Let's Talk Gender
Trans rights are human rights.
In my latest TV recap post, I mentioned being very busy offline, and I received a request to describe some of it.
President Trump has released an onslaught of hatred masquerading as Executive Orders and new American policy. The federal funding debacle, the plot to defund scientific research and higher education, the mass deportation plan, and the anti-DEIA crusade all directly affect my career and my community. But I am best informed to speak on the anti-trans agenda. I have personally navigated the healthcare system to get gender affirming care for a minor, and I have studied and written about psychology and feminism for many years.
Since my main beat is tearing my hair out over SVU and it’s possible some readers are not well-informed about transgender topics, I am starting with a beginner’s guide. If you are well-informed, you may skip to my personal experience and beliefs.
Trans Rights 101 - The Basics
What is gender identity versus assigned gender?
One’s ‘gender identity’ is how they experience gender. ‘Assigned gender’ is the gender they were assigned at birth. Usually, these genders align, indicating the individual is cisgender. In a small percentage of people, these genders are misaligned, indicating the individual is transgender.
Examples of gender identity are:
transfem or trans woman, a woman who was assigned male at birth
transmasc or trans man, a man who was assigned female at birth
nonbinary, someone whose gender identity is not exclusively male or female
genderfluid, someone whose gender is mutable
What is gender dysphoria?
Gender dysphoria describes a feeling of emotional distress when one’s gender identity does not align with their assigned gender. Not all transgender people experience gender dysphoria.
Is gender dysphoria a mental illness?
Gender dysphoria is listed in the Diagnostic and Statistical Manual of Mental Illnesses, or DSM-5 (link). See below for my thoughts.
What is social transition?
The framework for social transition is personal. It can include using a new name, using preferred pronouns, changing one's appearance with a haircut, makeup, and/or choice of clothing, or coming out to friends and family, at school, or at work. Social transition is separate from medical and legal transition. Some transgender individuals socially transition in some spaces and not others.
What is medical transition or transgender healthcare?
Again, the exact framework of one’s medical transition is personal. Examples of transgender healthcare include puberty blockers, hormone therapy, and surgery. Transgender healthcare providers include endocrinologists, plastic surgeons, and their staff. Primary physicians, including pediatricians, are usually part of a transgender patient’s healthcare team, and mental healthcare is often an important component of care. Lab technicians and pharmacists are also a part of transgender healthcare.
What is legal transition?
Legally transitioning includes updating gender markers on state and federal documentation and legal name changes. As with social and medical transition, the extent of a legal transition is personal.
Trans Rights 201: Myths
The paradox of Personal Choice
I say above that the parameters of social, medical, and legal transition are directed by personal choice. However, personal choice is confounded when the government regulates transition. Currently, the executive office of the United States, as well as many state and local politicians, are attempting to ban and eliminate all versions of transition: social, medical, and legal.
The system is not broken; it is working exactly as intended: to support and uplift the norm. That norm is white cis men who own property, and anyone who does not attempt to assimilate to it is deemed a threat.
Gender dysphoria is a mental disorder, and gender-affirming care is pharmaceutical and surgical mutilation.
No. Gender dysphoria is a symptom. Yes, I disagree with the DSM-5 on this issue. I also think psychiatry should be focused on addressing symptoms rather than diagnosing disorders. But insurance can’t bill for symptoms, so we are stuck in diagnosis hell.
However, regardless of whether gender dysphoria is a symptom or an illness, gender-affirming care is the treatment.
Puberty blockers and gender affirming hormone therapy (GAHT) are safe, effective, and reversible. Puberty blockers are prescribed to cisgender children regularly with no outcry. More breast augmentations (“boob jobs” which are also gender affirming care) than mastectomies (“top surgeries”) are performed on minors.
Trans men are just tomboys! Trans women are just sissies!
Gender dysphoria has been described as a feeling of being “born into the wrong body”. I hate this because it suggests the existence of a “right body.” Bodies come in all shapes and sizes and abilities, and they are all valid and deserving of respect.
I also object to the diagnostic criteria of gender dysphoria in children including a “strong preference for the clothing and activities of the other gender”. First of all, clothing and activities shouldn’t be gendered, especially for children. Second, fashion, in particular, changes. I am basing the ‘norm’ (white cis men who own property) on the founding fathers of the United States of America. Here is a representation of fashion at the time:
Instagram “Trad Wives” might mimic this dress, but their husbands (and sons) absolutely do not.
