Tag Archive for: gender

Health Care Or Home Purchase? The Transgender Dilemma

Today I completed the US Trans Survey, a comprehensive study gathering information that will be used to inform public policy towards transgender people in the United States. Trans, genderqueer, and non-binary folks: if you haven’t taken the survey yet, please do so now! Our data is urgently needed.

On paper, my answers to the survey questions are encouraging. I have never been assaulted or harassed due to my gender identity. I have never been fired from a job or made to feel uncomfortable at work as a result of my trans status. I have had positive personal relationships, and I have not experienced homelessness. My answers, of course, are only a tiny fraction of the trans experience, but they are mostly good news. Unfortunately, they don’t quite tell the whole story. At the conclusion of the survey, participants are asked to share a personal story of either acceptance or discrimination to help round out the picture of their experiences. I’d like to share here a selection from what I wrote:

In many ways, I have been very fortunate as a trans man in the United States. I have a supportive immediate family, a wonderful fiancee, and a full-time job. However, although my salary is enough to support me, I am struck by the difficult choices I’ve had to make because of my trans status and my inability to get comprehensive transgender health care.

I began my medical transition four years ago with hormone therapy, but my health insurance has never paid for any of my trans-related treatment. Because I am fortunate enough to be employed, I have been able to pay for my hormones out of pocket, and I felt secure in the idea that I would be able to continue doing this indefinitely. However, I was recently shocked to learn that my usual, trans-friendly pharmacy has been barred from issuing my normal hormone prescription, and that the only replacement available would be twice the cost. Because of this capricious regulatory setback, I’ve been unable to get my regular medication, and this puts my health in a precarious and unexpected place, at least for the short term.

This short-term situation is frustrating and difficult, but it doesn’t even compare to the long-term anguish of having to choose between chest surgery and the normal life expenses of a young professional. Although I do have health insurance through my employer, all of the plans available to me specifically exclude coverage for any type of transgender care; thus, I would have to pay out of pocket for gender-affirming chest surgery, even though my doctor would affirm that such surgery is medically necessary for my health and well-being.

The practical upshot of these policies is that I must continually choose between my own health and well-being and my ability to afford the purchases and milestones that will contribute to my long-term livelihood and stability, and that will help me to contribute to my family and community. I am getting married next year, but I can’t possibly afford a wedding alongside a surgical procedure, so I’ve delayed my surgery. After the wedding, I’ll need a down payment for a house — there’s another delay. Once my housing is settled, perhaps I’ll want to raise children with my partner. Will I have to choose between top surgery and infant expenses? I’m sure that I’m not the only transgender millennial being held back by tough choices between medical care and participation in the so-called “American Dream.”

The refusal of American health insurance companies to cover transgender-related care — and the failure of our legislators to require them to do so — is a national embarrassment that could have far-reaching economic consequences.  Just as housing, employment, and other forms of discrimination have created a wealth gap between white and non-white households, I have no doubt that the denial of comprehensive medical care for trans folks will likewise affect our incomes, stability, and earning power.

To force transgender people to choose between medical care and major life purchases is to hamstring the economic potential of an entire class of people in the United States. These discriminatory policies are hurting us as a nation in both moral and practical terms. Allies, please urge your legislators to step up and ensure that all insurance policies provide comprehensive health care for transgender people!

Reclaiming My Feminism

When I finally realized my gender identity around my junior year of college, one of the first things I did was attend a meeting of the women’s group on campus. It did not go as planned.

It was not my first encounter with feminism. I had been taught about women’s liberation all my life. I was raised by a strongly feminist mother who told me horror stories of being required to wear skirts as a child, and who encouraged me to become whatever I wanted, regardless of gender stereotypes. In the house where I grew up, Barbies were unwelcome, and Our Bodies, Ourselves was prominently featured on the bookshelf. Yet in spite — or perhaps because — of these early lessons, I never really identified myself as a feminist. To my younger self, my mother’s feminism seemed historical; I had never been prevented from doing or saying something because of my X chromosomes, so I assumed that the need for action had passed.

As I grew into young adulthood and became more aware of the world around me, those assumptions vanished. I learned about women’s struggles abroad, and also those closer to home — and the more I learned, the more I realized that I was also struggling. I began to recognize and interrogate the gender roles I’d been brought up with, not because my parents had fed them to me, but because I had absorbed them from the larger culture. From fairy tales and movies, textbooks and TV shows, toy aisles and playgrounds, I had picked up the stereotypes to which I had earnestly striven to conform. In those first years of college I realized, with the sudden shock of a cold-water wake-up call, that I didn’t want to wear skirts and make-up and date boys. I had only assumed that I did.

It took more of a push for me to recognize my transgender identity (which is a story for another time) but when I came back to college in the fall of my junior year, I felt electrified by my new knowledge. Ironically, it was the realization that I am not a woman that made feminism and gender studies feel relevant and personal to me. It was in the midst of this giddy excitement that I went along to that women’s group meeting on campus, but I was about to get a shock of a different kind.

I can’t remember the name of the club, nor the discussion topic for that day. I do remember that most of the other group members were also residents of the Womyn’s House on campus, an all-female dorm for students who were devoted to feminist causes. The discussion, from what I recall, was avid and fruitful. It was towards the end of the meeting that I had the opportunity to introduce myself, and it was one of the first places where I shared my transgender identity with others — and the first where I shared it with strangers.

