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THIS DOCUMENT IS A LIVING DOCUMENT. This is an attempt to start to bring together a lot of information regarding common concerns as we try to figure out wtf will actually happen ad/or change in this new old world. A lot of the bigger questions remain unclear, especially around what will happen with regards to things like immigration, marriage equality and reproductive rights. What Trump has said he wants is not necessarily what he will do—or do right away—but we can make some guesses. It is to be expected that more information will follow and refine. Dive in and edit away/add things you know.
Bureaucracy and paperwork are not necessarily radical acts; this is more on the side of the “cover your ass as much as possible” spectrum of responses. Interacting with these structures requires making choices that may not feel good but result in bureaucratic coherency that will protect you later. Please maintain the focus on concrete acts of preservation and planning. You are encouraged to find other ways of supporting broader struggles for justice. There will be many.
The basic idea is this: you have to cover your ass with regards to the federal government. You want to go into this as tidily as possible and assess the risks of leaving things legally unclear. Do your gender markers agree as much as possible? If not, think about whether or not it makes sense to reconcile them. Do you have a clear plan for preventing pregnancy if you might get pregnant somehow? If not, think about what you might do if that happened. Do you have a clear sense of how you will ensure your family structure and safety? If not, you should talk together about how to speed that process up. What is your immigration status and is there anything you can do to push it forward towards your ultimate goal?
If you have been putting off dealing with something medically or administratively, especially something that relates to intersection with the federal government, this is the moment. Get your new social security card. File your updated immigration paperwork. Renew your passport, or get a passport with your updated gender information.
Here is another guide that is pretty great and has a lot of info:
Concrete Suggestions in Preparation for January (by demographic issue, but for any interested readers)
Here’s a link from the Huffington Post that talks about things to do and includes suggestions for anti-racist work.
Here is a link from the Southern Poverty Law Center about how to speak up when you hear everyday bigotry, even if you have less power than the person talking.
CLICKABLE TABLE OF CONTENTS
*to get something in the TOC, make it a heading using the heading drop-down menu. H2 is the big bold headers, h3 is for sub-listing, h4 is for a sub-sub-listing. If you made a change and it isn’t reflected automatically, click into the TOC and then hit “refresh.”*
*to get something in the TOC, make it a heading using the heading drop-down menu. H2 is the big bold headers, h3 is for sub-listing, h4 is for a sub-sub-listing. If you made a change and it isn’t reflected automatically, click into the TOC and then hit “refresh.”*
While government provided social safety nets may be ripped to shreds in the coming years, private organizations still provide financial assistance, goods and food, mental health assistance, housing, and a huge number of other services that can try to fill in the gaps. Unfortunately information about how to apply and what they offer is scattered all over, and some orgs don't even have websites. Auntbertha.com is a huge database and search tool to locate these programs, figure out if you're eligible, and contact or apply all in the same place. Its free and good and getting better all the time (I just recently started working with them to redesign some stuff to make it a lot easier to use).
Know a program Aunt Bertha doesn't have? Help people in need access it by suggesting it [https://www.auntbertha.com/find_a_program] Every zipcode in the country has hundreds of programs listed, many of which are national, state, or region-wide, but a lot more small/grassroots/local programs are listed in big cities.
Outlining his first 100 days in office, Trump (#notmypresident) has stated that he would like to introduce ten pieces of legislation that would amend if not fully repeal Obamacare and replace it with Health Savings Accounts (“allows individuals to purchase health insurance across state lines, and lets states manage Medicaid funds”). Senate Majority Leader Mitch McConnell concurred that repealing Obamacare is a “pretty high item on our agenda”.
Don’t be deterred from signing up for Obamacare and encourage your friends to sign up as well. While it seems highly likely that the ACA will go away, even a few months of coverage is better than nothing if you would otherwise be uninsured.
However, you are still encouraged to sign up for the coming year. Relatedly, I have heard theories that since you sign up for a year, you are making some kind of contract with the insurance company, but I’d read your whole policy - yes, the fine print - before you go in expecting that to work. “Contract Termination” might be a good keyword to search for, but if it isn’t there, that doesn’t mean there isn’t a section about it. And if you find out, POST IT HERE.
If you expect to lose your access to health coverage and are low-income, find out whether your state has a plan, Medicaid expansion or otherwise (e.g. Romneycare in MA). Income restrictions vary and some states have (or had before the ACA) a lottery or waiting list you might want to get on ASAP.
Most Obamacare plans at this point give you free wellness visits at least once a year. This would be a great time to ensure that you are ok, even if you hate going for a checkup. Find a friend if you must. You just want to affirm health while you can and if there’s anything, have some time to follow up. If you hate it now, you’ll hate it even more when it costs you more money.
Think long term—prioritize the things that are expensive that may not be covered in the future like intense dental work, MRIs/expensive tests, etc. Find a way to get support - a friendly pal, a xanax, meditation, you name it - and for the love of god at least go get a checkup. Lab work is another good idea. If you don’t know your family medical history, find it out if you are able so you know what you may need to prioritize in the future.
You should look into getting all your vaccines up to date asap! I know shots aren’t fun, but there are so many reasons that now is the time:
Note that legally, under the Obama administration (this might change under Trump), you cannot be denied coverage for appropriate health care due to your gender marker (e.g., health insurance companies must cover pap smears for anyone with a cervix, prostate exams for anyone with a prostate, breast exams for anyone with breast tissue, etc). Of course this doesn’t mean that individual clinicians won’t be assholes, or that they’ll obey the law, but insurance companies are not allowed to discriminate.
For more information, see:
Here’s some smart shit from Kelli Dunham:
General tips on finding a counselor/therapist anywhere
Now is the time to pick up new emotional wellness skills and practices. Learn to eat for health. Learn new chill out skills like meditation or yoga. Take up new hobbies that affirm your existence. Join with others in these activities and have accountability buddies. Seriously, lifestyle changes are really fucking hard and there’s going to be a lot of bullshit happening to make this difficult, but we need to not just survive the next few years we need to fucking thrive. Look at your bucket list, get a buddy, and commit to taking better care.