Third, basing the medical diagnosis of a health condition on whether a child likes Barbie or Batman is horrifically insulting and truly absurd. Basing whether or not a child gets actual healthcare on if they fit into the concept of a gender wholly based on stereotype and whim is nonsensical and, more importantly, dangerous. Personally, I think assigning gender to activities or interests is the actual pathology.
It’s too easy to get hormones and surgery!
The idea that any part of gender affirming care is speedy or reckless or easy or happening without oversight is 1) absurd on its face—tell me you haven’t tried to navigate the American healthcare system without telling me you haven’t tried to navigate the American healthcare system, 2) a full-on lie told to scare and confuse you, and 3) DISINFORMATION. I have firsthand knowledge, and I have something to say.
My son was never on puberty blockers because he was past puberty when he came out as trans. None of the many, many healthcare providers or teachers we interacted with between the ages of 10 and 15 asked if he was experiencing gender dysphoria. Not one. If anyone suggested it, if we considered it, if he had been given access to puberty blockers or an earlier social transition, he and I would have had a much less stressful five years. He and I both would have had better health outcomes then and now. Doctors and teachers are not “turning kids trans”. A trans kid was right in front of all of us, and we didn’t know. He dressed as T-Rex to go to ballet class on Halloween. There were five princesses and a dinosaur, and not one person suggested he was trans. Ever. He came to me and then we went to the school and the doctors.
The processes to access hormone therapy and surgery are extensive. The first conversation is with a primary care physician, in my son’s case, his pediatrician. They gave us a referral to an endocrinologist. We were given an appointment eleven months later despite a note indicating suicidal ideation. We called the pediatrician back and got a second referral to a different medical group. It was still a four-month wait. We met with the endocrinologist for two informational sessions and a consultation before starting testosterone. Bloodwork was required to begin and then every 90 days for the first two years. All of these visits, the lab work, the medication, and the supplies required to administer it come with copayments.
After a year on T, we received a referral to a plastic surgeon for top surgery. Again, the earliest visit was nearly a year out. Again, we asked if there were any options and got a referral to another medical group with an earlier slot—which was ironically the same group we’d tried first before. We were batted back and forth between them like a tennis ball, and it is only luck that all these medical groups were in network with our insurance. Also, we only got an earlier appointment because I was willing to drive over an hour to their satellite office, which had an opening because it’s far-flung. We made a day of it and went to the zoo.
After the initial consultation, we submitted extensive paperwork for insurance approval. A pile of forms and four separate letters from his pediatrician, endocrinologist, therapist, and psychiatrist. A full physical and mental work-up as well as proof of hormone therapy and social transition. The surgeon cautioned us that the approval process is arduous, but their office was well versed, and they were committed to getting it authorized.
They were right; it was a battle that took months and multiple resubmissions to win. The surgery is outpatient and very safe but requires a team of highly trained individuals and an adult caretaker (me) willing to take on responsibility for a week of significant aftercare followed by five additional weeks of recovery. Again, all of this requires copays and deductibles, as well as me taking time off from work. It takes a whole team of people who have to fight with bureaucracy to get it paid for and the willingness and ability to drive all over the state to get timely care.
None of this, NONE of this, is taken lightly or treated flippantly by anyone involved. All of this, ALL of this, is proven to be safe and life-affirming healthcare.
We live in a pure blue state. I’ve lived my whole life in a small suburban city centered around an elite liberal arts university. By anyone’s definition, my community is a lefty bubble. My son and I did not encounter any bigotry from the many medical professionals involved in his care. But it took years. It took extensive and exhaustive preparation and proof of need. It took insurance and money. It took time and the ability to take time off. It took more patience, frankly, than I sometimes had to give it. Because I saw the look of relief and joy on my son’s face when he got his first testosterone injection. Because just over a year before that day, I’d stayed with him in the ER of a children’s hospital for seventy-two hours. Because I know from personal experience that access to this care is a matter of life and death. And because now when I look at photographs of my son as a child I see a boy. Regardless of what he’s wearing, or the length of his hair, or what toys he’s playing with, I see a boy. He was always a boy.
