In defense of the sanctimonious women's studies set || First feminist blog on the internet

Why I Hate Filling Out Forms

Queen Emily

I hate it, every single time.  Name, sorted.  Then…  clunk.  Sex – M or F.  Sod.

It seems like an easy question, right?  For most people it is.  For me, it should be an easy question.  I live and identify unequivocally as female.   I’m not a genderqueer person for whom the very either/or question is wrong.  So why the rising sense of panic?

The problem is this, my birth certificate says I am male, my gender presentation is female.  They do not match.  Until I can afford expensive genital surgery, I cannot change the marker on my birth certificate.  No matter what I put, in a cissexist world, I am situated as a liar.

 

A small example:  Imagine you went to the hospital, with stroke-like symptoms (it was later found to be “complicated migraines”).  Because you want to actually be treated, you do not out yourself as transsexual.  When the triage nurse filled in the forms, he puts female, and you leave it there.  All is fine, the doctor for once treats you seriously, possibly because of the presence of your mum, aunt and cousin (quick lesson you learn when dealing with doctors while trans: there’s safety in cis scrutiny.  Bring your mum or your partner with you into the examination room). 

Fast forward to a week later, and I’m (sorry, you) at a neurology department to see a specialist to organize an MRI, when one of the reception people comes out to see you and starts screaming that you’re a GODDAMN LIAR because your forms say I’m female but some quirk of the computer system has found your birthdate and surname and pinged up an old treatment from when you were six.  Because of this, they decide that your name isn’t real either, and it takes three trips to different departments with your changed birth certificate (changed in name but not in sex).  In the end, they put a post-it on your file, with your name, your legal bloody name, in quotation marks like it’s a fucking nickname.  And these are the people who are supposed to help you. 

Now imagine what happens in an emergency situation.

Imagine you’re me, six months before this, and you’re young and naïve and full of stupid, figuring that putting M will help them you treat you better (ha!), checking yourself in to see a doctor because you’re struggling to breathe.   And the dude takes one look at your forms and your barely passing self, and refuses to enter the room.  He just stands there at the edge, asking you to holler symptoms at him, and you sit there knowing that if you collapse, this man will pause and debate whether to save you or not.  This is what happens when forms, bodies and cis prejudice collide.

Now imagine what you do in a Customs line when you enter a country.  Imagine you’ve heard from acquaintances who’ve been turned away by the US, or that worst-case-scenario lurking at the back of your head about Homeland Security issuing a memo about “cross-dressed terrorists.”  What do you put then?  What do you wear then?  How do you present?

Imagine how vulnerable you feel.  Driving (what if a cop pulls me over).  At the bank (what if they think I’m trying to scam my own money).  At the doctors.  At school.  At work.  At anywhere they want a piece of ID, anywhere they want you to tick a box that divides humanity into two.   Anywhere they want you to fill out a form.  Confess, little tranny girl, confess.  Tell them what in their minds what you “really” are.  Or else.  And they’ll get you anyway.

Because it’s not likely to be a problem for most of y’all, this is something that I’d wager the average cissexual person has rarely to never thought about.  That tiny little box is the epicenter of governmental interest, of laws, of bureaucratic guidelines.  Lawsuits are fought over the right to change the letter in that little box. 

This year, the State of Illinois refused to allow two trans women who’d had gender confirmation surgery in Thailand the right to change their documents, because it didn’t occur in the US.  Last year, in Australia, one state refused to let two trans men change theirs because they hadn’t been sterilized (no more Thomas Beatties for us please!).  This little box is a political battleground, one that we trans people are fighting on for the right to not be outed at every single crucial moment of our lives.  In essence, to have our identifications treated as real, as worthy of respect as yours. 

For those of you who “don’t believe in gender” (as I’ve heard some feminists say) – I’ve got news for you.  Sex and gender are always with us, on every form, every piece of ID.  And every confrontation where someone scrutinizes your ID is one where they measure your gender presentation against your legal sex, to check to see if they match.  So sure, you can not believe in gender, and maybe if you clap your hands real hard, it’ll disappear, but I fear it will be with us for some time. 

*note  It’s sad that I need to do this, but after my first thread..  This post is not an excuse to ask any random question related to transsexuality that’s currently bothering you.  Any such posts will be edited to say “I am a panda.”

111 thoughts on Why I Hate Filling Out Forms

  1. A quick question for you, Queen Emily; do you see these boxes as having a use (if so, in what situation are they useful? in what situations aren’t they?)

    If they are useful (this is a longer question…) what do we do about making them more non-cis applicable? Because trans individuals will always face this problem whilst the cis dichotomy is applied, so what do we do to alter that cis-centric advantage, the unspoken cis privilege involved in the dualism of ticky-boxes?

    If they aren’t useful… how do we get them redacted, removed, stripped from forms?

  2. I was wondering the same thing. What do you see as a solution? Having MtF and FtM boxes would require you to out yourself. You identify and live as female so would a solution be to make it easier to change birth certificates? It doesn’t seem fair to require genital surgery. Perhaps an “other” option on forms would give trans people the choice of whether to out themselves on forms?

  3. this is something that I’d wager the average cissexual person has rarely to never thought about.

    You’re right, I can’t remember ever thinking about it. [going back to check my priviledge at the door]

    And the dude takes one look at your forms and your barely passing self, and refuses to enter the room. He just stands there at the edge, asking you to holler symptoms at him, and you sit there knowing that if you collapse, this man will pause and debate whether to save you or not.

    O my dogs, I’m so sorry! To have to struggle with this issue when you’re not having a medical emergency is bad enough, but when you’re having trouble breathing? And from someone who is supposed to be a healer. I’m just so sorry.

  4. Daniel, I’m not Queen Emily and I’m not trans, but other than in very particular medical situations where that information is pertinent, in which case the doctor needs to stop being an asshole and just treat the person who needs treatment, I can’t think of any reason why anyone would need to know what anyone else’s born gender is. Even in the cases of identification, like at customs or on a driver’s license or whatever, there are plenty of other things that can be used in a description (height, eye color, whatever) that male or female don’t need to come into play.

    As to what to do about it, though, I don’t really know.

  5. Huh, I think the Feministe server has eted my response.

    I don’t think that most of the time, it really serves much of a purpose. Given that most ID has a photo, it’s not actually very useful to divide humanity into two groups. You can add an ‘other’ I spose, or maybe just make the question optional. But that’s not a legal category, so there’s limited usefulness for it.

    Lyndsay, that’s the best solution for binary ID trans peoplerig ht now (though I know some activists who don’t binary ID are lobbying in places for a third category). Make birth certificate change not conditional on surgery. I’ll sign a declaration in front of anyone they want that I’ve lived as a woman for years, and have no intention of going back or going off hormones…

  6. Personally, I think the government has no need to know your sex or gender. They have your name & your picture on your main ID and that’s good enough.
    Yeah, sure your doctors need to know your sex. But sex is a whole lot more complicated than just “male” and “female”. So is makes more sense to be more specific about what organs/parts you actually have & don’t have.

    Having “male, female, & other” or “male, female, ftm, & mtf” don’t work. “Other” ungenders many of us (like if I saw that I’d choose male because I’m a guy, not an ‘other’). Having mtf/ftm erroneously assumes that trans* men aren’t male & trans* women aren’t female.
    If a group wants to know what the genders of it’s members are, then a blank space is much better.

