Q&A With Katharine Gordon: TSA Diabetes Policy

This article was first posted on Feb. 5. 2014

Katharine Gordon is Director of the American Diabetes Association’s Legal Advocate Program. This program provides assistance and information to people experiencing discrimination because of diabetes in schools, the workplace, jails and prisons, and other areas of daily life.

Getting through airport security with diabetes can be a pain. Katharine Gordon, Director of the Legal Advocate Program at the American Diabetes Association, works with the Transportation Security Administration (TSA) to make it a little easier, safer, and more pleasant for all involved.

What do you do as a Legal Advocate for the ADA who works with the TSA?

Since the TSA’s founding [in 2001], the American Diabetes Association has been in communication with TSA because diabetes in particular really does affect airport security screening, where you’re bringing on sharp objects, you’re bringing liquids, you have devices that might not be familiar. So we, from the very beginning, recognized a need to be in communication with TSA.

TSA actually has a disability coalition, which is a large group of people from many different disease and disability groups. We have an annual conference and quarterly phone calls, so we have regular channels of communication. One of the things that we work on is  alerting TSA staff to problems, for example, if we’re starting to hear multiple stories about a certain airport,  we would want to approach them about that.

In terms of individual assistance, we ask people to go through the TSA Office for Civil Rights (OCR) complaint process, which can often, at a minimum, lead to the retraining of employees who haven’t followed the procedures, or who haven’t treated travelers with respect and dignity. There are not many ways for passengers to file a lawsuit or do more than go through the administrative procedures. However in my experience, very often the folks at OCR are able to really get to the bottom of the problem.

Is everyone who works at the TSA trained to recognize diabetes technology?

They’re supposed to be. They do all receive some training in disabilities. Recently, in the past few years, TSA started to do more in terms of training for a wide range of disabilities. For example, disease groups will actually come into an airport and do live training with TSA officers.

One of the big issues is:  “Is everybody receiving the training that they need? Are they really getting the reinforcements that they need? Is it effective training? If they are overloaded with information, how can we make sure that they actually are using their training and complying with it?”

For the most part, in the vast majority of cases, the policies themselves aren’t inappropriate. However, one of the problems is that sometimes customers are not aware of them, or TSA officers themselves are not aware of them. Sometimes, if a traveler has an object that officers haven’t seen before, they’re resistant to whatever the person is asking to be done. That can be a real challenge.

One of the biggest changes that we’ve seen—and it’s certainly not perfect yet—is that TSA is beginning to view itself more as a customer service provider and less as only a law enforcement agency. I would say that most problems occur when there’s a lack of communication with the TSA officer who doesn’t really want to listen to what the traveler is saying. And that’s when the conflicts come up. If TSA officers could demonstrate more respectful dialogue, I think that almost any issues that people with diabetes would have while travelling would be eliminated. In fact, there is a consensus among disease, disability, and civil rights groups that a top priority of TSA must be to improve the ability of all of its officers to communicate appropriately. (I do want to recognize that many TSA officers are excellent.)

For the vast majority of people with diabetes [going through security] is completely incident-free. There might be a bit more scrutiny just because you do have sharps, and you do have other medical devices, but for the most part people get through pretty easily without problems. But if you have some reason to think that that might not happen, there’s something called TSA Cares (1-855-787-2227) where you can call 72 hours in advance and you can ask for support at the airport. So let’s say that your elderly grandmother is travelling by herself. You can actually ask for some assistance at the airport to facilitate the screening process so that she’s not in as vulnerable of a position.

If someone wanted to know whether or not a certain pump or CGM could go through the imaging systems, would TSA be able to provide advice on that, or is that something that travelers should look up beforehand?

Travelers should look to their manufacturer, because different manufacturers have different policies.

You have the right to be allowed to go through the scanner with your pump and/or CGM. If you don’t want to go through the scanner, you don’t need to, but then you would be subject to the full body pat down. And if you do go through the scanner, you should only be searched in the area where there was an alarm. So let’s say that you go through with your pump on and you have an OmniPod on your left arm. Theoretically, you should only have the pat down of your left arm, not the entire pat down. You always have a right to have somebody with you to witness any additional screening, and have it in a private location if you would like that.

So you’re saying these are the things that people should be able to expect. But are these expectations a reality? Have you heard stories where people aren’t allowed to get the pat down if they want it, or if they had a more invasive pat down than they thought they needed?

I’ve heard infrequent incidences of this. And if they occur, we really, really recommend that people call 1-800-DIABETES and ask how to speak with a Legal Advocate.  We can speak with them about it and give them information on their rights, and as part of that, we always encourage them to contact the Office for Civil Rights. In some situations, with the individual’s permission, we will also contact TSA directly about the incident.

For the most part it’s quite rare that somebody has a problematic experience, so people shouldn’t feel afraid to fly, or feel afraid to travel in any way. However, it certainly is not a perfect system and we rely on travelers to let us know when it’s not working so that we can advocate with TSA to either change policies or to ensure that there is better training.

Is there anything you’d like to add?

