To deal with one‘s own privileges, with racism, with prejudices and everything that goes with it To deal with one‘s own privileges, with racism, with prejudices and everything that goes with it

Why did you found Casa Kuà and why are you part of the initiative?

We wanted to have a permanent place, where people could come and build something. Since I also practice Chinese medicine, the question for me was: “For whom do I want to do this and in what framework? Do I now only want to treat rich, middle-class people who can somehow pay €70 an hour?“ And the answer was quite clearly: no. The question was what other ways are there to make this more accessible – financially, but also at other levels. And then in kitchen table discussions we decided to just do it. We are self-organised. A trans*, inter*, queer health and community centre.

One thing was to have a permanent space. There are definitely trans* and queer spaces in Berlin, but they are very white dominated. Other people and I were tired of always working on the same issues, conflicts and structures. That‘s exactly why we want to build a space just for us, where we are the focus, us and our needs. That was also an important point.

What do you do well in Casa Kuà?

For me, it is important that people can get involved at different levels, depending on their capacities. That can also fluctuate sometimes – for two months people have time and then again they don‘t. Because the very people who are involved here are also affected by racism, trans*phobia, etc. – I won‘t list everything here. This means that our lives alone take up a lot of our capacities. That‘s why it‘s good that each person can contribute as much as possible.

What I also like is that we have restructured ourselves about five times since the beginning. It was important for us not to act according to the textbook, that it has to be like this and like that. It‘s important that people who join us can also contribute. And if we see that something is not working, then we look at how we can do it differently.

What does the community that comes to Casa Kuà, or that is Casa Kuà, lack in terms of medical care?

On the one hand, there are those people who have no access to healthcare because they have no papers and no health insurance. The first demand is clearly that they have access to healthcare at all. Then there are those who actually have access in theory, but in practice it is different. I had a person here a few weeks ago who said she would rather suffer than go to a white cis doctor and have to listen to all kinds of things. Clearly, many people who are affected by racism and trans* people who are affected by racism have to face violence to access healthcare. As a result, many people either don‘t go to doctors, psychologists or psychiatrists at all, or only in an emergency when there is no other way. This is of course a very big problem.

One demand that always applies – and I also have this demand for all other people in society – is to deal with one‘s own privileges, with racism, with prejudices and everything that goes with it. The fact is that doctors are in a completely different position of power. They can decide what happens to a person. Whether they get follow-up treatment or are sent home. It is not a question of a person not wanting to sell me bread rolls. It‘s different if a person doesn‘t want to give me medical treatment.

What would have to change in the area of access and training to health professions?

It is clear that the health system is not worse than the rest. But it also has a greater impact on people. The general demand is that structures have to change. The demands become more specific when we ask: “Who can become a doctor? Who has access to training and studies at all? Who has the money for it and who is supported?“ For people to really have access to healthcare, and not just on paper, a lot needs to change. Having a health insurance card is a first step, but unfortunately it is not enough.

It is no secret who has access to the studies and that factors like racism and classism are involved. I have now learned how much it costs for psychologists to get a licence to practice psychotherapy. It is unbelievable how much it costs. This makes it even clearer why there are so many white cis people in these positions and most of them probably come from middle-class backgrounds. They can‘t comprehend what other people‘s lives are like.

I can imagine that it would make sense to say in the admissions, such and such a percentage of those who are admitted have this or that background. If the field doesn‘t remain such a one-dimensional block of experience, that will make a difference. I would be very happy if I didn‘t have to tell people what racism is. The last time I had to refer a psychiatrist to Wikipedia.

What kind of awareness would people currently working in the health sector need to have?

I think if at least some very simple basics were learned, that would help. For example: How do I address a person? What pronouns do I use? Asking what name people want to use. Especially when people are called over the loudspeaker in the waiting room. And: Maybe not to ask immediately where people come from. Unfortunately, when that is the first encounter, the first question, the first attribution, it is just over for many people. But I don‘t want to tell all my stories now. But I myself have also walked out of a practice because I was asked, “Where are you from?“. A friend of mine was kicked out of a practice because he didn‘t want to say where he was from. That‘s exactly the kind of situation we‘re talking about. Then I think to myself: that‘s already very basic. But not even that is the case, unfortunately. Maybe just: How am I not shit to people 1.0? That would be a start. The first step and then it can go much further. And there are always people to whom you can tell everything and give all access to all information. They still won‘t change. But it would be a first attempt. What about critical whiteness? What is racism? What is everyday racism? What is trans*phobia? How do I treat people with respect? Just start with respect. Sure, everyone makes mistakes. But when people are pointed out and continue to insist that it‘s okay to ask this question, that‘s problematic.