If you live in a November Project city, seek out these free fitness/incredibly positive groups.
** moving to the wiki as of 4pm 11/12/16 **
If you are under age 30**, try to start the HPV series of vaccinations ASAP, as they protect against strains of HPV which cause cervical cancer (thus if paps are no longer available you have lowered your cervical cancer risk through other means). The Center for Disease Control has also said that the HPV vaccine is recommended for men and boys. It's super important for MSM (men who have sex with men) and MSMW (men who have sex with men and women) to also get the vaccine. See this Medscape article and check out Australia’s Study for the Prevention of Anal Cancer (SPANC).
**The HPV vaccine is only approved through age 26! So you may not be able to get it covered by insurance if you want it after that age.
**Some counties have a grant for free HPV vaccines for anyone under the age cut off! This is a vaccine that costs hundreds of dollars if you don’t have insurance so it’s worth the homework of calling around. Travis county (Austin, TX) offers this service currently. This grant sometimes also applies to other vaccinations so get ‘em while there are funds available for them! The less sick you can be in the future, the better!
The HPV vaccine is a multi-shot series. Some providers can save you money by writing a prescription so that you could buy the vials yourself from a pharmacy and keep them in the fridge, then a nurse can give you the injection.
As for legal abortion: it is safe to assume it is very likely to be threatened. Cosmopolitan (yeah Cosmo!) has a clear-sounding overview: http://www.cosmopolitan.com/politics/a826241o9/donald-trump-abortion-roe-v-wade/ - this is not a good look. The ACLU analysis doesn’t think a Trump administration will be able to outright overturn Roe, but certainly all kinds of restrictions can be imposed, as they already have been. More details on that here: https://action.aclu.org/sites/default/files/pages/trumpmemos.pdf.
If you are a doctor, medical student, resident, fellow, and in some states an NP, CNM, or PA, consider getting trained to perform abortions as soon as possible. Clinics will need you, and if we have to go underground, well…
If you need an abortion but can't afford it: Federal funds are already restricted from funding abortion, so Trump can’t really do much in this regard - we’ve been living the worst case scenario since the passage of the Hyde in 1976. If you need an abortion, however, it is possible that your state has allowed Medicaid to cover abortion services. Check to see if Medicaid covers abortion in your state - you may be able to get on Medicaid or even get a fast-track to getting Medicaid if you are pregnant. If you’re not sure, call your state’s Medicaid office. If you have private insurance, call your insurance to ask if they cover abortion. Ask your clinic about any discounts they may have. Ask about an abortion fund in your area, and ask about national abortion funds like WRRAP (Women’s Reproductive Rights Assistance Project), NAF (National Abortion Federation), or the National Network of Abortion Funds’ George Tiller Memorial Abortion Fund and Dr. Willie Parker Fund for Abortion Access in the South. To see a list of local abortion funds, click here. Abortion funds cover a range of services including financial assistance for abortion procedures, practical support in the form of lodging, transportation, and/or childcare, financial assistance for Plan B, referrals to other services, Medicaid enrollment, etc. These services vary from fund to fund - some only do lodging, or some only do financial assistance. Many abortion funds are gender inclusive and affirming, and strive to honor the racial, class, age, immigration status, and language diversity of folks who call. Most are also looking for MONEY and for volunteers to help with fundraising, intake, logistics, community organizing, and practical support, so please give your time, skills, energy, and $$$ if you can/if you feel inspired.
From www.annaalexisnichols.com/abortion and www.womenonwaves.org:
In the case of abortion becoming more highly regulated, it is possible to perform a SAFE abortion at home using MISOPROSTOL alone. There is NO need for foreign objects.
There are two ways of getting an abortion: 1) Medical Abortion with Pills and 2) In-Clinic Abortions. The majority of abortions (95%) take place in the first trimester.
On Medical Abortion:
The abortion pill is actually two medicines used to induce a miscarriage--mifepristone and misoprostol. These medications are used up to 10 weeks (70 days) after the first day of the last period with 96-98% efficacy of inducing a miscarriage. A medical abortion with pills is NOT the same thing as the morning after pill (i.e. Plan B). The morning after pill only works within 72 hours after unprotected intercourse and works to prevent implementation and fertilization, while medical abortion works to remove an already fertilized and implanted egg. Ella, another emergency contraception option, works up to 5 days after unprotected sex/contraceptive failure and may be more effective for people with higher BMIs.
You do not have to be at a doctor’s office or clinic in order to take abortion-inducing pills. The risk of a medical abortion is the same as a miscarriage (which happens in 15-20% of all pregnancies, more than likely beginning OUTSIDE of a hospital or clinic). The effects caused by Mifepristone and Misoprostol do not need to be monitored in a clinical setting. These medicines are listed by the World Health Organization (WHO) as essential medicines, meaning they are fundamentally important to a healthcare system. They are safe at appropriate doses, and studies have proved that women can correctly and safely take Misoprostol at home! (Check out these references: here). Note that people have been prosecuted in the US for self-inducing abortions. Be aware of the risks if you take this approach.
People with negative blood types (e.g. A-, B-, O-)are strongly recommended to get a RhoGam or MicRhoGam shot with theirpregnancy whether the pregnancy ends or continues. This is to reduce the risk of complications in future pregnancies. People who don’t know their +/- Rh status are recommended to get the shot as well.
However, in certain places where abortion is illegal or accessing abortion pills is especially difficult, it is possible to perform a self-medical abortion using just Misopristol.
Misopristol (also known as Cytotec) alone has been shown to induce a miscarriage with 90% success. In places where the Mifepristone+Misopristol abortion "pill" combo are not available for legal reasons, Misoprostol IS likely available, as it is also used for stomach ulcers, arthritis, and to prevent post-partum hemorrhaging. So you can likely get a prescription to Misoprostol under the guise of one of the above conditions, and use it to an induce an abortion.