Trans Rights 301 - Action
Here’s what I’m doing.
ONE: I am a founding member of a Trans advocacy group at work. It includes transgender people and parents of transgender people and is specific to advocating for employee protections and benefits. We formed two years ago and have had noted success changing policy for the better. That we already existed before the current crisis meant we could get connected quickly and be heard this week. The administration is actively engaged with our concerns. We also act as liaisons for anyone with privacy concerns and provide information and support to anyone with questions.
This work requires research (I know so much more than I want to about health insurance processes), assessment, communication, negotiation, a receptive employer, and a lot of patience. We started with four people who had questions and concerns, and we’re still small, but we’re growing. We are not changing the world or addressing the systemic attacks being leveled on the transgender population writ large. But we are protecting our community and affecting change on a very local level.
TWO: I submitted testimony to the state committee reviewing a proposed amendment to the Connecticut constitution. The public hearing is tomorrow. Here is the proposal:
The proposed resolution will revise the 25th Amendment to the State Constitution, known as the Equal Rights Amendment (ERA) with the following language. The new language explicitly defines who is included under sex discrimination and reads as follows:
No person shall be denied the equal protection of the law nor be subjected to segregation or discrimination in the exercise or enjoyment of his or her civil or political rights because of religion, race, color, ancestry, national origin, sex or physical or mental disability. As used in this section, discrimination in the exercise or enjoyment of civil or political rights because of sex includes, but is not limited to, discrimination, in intent or effect, based on pregnancy, including preventing, initiating, continuing or terminating a pregnancy; sexual orientation; gender identity and expression; and related health care.
Here is my testimony:
My name is Anika Dane. I’ve lived in Middletown, Connecticut, for nearly my whole life. I grew up on the Wesleyan campus, and I’ve worked there since 2007. A significant and important part of my job is coordinating student groups dedicated to inclusion in science. The proposed amendment is in line with those goals: protecting access to essential healthcare.
I have transgender colleagues, students, and friends. And, most pertinently, I have a transgender son. I have personally navigated Connecticut’s healthcare system with my child, and I am pleased and proud to report that all of the medical care providers we encountered were compassionate and affirming professionals who took my son’s agency and bodily autonomy seriously and fought for him and his civil rights against all external barriers. They provided and continue to provide the best level of care. This amendment would protect and affirm my son, myself, and every one of those professionals. It would protect and affirm the essential, life-saving healthcare that Connecticut is already a leader in providing.
I am grateful to the Committee for your attention to this matter and for your time today.
For the record, I also support protecting a woman’s right to choose, any pregnant person’s right to choose, and a doctor’s right to provide the best care available.
Everyone in every state has the right to provide testimony to support or oppose what is happening in your state.
THREE: I have my pronouns in my email signature, and I include them when introducing myself. It seems small and even silly to a lot of people, but it’s a very simple way to show support and change the narrative. If everyone does it, it’s no longer weird or silly. That’s the whole point.
FOUR: I am taking every opportunity to learn. This is not specific to the topic; it’s more my life philosophy. I work at a college, so I get lots of opportunities to learn. This week, I participated in the second of four training sessions on intercultural learning. Next week, I am starting a series on organizing and communication strategies put on by the AAUP, of which I am a proud member. The grad course I’m taking this semester is “Magic, Miracle, and Witchcraft in Europe and America until 1830”. A history course is outside what I normally choose to study, but I’m interested in witches and witchcraft, and I think that’s a perfectly good reason to take a class. And hey, a course on the history of persecution by the church is not NOT relevant to current events.
FIVE: I spend time every day doing something fun. While we are fighting for our right to live, we must also do the living. I do Zumba. I write and read fanfiction. I introduced my son to the X-Men. I go to concerts. I participate in quote-post memes on social media. I cuddle with my cats. I obsess over geriatric cops who need to kiss already. I use my clothes to make a statement and dye my hair colors not found in nature. I play Animal Crossing. I watch terrible television so you don’t have to. I spend time, every day, doing something fun.
I am not posting any of this for kudos or acclaim. All I want is for everyone out there to feel empowered. Whoever saves one life saves the world entire.