The announcement by the American Medical Association that transgender care including SRS is medically necessary and that insurance should cover it has me thinking. As I go through the system laid down by the medical and psychological communities, I am struck by the notion that my "diagnosis" comes about entirely by what I told them. ->-bleeped-<- or by the more controversial term, GID, is different than other medical conditions like cancer or heart disease in that there is no physical evidence or observable disease process. Also, the medical community and therapists don't prescribe the treatment the same way as other conditions. Instead, it is up to me to decide how far I need to go in my transition. It is up to me to decide that surgery and hormone treatments are best for me. I have heard countless stories of transwomen who can't wait to transition. They are in the driver's seat.

Consider this comparision with cancer. Both are commonly progressive and life threatening if left untreated. There are effective treatments for the conditions. They are both well documented with common symptoms for each sufferer. But in the case of cancer, few would opt for not getting surgery and those that do would be going against the advise of their physician. But the trans person can opt out. We can say no and it would be accepted in a heartbeat. Does this signal a level of doubt on the part of the professional? Is this why we have such a protracted period of therapy and RLE? Why is it that three letters from three professionals are required? I wouldn't need three letters to get my cancer surgery should I get that disease. Or is it really because of the nature of the trans condition? I have wondered before how many come to a professional and decide they are not trans? What percentage of trans folk "Wash out" and don't transition? On the other hand, how many who have transitioned regret it? The numbers I have read is that the overwhelming majority do not regret it, to the tune of 95+% which is incredibly high. So what is the big delay about?

This leads me to ask: How many trans folk who cannot afford hormones or therapy commit suicide in utter desperation? Aren't the restrictions for care so onerous that only the financially well off can afford and achieve total transition? It costs a lot more than just medical bills. The cost of changing one's name, all new clothes, new cosmetics are very significant. Many lose their jobs just because they have a gender identity problem. This doesn't make sense other than total and callous ignorance by society. The murder rate is 25 times higher for transwomen than the average US citizen. One a month is killed. That may not seem all that high but consider that the statistic is based on those who can be verified as trans. How many die and aren't recorded?

Where am I going with all this? Our struggle is incredible to fight against society, restrictive medical care, government obstacles to identity change, loss of employment or being forced to work below potential, unaccepting families and our own guilt and shame. With this gauntlet, we are in the driver's seat. There is no one that will take our hand and comfort us though the whole process. No, it is up to us to daily take up this burden and stand up to it all and live. Isn't it amazing that we don't all perish? What does it take to walk out there in society every time knowing that the possibility of being beaten or killed is vastly higher than the person walking beside? It is a miracle that we survive in such numbers as we do. Thankfully, there are some things that are changing as evidenced by the AMA's resolution. Please, society, get there faster!

all i can really say is that i totally agree- with everything you just said.



Warrior Princess Mickie

Personally,  i can't say i agree with much of the original post at all.  While i do agree that insurance should cover treatment as it does with most other disorders, some of the reasoning here i can't agree with.

QuoteConsider this comparision with cancer. Both are commonly progressive and life threatening if left untreated.

The comparison with cancer is mostly an apples and oranges situation. It's almost insensitive in a way to claim that a disease that kills you without any say of yours to what does end up being a choice to end one's own life. Like it or not,  it is a choice,  even if one not made in the best of mental states.

QuoteWhy is it that three letters from three professionals are required? I wouldn't need three letters to get my cancer surgery should I get that disease.

Again,  i can't see how this comparison is valid. SRS is a life altering, permanent surgery. Many cancer surgeries aren't.  Once they've been completed you can go back to the same daily life as you had before.   Mind you,  i am making the distinction that is it the SAME daily life.

A better comparison would be to something like a gastric bypass surgery for which you DO in cases need a psych consult and letters stating that you're of sound mind to deal with the life changes that going through with such will produce.

QuoteThe cost of changing one's name, all new clothes, new cosmetics are very significant.