WHO guidance on safe abortion (including their best data on safe dosages): http://www.who.int/reproductivehealth/publications/unsafe_abortion/9789241548434/en/
Misoprostol alone for medical abortion works best in the first 12 weeks of pregnancy. The medicine causes contraction in the womb, leading to expulsion of the pregnancy
Getting Misopristol at a pharmacy: Brand names for Misopristol are Cytotec, Arthotec, Oxaprost, Cyprostol, Prostokos, and Misotrol. They are sometimes sold over the counter without a prescription, or sometimes a prescription may be required (depends on where you live). For more information on where to get Misopristol...check this out. A woman could also make their own prescription (Here is an example prescription for misopristol). In some places it may be better if a man goes to a pharmacy if there is no prescription or the prescription is not legit, as it will raise less suspicions. A woman should buy at least 12 pills of 200 mcg Misopristol.
To obtain one of these medicines, one could, for example, say that your grandmother has rheumatoid arthritis so severely she can not go to the pharmacy herself, and that you do not have money to pay for a doctor to get the prescriptions for the tablets. If there are problems to get the medicines in one pharmacy, try another pharmacy, or a male friend or partner might have fewer problems obtaining them. Or perhaps you can find a doctor willing to prescribe them.Usually one can expect more luck at the smaller pharmacies that do not belong to a chain. Sometimes Cytotec can also be bought on the black market (places where you can also buy Marijuana). However try to make sure that is really is Misoprostol and not fake pills or some other medicine!
here is a link to how to do an abortion with misoprostol only (if the abortion pill, mifepristone/misoprostol becomes highly regulated, this is a safe and effective way of inducing a miscarriage UP TO 12 WEEKS)
For more information: http://www.annaalexisnichols.com/abortion/
PRINT THESE STICKERS OUT AND PUT THEM EVERYWHERE:
IMPORTANT: Some states have laws against women trying to self abort outside of doctor’s scope...if you are concerned after taking misoprostol about complications, go to a hospital...tell the doctor you had a spontaneous miscarriage (THERE IS NO WAY FOR THEM TO KNOW YOU TOOK MISOPROSTOL). The effects of the medication is the same as a spontaneous miscarriage.
Baby prevention plans for uterus-havers at risk of pregnancy aka abortion and birth control
All health care plans are currently required to cover IUDs, aka tiny pieces of plastic, with or without hormones or bits of copper, that hang out in your uterus keeping babies out. These are good for a long time (between 3 to 12 years, depending on which one), and while they’re not safer sex for the prevention of STIs they are very good at preventing pregnancy (over 99% effective).
You should not feel the IUD after it is inserted but it is possible that you will have cramps for the first couple of days after insertion and cause bleeding. Be sure to wear pads and take care of yourself! This is not meant to discourage you from getting one though, just keep in mind you may want some ibuprofen on hand.
If you get an IUD in a pre-lack-of-insurance rush and end up not liking the side effects, but can’t/don’t want to pay for an appointment to get it removed, take matters into your own hands! If the strings are left long, you can actually just pull it out yourself*. There are youtube videos out there with more info, but if it doesn’t come out easily or hurts when you pull the strings, then a good idea to stop and see a provider to get things investigated. NOTE: Family Planning clinics and Planned Parenthoods almost always offer a sliding scale; while they still exist, they are another good option for removal.
*From a healthcare worker: You can self-remove if strings are long enough but do proceed w/ caution -- if experiencing heavy bleeding or heavy cramping after removal, seek medical care if at all possible.
Another longer-lasting option is the Nexplanon, a small rod that goes under the skin on your upper arm and prevents pregnancy & regulates hormones, but has to be replaced every 3 years (now many providers are saying you can leave it in up to 4 years based on updated research). And if you’re a person who prefers pills/patch/ring, check your insurance to see how many months’ supply you can get ahead of time, and see if your provider or health center can give you any free sample packs for the point after your insurance runs out.
Keep in mind that removal of the nexplanon is much harder to do safely at home than removal of an IUD, and should be done by a medical professional. The hormones in nexplanon are not as localized to your reproductive system.
What about natural family planning? Unlike the IUD, it doesn’t require seeing a provider and doesn’t cost anything, and is quite effective when used consistently and correctly (95–97% with perfect use). Readers should be aware that perfect use is very hard to achieve (with all methods of birth control). Here is a link to more info from the CDC on efficacy of NFPhttps://www.cdc.gov/nchs/data/icd/att4_nfp_mar06.pdf
It would be a great idea for EVERYONE with the financial means to buy emergency contraception (EC) for themselves, their partners, and/or their friends (Plan B is over-the-counter, Ella is a prescription medication that is more effective for 5days and for people with higher BMIs). People of any gender or age can pick up Plan B at a drugstore or any family planning clinic; people with a uterus can have a provider (including those at family planning clinics/ planned parenthoods) prescribe Plan B, EVEN IF YOU DON’T NEED IT RIGHT NOW. Many providers will write a prescription with multiple refills, so that even if you use one dose you can access more without returning to the clinic. Keep it on hand for you or for others because a) many people may lose health insurance coverage, which means they may lose access to their preferred method of birth control and thus may go without and b) we are looking at an environment extremely hostile to survivors of sexual assault; it’s an uphill battle to get hospitals to dispense EC to survivors NOW -- there’s no reason to believe it will improve. If stored long-term, Plan B should be kept in a relatively controlled environment of 68-75°F. It has a shelf life of 3-4 years, which is coincidentally the length (we can hope) of the Trump administration. But check the expiration date on the package. E You can also purchase the generic form of plan b, Take Action, over the counter. Unsure if there are weight restrictions for this medication or not.
Keep in mind that Plan B and similar medications are possibly less effective for those over 160 pounds. The research on this is debatable/contested but it is something to keep in mind. Remember that Ella may be more effective than Plan B, but you CAN NOT purchase it or get it without a prescription.