I think the biggest thing is being prepared. We have a tip sheet that you can print out, we have a variety of resources on our website about travelling and diabetes, and the TSA has a tip sheet you can print out. Print those out and have them with you so you can know what to do and know what to expect and know what your rights are. At the same time, you can immediately know what to do if something goes wrong. [And if something happens,] these are very significant issues that we take very seriously and would like you to contact us.

But at the same time, most people fly without incident, so concerns about TSA shouldn’t dissuade people from making any of their plans. We have all heard TSA stories about a wide range of issues. However, we never want these stories to limit people’s lives. We want to find out about all problems so that they can be addressed.

**Remember when you’re travelling, or even in your day-to-day life, it’s always best to have a diabetes alert somewhere on your person, whether in the form of a bracelet, tattoo, or wallet card. Check out the ADA’s printable diabetes alert card and basic info sheet about diabetes and treatments.


  1. I have been under the impression that an insulin pump should NEVER go through a scanner. I have been told many times during my son’s 20 years of pumping that he should either take it off and put it with his electronics or submit to the fully body patdown.

    • After getting insulin on my hands the first time going through TSA security and taking my pump off, which set off the explosive alarm …that was fun, I never took my pump and more recently sensor off again. Thats about 20 flights in 7 years.

  2. I was just flying a few weeks ago, and as I already had one pump show errors and the manufacturer not warranty as I had traveled and went through the scanner, I asked to be patted down and explained why. I was really upset when the TSA agents seemed as if I were a bother and actually told me “We don’t have someone to do that”….Ummm, really? I persisted even after 2 different agents told me “It will be fine, people go through all of the time, just go”. I was VERY disappointed in the attitude displayed and the persistence and most that I felt that if I didn’t walk through the machine I would not be helped. FINALLY, a young pregnant agent came over and helped me. It took her like 2 seconds (and again, I was prepared, so I don’t even care that they do it in the middle of where people are walking by). I explained the cost of my pump and CGM and the fact that these devices KEEP ME ALIVE. I just wish that there was more understanding from the other agents (Tampa FL). It was not busy and I actually took more time to step out of line than it would have taken for me to just “walk through”, the whole thing could have been over in less than a minute had they not argued with me.

  3. I travel frequently for business and my experience with TSA includes:

    1) I have been told by TSA agents that my pump CAN go through the scanner even though the manufacturer says it should not. They get REALLY irritated and say if I miss my flight it is my own fault.

    2) TSA agents tell me no is available to do a private pat-down–that I have to do it in public because they are short staffed.

    3) TSA agents say I CANNOT bring applesauce packets, juice or soy milk (all under 3 oz) with me for low sugars on flights of all timeframes from 1-12 hours and try to confiscate these items unless I demand to speak with a supervisor

    4) I ask the TSA agent doing the pat down NOT to press hard on my infusion site as it may bend or damage the needle providing insulin–and 90% of the time they press extra hard just to show me who’s boss or perhaps they stupidly think I’m hiding something in my infusion site. I’ve found that being nice or educating them back-fires. They don’t care and just want everyone to follow their rules without exception.

    Bottom line: I signed up for Global entry (TSA pre included) so I do not have to endure this discrimination coupled with stupidity. If I sound harsh, it is because I travel a lot and find most agents hate their jobs and take it out on passengers when they are able to. If I didn’t need to fly for business, I wouldn’t.

    • I travel often I wanted to know about the Global entry..TSA pre.. Sometimes, I get it on my ticket other times I don’t….

    • Whenever I go through pre-check line I still need to go through same process of being scanned for pump and sensor and then have hands checked for explosives. The first time I did this I took pump off and got insulin on fingers which then got read on the machine as an explosive. That was fun… I never bring fluids opting to go with sugar tabs and PBJ sandwhiches. I guess I have been fortunate as I have never experienced a bad TSA agent despite frequently flying for work. All the Best BT

  4. We’ve been flying with my son a few times each year in his 15 years, and he’s had diabetes for 13 of them. He is on the Omnipod and cgm and used to be on the Cozmo pump. We have without fail run my bag and his through the belt scanner and kept his pump and cgm on while he’s gone through the personal scanner. In all these years, he’s been stopped only two times to have his pod examined briefly and our bags have never been searched (except once when he forgot he had his pocket knife!) Regarding liquids, for flights, we simply change up what we take for lows. Rather than juice boxes, he brings fruit gummies or Gu’s. There are many snacks that can work that are dry – and many are healthy. I’m saying this so people who haven’t flown yet – or much – don’t fear that problems are the norm – they’re the exception as she states above, which is good 🙂

  5. I have found you can not rely on the TSA personnel with regard to whether it is safe for your device to go through screening. In every case where I have traveled with my child, I have opted for pat down rather than take the chance. In most cases, it has been respectful and pleasant, but there have been some exceptions. In one case, we were delayed over an hour while they argued that we had to go through the scanner regardless. I always obtain a supporting letter from our doctor. They argued that the letter specified only needing food and medications but because it did not say we have a pump they were going to make us go through the scanner. My advice is to do all your homework ahead of time, allow extra time for processing and be ready for all circumstances. Its an education process for all.

