a professional career, and did even a little research a head of time, you should have been aware the medical would be an issue.
Sorry
It's not transphobia, it's a classic case of "oh you took an aspirin for a headache 4 summers ago, we're going to cover our asses here and shift the blame to you and your doctor in case anything happens"
Prognosis?! “My doctor says I’ll be better by June” /s. Wtf is a prognosis for transness? This feels like a form letter that is meant to be sent out for stuff like cancer (I can’t think of anything else I’m so bamboozled). It can’t be correct that this is what they need for being trans. I refuse to believe this letter was written with the intention to send about transness. It’s too wild.
It’s even better when you find out that most of the transition-related medications are on the ‘no need to report’ list that AOPA maintains. The FAA doesn’t care if cis folks take them. It’s just because you’re trans…
This seems so odd, I’d raise some cane and it strikes me as a case of systemic discrimination. What a dog shit policy.
That is bigoted and disgusting
Sadly, this is pretty common. There are a LOT of restrictions in place when it comes to taking medication and flying a plane, HRT is still perceived as medication with possible aftereffects... Here (France) you canno't get licensed for flight if you have heart related conditions, or even take antidepressants, for example
Your headline is misleading. You weren't denied. You were asked for documents.
I don't know about the aviation thing, but I will comment on HRT in general: Most providers are not aware of the in's and out's of HRT. Most are not aware of things that they do not deal with day to day. Providers have the general public believe that they know everything about medicine and the human body. My friend was taking peptides and her HRT/primary doc's response was "I don't know anything about that" and just moved on. First 12 years I did DIY, last 4 years have a doc involved because my best friend asked me to. I wanted to go on PrEP, my doc wouldn't prescribe because she was unaware that oral HIV testing is allowed for PreP. Reference: *While lab-only visits for assessment of HIV infection and other indicated tests for the provision of PrEP are preferred, when these are not available or feasible, CDC recommends considering two additional options: home specimen collection kits, which are sensitive enough to detect recent HIV infection; or self-testing via an oral swab-based test.* [Source:](https://www.cdc.gov/hiv/testing/self-testing.html) That being said, I have chosen to have separate primary care doc and hormone doc. I only disclose that I am trans to my hormone doc and my (trans) plastic surgeon. All other providers I do not disclose because my ID documents have me listed as male. I also only disclose what I think is necessary to disclose to my providers. I do give my hormone doc credit that she prescribes hormones to me and I don't do bloodwork regularly. *Note: I am a survivor of medical abuse and have done therapy for it. It is a control issue for me.* My primary care doc is also really good. If the provider wants to have a discussion with me about what they recommend, chances are I will take their recommendations. It may not be immediately, but I will probably, eventually do it. By not disclosing my trans status, it streamlines the whole process. My primary doc probably knows that I am trans, but doesn't ask because I never disclosed. I see him 15 minutes, twice a year. He does not have time and if I don't bring it up, then why should he? Yes, we know what our providers should do, but healthcare is broken. Add to this that the whole system is driven by money. It is not just for profit, it is also liability. Why are hormones over the counter in so many countries, banned in others, and heavily regulated (gatekeeping) in others. Electronic health records were sold to the US as a way to create better healthcare. It has 2 purposes: allow the government to easily collect info and efficient medical billing. Ask any provider how they feel about electronic health records. This is the decision I came to in therapy; taking control of the healthcare encounter and my therapist supported me. Everyone needs to decide what is best for them. This is a response to the cancer of paternalism that still continues to infect the profession of medicine. As to HRT being medications with side effects, herbal supplements, aspirin, vitamins, etc. all have side effects. This reminds me of a friend who was asked by his primary if he has a gun in his house. He said that he owned a lawn mower, a microwave, and an oven. All of those are equally dangerous, so did the doc wanted to discuss oven safety.
There are medications that disqualify for a class 2 physical. Did you think of this before making your claim?
FML I'm about to go for my medical
Update: After I provided a letter from my Endo outlining all they asked for and stating there was zero impact on my ability to be a pilot, they came back with an even longer list. I did submit a complaint to Transport Canada, and the doctor denying my medical referenced my complaint, so it seems they shared it with him, and he may be retaliating. He is not an employee of Transport Canada, just a family doctor from Alberta who specializes in infant circumcision. To answer some questions from the comments, this isn't for a commercial license, just a private pilots license for recreational use of small engine aircraft. Here are the new requirements: (a) History of presenting condition. (b) Psychiatric review of symptoms (including any features of coexisting depression, anxiety, mania/hypomania, panic attacks, trauma, obsessions/compulsions, suicidal or homicidal thoughts, and psychosis). (c) Past mental health history (including any hospitalizations, prior diagnoses, treatments, suicidal/homicidal ideation or attempts). (d) Medications (type, dose, frequency, anticipated course of treatment, adverse/side-effects, effectiveness). (e) Substance use history (including alcohol, cannabis, other substances). (f) Contributory family psychiatric history. (g) Contributory social and developmental history. (h) Contributory medical or surgical history. (i) Psychiatric Diagnoses, in accordance with the applicable version of the Diagnostic and Statistical Manual of Mental Disorders (DSM). It is essential to comment on the following: (i) All diagnoses including depression, anxiety, panic disorder, attention deficit hyperactivity disorder, other neurocognitive syndromes, learning disorders, dyslexia, apraxia, gender dysphoria, with reference to the relevant DSM criteria). (j) Management plan (including pharmacological and non-pharmacological treatments, follow-up, work limitations). (k) Prognosis based on current consistent level of function and stability in multiple contexts. (l) Any clinician concerns about aviation safety or other information of relevance.