COPPER IUDs can be used as EMERGENCY CONTRACEPTION up to FIVE DAYS after Unprotected sex (and then you are also protected for the next 12 YEARS!!!) It also works regardless of your BMI!!!
Here is a coupon for plan b:
Here is a equivalent dosage chart of other birth control pills that will work the same way:
Basically even if you run out of or cannot access Plan B pills, it can be substituted with multiple birth control pills taken at once. You should follow the chart or even keep a paper copy instead of guessing so that you will know you have taken the correct dosage. .
Question: What birth control option is the best low hormonal option for someone self-managing PTSD (or other mental health conditions) without medication who doesn’t want hormones changing her moods too much because that would make things harder?
Answer: the Paragard is a copper IUD. It’s non-hormonal. The fertility awareness method used correctly is completely non-hormonal, but does require dedication, time, and the discipline to monitor your body daily. Worth it for some. Nuvaring and the hormonal IUD both localize hormones somewhat to only the vaginal area, this can reduce symptoms. Paragard/copper IUDs will generally make you periods worse, if you have them.
** moving to the wiki as of 4pm 11/12/16 **
Note that legally, under the Obama administration (this might change under Trump), you cannot be denied coverage for appropriate healthcare due to your gender marker (e.g., health insurance companies must cover pap smears for transgender men, prostate exams for transgender women).
It is not as if healthcare providers are just going to disappear. It is more likely that access to insurance will be curtailed and some of the protective rules will disappear. It is highly likely that this will affect people buying on the exchanges far more than people who have insurance through their jobs, et cetera. A lot of this will come down to access to economic privilege and learning how people with insurance/$ can support those without.
Gynopedia - includes reproductive health laws and resources for major cities around the country/world. Currently only includes information for a handful of major U.S. cities, but may be useful for some.
Fenway Health is an LGBTQ community health center and advocacy organization founded originally by students affiliated with Northeastern University. They offer medical, dental, and eye care in an affirming environment, including HIV prevention and health navigation services. They also have extensive mental health care resources and regular free support groups for different queer identity groups.
Rosie’s Place is an entirely donor supported sanctuary for poor and homeless women in Boston (they do not accept any local, state, or federal aid). They are LGBT*-affirming and provide food, shelter, and advocacy to connect disadvantaged women with accessing, among other things, emergency funding for preventative healthcare and medication.
Boston Medical Center is the largest safety-net hospital in New England, meaning they maintain an open door policy for services and a majority of their patients are on Medicaid or are uninsured. They also offer BMC HealthNet which ranks among the best Medicaid plans in the country and offers a lot of traditional benefits. Massachusetts may be the state most shielded from a Republican administration gutting the ACA, so BMC's resources and other MassHealth benefits should remain available to help even if federal policy threatens access to particular types of healthcare.
Howard Brown Health - Easily the most valuable resource we have in Chicago. They provide counseling, free STI testing, HRT, legal counseling, and so so so much more. Like woah. They also have a huge list of resources, and have nights where they do free reproductive health exams for women and people assigned female at birth. And yes, by women they do mean trans women too. If you’re trans and want to start HRT they have a drop in night twice a month, and even if you make an appointment you can walk out with hormones same day. They use a consent based model. You just have to know the effects, possible side effects and agree that’s what you want and that’s it. Also they do some sort of magic if your insurance doesn’t cover hormones! I’m not sure how they do it (they call it the Howard Brown discount), but you get it if your insurance won’t cover it. Definitely worth looking into. A+ clinic, does recommend.
(***note: I started testosterone through this exact clinic, 20 needles and a 200ml vial for $35. Their discount is Huge)
Chicago Women's Health Center provides a wide range of sliding scale reproductive health and other services that are feminist, culturally competent, and queer/trans competent.
Columbus Public Health maintains a listing of free and sliding scale healthcare, dental, and vision services as well as resources for help with prescription drug costs. Find resources under the links “Heathcare Resources” and “Assistance for Prescription Drugs”
Equitas Health - provides LGBTQ culturally competent comprehensive healthcare services, including primary care, gynecology, dental care, behavioral health services and counseling, legal services, pharmacy, and HIV/STI treatment and prevention.
New York City Free Clinic - “a comprehensive free healthcare clinic, believes that high-quality healthcare is the right of all individuals. We provide, at no cost to our patients, the full range of healthcare services that include specialty referrals, counseling, patient education, social services, and screening and registration for public health insurance.” (requires pre-screening for free health insurance by social worker; call this number 212-206-5200 for screening, calls can be made Mon-Fri between 8 AM and 10 PM or Sat-Sun between 8 AM and 8 PM.) 16 East 16th Street, New York, NY 10003
Women’s Health Free Clinic - “The Women’s Health Free Clinic (WHFC) became the nation's first comprehensive, free, student-run women's health clinic when it opened in February 2008. The clinic is a partnership between New York University School of Medicine, the Reproductive Health Access Project, and the Institute for Family Health.” (also requires pre-screening by a social worker 212-206-5200, Calls can be made Mon-Fri between 8 AM and 10 PM or Sat-Sun between 8 AM and 8 PM.)
St. Anthony’s Clinic - (718) 401-9705 Adult hours are on Saturdays 8am-12pm, children’s hours are from 9am to 12pm on alternating Tuesdays. This is a Catholic run clinic, so not sure how queer friendly it is there. “The clinic offers physical exams, asthma care & education, well child visits and immunizations, anemia checks, and various medicines. Urologist services are available on the third Saturday of the month. All visits and services are offered free of charge.”
