The New York Times reports that in the last few years, several elite U.S. universities have begun to cover sex reassignment surgery and/or hormones for transgender students. On the one hand, it’s great that they’re reporting news like this, and after years of extremely disrespectful coverage of transgender issues, it feels like a victory that their “balance” is limited to noting that “the idea still seems radical to plenty of people.” On the other hand, not a single trans-identified person is quoted.
But what I really want to highlight here is how this kind of article utterly fails to connect some really big dots, leaving readers with a very narrow picture of reality.
This story as framed by the Times is, of course, extremely important to the students who will take advantage of these universities’ policy changes. But the arguably much more important big-picture story here that the Times obscures is about how economic disparities get magnified in our society: Only those transgender youth privileged enough to get into schools like Princeton or Stanford will have access to full health coverage that will enable them to align their gender presentation with their gender identity–which can have important reverberations down the line for their job and life prospects.
Not all transgender people want to take hormones or undergo surgery, but for many it is a medical necessity–something both the American Medical Association and the American Psychiatric Association have recognized. Access to such health care improves their mental health while decreasing substance abuse. It typically makes it easier for them to get ID that reflects their gender identity, which in turn helps them get and keep jobs and avoid harassment; trans people who don’t “pass” are more vulnerable to employment discrimination, which is still legal in many parts of the country. Without access to appropriate health care, many trans people go into debt or criminalized activities like sex work in order to access hormones or surgery, and self-administer hormones and silicone, which can put them at increased risk of HIV, hepatitis, liver problems and other serious health complications.
The real story here is that so many transgender people–those without access to elite higher education or certain Fortune 500 jobs–face serious health care discrimination that puts them at an even greater disadvantage than they already face. If we had a single-payer system, where your health insurance didn’t depend on where you go to school or if you have a certain kind of job, it would still be a struggle to get these things covered, no doubt. But it would be one unified struggle, instead of thousands of disparate ones.
And it would mean those economic and health disparities wouldn’t be exacerbated. That’s a story that is extremely important not just to the transgender students at elite universities, but to all transgender people in this country.
But don’t hold your breath waiting for a New York Times story to provide that kind of analysis.