I can somewhat understand a complaint about the first,  but the latter two are completely irrelevant to your point. The choice to buy new clothing and cosmetics are something one chooses to do and it does nothing for your point to complain about things that aren't particularly necessary.

QuoteThe murder rate is 25 times higher for transwomen than the average US citizen.

This, combined with the previous quote also illustrates the silly assumption by much of the general public that the only transsexuals that exist are male to female. This bit is a little off the topic but it is a pet peeve of mine to see such a thing perpetuated.

Quote...unaccepting families and our own guilt and shame.

Call me heartless,  but these aren't anyones problem but your own and aren't up to the medical establishment to fix.

QuoteWith this gauntlet, we are in the driver's seat. There is no one that will take our hand and comfort us though the whole process.

Yes,  because personal responsibility does account for a large majority of life. When you CHOOSE,  yes i said the horridly dirty word here.  When you choose to transition,  because you believe that it's what you have to do, you also accept the responsibilities and consequences that come with it.  You could certainly wait until society catches up and the things that are truly wrong,  such as discrimination and unnecessary medical restrictions are removed from the path.  But,  it's never going to be a cakewalk.

I've seen too many trans-people with this looming sense of entitlement. Accept me or else! That often seems the rallying cry. I've also seen just as many who are quick to play the martyr role while at the same time trying to climb up the social ladder atop the bodies of those unfortunates who are viewed as less valid.

I have turned this into a bit of a rant and i do apologize but these things that keep being portrayed are far too often so slanted and distorted to make one somehow take pity on the poor transsexuals that it disgusts me.

I never meant to upset anyone by my post much less disgust someone.  I didn't realize that venting frustration about the overwhelming difficulty of transitioning would be controversial here.   OUCH!!!

Maybe my comparisons were not totally medically applicable but my SO has had melanoma so I have experience dealing with that condition. The point remains that we have a lot of responsibility to self diagnose a life threatening condition.  There are more ways to die than by one's own hand directly. One can be so depressed that one turns to alcohol abuse or drug abuse leading to automobile accidents. One can delay going to see a doctor for another life threatening disease because of not being able to deal with the trans issue.

I did include stuff about things which were not exactly to the point such as the clothes etc. But they do serve to point out the amazing number of areas we have to adapt to. I never meant to slight FTM's maybe I should have started with a disclaimer that my post was from an MTF perspective.  BTW. I have several FTM contacts and my prior therapist was FTM so I am not exactly ignorant about their problems. 

The murder statistic is not based on which gender trans person is murdered. I didn't think it was in question. How does this relate to a silly assumption of no FTMs?

I wasn't asking for pity in a group that is supposed to be experiencing the same difficulties.

A looming sense of entitlement? Accept me or else? What am I going to do, gather with a gang of trans people and storm the courthouse or take hostages?  I am entitled to human rights and to be recognized as a person who deserves as much consideration as any other.

Sorry, but JC's post stung me hard.

I understood what you were saying, Maggie.

People every day do opt out of cancer treatments and other life-saving or quality-of-life saving proceedures.  They don't need 3 months of therapy and letters that state they are of sound mind and that they are aware of the consequences of opting out.  We transfolk are opting IN. 

Two cases in point:  My mother just had a biopsy for a breast lump.  She doesn't even know what it is yet and already she says she's NOT doing radiation and definitely NOT doing chemo.  This from a woman who has longevity in her family and conceivably she has at least 25 years left to live.  Who would NOT want to get rid of the cancer??  Nobody's making her go to a shrink.

My mom's now-deceased boyfriend.  Opted out of  knee surgery (total knee replacement, bilateral) and instead decided that sitting in a chair in front of the TV for the better part of 20 years was a better life, because there are 'no guarantees with surgery' (his words).  But he also wouldn't buy a scooter chair and ended up putting a huge strain on my mother because he couldn't walk.  He also chose not to see a doctor as his health failed (different condition), and getting a diagnosis sooner may have added years to his life, but he chose not to.