The Institute for Family Health - from their website: “You can come to us even without insurance. Everyone is welcome, even if you cannot pay. Patients pay based on their income.” They provide services to undocumented patients. They have LGBTQ services, HIV testing/treatment, counseling, trans affirmative health and mental health services, abortion, and many birth control options . As of now they also take medicaid/medicare. Social workers there will help you search for low cost prescriptions, either as generics or help you apply to Patient Assistance Program or the 340B program. Locations in Manhattan, the Bronx and the Hudson Valley; to contact 212-633-0800
Third Root - from their website: “Third Root is a holistic community health center offering yoga, acupuncture, massage & herbal medicine. We offer sliding scale fees, a staff trained in anti-oppression, and a clinic that is building bridges within a community.” POC/LGBGNC worker owner coop. Open 8:30-8:30 Monday-Friday; 8:30 until earlier on weekends. Volunteer opportunities in exchange for yoga classes and community acupuncture. Located in Brooklyn, Contact: 718.940.9343 or firstname.lastname@example.org
Callen-Lorde? - Healthcare and services targeted towards LGBTQ folks. Includes primary care, HIV/AIDs care, women’s health care, trans health care, dental, mental health and social services. Offers sliding scale payment based on income. Also accepts medicaid/medicare. Locations in Manhattan and in the Bronx. Contact: (Manhattan office) (212) 271-7200 (Bronx office) (718) 215-1800
Betances - Offers sliding scale healthcare based on income (screening required, also takes Medicaid/Medicare) Offers Comprehensive Primary Care, HIV/AIDS Care, Mental Health Care, Women’s Health Care and Dental. In Manhattan and soon in Bushwick. Contact: 212-227-8401
Ryan Clinic - (212) 749-1820, 6 medical sites in Manhattan, Medicaid/Medicare and other insurances, sliding scale if uninsured and can help with health benefits applications.
Montefiore (Bronx) - comprehensive primary care (adults, children, OB/GYN, including family planning services/access to abortion), specialty care, HIV+/Hepatitis C care, social services; sliding scale for uninsured folks
Mazzoni Center - Address: 21 S 12th St # 12, Philadelphia, PA 19107. Phone: (215) 563-0652. Hours: 9AM–5PM Provides a wide range of services to LGBTQ* folx in the region, including mental health services and family medicine. A strong focus on trans healthcare, some sliding scale services. There is a waitlist for some services because of the high demand. While a community resource for some LGBTQ POC, Mazzoni Center has a history of anti-blackness, specifically targeting and singling out black staff.
Greater Philadelphia Health Action Inc. - Locations throughout the city with a commitment to serving people independent of insurance. Operates in many of Philadelphia’s poorest areas and has experience serving folks without coverage.
Metro Community Health Center - 412-247-2310, M - Th - F: 8:00 a.m. - 4:30 p.m.T - W: 8:00 a.m. - 7:30 p.m. 1789 South Braddock Avenue Suite 410. Queer-friendly GP for people of all genders and HIV status.
PERSAD Center - 412-441-9786 Primarily a counseling/mental health services center for LGBTQ folks (allies also welcome). Also does other services like connecting people with foster care, substance abuse treatment, and intimate partner abuse. Offers sliding scale last I checked.
A list of free and reduced cost clinics in Philadelphia county -NOTE: not all of these have been reviewed or have additional information on how current the list is.
Women’s Community Clinic -- Located in San Francisco’s Fillmore District (sliding scale based on income/Medi-Cal/no-insurance), offers the full range of women’s health care including primary care, sexual and reproductive services, and mental health. Serves women and girls ages 12+ and offers client-centered, culturally-inclusive and judgment-free birth control, pap smears, medication abortion services, regardless of their insurance or immigration status.
Berkeley Free Clinic - offers free limited medical care from lay healthcare workers and medical professionals. This includes STI testing, Acute Primary Care, Dental Services, Hepatitis Testing, women’s, Trans*, and gender non-conforming services, as well as peer counseling.
Country Doctor: http://countrydoctor.org/
International Community Health Services, s: http://www.ichs.com/
what options are there (if any) for continued care and maintenance of illness if all access is decimated? What is the baseline needed and how might that be able to be met? For people who need daily maintenance meds - how will we help make sure people are getting what they need. Insulin, albuterol, pain meds, mh meds, hiv meds, anti-seizure, etc etc etc - while you can still see your doctor, discuss lowest possible dosages, alternative/augmentative methods to lower costs
General note about medications: Trump’s 100 day plan suggests he plans to greatly loosen FDA standards to bring more drugs to market more quickly. If this does come to pass and your doctor suggests you begin taking a new medication, do not be afraid to express a strong preference for medications that have been on the market longer (and thus have a well known safety and side effects profile). Older medications usually cost less anyway.
How long are your meds good for? If you are insured precariously, you can and should talk to your doctor about them writing your prescription for more than you need. I know at least a few people who have been able to do this for non-opioid or otherwise scheduled medicines. This obviously depends on whether or not what they are prescribing/would be prescribing is within/beyond maximum doses/are they willing to help you but it is worth bringing up.
Even some low-income plans have multi-month med access pharmacies where they fill your prescription for more than one month at a time all at once for only one copay. If your doctor writes your dose at 2x your normal, and you fill it there, voila - that’s 6 months at least. Not a miracle but at least a start.
Some medicines are relatively cheap, but most doctors’ offices charge around $300 for a visit. If there is a medication you need to stay physically or mentally healthy, check on its price. (Also keep in mind that drug prices differ wildly pharmacy by pharmacy. Pay that $25 (or whatever) copay now and ask for a year’s worth of refills on your essential medications. Even if you have to pay out-of-pocket for the drugs, at least you’ll have saved yourself a large office visit fee.
Other medicines it is potentially easy to get and could be helpful to access/store for your community as well as yourself:
Shelf life of multi-use vials (i.e. for testosterone injection):
The United States Pharmacopeia (USP) General Chapter 797  recommends the following for multi-dose vials of sterile pharmaceuticals:
If you need expensive, name-brand drugs for a chronic condition, see if the pharma company that sells your med has a Patient Assistance Program. If you qualify by income, the meds are free. Unfortunately this will only work for name-brand (not generic) drugs,
>If I am willing to hoard hormones for trans folks, or essential meds for other folks, can we figure out a way to get these where they need to go?