    (lets hope the server lets this through!)

  7. It would definitely be better if we made it easier for trans folk to get their documents changed to match who they are. But that still doesn’t apply to folks who don’t identify as either male or female (whether they’re cis or trans), people who would rather say “neither” or “both” or anything else when presented with that check box…

    so we should address the documentation issues for its own sake, but it wouldn’t be the whole solution here.

  8. @Drakyn Yeah, well I don’t like MtF or FtM as a term anyway. I don’t consider myself to have been male before, so.

    It probably says something about me that I’m worried about how that would function as a different way to manage trans populations, anyway.

    @Amandaw Yes, absolutely. People who identify as third genders definitely need that option. This year a report from a Federal Human Right commission in Australia recommended that very option, to much disgust and transphobic joking (especially from conservative quarters). So it’d take quite a push to get that anywhere, I suspect.

  9. and queen em… alls I can say is, fuck, we really fucked things up for you guys, didn’t we?

    all the shit everyone has to go through to get medical care is bad enough already. but I get to go through it with cis privilege. and knowing that the few times I’ve been treated really well by medical professionals, I might not have at *all* w/o that privilege — ugh. I don’t know. I know how exhausted I get when it’s nothing but red tape and roadblocks and you never actually get close to actually recieving care. At least I get a break from that once in awhile. A lot of people never do.

  10. I feel the same way Em; about the dislike of ftm/mtf, never actually being [assigned sex], & how it would get used against us. -__-

  11. Thanks QE for posting this. Regarding your last paragraph (not counting the one beginning with an asterisk): I think feminists who say these kinds of things (that they don’t believe in gender) are making a mistake between “is” and “ought.” I am a philosophy student, and in philosophy there is a lot of discussion about the is/ought distinction. Nevertheless, this distinction is confused all over the place (even within philosophy).

    For example, I don’t believe in sex/gender, in the sense that I think it ought not structure society in the ways that it does (which, I think, your pointing out in this post). Nevertheless, I do believe in sex/gender in that I think you are right it DOES structure society in many, many ways.

    Of course, this raises other OUGHT questions, like what role (if any) should sex/gender play in structuring society?

  12. So my comment never seemed to have posted but, basically, I said thank you a lot for this post – it really opened my eyes to something that probably would have never occurred to me otherwise and has helped me to better define WHY I consider it important to be an ally to the trans movement in a more concrete manner.

    I’ve e-mailed my supervisor at work and will be scheduling a meeting asap to see if I can convince the library I work at to change our forms as an example for the college – though I’m not quite sure what the best thing to suggest we change it to should be? I doubt they’ll be on board with doing away entirely with the field on our new patron etc. forms so maybe just a blank line? (I’m sorry if this is a derail, I think what I really am asking is what SHOULD be on the forms to make them more inclusive, so I can go about the business of making them appear that way in my corner of influence – I’d rather get advice from someone familiar with/effected by the current forms than to make presumptions.)

  13. Great post.

    I’m always amazed how many forms include this little box (and online ones make it mandatory) when it’s quite irrelevant to the point of the form – which may be, for example, to sign up to a newsletter, or buy a book, or whatever. It seems to be a default question – in a way that equally irrelevant matters such as eye colour or handedness are not. If only there were some institute of form design, that we could lobby them!

    A lot of forms further confuse the issue by asking for ‘Gender’ rather than ‘Sex’ – except that you often suspect it’s just a euphemism, and they mean Sex really. Then you get into an even worse mess trying to second-guess what the people want to know, and how that matches up with what you can honestly say, and what consequences that exposes you to.

  14. Even in the cases of identification, like at customs or on a driver’s license or whatever, there are plenty of other things that can be used in a description (height, eye color, whatever) that male or female don’t need to come into play.

    *delurking* (Hi Yall!)

    Not only that, but you know, my DL still has the same identifying info on it that I filled in when I got my learner’s permit at 15, half a lifetime ago. The weight is 30 pounds off, the height is a blatant lie, and my hair has changed color all on its own. Nobody cares. If anything, I might get a sly comment from an occasional bouncer. Which I would just roll my eyes at and move on.

    Which hits on my first thought at reading this – even if it weren’t actually a very literal and pragmatic thing to fear, just having to carry it around as a complex or psychological baggage or whatever is awful enough. To have to worry every. single. time. Even if every doctor and nurse and customs official and cop are super awesome kick-ass trans allies. You still have to worry, because someday you might run into one who isn’t.

  15. I *hate* this shit, and I present pretty much how my bits say I “should.” Such classifications make as much sense as dividing the world into attached and detached lobes.

  16. I think (at least in nz where i live) that a lot of the questions about gender are for statistical purposes. The information on who is using the services from what bits of society is important, but doesn’t necessarily need to be done in that form. What if sometime while you’re waiting for an x-ray or whatever (always so much waiting at hospitals) they hand you a little survey? Not when you’re signing in or need immediate help. In a situation like that it seems to take a lot of stress out of the situation (maybe? i’m cis, so don’t have much of a prob with it) and in this context it seems easier to add other options.
    Not sure what to do about the prob with a doctor looking at your medical history and finding you were born as the other sex though. Except training doctors to deal with such situations and be accepting.

  17. It frightens me to think of things like this happening to people all the time… The unfairness of it makes me want to bite something.

    I can understand, though, the need to ask (seemingly) simple questions like that for several reasons. Your sex certainly can be medically important, and in any setting, it’s an identifying feature that helps, say, a retail employee spot a stolen credit card.

  18. For the people who are offering reasons “why” —
    I don’t think the issue is just that Emily doesn’t understand the reasons why things are the way they are.

    And it can come off as a refutation, often. “This is why it’s done. So don’t worry about it any more”

    For sure, medical information is needed. That kind of situation will get sticky, and I’m sure Emily and others will let you know how they think things could be structured more fairly.

    For other purposes, for the most part, trans folks’ right to participate in society without additional obstacle should override considerations like statistic collection and inertia (everyone asks it so everyone else does it automatically). Statistics are useful, but not so useful that it justifies a barrier to trans folk, and an additional dig to them at that — “here’s a reminder that nobody REALLY thinks of you as just like everyone else.”

    Understanding “why” is important, surely, so that we can figure out how to make it better. But sometimes just offering a reason why comes off as justification. And that’s just not good enough.

  19. I already feel anxious about feeling out forms, and can only imagine the amount of fear of making the wrong choice. It sounds like you’re damned if you do or don’t. Other than changing society’s views, I understand there’s little to be done aside from removing the m/f question.

    In your experience has there been any necessity for that question in your healthcare? Do you feel like there’s an additional worry that if you don’t put your born sex you may not get proper healthcare advice or is that not generally the case?

    -this is just a side note, but it’s that some feminists don’t believe in an “innate gender” not gender in general, which they believe is a social construct. I understand you being opposed to that view, but misinformation about certain feminist views on a feminist site seems like it should be corrected imo.

  20. The last time I checked into my university’s clinic for a checkup, I noticed that they had changed the form to include trans identified people, asking for biological sex as well as gender presentation and by which pronoun the individual would like to be identified.

    I even took a photo with my cellphone, but I don’t know how to get those on the internet.

    Anyway, even as a cis person, I’ve always hated those either/or forms. It’s never seemed right to me.