We all know that medicine is not an exact science and there are no guarantees; surgery and anesthesia is risky but in most cases the potential benefits outweigh the risk.

Yes, in our cases being transgendered/transsexual isn't immediately life threatening, but it does cause a lot of depression and substance abuse and lower quality of life when transitioning is out of reach (or not yet diagnosed, in my case).  I look back on my life, and while overall I'm happy with it, the choices I've made, the cool things I've done, I feel like I was encased in a plastic box the whole time, not allowed to be ME that whole time.  And now the walls are coming down and I can breathe!!  It's like years of heavy baggage just got hauled to the curb and removed by waste management, LOL.

The roadblocks are there probably more to CYA for the docs and therapists, so later the few who might have regrets (or get brainwashed by reparative therapy) can't come back and sue the docs and therapists for 'allowing' them to 'mutilate' themselves in this way.

For me, I figure, what's the worst that can happen if I transition?  Well, I might be one who has side effects of T, or I might have a problem with anesthesia, or, I transition and find that being male isn't all that (well, I'm male and matching my psyche SHOULD make me feel better), but I can't imagine it being worse than trying to fit in as a woman when clearly I am not.

Anyway I'm undercaffeinated and rambling.  But don't feel bad, Maggie.  I liked your post!  And agree with it.

Jay

Quote from: Maggie Kay on June 20, 2008, 12:32:04 PM
I never meant to upset anyone by my post much less disgust someone.  I didn't realize that venting frustration about the overwhelming difficulty of transitioning would be controversial here.   OUCH!!!

Never appologize for your feelings Maggie!

Actually I agree quite strongly about your corollary between cancer and transsexuality.  I personally believe that GID is a fatal condition.  I know from personal experience that I would have died from my own hand if I had not sought therapy and transition.  And that also is a common symptom among other transsexuals.  The pressure and depression continue to build until there is no other relief, no way to address the suicidal depression except to transition or die.

The statement you made about the diagnosis being entirely within your self is quite true!  There is no objective test for GID.  Basically you are transsexual because you say you are. 

The point of the therapy and extended RLE is not so much to convince the therapist that you are gender disphoric (see above), but how you come to terms with that statement and how you re-integrate yourself into society and family within your chosen gender.  I personally did not see my therapists as gatekeepers but as guides or coaches to help me find my way.

Additionally just two letters are required to be a candidate for GCS.  And just one letter is needed for HRT or an orchi.

By the way, being gender disphoric is not a choice.  What we choose is if or when to deal with it.  But it was always there.

An interesing point about FTM transsexuals and racial profiling.  One of my friends is a black FTM and one of the things he noticed is that when he came out and transitioned he was pulled over many more times than when he was female.  I've also heard that from other non-white FTM's.  What they have related is their fear of being abused physically and verbally by police if they have to show their ID and their gender markers don't match how they are presenting.  It has happened.

I don't think much would change in the WPATH policies and procedures were the insurance companies to start covering GCS.  One of the reasons for the success rating for transitioning is the extensive therapy and RLE.  The cost of the operation is another factor that filters out those who may not be GID but the counselling will also do much the same.

While there are some who have a "->-bleeped-<-r than thou" attitude, I think for the most part the rest feel that this is a very personal journey and don't really care what others think or how others have done it.  And I think we are happy to find others that we can share our trials and tribulations with who truly understand what we go through.

You are turning into quite the fiesty one aren't you!  Good for you girl!

-Sandy(*smile*)

Quote from: JC on June 20, 2008, 11:50:35 AMWhen you CHOOSE,  yes i said the horridly dirty word here.  When you choose to transition,  because you believe that it's what you have to do, you also accept the responsibilities and consequences that come with it.