Strategies for assisting when someone else is being verbally attacked
Inclusive firearms resources
You do not need to go to a gun store (which are often unfriendly spaces) to obtain one; big-box stores such as Walmart and many sporting goods stores will carry firearms as well. You can also purchase firearms from online retailers. The firearms must be shipped to a licensed dealer (referred to as an FFL), who will perform the background check. The FFL will charge you a fee for this service, typically around $20 per firearm. Most large online retailers will have a list of FFL in your area that you can choose from, but if they don't, you can find one by searching the Internet. Make sure to call a prospective FFL and ask what their transfer fee is before having a firearm sent to them, as some charge more than others. Once you order a firearm, notify your FFL that you have a shipment on the way. Be sure to check the laws in your state (and municipality) as gun laws across the U.S. are inconsistent. Different areas have different regulations on what can be purchased, owned, and carried. The process may take time depending on where you live, so it may be best to start sooner rather than later if you plan to.
Guns are not magic. They will not protect you on their own if you do not know how to use them. Consider a safety/training course (in most places, this is required to obtain a purchase/carry permit anyway). Be prepared to practice shooting on at least a biweekly basis for several months. If you are not completely comfortable and proficient in the use of your firearm, it will not serve its purpose. Ammunition is expensive. Online retailers usually have better deals. Look for specials on shipping as ammunition is heavy. The GunBot app is an excellent tool for quickly finding the lowest prices among registered retailers.
A small safe for storing the weapon at home is very important, especially if there are children in the home. It should be a “fast access” gun safe so as not to impede your ability to reach the weapon in an emergency. Storing ammunition separately from the gun will make it harder for accidents or mistakes to occur. However, this will prevent it from being used quickly in an emergency. It is most important to practice the key rules of gun safety:
Please do not purchase a gun if you or a member of your family has ever had suicide ideation.
There are endless arguments about caliber, type of round, and type of weapon to use for home or self defense. You should carefully consider your purchase, and ideally handle multiple guns before buying one to get a sense of what works best for you.
Type of round:
Hollow points are generally agreed as the best for defensive weapons. They minimize over-penetration and maximize the effect on targets. However, they are not legal in all areas (for example, they are banned in New Jersey).
Size of gun/round:
Generally speaking the larger/heavier the gun and smaller the round it fires, the easier the recoil is to manage. This is because a heavier gun will move less in reaction to the gun being fired, and a smaller, less energetic round will provide less kick to begin with. The argument that larger rounds have more "stopping power" is beyond the scope of this document.
A compact handgun is a good choice for self defense carry as it is more easily concealed than a larger model. However, bear in mind the kick will feel stronger with a lighter weapon, and the magazine capacity will likely be smaller as well.
A rifle or shotgun is obviously not feasible for daily carry but is possible to use for home defense. In many areas where handgun purchases are restricted, these may be the only options. If you are going to use a rifle for home defense, consider a pistol caliber carbine. The barrels are shorter, allowing for easier movement inside your home. The pistol caliber rounds are less likely to overpenetrate walls and strike unintended targets. If you are going to purchase a shotgun for home defense, look for a shotgun made for that purpose as it will also have a shorter barrel and a larger magazine capacity than a hunting shotgun.
Pepper spray does not work in all situations. The effect varies from person to person, especially depending on whether their eyes/nose are covered. In tight spaces or when spraying into the wind, it’s possible there may be backwash. For this reason, pepper gel or pepper foam is more effective in some situations. More manufacturers are including bright orange dye in these products to aid in the identification of assailants.
Bear spray is a large can of pepper spray carried by backcountry hikers to deter aggressive bears they may encounter. The advantage of bear spray is the length of the stream of pepper spray, which allows you to engage a target at a much safer distance. The disadvantage is that bear spray comes in a large bulky can.
Another option for you could be a pepper ball marker. These self defense tools operate similarly to paintball markers but fire pepper or tear gas balls that rupture on impact.
These do not work in all situations. People wearing heavy clothing may be difficult to get a good “connection” on. They only briefly incapacitate people unlike pepper spray which may be debilitating for a while.
Knives are not a good idea for self defense. Many places have laws against easy-open variants like switchblades, gravity knives, and so on. Even if they didn’t, a knife is not a good defensive weapon for legal and practical reasons. It may be useful to carry a pocket knife for other purposes, but that’s not the point of this doc.
It’s not like the cops are going to have our backs any more than they already do. It is likely that they will continue to be sources of even more violence than before, if you can wrap your head around this. That means that we are, more than ever, going to have to find ways of creating alternative structures and options for protecting ourselves and the people around us.
** moved to wiki 3:30pm EST 11/12/16 **
BIG FAT DISCLAIMER: The steps listed here will definitely help discourage/mitigate government/corporate surveillance, but are in no way guaranteed to prevent it entirely. Do what is practical for you, but the only way to wholly avoid being spied on is to throw all your electronic devices into an incinerator. Find the balance between usability and security.
Get the fuck off facebook/use it way less! No more phone numbers, addresses, check-ins. Facebook is a known collaborator and conspirator with the FBI.
Instead, share your email address and phone numbers with contacts, and use one of the many other online media platforms. (links TK)
If you still consider social media essential, consider open decentralized platforms such as GNUSocial (Twitter replacement) and Diaspora (Facebook replacement), but keep in mind these are only useful if other people you know use them as well.
Choose Firefox over Chrome. Choose anything over gmail. Google is also a known collaborator with law enforcement. If you would rather not use Firefox, there are alternatives such as Opera or Vivaldi.
Learn about VPN for web anonymity, and see about installing it on your home internet. (also yes TOR!) You can also use browsers that include VPN on your mobile device (like Tob for iOS). Many VPN providers have a mobile app you can install for simplicity.
Tor a simple and secure way to protect your privacy while browsing the web - here’s a how to beginner’s guide for installing and getting started with Tor. (Please be aware: simply installing Tor might put you on the NSA watch list.)
