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.
Interesting development, it’s indeed quite radical to most people as transgenderism is still largely a taboo subject.
Loved much of this article, though to use this author’s words, in some aspects “it fails to connect the dots”.
For starters, the article wasn’t about unified system for healthcare. Using transgenders who need to undergo surgery and who represent less than 1% of the population as the rally point is not argument that would sway the masses.
Next, the author argues that if every health care plan doesn’t do the right thing (cover medical necessities for transgenders) then none should. The idea that if most can’t agree to provide equality to a disadvantaged group, then no group should do it should be self-evident as way to ensure that progress on social injustice issues is never made.
Successful businesses and colleges understand that not only is it right to treat transgender people fairly, but it is also the expectation of the keen minds they wish to attract who expect that everyone will have a level playing field.
“Injustice anywhere is a threat to justice everywhere.”
Caroline,
I didn’t read that in the article at all. What she’s saying is that this seems to only help those who are already sorta well-off, while those who are poor, disabled, live in the wrong states, etc., are still stuck in bad situations. To be honest, there doesn’t seem to be a lot of the transgender community fighting for the more disadvantage of us. I think two prime pieces of evidence of this fact is that most activists seem to have given up on the Medicaid fight and the fact that last year and in 2011 each, the Jim Collins Foundation* has only been able to pay for the procedures of two people (out of hundreds of applicants), at a total estimated cost of $30000 each year. This last point I think is important and shows the dog-eat-dog nature of the trans community. Whereas organizations like HRC and the Trans Law Foundation can be well-funded, the Jim Collins Foundation just doesn’t seem very well-funded and it seems like people in general are not interested in helping poorer trans people transition.
* The Jim Collins Foundation is a non-profit organization that provides grants for transition-related procedures each year.
Caroline,
Ah OK. I haven’t seen much of it. All I’ve seen are real-life trans support groups dominated by a few gender theorists and a sorta “I got mine you get yours” attitude among many trans people.
And even without making it all the way to a single payer system:
– Individual states can mandate trans health coverage for all insured persons– see what Oregon recently did http://www.americanprogress.org/issues/lgbt/news/2013/02/15/53599/every-state-can-implement-transgender-inclusive-health-coverage/
– Obamacare can potentially be used to get health coverage for trans people nationally— HHS could get trans coverage into the public-assistance programs on the exchanges, and I *think* they could possibly even use their power to ban gender discrimination practices to mandate national standards like Oregon’s.
We need to be exploring solutions to these things. The media only notices when it’s, like, prisoners needing trans care, or students, and the reality I see— that there’s an entire class of people almost forced outside of the health care system, and most of the trans people I know are getting their HRT from offshore pharmacies— just isn’t filtering into public consciousness or public policy at all. Thank you for bringing attention to this.
State regulators don’t have authority to force insurance companies to cover specific procedures, like hormone therapy or genital reconstruction. But they’ve told insurers that if they provide breast reduction for patients with back pain, they can’t deny it for a gender reassignment that’s been deemed medically necessary. Insurers could unilaterally exclude coverage of, say, breast implants, but it would have to apply to all policyholders equally, including breast-cancer patients.
http://www.huffingtonpost.com/2013/01/12/transgender-health-coverage-california-oregon-insurance_n_2463615.html