  21. Pingback: Femmostroppo Reader - July 2, 2009 — Hoyden About Town

  22. I’ve done some volunteer work with Planned Parenthood in Portland, OR. On the forms patients fill out, they ask for your legal name, preferred name, sex at birth, and preferred pronoun.

    This seems reasonable to me in a medical context, especially for reproductive health issues.

    As far as birth certificates, drivers licenses, passports, etc, these are all legal documents, not medical documents. I see no reason why a persons sex needs to be there in the first place. A persons body and body history are none of the governments business.

  23. Thanks for this.

    This is one of those experiences that is so pervasive for trans folks that we (at least I) don’t think to mention it. Everybody knows that’s part of living in this world trans, right? Wrong. Not everybody knows.

    It’s nice to have it said so well and nice to have people respond like it’s as disgusting as it is.

  24. I’ve done some volunteer work with Planned Parenthood in Portland, OR. On the forms patients fill out, they ask for your legal name, preferred name, sex at birth, and preferred pronoun.

    sex at birth is not simple for intersex folks.

  25. Well, no Voz, it isn’t–

    But I’m not sure how that option could be solved unless we put “intersex” as an option to circle. Otherwise we are left with the problematic “Other.”

  26. The M/F boxes on forms bother me as well. I’m a transguy who managed (due to a sweet woman at the DMV and a state that doesn’t seem to care too much) to get a driver’s license with an M on it a few years back, and that’s eased my mind a bit in terms of traffic stops and things like being carded at bars.

    But my health insurance still has me listed as female, because I will probably have a hysterectomy in the next few years and I don’t think there’s any way I can manage that if my medical records say “male” on them. I don’t really know how I’ll approach it the way things stand now, but it’s not something I’m planning on doing really soon and I’ve honestly just pushed it to the back of my mind.
    I do worry every time I see a new doctor, though; my regular doctor also oversees my hormone treatments and is wonderful, but I’ve had to see some specialists lately for some wrist pain that no one can diagnose and it’s made me fairly nervous every time.
    I don’t have the horror stories that Emily’s mentioned in her post, but the fear of harassment or worse is always in my mind, whether I’m at a doctor’s office, in an unfamiliar town, in a public restroom, etc.

    (as a side note, Emily, it’s great to see you posting here.)

  27. “The last time I checked into my university’s clinic for a checkup, I noticed that they had changed the form to include trans identified people, asking for biological sex as well as gender presentation and by which pronoun the individual would like to be identified.”

    Still seems a bit confusing for me at least I have normal hormone levels so thats pretty biological and impacts my health but I also unfortunately have genitals which are considered biologicaly male which have other health impacts. And then I identify and present as female.

  29. It is my hope that some day every state in the US will allow trans folks to change the sex on their official documents to conform with their gender identity. In my (backasswards) state, as of my last check, they will let trans people legally change their names but not rectify their sex. I have trouble comprehending the kind of privilege and bigotry that extend to actively endangering the health (mental and physical) of trans people.

  30. Voz, if I remember correctly, the forms I describing provided a write in that one could easily use for that purpose.

    I respond because I am also in Portland, Oregon, so we’re probably talking about the same paperwork.

    I thought it was pretty progressive, anyway.

  31. Nicole, sorry, it actually said sex at birth, not biological sex. That was my mistake.

    See pianodreamer’s comment as we are in the same city.

  33. @cola At birth, I had no sex. But some old guy in OB/GYN drag thinking about a nice afternoon on the links tried to give me one..and it was a lil harder than anticipated. I was born me, not male or female. Society backed him up with the weight of the world, and society was wrong.

    SThe phrasing “sex at birth” privileges past over present reality, and is not a likely precursor to good care. It is not medically relevant except in the most abstruse cases, and makes me a target for the cissupremacist staff.

    I see it as essentialistic and regressive, because I have never seen it used differently.

    BTW…the best care came from doctors who never challenged my womanhood, as your “progressive” form does, in fact, outright denies mine entirely.

    I would walk out of a place that did that, and roll the dice with self care.

    Don’t even go there with the “male, female, intersex” crap..I have no patience for reifying the bimodal distribution of “male” and “female” as two cleanly separated naturally existing, static categories, and unsexing and ungendering those with histories describable as “intersex.”

    Any excuse to ungender trans men and trans women seriously needs to die. Now.

  34. When I notified my insurance company of my name change, I got a call back the next day asking if I had the “surgery.” So now my insurance card has a “M,”my driver license has a “F” and my Social Security card has me listed as male.

    My other worry is when I fly down to North Carolina for my nephew’s wedding, so what will happen when I go through security and my ID’s don’t match?

  35. i think the way the forms pianodreamer described sound like a pretty decent way to solve this problem – when the forms are for medical purpose, at least. but i think, instead of the either/or, M/F boxes to check, why not just have a blank to fill in, like there is for your name and birth date? that would solve the problem for intersexed individuals as well, it seems to me.
    however, while i think there should be a way to handle the issue on medical forms (because the organs and hormones in your body affect many different health issues), it should not be required information for identification purposes, like driver’s licenses, etc.

  36. Great post. This really unpacked cis-privilege for me – I appreciate it.

    Also, I had never heard “gender confirmation surgery” to describe that procedure before. And it immediately felt like YES.

    Thank you.

  37. As someone who is just beginning her transition, I am feeling this very acutely at the moment.

    I’ve not yet changed my name, so not been issued with new ID or health care cards. I’m left with lots of uncertainty: what name to write, what honorific to use, how to indicate my gender. On paper forms I have a habit of leaving things unanswered.

    I’m not sure why people who aren’t providing healthcare need to know your sex or gender. I suppose the Government might like to collect statistics on birth sex and gender mix (i.e. via the census). It just seems to me like a question a lot of people ask for no reason (except that it’s what you ask on forms).

    At least drivers licenses and Medicare cards in Australia don’t include your gender/sex. But currently I’m freaking out about having to get an eye test at some point, if I’m not read anyway, the name on my card is going to give it away.

  38. I am very sorry to hear of how you have been treated. It is ridiculous that anyone needs to know your gender (for anything). I can understand medical stuff in regards to hormones and the stuff like that, but not a generic trip to the doctor.

    Several places where I have had to fill out applications, there is usually Male, Female, Other or Undisclosed. The undisclosed is wonderful because anyone can use it for a variety of reasons. Maybe if you can get enough people to petition for places that aren’t too big (like local businesses, hospitals and schools/colleges/universities) for them have an undisclosed checkbox for their sex category.

  40. Hmm, the solution would seem to be not to have tick boxes at all, but rather a text box. I can only think of a good five or so gender IDs immediately of the top of my under-educated head, but it wouldn’t matter if I could think of five thousand. There is no technological or conceptual boundary here. We solve complex categorisation problems all the time on forms and data submissions. Even on user submitted forms. We don’t have just two blood types, after all.

    Essentially, less long winded – there is no logical reason I can think of even on medical forms to insist on an unchanging binary which is medically known to not fit everyone in any case.

    I can think of some reasons the government might need to know someone’s current gender in combination with other factors due to provision of money for various services. I can’t see how it would be valid outside that system: We need to know this so we can help this group achieve better outcomes in health/schooling. Not for policing purposes.

    Unfortunately, we’re still at the state where, government or medical or social, the information is used for policing ‘correct’ behaviour rather than what it should be – providing good service. The fact that there is often a situation where patients must choose between providing incorrect information or being safe is appalling. Essentially, they are having to decide at a vulnerable point which risk to take where.