Switch from Google to a search engine that doesn’t track your search history (e.g. DuckDuckGo)
Marriage or not marriage: the LGBT+ shotgun wedding
There are going to be a lot of questions coming with regards to what happens with same-sex marriage. Marriage is controlled state-by-state and only mattered nationally because of the way the Supreme Court allowed it. I do not believe it can be immediately rescinded but better safe than sorry, especially if you are planning to use your marriage for other things like health insurance or immigration. Conversely, if you live in a state that is more conservative-leaning, it will be easier for them to stop performing gay marriages, so I would get that done sooner rather than later.
If you have been planning your gay destination wedding, save the destination for the party and tie the knot legally. How you need to do that varies state to state but usually you get a license and then get it signed.
As a side note, choosing to marry will affect your taxes. If you get married by the end of the calendar year, the IRS considers you married for that whole year.
ALL THIS MEANS you have a month or so and you should talk together about it. Getting married is in fact forming a contract with another person. Exactly what happens varies by state, but you may become liable for your new spouse’s debts and have rights to their assets. So long as the federal government recognizes same-sex marriages, this will impact things like taxes, financial aid, and student loans, so think about your financial position.
We don’t know what happens if same-sex marriage gets overturned; it will depend how they do it and whether they choose to backdate it to marriages that were begun when marriage was legal. Getting a divorce as an LGBTQ person is usually costly - several thousand dollars. Have conversations about finances, property, retirement accounts, etc. BEFORE you get married. Just because we have this right now doesn’t mean we need to jump into it tomorrow – it takes a lot of money, time and headache to undo it.
There are pre-nup forms you can get online that can help structure a discussion about how this might work in terms of splitting assets; having at least some conversation before you do this can potentially save you a lot of trouble later.
ID's and other identifying info: make copies of your passport, ID, etc and have them in a secure place outside of your apartment (friend, family, safe deposit box) should you need to leave your home quickly.
Do AS SOON AS POSSIBLE with as many docs as possible.
This is a general reference: http://transgenderlawcenter.org/resources/id/id-please. Another: https://translawhelp.org/
Having a passport with the correct information on it makes getting any other documents (state IDs, etc.) much much much easier in the future. Prioritize this if you can.
Please keep adding!
Most filing fees are increasing on December 23. If you can get your applications in before then, you'll save some money. However, they’re also introducing a partial fee waiver for citizenship applications, for people between 150-200% of the poverty line. If you qualify, it is worth considering the cost benefits of waiting. But make sure they are done correctly. Mistakes can be costly.
Here is a big list of recommendations from the National Immigrant Justice Center. Highlights include: do not file an initial DACA application; if you have DACA, do not apply for advance parole; if you have advance parole get back to the US by the inauguration on 1/20/17. This stuff gets complicated fast and it is best to consult a lawyer. En Español.
Here is another resource from the Catholic Legal Immigration Network: https://cliniclegal.org/sites/default/files/How-to-Prepare-for-Changes-in-the-Presidential-Administration.pdf.
¡Conozca sus derechos! (PDF)
From their website: "IDNYC secures the peace of mind and access to City services that come from having recognized identification. IDNYC benefits every city resident, including the most vulnerable communities—the homeless, youth, the elderly, undocumented immigrants, the formerly incarcerated and others who may have difficulty obtaining other government-issued ID"
If you are a person parenting a child conceived with donor gametes or via reciprocal IVF, pursue options to adopt if the child is not both genetically your offspring and came out of your body. Do not rely on marriage or birth certificates to protect parental rights. An adoption is a court order and will provide the highest level of protection. http://www.nclrights.org/ has state by state guidelines on second parent adoptions and queer adoptions.
Best to get this set up now as otherwise control will default to your legal family for medical decisionmaking when you are incapacitated. (The legal ranking is generally legal spouse if applicable, then any living parents/guardians if applicable, then any children who are 18+ years old, then legally recognized siblings.) Especially for people who have a clear sense of who they would want making decisions for them, it is good to do this legally. This structure exists quite outside of marriage etc - you can give control to your roommate, your best friend, etc. It is highly recommended to talk to your person about what you want and why it’s important to you, and make sure they understand and are on board and ready to advocate for you -- in addition to making them your healthcare power of attorney and, if you want, documenting your wishes.
How this works in different states is outside my scope of knowledge - what’s up federalism! - but this is one way of making strong paperwork and again, exists for lots of reasons (ie, elderly people who want their children to make decisions for them.) If you follow the link below, whatever you find locally will have knowledge of the details for your location.
A power of attorney grants someone the right to make decisions, and is usually granted on things like bank accounts etc. Including a POA in a living will is way of ensuring if you’re unable to use your money, someone else who you trust can use it on your behalf/as you want it used, while you are alive.
on the street, at protests, when an agent comes to your door - will add more resources
If you have a smartphone consider the ACLU police conduct app. It gets video of police encounters you record straight to the ACLU. It can also alert other users nearby to come serve as additional witnesses. https://www.aclu.org/feature/aclu-apps-record-police-conduct
If you are eligible for some form of forgiveness of your federal student loans (based on disability, public service, or anything else), it could be a very good idea to apply for that sort of relief right away, just in case it disappears. You can find info on how to do that here: https://studentaid.ed.gov/sa/repay-loans/forgiveness-cancellation
If you are low or low-ish income, you might also qualify for “income-based repayment” of federal student loans. There are several programs under this umbrella, but basically, if you qualify, you will make loan payments that are a specific fraction of your income. If your income goes down (or up) so do your payments, and after a set number of years, the remaining debt may be forgiven. Apply now in case rules change; you may be able to stay in the program. https://studentaid.ed.gov/sa/repay-loans/understand/plans/income-driven
If you are a freelancer/self-employed, please file for an EIN (it’s free from the IRS), and even more important: start filing a schedule C on your taxes (which you can do w/o an EIN, it’s just cleaner to use EIN). Why? Because claiming the money you are putting in the bank (or paypal) means less likelihood of being sought for tax fraud on unclaimed income, and claiming the expenses means you – especially if you’re making $2-8k on a small biz venture – will actually incur a loss and pay less taxes overall. And who knows what the fuck taxes will be used for moving forward. Freelancers’ union instructions.
