How Do Peace Corps Changes Impact Transgender PCVs’ Medical Care?
John F. Kennedy once asked what can we do for our country. Many stepped up. We have skills to share. Initially, the overwhelming majority of Peace Corps Volunteers (PCVs) were from a very narrow demographic (race, gender, age, abilities, etc.) of the general public. Over time, the demographics slowly evolved to be more diverse. And now, there are transgender PCVs too!
Serving as a Diversity PCV
It is rarely easy to serve as a PCV from a diversity demographic. HCNs may or may not be welcoming of a PCV that did not fit their view of what an “American” is supposed to be. Sometimes you can win them over. Sometimes you just have to make it work as best you can. But regardless of HCNs’ views, diversity PCVs can find support and allies within their PCV group and across the RPCV community who accept you for who you are.
Unfortunately, some host countries discourage or refuse LGBTQ+ volunteers from serving in that country altogether. Therefore, transgender PCVs can only serve in certain host countries. Before the transgender applicant is accepted for service, Peace Corps makes sure the applicant is only placed in a country where a transgender PCV is accepted and where Peace Corps can provide their necessary gender-affirming health care for the entire time in service.
However, this is no longer the case. Peace Corps recently notified transgender PCVs that they have to choose.
What are the Choices to the Transgender PCVs?
(1) Forgo [gender-affirming] treatment to continue Peace Corps service; OR
(2) Accept medical separation and immediately leave Peace Corps
Basically, the PCV cannot stay in the Peace Corps while continuing gender-affirming treatment. But this leaves a lot of questions.
Why Is Early Termination a Problem?
Many PCVs love and value their time in service. They adore and respect their host community. They want to stay as long as they can to learn about the culture and share theirs in return. There may be in-country service projects that will need the remainder of the 2-year service time to complete. Some PCVs extend into a third year to finish their project.
As Peace Corps Volunteers, we accept that we have to pause our lives in the USA to serve. PCVs agree to serve overseas for 27 months without pay. We leave our jobs, give up our homes, store our possessions, rehome our pets, and more. We say goodbye to loved ones (knowing they continue their daily lives without us). Many outside of the Peace Corps community do not realize this sacrifice and commitment.
The PCV may already have plans in place specifically after the 2-3 years in service. And, some benefits (NCE, loan deferrals, etc.) of Peace Corps service are only available after the full 2-year completion of service.
And, medical separation carries a certain stigma. It sometimes comes with questions that the RPCV is not ready to answer. And, the label could impact future job prospects. But refusing to provide medical care previously promised is a situation created by Peace Corps, not the transgender volunteer.
We all know that things can happen that interrupts service. It is one thing if there was an unexpected medical situation (injury, infectious disease, etc.) requiring medical care that the PCV can only get in the USA. Or, it is understandable if the drug manufacturer no longer made the needed medication and there are no other available medical substitutes. But this does not seem to be the case.
Questions to Peace Corps
- Why is this policy change made? Is the drug manufacturer no longer making the gender-affirmation medication and there are no other substitutes?
- Is the restriction on gender-affirming care for all Peace Corps host countries or only for certain host countries? If gender-affirming medication is available in a different country, can the PCV transfer or travel to the other country?
- When Peace Corps refuse to provide medical care it previously agreed to provide (but that medical care is otherwise available), can the PCV make their own arrangements to locate and pay for the medical care without Peace Corps assistance or involvement?
- If a cisgender/non-transgender PCV is using the same or similar medication (testosterone, estrogen, etc.) for other needs, will they be allowed continue the medication or will they also be required to choose (stop taking the medication or leave Peace Corps)?
- Why can’t the policy be applied only to new applicants so that current transgender PCV can complete their service?
- Does the Peace Corps expect to only stop providing gender-affirming medication? Or, does Peace Corps plan to stop all transgender care?
- Will Peace Corps reject transgender applicants (needing gender-affirming care) for Peace Corps service going forward? Or, can they serve if they agree to “forego” their gender-affirming care?
What Happens Now?
Broken promises and (civil rights impacting) “policy decisions” irreparably damage the credibility of any organization. Is Peace Corps now refusing to provide the medical care that they previously promised to provide (and still can) when they invited the PCV to serve? Is Peace Corps forcing out PCVs in a demographic they previously agreed to support? Will there be additional diversity demographics that Peace Corps will refuse to support going forward?
The Peace Corps community and future applicants need to be able to trust Peace Corps, and the US government by extension. So, when Peace Corps makes a significant “policy change” that disrupts a PCV’s service or targets a specific demographic of PCVs, the PCV and RPCV community needs Peace Corps to help the community understand. If not, how can the Peace Corps expect future applicants to commit to serve for 2 years knowing the Peace Corps will not commit to them?