<snip>

I've seen too many trans-people with this looming sense of entitlement. Accept me or else! That often seems the rallying cry. I've also seen just as many who are quick to play the martyr role while at the same time trying to climb up the social ladder atop the bodies of those unfortunates who are viewed as less valid.

I have turned this into a bit of a rant and i do apologize but these things that keep being portrayed are far too often so slanted and distorted to make one somehow take pity on the poor transsexuals that it disgusts me.

What a hurtful, heartless response.  We didn't choose to be born this way.  If you feel this way I have a question for you:

Why are you here?

We do not act with a sense of entitlement.  I think you confuse entitlement with righteousness.  Our cause is right and just.  If you disagree with that I ask again:

Why are you here?

It is NOT entitlement to ask for respect and our civil rights.  I guess your kind probably thought African Americans were just being uppity back in the 60's huh?  To move society forward requires effort.  There are many of us out there in the trenches trying to make this happen everyday.  We are trying to improve everyones lot and for this you complain?

Why are you here?

Your attitude confounds me.

Hi, Maggie,

I have to agree that the post questioning you came across as vibrantly self-righteous and more in the way of a personal difficulty with how others view the world we live in as reflected through the glasses of one's own experience; rather than an attempt at understanding and giving feedback that might be valuable and one might be able to actually HEAR. It was instead more along the lines of "wtf is the matter with you that you don't see things the way I do?" Such a stance doesn't just sting; imo, it demeans and alienates and gashes another.

That's never a particularly good stance for winning hearts and minds. But is an extremely useful way of trying to show others that I believe my position should be adopted by everyone else. I find that when I do so, it tends to alienate others rather than to show them my insightfulness.

Transition tends to be a white, middle to upper-class economic endeavor in USA. Although many gender-variant people abound in the country, for many it's very difficult to obtain, through the processes some take for granted, the care and assistance the less-privileged need as well. I'm glad you are sensitive to that. Your pleas are poignant and well-taken, even if one or two may be beside your original vector of statement. You did a very good job.

That the medical establishment is beginning to recognize that clinical help may need to be made more widely available and accessible to a lot of people who currently do not have the means to access it is a very positive development. It's a step, not, perhaps, a solution. A very important step.

Sometimes we may well need to wear the hats of activists and teachers, but there are ways of going about that that are not inclined simply to plumping my own sense of self-importance and entitlement at the expense of others. I believe that the poster perhaps, for at least a minute, lost track of that. I'm sure they will regain their equilibrium and see that sometimes one needs to walk with the one they are attempting to 'teach' rather than to run ahead and belabor the fact that they think they are on a different plane than the prospective taught person.

We teach best through example and looking one another in the eye and standing beside one another. You do a brilliant job of that. Thank you.

Nichole

Had I not spent the last 60 some years of a personal hell fighting something I most certainly didnt ask for I might be inclined to lean towards your view JC. The main problem I have it is that its pretty much the same view that my adult children seem to want to espouse in trying to keep me from transition and as a means to expell me from my own family.

Im really not quite sure where you are coming from, its a pretty radical view and one Ive only seen once before, especially on a site like this. But Im sure you have your reasons and unpopular as it appears to have been, it most definately was thought provoking.

Maggie, I think you said nothing more than what most of us feel and you certainly dont need to apologize for what you feel. I think you called it better then I could have. Hugs

Wendy

Quote
Im really not quite sure where you are coming from, its a pretty radical view and one Ive only seen once before, especially on a site like this. But Im sure you have your reasons and unpopular as it appears to have been, it most definately was thought provoking.

Radical? I personally wouldn't use that term but maybe it does fit. Unpopular? Quite obviously.

Especially since my presence here has been questioned and i've been called various slurs in pm, such as transphobic and vain.

This is the very thing that i can quite easily defend my points with. If people see an opinion they don't agree with then it's time to hurl a bit of mud that way is what seems to be the status quo.

