I failed! Oh, I so failed. I have allowed work and life to get in the way of the Daily Challenge. In my defense, this is one of the four hardest weeks of my job each year, in terms of workload, stress, and late nights. I intend to catch up, however! Beginning with Tuesday …
June 10, 2014 — Write a post based on the contrast between two things — whether people, objects, emotions, places, or something else.
This one is interesting. In fact I do have two things I want to contrast. Not two people, or two things, but two conflicting views in my own head: what to think about the recent World Health Organization’s statement on transgender people and forced castration.
The statement, Eliminating Forced, Coercive, and Otherwise Involuntary Sterilization, is actually an interagency statement written by not only WHO, but several UN organizations. The statement is not solely centered on transgender issues, but it has earned notice in the trans community because it does include transgender people in its larger message, which is, as the title suggests, a statement against sterilization requirements — which includes GRS requirements for gender marker changes on legal documents. The statement reads:
Some groups, such as transgender and intersex persons, also have a long history of discrimination and abuse related to sterilization, which continues to this day. Such violations are reflected, for example, in the various legal and medical requirements, including for sterilization, to which transgender and intersex persons have been subjected in order to obtain birth certificates and other legal documents that match their preferred gender (15, 16, 63). Intersex persons, in particular, have been subjected to cosmetic and other nonmedically necessary surgery in infancy, leading to sterility, without informed consent of either the person in question or their parents or guardians. Such practices have also been recognized as human rights violations by international human rights bodies and national courts (15, 64).
Which is definitely true. In most states in the United States, either GRS or some lesser but no-less permanent procedure is a legal requirement for getting a gender marker change. Here in Michigan, I do not need to have full GRS, but I do need to have an orchiotomy — less extreme than GRS but no less effective in terms of sterilization. It’s not forced, but its definitely enforced, as I’m being told that I can only have this life-affirming legal identity change if I undergo the procedure.
Here’s the problem. The WHO statement very much paints GRS in a negative light. Think for a moment about the contrast at work here.
On the one hand, the trans community at large wants to gain support for GRS as a medically necessary part of the larger treatment options available to us. We want it to be viewed as a viable treatment option, as “medically necessary” is the crowbar that leverages the coverage of GRS by insurance policies. It is a positive, even life-saving procedure.
On the other hand, if we celebrate the WHO’s statement, then we are casting what is, for many, a life-affirming surgery as coerced sterilization. We are turning around and casting this positive, even life-saving procedure in a decidedly negative light. “Yeah! Don’t make us do that horrible, horrible thing … that our doctor says we NEED in order to treat us! And that many of us really want!”
This is the potential Catch-22 of being trans in many countries. Can we say, on the one hand, that GRS is an important — nay, vital! — part of GD treatment regimens, and then turn around and say, “But it’s also evil and wrong”? And by acknowledging that GRS requirements amount to “coerced sterilization,” couldn’t we be interpreted as drifting uncomfortably close to the kinds of verbiage transphobes use to dismiss GRS? They love to say things like “You’re mutilating your genitals!” and “You’re just removing healthy organs!” They cast something that’s meant to heal as something that causes unnecessary harm — which is akin to the WHO’s statement.
We want it, but we want to decry its requirement, but we need it to be medically necessary in order to have any hope of getting it paid for, but we don’t want to be told that we can only be ourselves legally if we get it. It’s a bit of a Gordian Knot, at least rhetorically. On a day-to-day level, this means that when we talk about this WHO statement we need to make sure that we do so with nuance. It’s not the surgery that we find offensive or oppressive; it’s the burdensome requirement for legal recognition that’s the problem. And we need to be sure that we frame it that way.
Of course, all of this is only a problem because of legal gender. Really, why does gender need to be something that is stamped for approval by the government? I suppose its purpose is to determine how some laws, ordinances, and private policies apply to individuals. For example, have an M on your birth certificate? You can only get married to someone with an F on theirs, at least in most states. Have an F on there? At my workplace you couldn’t choose to wear a three-piece suit, even if you looked awesome in it.
The truth is, all we would need to do is change a relatively small number of laws and this whole conundrum about legal gender and surgery requirements would go away. In that better world, gender would cease to be a legal marker at all, for any purpose, and GRS would be only one of several possible “medically necessary” (and therefore insurance-covered) options for treating GD. Until then, we must try to navigate this contrast, this contradiction, as we work our way towards living as our authentic selves.