    (It’s probably derailing, but I feel the rage of incorrect classification whenever I see ‘declare whether you are bisexual or homosexual’ on forms rather than ‘declare infectious disease history’ or what have you. And what on earth does someone who is trans and in heterosexual relationship do at THAT point if their presentation is not considered ‘real’ by the doctor involved? Be accused of lying, I suppose.)

  41. Steampunked, it’s like the author said. There is gender in this world, and it affects so much of our lives, it can’t be ignored. It matters medically, and in terms of government. We can’t just pretend men and women are treated the same, for instance, (let alone those who don’t conform to their perceived sex) and look the other way while one or the other lags behind in any way because of discrimination. And on the other hand, gender is important particularly in this instance because what would be the point of changing your alignment if we pretended there were no difference? Clearly there is, or the kind of dissonance between their bodies and identities many people feel wouldn’t exist.

    Additionally, I found the photograph I took of the form. It only offers male and female for sex at birth, and m/f and other for gender identification. Interestingly, it offers Ze as a preferred pronoun and the space for preferred name. Still, I’m all for a blank space to simply write in that information. I think that would clear up a lot of issues.

  42. I think while more boxes or a fill in might be appropriate for some trans people, I personally wouldn’t choose anything but male.
    And to the man talking about hysterectomy–i’ve heard of men getting them covered even while insured as male.

    Something I want to add to this is that my insurance has refused to pay for necessary, routine blood work (ie CBC) because (as far as I can tell) they know I’m trans and they have an official policy not to pay out for “gender transformation” (i don’t have the plan guide right in front of me but i swear that’s what it said) purposes. Which, because I am transsexual, could include pretty much anything.

  43. Amandaw – But there is a difference between explanation and refutation. Just explaining why isn’t an attempt to excuse it – “That’s why, so you shouldn’t be bothered” – or dismiss it – “That’s why, so get over it.” It’s just “that’s why.” And I don’t think, just from what I’ve read, that anyone in this thread has been trying to excuse the status quo. But asking why can help us identify the reasons and justifications for the status quo, determine which are legitimate and which are bullshit, and fix the problem to accomplish any legitimate goals without othering or creating societal barriers for trans people.

  44. This makes me so angry.

    Healthcare is a human right. Trans people, pwd, poor people, queer people etc., are human. Period.

    I hate that we have to accept anything less than full access to healthcare for everyone. These days, a lot less.

  45. What is it with those boxes? I have seen one set of medical software that had more than one box, though as far as I can remember the options weren’t necessarily ideal.

    I blogged this a while back:

    Question One on the WA Health Department’s tick-a-box Diversity Questionnaire sent out to all employees:

    1. Gender:
    [ ] Male
    [ ] Female

  46. Is there a consensus here about would be a better approach? I having lunch with a dr friend next week and I thought I’d bring it up. It seems to me it would be preferable even at the doctors office to remove it from the form and only ask specific questions if its relevant to the reason the person is at the dr. (I doubt its relevant what sexual organs you’re carrying when you have strep.)

    But others have suggested a line or text box. What would you call the box? Even the box sounds like it forces a person to out themselves for no reason.

  47. That should be “more than two boxes”, obv. It’s frustrating that that little “Edit” link doesn’t seem to do anything.

  49. The ideal solution would obviously be for people to take other people’s word for it that that really is how they identify in terms of gender/sex. Alas, not likely to happen in the near future.

    Next there’s the possibility of human rights legislation forcing people in an official capacity to accept a transperson’s stated identification. Europe, and in particular Britain I know have gone some way towards this. However, the protection is mainly (only?) for those who have had gender confirmation surgery (great term btw) and in practice you can only get that if you perform gender correctly for the identity expressed (i.e. a trans woman can only get surgery if she performs femininity to a satisfactory level, a trans man has to perform masculinity) – I’ve heard more than one account of this type of prejudice in the medical establishment. The law is, at any rate, a most imperfect instrument for changing behaviours like this.

    The most viable option seems to me to press for a “prefer not to say” (or even, “mind your own f**king business, pervert!”) box instead. After all, in real life, most people have to take the socially-presented gender as being indicative of sex anyway, and if you go trying to peek up people’s skirts or down their pants all the time, you get arrested. And as far as I can see, these boxes are the equivalent of doing that!

  50. In the UK you always get the ethnicity question in forms and they go through all the available choices, then at the end you have the I prefer not to say box.

    I would say that little box should also be included where sex or gender is asked with legal protection for those ticking it will not be discriminated against for doing so.

  51. I’m cis, but I wonder whether it might not help to have the Sex/Gender question on documents answered not by check boxes but by a blank space to fill in? So that people could use their best judgment about how much to “explain” if they wanted to explain at all?

    This is a great post — the description of medical environments makes me particularly sad. I want to be a doctor, and I am currently a mental health and women’s health patient; being a patient has informed me about how I want to behave toward patients as a doctor, and getting as much information as possible from patients in other marginalized groups is really awesome and useful to me.

  52. Thank you so much for writing this Queen Emily. It is royally screwed up that our cisprivilege puts this highly unnecessary stress on you. “This little box is a political battleground” I’ll be a foot soldier.

  53. i got another one. SEPTA, Philadelphia, PA’s public transportation system, requires an “M” or “F” sticker on weekly or monthly passes. the agent selling you the pass decides unilaterally which sticker to put on. this is an immediate hazard to trans and genderqueer folks; even those who are mildly gender non-conforming can get screwed. an acquaintance of mine (a trans woman) was *arrested* because a bus driver, convinced that she was “male” (she had an “F” sticker), called the police. other trans people have been ejected from buses and trains.

    SEPTA claims that this bullshit “prevents fraud”. this, despite that all but a few transit systems have rejected the use of gender markers on passes as useless for combating fraud, a waste of money, and violation of city anti-discrimination ordinances which would leave them vulnerable to lawsuits.

    SEPTA has been sued. no change. activists have filed complaints with the city’s human relations commission, who have done nothing despite the fact that the city has gender-identity as a protected class in its anti-discrim ordinances.

    i have gotten into arguments with disrespectful, verbally abusive station agents because of this. because of the risks involved, i no longer buy passes, but use tokens instead; this is a financial hit for me as tokens cost more (per trip) than passes.

    SEPTA is openly and arrogantly flouting city regulations. they need to DIAF.

  54. oh and as an aside, there’s a non-profit in the city that provides health education and social safe-space to trans youth, that has resorted to, shall we say, unconventional methods to obtain a supply of gender stickers so that holders of passes can get the correct stickers onto their passes.

  55. A friend of mine was looking into the Australian Bureau of Statistics’ numbers on gender for an assignment recently, and showed me the emails he’d received back from them. He was politely shifted from person to person, all of whom basically said that the numbers of people who didn’t fit into either M or F (not even considering that ways of identifying this or that one’s identification throughout one’s life could vary) were so small as to be insignificant. Aside from the idea that a person could be ‘insignificant’, this forms a social construction of what is and isn’t worth being. Totally messed up.

  56. …and thank you, Queen Emily, for sharing this with us.
    /me privilege check.
    I’m another who’ll try and act on it where possible.

  57. at the clinic where I worked last year, we saw many patients with a high risk for developing cervical cancer. being able to run the patient database for female patients with risk factors for cervical cancer was something we did regularly.
    So I do think that sex is useful information for a healthcare clinic.
    And there really is no excuse for transphobic behavior among staff- it is a huge barrier to care if a patient cannot comfortable disclose to their doctor information relevent to their care.