  6. X-rays denature insulin. Do NOT allow repeated exposures to x-rays for your insulin vials. The TSA actually had warnings about this on their website in 2006, then removed them. There were also articles in the NY Times and elsewhere about this problem. When I asked about it, the TSA supervisor in San Diego said, “We can’t visually inspect for all of the stuff diabetics bring with them. It’s just too much stuff. We can’t be expected to be aware of all the warnings on our website.” Repeated exposures to x-rays cause the insulin to slowly lose effectiveness. Metal detectors do not harm the insulin.

  7. My experiences have been very similar to Leslie Ament’s. I have friends who’ve had pump malfunctions after going through the scanner—wish I could just do that! so request a patdown. I’m frequently told that no female is available and I will have to wait which has taken as long as 1/2 hour. About half of the time I can’t see my carry-on and purse on the belt while I’m waiting. I’m ALWAYS told that it is fine to go through the scanner “everyone else with a pump does it” even though the pump manufacturers say it is not ok. One friend was even strip searched because of her pump. I’ve also been given grief about having a back up pump in my pocket. Many TSA agents are polite and professional, but many are rude know-it-alls. They don’t care about documentation from your doctor or pump company and they don’t care what we say regardless of how polite and respectful we are. I generally avoid flying whenever possible because of the stress that going through security causes me. Next time I have to fly I’m going to contact TSA Cares and see if they really do care and if it makes any difference.

  8. I just went on a trip with my boys and TSA is always a cause of anxiety for my son; that and his CGM alarm making someone think he’s a threat.
    With my Joslin letter in hand, I pretty much bungled the departure screening. No big deal, but I have TSA precheck so it should have been even easier to manage. An early morning flight can do that.
    For the return, I had an actual plan. I put his supplies in one bag. He detached his pump and CGM since we know that it alarms and put that in the bag as well. When we were putting our other things in the belt, I informed the agent of my son’s status and that these were items that could not go through the scanner. I offered documentation, but they weren’t too concerned about it.
    The agent took the bag and brought it to do an inspection while we went through security. Everyone was super nice and compassionate. We went through without any challenges or problems.
    NOW I have a routine and that will help in the future. I also tweeted at TSA to alert them to our experience. I do think it may help to have precheck. Food for thought.

  9. The only way to deal with the nonsense of the TSA is not to fly.
    We have not flown in the last five years when the TSA agents treated my husband like a major criminal at San Francisco’s airport. They were extremely annoyed that he had actually worn shoes to the airport, and it was downhill from there. When I asked my husband if he was OK, I too was treated like a major criminal. All of the agents acted as if they had never heard of diabetes and an insulin pump. I have never witnessed such behavior in my 50 plus years.
    The TSA can say what they want, but we will never fly again.

  10. I agree with Leslie 100%. I also travel a lot for business and find that many TSA workers are not adequately trained with respect to diabetes, insulin pumps, and the need for treating hypoglycemia. More training is needed and increased effort toward training TSA workers in how to treat people with dignity and respect….one agent told me it was my fault that I had type 1 diabetes and tarted me very poorly…completely uneducated, unprofessional and unacceptable behavior.

  11. I travel internationally and have noticed that in the last 2-3 years TSA agents have become more polite and knowledgeable about diabetes and therefore more understanding. I now am able to pass through security with confidence that I will not have problems. This after an over zealous agent in France delayed me because of my syringes and I missed my flight home. The notes from doctors don’t work unless the TSA agent can read english and tell that it is an official document ( this happened six years ago ) and since then I’ve not had the same problems. Hopefully it gets better with time. It does understandably discourage one from wanting to fly anywhere!

  12. Things w/ TSA have improved dramatically during past 3 yrs. Clearly better educated re insulin pump, Agents are generally polite and knowlegeable/dismissive in my recent airport transits in both US and foreign countries

  13. When dealing with any level of Officialdom, my first priority is to survive the encounter. Then I try to imagine that it is my job to offer them excellent customer service, rather than vice versa. After all, it may be my last opportunity to do a kindness for someone who can’t reciprocate. Probably I’ve just been lucky. On the other hand, like lighting a candle in church, it couldn’t hurt.

  14. I have had both OK and bad experiences with TSA
    I too have global re entry but even those lines with just the metal detector will randomly pick a person to be checked and then go thru the scanner.
    It has Happened a couple of times.
    The one time I asked for a pat down they tried to convince me that it was not necessary and the whole thing became a long drawn out rude process.
    I always carry a 2 nd pump with me ( batteries out) and put it thru with my carry on. They have never questioned that or the syringes or insulin.
    I put my pump in my bra and unless the metal detector goes off randomly or something else triggers it, I just walk thru.
    And if I do end up with the scanner, I just tell them I have a pump do the hand test. I’m not asking for the pat down again. It is not worth the aggravation and some times rude scene that they try to create for me.

    The pump companies and TSA need to come up with a standard plan for all of us.

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