I don’t know what I expected — support, solidarity, encouragement? — but it wasn’t what I got. It could have been worse; I could have been yelled at or ridiculed, or even subjected to violence, as so many transgender people have been. Instead, what I encountered was a sudden distance, with a hint of betrayal.

The women at the club that night didn’t see me as a fellow feminist warrior. They saw a tool of the patriarchy. Why do you want to be a man? they asked me, as if I had just announced to a group of socialists my intention to become a hedge fund manager. Why aren’t you happy being a woman? What’s wrong with women? Why do you want to switch sides? Not everyone said these things, but the ones who did are the ones I remember. To them, I wasn’t a gender pioneer. I was a traitor.

I never went back to the women’s issues club. I still believed in all of the things they wanted to achieve — equal rights, equal pay, respect for women and their bodies — but I didn’t feel comfortable in that group. For a long time after that encounter, I even stopped calling myself a “feminist,” advocating for words like “humanist” or “equalist” instead.

I still consider myself a humanist, but now, more than ten years after that club meeting, I am beginning to reclaim my feminism. For a long time I thought that “feminism” had an image problem, that the word was too scary or too exclusive or too damaged by its enemies to remain relevant. Now I know better, thanks to another word with an image problem: “queer.”

My understanding of the word “queer” has always been a positive one, associated with things like queer studies, queer theory, genderqueer, and the LGBTQ community. But when I was researching the etymology of the word for a presentation earlier this year, I realized how profoundly its meaning and usage have changed in just my own lifetime. If a former slur can become the name of a movement, then surely we can’t give up on the name of the movement that came before it.

The feminist movement laid the groundwork for the gay rights movement, and both still have work to do. So I’ve put the past behind me to say:

I am a feminist.

And so can you.

Body Image and the Transgender Man

There has never been a time in my life when I did not feel fat.

I was never directly bullied for my weight when I was a kid, but I was always aware of it. There was an undercurrent of worry to my mother’s persistent efforts to teach me about nutrition. I remember having colored cards that represented servings on the now-obsolete Food Pyramid, which I would move from one envelope to another as I “spent” them throughout the day. I was required to join one sport or physical activity per season, a melange that included a lot of left-field daydreaming (few balls ever sailed that far), soccer goalkeeping (I didn’t have to run much, and had the advantage of surface area when the ball came at me), and one ballet performance where I was cast as “the boat,” a part where my body was literally covered by a cardboard set piece as I danced across the back of the stage.

USDA 1992 Food Pyramid

Remember this gem from 1992?

My favorite activities were ice skating, because it required big puffy winter clothes, and swimming, where my body was hidden by water and my buoyancy was an asset. Although I thought of myself as anti-sport and proudly self-identified as a nerd, in retrospect I did and enjoyed a lot of athletic activities as a child. My elementary school summers were spent hiking in the mountains or swimming in the rivers of Vermont, where I grew up, and the winters were filled with cross-country skiing, skating over frozen lakes, and trekking through snow-covered forests. Yet even when I passed the swimming test and got my first job as a YMCA lifeguard at 15, I was never thin. And I knew it.

What started as an uncomfortable but accepted childhood reality — one friend nicknamed me “chipmunk” because my cheeks were fat — grew into a filter of shame that overlaid my self-image. As the new kid in middle school, having just moved south to Pennsylvania and away from my New England roots, I took to wearing huge, oversized T-shirts over leggings, a combination that was well out of fashion but which concealed my lumpy body from sixth-grade eyes.

My new hyper-awareness of body image coincided with the advent of puberty. The shock and dismay that I would later recognize as dysphoria stemming from my trans* identity was immediately mixed up with body shame. In retrospect, that body shame might have been the reason why I didn’t understand my gender identity until much later, when I was halfway through college: I knew that my body felt wrong and awful, but rather than realizing that it was because I was a man growing unwanted breasts, I assumed that it was because I was fat and ugly.

Aiden in 7th Grade

My 7th grade class photo, taken in 1996.

Transition has helped me to make incredible progress towards a positive body image. Part of this is due to physical body changes, like hair growth and fat redistribution, that stem from hormone treatment. Part is simply the relief that comes with aligning my physical body with my gender identity — I recognize myself when I look in the mirror, rather than staring at a stranger. Another part is the shift in expectations that comes with a new set of gender norms: where I was previously seen as a stocky, broad-shouldered, big-footed girl, I’m now a medium- to slim-built man. My clothes are sized small or medium instead of large to extra-large. As transparently artificial as that barometer is, it still makes me feel better.

AIDS Run Philly, Oct 2014

I’m not the Rocky type, and that’s fine with me.

Yet even as a confident, self-assured, outspoken adult, I still struggle with my body and weight, and I think a lot of that stems from being raised as a girl. Our society glamorizes Photoshopped supermodels and bombards women with unrealistic body images and product advertisements that play on shame and self-hatred, and it’s hard to shake off those messages. The ideal that I imagine for myself is not a hunky, muscular, square-jawed movie star but a slim, slight-shouldered, and slightly androgynous masculinity that has more in common with British alternative rock than, say, pro wrestling. Is this because I accept a wider spectrum of masculinities, or because I was bombarded throughout my childhood with the message that big is not beautiful? It’s hard to say.

What worries me is that I, at thirty-one, am staring at the mirror and yearning for the flat stomach of rock stars and fashion models. Even after transition, after rejecting the expectations that came pre-packaged with my assigned sex, after taking control of my  own gender identity and exercising my agency to live as my authentic self, I still dream of being skinny.

If my female upbringing is still warping my body image two decades later, what does that mean for today’s fifteen-year-old girls?