  58. Your treatment at the hospital by the doctor was disgusting. I wish I could say “I can’t believe it,” but sadly, I can. About three years ago I started to really be aware of transphobia and I just don’t know how to get the world to change. “Dudes should be less scared” doesn’t cover all of it and isn’t exactly a precise game plan anyway. I hope that over the years, as individuals get exposed to people not like themselves – in regards to race, gender orientation, class, etc. – that more of them react by accepting than by fearing.

    That being said, I read an article just this morning about racial profiling among French police. Since France doesn’t require any reports to note race, there is no way to track racial profiling, so the people who were investigating had to stake out a public area and track who the police pulled out of the crowd and so on.

    I think the M and F boxes are there to make sure that an appropriate level of service is given to everyone. Well, that’s probably second behind the medical reasons, like, “giving this medicine to a pregnant woman is really, really bad, so we have to triple check her pregnancy status first” or “this condition affects men 90% of the time, and putting the M in the box might remind Dr. House that it could come up.”

    Of course, not every doctor is Dr. House. Most medical emergencies are horses, not zebras. But I think that the box is at least partially there to help with medical care.

    In that case, I would hope that in a future where transfolk are accepted all the time, their medical needs can be met without prejudicing their care. If the treatment options are different depending on born gender, I would hope that there was a checkbox for that, because transpeople deserve the best care based on who they are, from the beginnings of their lives through the ends.

    Oh, I hope I’m not making a botch of this. I just mean that in the second scenario above, where Dr. House knows that the illness never affects women, he can see the box on the form that says “born presenting male” and know that this person’s arteries might still qualify for the disease, even if the person’s body and soul do not.

    Like I said, I hope that becomes the case some day. From what I’ve read and the transfolk I’ve known it will be hard to acknowledge “born presenting male” if every fiber of your being is screaming, “I am a woman.” But I hope that the future holds less terror and less screaming, because there’s more acceptance to be found there too.

  59. ” all of whom basically said that the numbers of people who didn’t fit into either M or F (not even considering that ways of identifying this or that one’s identification throughout one’s life could vary) were so small as to be insignificant. “

    What on earth? Even if you _only_ looked at people with intersex conditions and omitted trans people altogether (which would of course be a ridiculous way to do things), that’s around 1% of the population. Some of whom might identify as one of a binary, and some of whom might not. Especially given a chance.

    The census quite happily separates out, counts, and publishes data on, for example, religions in the 0.3-0.4% range (Churches of Christ, Salvation Army, Jehovah’s Witnesses, Judaism) without anyone suggesting that they’re “insignificant”. They’ve got a whole freakin’ webpage on the Jedi.

  60. “Oh, I hope I’m not making a botch of this.”

    Wellll… only in that using “Dr House” as an exemplar as Superdoc for Non-Cis-or-Binary-Folk isn’t necessarily the greatest way of doing things, since House has committed absolutely massive intersex fail in the past. He’d be a great example of a doctor who would be 100% unsafe to trust.

  61. at the clinic where I worked last year, we saw many patients with a high risk for developing cervical cancer. being able to run the patient database for female patients with risk factors for cervical cancer was something we did regularly.”

    But isn’t the pint of this that not everyone who ticks the “F” box will have a cervix? And not everyone who ticks the “M” box *won’t* have a cervix? I’m not cool with forcing people to ungender themselves for medical care. If the issue is with individual organs, than maybe we should have “cervix y/n” and “prostate y/n” or something instead. (Okay, probably not.)

    Even a logistical solution to the ticky box problem is meaningless if the cissexist and transphobic attitudes behind them are still entrenched. The boxes (or even blanks) are like ammunition for these awful ‘tudes. Trans people are accused of deception in all kinds of stupid contradictory ways, but their honesty gets used as a death sentence anyway. Hell, even “I prefer not to say” probably gets coded as “not cis!!! run away!!”. The whole question is a trap.

    Thank you for the post, Queen Emily.

  62. Wait, I said a logistical solution would be “meaningless” and I want to retract that because I just realized that a seeing a fair and inclusive question in the subject might really mean a lot to someone, and it’s not my place to say otherwise. Sorry for that.

  63. Well, I’m glad to see we haven’t had anything so spectcularly stupid I’ve had to panda someone up a notch.

    Couple things:

    For the people suggesting it might help health care to have “assigned male” somewhere on a form, reading my examples (and I have more, oh so many more) does it sound like my giving over that information *helped*? Like I said, I shared that particular idea early on, and then I realised that’s the kind of thinking that could get me killed. That might sound like hyperbole, but I can’t afford to have that kind of magical trust in doctors.*

    Similarly, statistics seem a particularly weak and abstract reason (excuse?)when you’re talking the kind of vulnerability I’m suggesting here. It doesn’t explain the kind of governmental effort being put in to enforce these categories. When you have an Attorney General baldly stating stating “the ability to bear children is plainly not male” (click on the link about trans men in Western Australia) then it’s clear there’s more going on there than just messing up their stats.

    It’s not just this happy neo-liberal realm where people haven’t been properly serviced by accident, there is real power being asserted here–and I’d wager that WA said out loud what the vast majority of states in Australia and indeed over here in the US are thinking.

    * aside: House is a bad example anyway, since despite the throwing-the-medical-dictionary-around feel of it, it’s essentially a normative morality play. House’s detective work maps people’s hidden (or not so hidden) ideological characteristics onto a disease. I like the show, but it does get on my tits sometimes.

  65. male is not an absolute state, not is female. The real power used in defining us by birth assignment, which is arbitrary, doesn’t just attack our identities.

    It demonstrably denies us decent medical care, no matter how “hip” the provider.

  66. slightly O/T–

    I’ve had to stop watching House. The insane way the show deals with pain management and disability just frustrated me far too much.

    He manages to offend all other groups equally regardless of orientation or race, but the real ‘morality’ I see in the show is the drama around his “addiction.”

    /offtopic rant here.

  67. I do like the idea of allowing people to fill in a blank for sex at birth and gender presentation.

    the only potential problem I see with it, is that it would make it more difficult for people with language barriers to fill out the paperwork.

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  69. Trans history is absolutely relevant to health care. Ten years of testosterone pumping around in here did some things. Fine. Not arguing that.

    But, you know… being on the Atkin’s diet is something that is relevant to your health care. Snorting cocaine is something that is relevant to your health care. Living with cats is something that is relevant to your health care. HOWEVER, disclosing them is not a necessary condition for your treatment, and if your doctor discovered them in the course of your examination, he probably wouldn’t call you a liar or refuse to treat you.

    I tell almost everyone that I’m trans. There are a couple of reasons for this… one, I believe that trans visibility is necessary for a change in public perception (I do not want The Maury Show to be the only source from which people “learn” about trans people), and two, I’m fucking stupid. I am dumber than a motherfucking brick. I get burned SO MUCH by disclosing. And I keep doing it. My partner gets burned by disclosing that she’s intimate with a trans person. She does that anyway. There is a cost, and it should be a personal choice for everyone whether they pay it.

    Expecting disclosure on every piece of paper a person comes in contact with is something that society really needs to get the fuck over.