We had also started to organise a workshop on trans*phobia for doctors and other people working in the health sector. But it was dependent on a doctor to take part. And the doctor we wanted to do it with didn‘t have the German licence yet. But maybe in the future. As far as I know, there are such workshops, but it‘s always the question of who actually registers for these. There has to be a basic interest for people to go to such a training. It would be good to make something like this a compulsory part of the medical studies, as part of the basic courses.

At the school where I studied, they also offered a workshop. But what actually reached the people was of course limited. For those who are already resistant and trans*phobic, workshops are not enough. That‘s why it‘s also a social question. But if there were at least more sensitised medical professionals to whom we could send those affected, that wouldn‘t be bad. That‘s probably why the only option is for more trans* people to work in health care professions themselves. If that were the only option, it would be a bit sad. But it would also be good.

We have started to compile a list of racism-sensitive, trans* sensitive doctors and therapists. There are also lists from other organisations here in Berlin. But if a person is on a list, unfortunately that doesn‘t mean anything. Because there are so many differences in the community. If a white trans* male person feels comfortable somewhere, it doesn‘t mean that a trans* female person feels comfortable or that a Black trans* woman feels comfortable. At Casa Kuà there is not only one community, there are many different communities. That‘s why it‘s hard to recommend one person from a list.

What changes would be necessary on a legal level?

I have spent too many years in my life trying to change laws. I‘m out of that now. Other people can do that. All the legal demands can be done by other people. I don‘t do it and I think it‘s good if other people do it. I don‘t put my energy into it any more.

We started Casa Kuà because we didn‘t want to wait for someone to do something for us. Because if we wait until things change ... That‘s why we want to have this self-organised place where we can see how we can create alternatives. What does health mean to us, what do we do with it and how do we do it? I think demands are important, but I don‘t want to wait for them ... I won‘t live that long. Some things are happening on the legal level. But especially on the legal level it can always be taken back. It is never something that is decided once and then it is fixed.

In a conversation with people from a group from Latin America, it became clear that even though abortion was legal, they maintained their DIY structures. Precisely because they don‘t want to rely on it staying that way forever. It had been shown in other places that those who relied on abortion staying legal and then disbanded their self-organised structures, are now feeling the consequences. We see this with the history of abortion laws in the US, where many self-organised structures that existed before simply disintegrated and all the knowledge was lost. Now people are seeing the consequences of that. So this is not something I would rely on.

What would other social groups have to do?

The first demand is: All white people have to deal with racism. And not just in a token way, as happens very often.

I believe that something can be done about racism at every level because it is so profound and starts very early. If you have bad experiences with medical treatment as a child, then of course you won‘t become a doctor at some point. Or if there is racism and trans*phobia at school: how far do these kids get in the school system and do they even have access to the professions? That‘s why I think there are social barriers at every level and we see the end result. But where it all comes from and how it is entangled in society and who is supposed to do what, I would have to write a book about that. But in general terms, it would be good to look at social structures and privileges and see where I benefit and how, and what I can do with my own privileges to change things. More specifically: Knowing I am white and cis is not enough. It‘s nice when everyone says that in a round of introductions, but the question is: What do I do now with these privileges, how can I make sure others have more access? How can I use my privileges to give them up and give more to others? This has to be dealt with on an individual as well as on a collective level, because this can be found in every structure.

What spaces would your community urgently need?

Spaces that the community urgently needs? Exactly what we do here, in fact that's exactly what it is. Sometimes I also see us as a bit of a bridge to the health system: we also have medical counselling here, we support and advise people in their processes or accompany them to appointments to translate or simply be there.

For me, it is also important that we do not make any compromises, no matter where the money comes from. For example, that we no longer say certain things or do things differently because we get money or want money. If we get money for what we already do, I think that‘s great. But an important point for me here is to pay attention to the extent to which this also changes the internal structures.