I'm basing my own opinions. Yes, they are indeed opinions, from my stance as a non-gendered member of a plural system that is taking steps to transition the body to a physically sexed state that i am comfortable with.  Which depending on which definition you use,  to transition from one physical sex to another would make one a transsexual. That is where i'm coming from.

I know about the trials and tribulations and whatnot,  i've lost the majority of my family though this also.  Woe is me....and good riddance to them.  Rather than come from a stance of wanting pity,  i chose to take control of my own situation there. This, is what i'm talking about.

Since i've also noticed that there have been a few failures in reading comprehension. I did NOT state that being transgendered of any flavor was a choice. It may not have any roots at all in biology that we know of,  but being such i do not personally believe is a choice. What i DO believe is a choice,  is whether or not one transitions.  Just as it is a choice whether or not one succumbs to their more fatalistic desires.  Choice and responsibility still go hand in hand there whether you find it an uncomfortable pill to swallow or not.

On the original topic,  i do believe that the AMA's stance is a step in the right direction. BUT, i will still not believe that is it enough until ALL variations of transgenderedness are accepted and validated.  Everything from your standard FtM/MtF and on to Non-Binaries who wish to transition and make their bodies congruent with their own identity.

If i sound angry,  i am angry over a lot of this. Especially over the comments and smites that i've recieved for stating my opinion and threats that have been handed down while i've stayed within the rules of the site. I certainly hope that not being satisfied with the status quo is radical,  but maybe it is.  *shrugs*

Quote from: Nichole on June 21, 2008, 09:47:58 AM


Transition tends to be a white, middle to upper-class economic endeavor in USA. Although many gender-variant people abound in the country, for many it's very difficult to obtain, through the processes some take for granted, the care and assistance the less-privileged need as well. I'm glad you are sensitive to that. Your pleas are poignant and well-taken, even if one or two may be beside your original vector of statement. You did a very good job.

That the medical establishment is beginning to recognize that clinical help may need to be made more widely available and accessible to a lot of people who currently do not have the means to access it is a very positive development. It's a step, not, perhaps, a solution. A very important step.

Sometimes we may well need to wear the hats of activists and teachers, but there are ways of going about that that are not inclined simply to plumping my own sense of self-importance and entitlement at the expense of others. I believe that the poster perhaps, for at least a minute, lost track of that. I'm sure they will regain their equilibrium and see that sometimes one needs to walk with the one they are attempting to 'teach' rather than to run ahead and belabor the fact that they think they are on a different plane than the prospective taught person.

We teach best through example and looking one another in the eye and standing beside one another. You do a brilliant job of that. Thank you.

Nichole

Giggles, I'm trying to change that. I need help so this bode wells for me. I dont want to be in transition for years because i could not afford a procedure.

Maggie, love you

All the very best to you in your attempts at changing that, Robin. It's something that needs changing. GID-relief and its related procedures and surgeries cannot simply be the personal possessions of the entitled, mostly white, mostly middle to upper classes. Others, who don't fit into that particular socio-economic group/s, deserve and should absolutely expect to be able to find relief as well, in exactly the same ways.

I spent a year working daily with transsexuals and other transgender people in an inner-city, free clinic and saw, very much first-hand way that therapy, hormone replacement and SRS are not simply things that cute (or not-so-cut), little (or not-so-little),  suburban, white-girls live with.

There are all races, ethnic-groups and economically-abled people, men and women, who struggle as best they can through the mazes of privilege and its lack to find a comfort for their pains. They are just as deserving as the computer-geek or the corporate CEO who also seeks to transition. And they are not only in pain due to their GID; they are also very often in pain due to the ways they have had to try and find the resources that will make their bodies congruent with their brains and souls.

Break down any wall that gets in your way, luv. You are absolutely a great example and a courageous and wonderful woman.

Hugs,

Nichole

i just thought i would stop by and say everyone makes valid points. everyone's situation is different and we have to deal with it different ways, no matter our barriers. we will make whatever we need to happen happen.


Warrior Princess Mickie