    GG@54, SEPTA should fucking burn. Good on the local organization for finding a way to mitigate the bullshit (at least for people who ID within the binary), but I really hope that someone in local government is sensitive to trans concerns and trying to fight it.

  70. Yep… there are a billion and one things that might be vital to providing you proper care, which aren’t asked as a matter of routine, and you don’t HAVE to disclose. And either way, the doctor should be prepared for any of those billion and one things. THAT’S THE DOCTOR’S FUCKING JOB. To balance all the INDIVIDUAL considerations in a person’s body, mind, history, present, and guide them toward better health.

    I’m never bothered about the fact that I don’t know half of my family medical history, because I don’t have a dad. That is some important shit. But I just write “unknown” and nobody gives it a second thought. They accept that fact and figure things out anyway.

    And that’s something that IS on the forms. How many things that are never asked on forms are still completely relevant to a person’s care?

    I just don’t buy “but they NEED to know” … it might be relevant it might not, but it seems like just because it’s status quo, people assume that there must be a rational explanation and anyone challenging just doesn’t understand that.

  71. Oh, I meant to say. For all the people asking about how to fix things, my first question is, can you get rid of it altogether? What purpose does it serve? Is it worth potentially hurting trans people to achieve that?

    eg to use GG’s example, why on earth does a bus pass require a marker?

    If there is (which I doubt there is, but accept that there’s going to be resistance), I suggest for medical forms that “assigned sex at birth” is a better option than the loaded “biological”….

  72. If we are trying to avoid use of passes by people who do not own them, it would seem MUCH more logical to simply add a photo than to use a gender assignment.

    As far as the medical forms, what about including on the “history” questionaire something like “have you undergone gender confirmations surgery” and leave off the m/f at the beginning?

  73. chava, that question already implicitly exists on most questionnaires, since most doctors want to know about any major surgery you’ve had.

  74. Ah–I always forget to flip them over and fill that part out, hence I’ve never seen it… *wonders what other important info might be back there*

    Well then, there really isn’t a need for the gender blank at all, is there?

  75. I’ve also stopped watching House. That and CSI. I started watching them because I like smart unusual people, but I got sick of the people who didn’t fit societal norms being guilty all the time for everything. Two babies at risk? Lesbians’ baby dies. Older woman in a bar? Gets beat up, but really, what was she doing there in the first place.

    Ug.

    So I apologize for using House in my earlier comment. I just meant to use him as shorthand for “Doctor who specializes in weird afflictions that might have enough of a gender disparity to warrant knowing current presentation vs. gender assigned at birth.”

    With medicine these days so much is about not being sued, or having you fill out so many forms that something contradicts something you said, which results in them denying you care/coverage/etc.

  76. wow. Thank you for posting this. I’ve been confused on some previous posts talking about the difficulty of transmen and transwomen of getting medical care… it never computed. I never imagined there existed doctors that would refuse to enter the room of someone with respiratory distress because they were trans.

    I didn’t know there were such idiots out there. Chalk up another chink of my “young and naive” beginning knocked out by reality…

    I’ve never liked checking the “male female” box, mostly because I think it’s none of their business 99.999% of the time… but I don’t have that confusion of trying to find the “right” answer to satisfy your critics… We should get rid of that box.

  78. Re: I’ve done some volunteer work with Planned Parenthood in Portland, OR. On the forms patients fill out, they ask for your legal name, preferred name, sex at birth, and preferred pronoun.

    This seems reasonable to me in a medical context, especially for reproductive health issues.

    That seems like the best option to me. And “intersex” should be an option for any “sex” question.

  79. Anyone who claims they “don’t believe in gender” is making a category error. It may be a broken category, but it exists. It’s as if an atheist said they didn’t believe in religion. Religion manifestly exists: there are churches and synagogues and temples and so on, there are prayers and icons and statues, there are people who will honestly tell you want they believe. That’s where gender is in our society.

  80. claire@70 – i think that palm trees will grow at the south pole before any government agency in this mess of a city will grow a spine and actually enforce the anti-discrimination ordinance.

  81. [edit] I am a panda

    [Emily: trans people can’t even bloody describe oppression without solving a systemic wide problem? You panda]

  82. Wow, I never really thought about how little things like that can affect people. Thanks for sharing this with us.

    Can I claim to be a panda anyway? I like pandas.

  83. Personally, I’d prefer it goes off altogether. Passport. medicare card, driver’s license, whatever else – none of their business. If he or she needs to know, he or she is going to ask.

    Wether I’m 25 or 50 I’m at risk for cardiac arrest, so it shouldn’t be just “ruled out” the way docs seem to take plain fun at “ruling out” intersex because I have a penis bigger than a micropenis (3 inch erect when adult or less). They do no tests whatsoever, they just say so and suddenly its the truth.

  84. You have my sincere sympathetic frustration. I hate it when officialdom puts me in a no-win situation, and for you, that situation could affect your health, finances, even your very existence and life.

    This piece is already making me ponder, thank your for writing it.

  85. I don’t think that disclosure of trans status on forms should ever be required – and I think that applies to everywhere.

    I’m bothered by the number of people who seem to feel it’s okay to demand that trans people out ourselves on medical forms. Being trans is between me, my GP, my endocrinologist, my surgeon, and my therapist. It doesn’t need to be on every form I fill out if I’m trying to get medical care, and in a lot of cases, “sex assigned at birth” is simply not relevant.

  86. And from personal experience, I’ve had one dentist deny me care because “he didn’t know how novacaine would interact with estrogen.” And I’ve lost track of the number of ER trips where care was delayed by someone wanting to have a trans 101 dialogue once they found out I was trans.

    And that’s on top of the plain old sexist bs I get when I’ve been asked on several occasions in the ER whether I’m pregnant, and then the ensuing argument over whether I can possibly know if I’m pregnant or not, until I either disclose that I’m lesbian or trans out of pure frustration.

  87. Disclosing the sex I was coercively assigned at birth has nearly killed me several times, and, the fact remains, at this point, when hormones and genital anatomy are relevant, I’m not going to be like the majority of people assigned that sex at birth at all.

    Like Queen Emily, I have complicated migraines (in my case, hemiplegic migraines with other features, that look like a stroke), as one of several disabilities. When symptoms beyond the typical migraine and aura first came up, I went to the ER. In addition to being constantly insulted by the staff once I admitted to being on hormones on my chart, and them changing many of the records because I was trans (and away from my “legal sex”, so changing that designation is no protection if they find out you’re trans, or you’re honest about it), getting transbashed by doctors, and having an overly rough nurse putting the IV in the arm that was working, even as I requested otherwise, threatened, denied food even though I was there almost twelve hours and told them I had blood sugar issues — surgery was never on the table, and being prevented from leaving even though they did nothing to actually treat me (they finally let me go when I recovered enough to start taking the IV out myself), when the ER’s neurologist came by, he spent about an hour talking about my junk, and doing nothing to treat or diagnose the symptoms I actually had.

    I’m now in PDX, and I’m non-binary ID’d, and Outside/In uses similar forms to Planned Parenthood – they have sex assigned at birth and gender identity. And a space for “ze” and a write in for other pronouns. Of course, they always use my legal, rather than preferred name, and the wrong pronouns, and a doctor there was doctor number six to deny me a prescription for hormones I’ve been on for half a decade, because apparently, as a PWD, I don’t get to have sex hormones in my body — the supposedly “inclusive” forms merely serve to remind us that we are always really what some doctor said we were at birth, no matter how we identify or what we’ve done to our bodies, and that our preferred names and pronouns are there to be ignored.