If you want someone to help you file your taxes, local organizations across the country offer free tax prep services if you make less than about $54,000/year. Check out their website for details and a location near you: https://www.irs.gov/individuals/free-tax-return-preparation-for-you-by-volunteers
Somewhere it will earn even a little interest. Like, even a 1% online savings account (for example: Ally 1% \ EverBank 1.11% \ CIT 0.95%). Why? Because if the economy drops, inflation is going to go wild, and our cash is going to be worth less, and able to buy less. So exclusively cash hoarding is not a great idea right now (or ever).
If you qualify, which might mean that you have earned income (e.g. you get a W2 from your job), consider whether an IRA makes sense for a bit of your savings. This will have tax consequences now and/or in the future depending on what kind you choose, but you can invest in diversified funds that capture both U.S. and foreign markets, so might offer a bit more stability over the long term. Besides saving for retirement, you can take money you have deposited out of a Roth IRA pretty easily if it turns out you really need it. Check with your credit union.
It’s not unreasonable to consider keeping some cash in another currency that is not closely tied to the U.S. dollar in case of USD hyperinflation.
Put money into an HSA/FSA: These are tax-advantaged saving accounts that let you use pre-tax money for health costs. They’re available to employees if your company offers them (if yours doesn’t, ask them to consider it–it’s a small thing in the scheme of HR benefits). It’s a double win because you get the full value of your dollar (no taxes) and you also reduce your income (lower taxes overall). You can use pre-tax HSA/FSA funds on a ton of stuff including therapy, band-aids, contact lenses or glasses, copays, dental care, and any out-of-network health expenses that count toward your deductible. With a letter from your doctor, you can even use HSA/FSA funds for over the counter medicines for acne treatment, allergies, and cold medicine. Here a full list of FSA-eligible expenses. Important to note: FSAs and HSAs have different rules and regulations so google for details. You have to set aside an amount for your FSA before the end of the year for the following year. If you don’t use up all the funds, you lose them. HSA money rolls over but you have to be on a high-deductible plan/meet certain criteria to be eligible.
Get the fuck out of big banks
If you are still banking with the dudes who brought us Dakota Access pipeline and the subprime mortgage crisis then get out! Visit banklocal.info for more information about how to change banks and a nationwide directory. Note: if you move your money into community development financial institutions (google that phrase and your state for results!) like community development credit unions and banks then your money goes into our low-income, poc, and immigrant communities as crucial capital for our homes, businesses, and education. When all other services get removed we’re going to have even more pressure on these groups so moving money now helps us all later, and structurally supports shifting resources from the 1% to those who need it.
In NYC Just Food maintains a long list but you can also google. Many CSAs are from farms in NYC while others are in the region. Many take SNAP benefits or offer sliding scale. Some, like Lancaster Cooperative, will set up a CSA at your business or organization. You can choose how to split up shares to make it accessible for everyone.
In NYC there are a lot of gardens where you can grow food, herbs, and find community that can support you as you learn to garden and cook. Check out GreenThumb, NYC Community Gardens Coalition, and 596 Acres to explore what resources exist for you.
In Chicago, here’s a map of community garden resources
In Denver, here’s a map of community gardens.
If SNAP benefits are cut a lot of people are going to experience food insecurity. Plan ahead and if you have meetings ask people to bring food, even extra nonperishable items that can be exchanged. You might even consider doing food sharing where you share leftovers with people. Lots of ways this can go. For people with corporate jobs who have catering, try to get a system in place where you can get leftovers from the office out to people in the community who need it. This isn’t legal exactly but if it’s informally organized it works. To look up your local food pantries in most cities and some rural areas you can go to Auntbertha.com. You can also look for them here: http://www.feedingamerica.org/find-your-local-foodbank/?referrer=https://www.google.com/.
Some supermarkets such as Trader Joe’s will throw out perfectly edible food in unprotected dumpsters. As a general rule of thumb the expiration date on a perishable item of food is usually 1 week later than whenever has been listed. If in doubt, your nose has tens of thousands of years of evolution behind it -- if something smells rotten or spoiled, it is! Trashwiki.org has a crowdsourced list of places in urban areas that have particularly bountiful “trash harvests,” use it! Ex, here’s a freegan map for Portland with lots of useful info on where to find free food.
Many public libraries have access to the NOLO legal series. They have a subseries on Landlord-Tenant laws and Tenant’s Rights.
Foreclosure Help: If you know anyone struggling to pay their mortgage or already in foreclosure proceedings, they may be eligible for a loan modification. Government funding for foreclosure relief WILL be affected come January, so getting in to see a housing counselor as soon as possible is the best thing to do. They are free and unbiased help. To find one in your area, go to HUD’s website to locate a HUD certified housing counseling agency: www.HUD.gov
If you’re a low-income homeowner, many cities offer home rehabilitation grants or low-/no-interest loans for home rehab through federal funding (CDBG or HOME). These funds may likely be severely reduced under the incoming Congress. Apply now if you need emergency rehab (heat, weatherization) and trust your city government to be a resource.
It is abundantly clear that federal funding will be cut to support organizations supporting abortion, gay rights, etc; it is also likely other federal funding will dry up for civil rights defense and other similar issues. This is a list of organizations, from mainstream to very grassroots, that could use your support. We make no endorsements and encourage you to be thoughtful about how you donate your money. Local grassroots organizations are going to be struggling mightily, will also lose funding and will have less access to wealthy donors who can help fill the gap.
<333 this is amazing you all are awesome. (you can delete this just wanted to say)
--Yep all love, great advice. Strength and love from Canada. Delete as needed but wanted to beam this.
I’d recommend saving a copy of this either on your desktop (and updating daily) or at least your google drive--a) for easier access b) if it falls into the wrong hands and gets taken down/taken apart ayy
This is the ray of light I needed today. This is how we organize. We know how to do this. Forward, always.