    I’ll stick to the grey market for hormones, and self-treat illness and when I need help, go to friends who are better herbalists than I am, thank you very much. Given that every time I’ve been in the hospital, it’s been a fight to get who I am recognized, a fight to have any control over my life, I’ve had food withheld, and been threatened when I got angry due to my mental health status.

    Being trans and being mentally diverse are two things my friends are instructed to not disclose if I end up in an ER again (which will only happen if it’s the only way to save my life).

  88. I’m sorry to hear about your troubles anarchafemme. I’ve been relatively lucky in only having to deal with my ignorant family doctor, my endocrinologist who doesn’t know about intersex, a couple ignorant therapists in the past, but nothing more in the ‘official’ functions stuff.

    I haven’t had any other issues needing me to go to ER except going there for suicide ideation in late 2005. I went there in the hope of getting hormones prescribed. When the psychiatrist there refused, I just left (they gave me the option). Frankly, they didn’t help at all, did they have any idea my suicide ideation was over desperation of not being able to get hormones? I’m lucky I found some just 3 months later, or I would have committed suicide.

    What could I possibly gain from being locked up in an hospital where I can’t do anything?

    I go for blood tests regularly, at least once a year. My legal name has yet to be changed. So when I go there, I give the form with all the test stuff, and ask they call Sara on the microphone when my turn comes up. They did it every time except the last. Thankfully my birth name can be either male or female. Last time my family doctor sent me, put my name as my legal one only. My endo at least adds Sara on his file, and on the lab tests. I don’t like depending on hospital staff’s good will to have my right name called though.

  89. I think there are two issues here. Three.

    One: Everyone should have the right to identify their own gender without contradiction – a woman with a trans history shouldn’t have to spend time worrying and wondering if she’s “allowed” to tick “F”, when her identity is female.

    Two: For people who prefer not to tick either M or F, there should be a third box “Other”, and the option of providing more details if required: and form designers should consider if knowing the person’s gender gives any useful information at all.

    Three: All the good forms in the world won’t help when the problem is basic hostility: anyone who is hostile to a trans person really needs their head examined.

    And this (for anyone who cares) is why I am still, itchily, mad at A Certain Liberal NotTooFeminist Blogger who thought it was funny to repeat a transphobic joke her boyfriend told her, and who dismissed all negative reactions to her “joke” as just random hostility that hurt her boyfriend’s feelings. Because the hostility expressed by transphobic jokes is part of the problem – it’s not something random that doesnt really matter, and you can’t make up for it by posting about how people ought to be nicer to the transfolks, as that notquitefeminist blogger did a couple of weeks later: you really have to start by digging out your own transphobic hostility, because you can fix problems caused by poor form design with enough goodwill, but without the goodwill, the best forms in the world won’t fix the problem. And repeating transphobic “jokes” is intrinsically destructive of the kind of goodwill that’s absolutely essential.

  90. passive activism- if i have a low key form with ‘sex: M or F’ i usually draw a line through and write ‘yes please’ or ‘gender: m of f’ becomes ‘is a social construct’

    of course, this only works for things like school forms not government forms where theres no legal ramifications, and i am exercising some cis priviliedge by being able to do this safely. but i tr yto look for oppourtunities where i can DO something with my privilege, and this is just a little one ive found.

  91. Even as a (cis) woman I am often uncomfortable checking a box in a lot of instances, especially on application forms. I have been for many years. When it is possible I check nothing or “prefer not to respond,” just because I know I’ll be treated differently even though my body matches my identity.

    I can’t imagine the way it would be to have that fear and awareness apply to medical care.

  92. This post is awesome. As a cis person, I may never have learned this without you sharing, Queen Em. I feel like I should read this over and over and live with it for awhile.

    It really is easy to miss the crap you have to put up with on a day to day basis that never occurs in my cis-life. It is eye-opening to realize that those little boxes are so ubiquitous (sp?) and for no good reason most of the time.

    Would it be a good thing for cis people to leave those boxes blank or to use jessicaannabelle’s tactic of drawing a line through the question?

    I really want to do something about this. I don’t want you to be hassled by a fucking set of boxes on a stupid form. I want more cis people to think about this and to find ways to combat this nonsense.

    Most of all, I want to thank you for disclosing your experience. It’s really opened my eyes. You are awesome.

  93. I think all forms should be legally mandate to have a M, F, and None of Your Damn Business choice.

  94. Thank you for sharing. As someone who only knows your struggle through friends and reading, I can simply not imagine. I try to add “Other” on forms, under gender/sex as an ally, and show the form makers that there are many people who care who do not themselves identify as trans. I hope there is equality and resolution in your lifetime, and in mine.

  95. This highlights one of the reasons why I had reassignment surgery over a decade ago. (And may your Dear and Fluffy Lord help you if you were unfortunate enough to have been born in a state which won’t issue a new birth certificate [which I wasn’t.]) It’s just a lot simpler legally.

    When I had a physical, I did tell my GP about being a post-op. He thought it advisable to do a prostate check, and said he was going to get a nurse. I asked: “What are you going to tell her; `I need you to assist me while I do a prostate check on the woman in Exam Room 7`?”

    He thought about that for a few seconds and said “good point.” He thought about it a few more seconds and said: “wow, what a deal you get, you get to have a pap smear, a prostate check and a mammogram.”

  98. Even in the cases of identification, like at customs or on a driver’s license or whatever, there are plenty of other things that can be used in a description (height, eye color, whatever) that male or female don’t need to come into play.

    When photo ID drivers licenses were first issued in Australia in the 1970s, they listed full name, address, date of birth, sex, and license number.

    I have no idea why, but two years later they dropped the listing for sex entirely. I can only imagine that some part of the bureaucracy became somehow enlightened. I only wish it was contagious.

    Also, your experience at the hospital sounds appalling. I’m saddened to hear of it, and I hope experiences like yours are relatively rare, but I’m sure I’m being optimistic in that hope.

  99. Unless your medical difficulty is directly involved in your reproductive organisms, I really cannot see why it is legitimate for any doctor to care one way or the other.

    We all have lungs, right? Hearts? Livers? Whatever business is it of theirs about other organs?

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  101. Thank you for writing this!

    I am a “pre-everything” transgender man (in other words, female to male.) I recently had to go to the emergency room for the first time since living as male full time. All my legal documents still have my evil twin on there in all her glory, so I didn’t disclose my transgender status to the ER so I wouldn’t risk not getting treatment. But what if I was already on testosterone, with a full beard and a lower voice? Or what if my name change, which is currently underway, was complete, and they were confused by a masculine name with “F” as a marker?

    I have already had the experience of going to a gynecologist who flipped out on me pretty much after I disclosed my desire to transition. He still hasn’t submitted some much needed info to my insurance, so now the lab running my bloodwork is trying to bill me for things that should be covered. He also didn’t send to my current doctor test results she wanted. This isn’t even transition related tests! Luckily I live in a city where there are more options, and I found a supportive clinic where I haven’t faced this kind of treatment.

  103. Jadey wrote:

    If the issue is with individual organs, than maybe we should have “cervix y/n” and “prostate y/n” or something instead. (Okay, probably not.)

    Why not? In the very specific instance of medical care related to specific organs, why not ask people to just list what they have? For example, the person above who needed prostate check and a cervical smear.

    The other issue is sort of healthcare related: the FDA is still behind the times and against the desire of all major bloodbanking organizations still bans any man who has ever had sex with men from donating blood, and your permanent deferral sticks with you even after the gender confirmation surgery, unfortunately. Not sure how to work that on the forms (#1 is to change FDA’s mind.)

    And other than that, I agree with chucking it entirely off of forms. We’ll have to refigure out how to deal with calculations for Title IX funding and the like (or rework all of those social systems), but that has to be doable somehow.

  104. Pianodreamer @ 68:
    I do like the idea of allowing people to fill in a blank for sex at birth and gender presentation. the only potential problem I see with it, is that it would make it more difficult for people with language barriers to fill out the paperwork.

    I see another problem: gender presentation, like sex, can be fluid, not a binary. What do you do if your gender presentation changes, sometimes on a daily basis? I’m sexed female, so have cis privelige in terms of answering questions about sex on medical and government forms, but am genderqueer. Depending on what I wear, people in the past month alone have read me as:
    – female
    – male
    – “is that a guy or a girl?” (I felt like turning around and saying “yes/no!”, but didn’t really want to run the risk of a problem in the grocery store checkout line).
    – there was one situation where two employees at my gym both simultaneously gendered me differently; one referred to me as she and the other referred to me as he; I didn’t correct either of them, as both and neither of them were correct.

    A blank would force genderqueer people to put down one, unchanging, gender presentation and deny genderqueer people the ability to explore different gender presentations.

    In response to the argument, “but you could just leave the blank unfilled,” then people would just gender me as my sex, and deny me my own genderqueerness. Not only is that unacceptable for me, but it would leave my doctor or other healthcare professionals in the dark about the fact that I’m genderqueer. That might be incredibly relevant to my health issues. Stress affects overall health, as well as definite medical conditions like hypertension. You can bet that you’re going to experience some stress if you’re trying to present–or being read by others as presenting–as some of these things: androgynously gendered, the “opposite” sex from your birth sex, “neither” sex, “both” sexes, no sex, or “all” sexes [God, even these terms are problematic; apologies all round]. I’ve been aiming to present gender presentations such as those, depending on how I feel that day. When I talk with my doctor about the causes of that stress, and possible treatments, I don’t want my gender identity/identities to be invalidated–especially if the stress from those identities is causing the problem. Nor is it acceptable to make my genderqueerness the scapegoat: “well, just stop presenting as genderqueer, because it’s causing you stress” isn’t an option. While presenting as genderqueer causes stress and poses real dangers, it’s relieving other, deeper stresses I’ve had about my own gender and gender roles in general, and I find that incredibly valuable and freeing, enough to risk the social and possible physical dangers).

    Another argument is “what difference does it make what your presentation is on any given day? Put ‘genderqueer’ in the blank and female in the sex box.” This would probably be what I would do given the form, but I feel like it’s the best of a set of bad options. If I come in presenting as androgynous one day, and male another day, and female another day, my doctor and all the staff would at least know they might haeve to recalibrate their expectations of my presentation each time–in that sense, it’s probably better than the form which I currently have to fill out at my doctor’s–but what would that process look like?
    – When nurses call my very feminine name so that I can go in to see the doctor, they’re not expecting to see someone who presents as male or something else entirely stand up. Would they call me on it? Would I have to argue for my gender presentation in front of 20 other patients?
    – Would I be denied care until my health insurance provider confirmed my sex and other ID details? Would my HMO add some kind of damning note to my file? Would I be denied care, period, because my HMO was convinced I was scamming?
    – How much time would it take out of the appointment time carved out of my workday? How much time would it take out of the HMO-allocated 15-minute doctor visit, time that could be better spent giving me healthcare?
    – Would my doctor avoid me because I make them uncomfortable, or become obsessed with my gender presentation while giving me healthcare, or give me a lecture, forcing me to switch to a less medically competent doctor so that I might have a socially competent one?
    – This is the situation where I live now, which is a very socially permissive, gay- and gender-variant friendly area. What happens if, God forbid, I need or want to move?

    I am very tempted to go to my next OB/GYN checkup dressed androgynously, because it would make me less stressed about the medical problems I have surrounding my reproductive system–and a more proactive patient, better able to take care of my own health and listen to my doctor’s medical suggestions for those problems–if I had a genderqueer presentation during the appointment, because I would feel less like my body’s sex was the sole definer, or indeed any definer, of my mental gender. I think this is especially valuable during an uncomfortable and necessarily invasive procedure into my genitals and sex life. Unfortunately, I also think that what is valuable for me might freak out my doctor. Unsure of what’s the best course.

    Thanks for a valuable post, Queen E.

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  107. I am a transman, and have had my share of run-ins with the medical community. I found a nice doctor very recently who doesn’t care whether my name is legally one thing and my preferred name another, it’s on my file as both, and my gender identity and my sex don’t have any bearing on my medical treatment. My ear infections (surprise!) are not affected by my testosterone levels. I have had bad doctors who spend more time concerned over my gender identity than over my specific complaint that day, but I generally have been able to find someone in whatever town I am in who is willing to give me respectful medical treatment without odd questions. I do often get weird looks when I need to visit a doctor for “woman” things, like an OB/GYN, generally I mostly get looks from people in waiting rooms not so much from doctors.

    and not to say that life in the medical community is totally peachy where I’m at, I face more discrimination in Emergency rooms than anywhere else, which is the worst I think. As, if I am in an emergency room I generally am having some sort of dire medical emergency, and my gender should have nothing to do with severe shoulder pain, or whatever.

  108. I’m hesitant here because I’m really just starting to examine my cis privilege — and I know I have some transphobia to confront internally — but I want to thank you for your writing. It is helping me understand how I need to alter my thinking and actions.

    Travis, when you wrote this: “I do often get weird looks when I need to visit a doctor for “woman” things, like an OB/GYN, generally I mostly get looks from people in waiting rooms not so much from doctors.”

    My ob/gyn practice added a male doctor somewhat recently, and I saw him when my regular doctor wasn’t available, and he was okay, but if having him in the practice makes it easier for men and women to show up in the office and be seen, I’m all for it.

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  110. How about side-by-side boxes for sex and gender? Verified non-matching answers would be the signifier for insurance workers (e.g. yours truly) and medical reviewers to understand why a patient might rightly have prostate trouble AND gyn exams. Intersex patients have had similar problems, and awareness of their challenges is growing, too.

    And to anyone who has been mistreated or marginalized or otherwise let down in the insurance/medical process, that is really rotten, and I’m sorry. I do hope that you are not hurt by the actual confusion it causes (foul behavior yes; confusion, hopefully not.)

    I know it’s one more negative thing to have to deal with, but I hope you know in your heart that sometimes it’s just the same administrative complication shared by people with common names, people who share unusual names, (non-transitioning) girls named Brian and Kevin, men who have breast cancer, people who have routine cosmetic procedures done as a matter of medical necessity (blepharoplasty, etc.) — lots of people have to go through the claim confusion, chaos, and vindication process. Admins are not clairvoyant, and a good deal of the time we deal with typos. And fraud. And mistaken identity. And identity theft.

    I’m not saying there isn’t far, far too much inexcusably bad behavior; only that it’s not always a personal attack. Even in a perfect world, there would still be certain kinds of confusion, and I hope folks don’t let the broader administrative issues get them down.

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