System Failure, Part II

- by Stacey Prince

A few months ago in a blog article entitled System Failure I wrote about some of the challenges facing transgender individuals, including transphobia and lack of access to appropriate services. I laid out how invalidation and discrimination experienced at the micro (family), meso (jobs, school) and macro levels (laws, lending institutions, insurance companies) contribute significantly to their emotional distress. A very concrete example of this is the incredible inaccessibility of gender reassignment surgery, which is explicitly excluded by many health insurance companies, yet prohibitively expensive to pay for out of pocket. Yet for many transgender clients, surgery and other gender confirming procedures are in my mind as medically necessary as is bypass surgery for an individual with severe heart disease, or insulin for a diabetic.

What I really want to focus on here is what TJP can do about it. What can we, as an organization espousing to integrate healing and liberation, contribute to the solution? How can we make this better? Do we work to reform existing systems ("sensitivity trainings" for hospitals and police officers, teaching clinical psychology graduate students and psychiatry residents how to work affirmatively with transgender clients, getting insurance to pay for SRS)? Instead of reform, do we work toward transformation, and what would transformation look like in this case--for example, can we envision and work toward a world in which regardless of their assigned-at-birth gender, pre- or post-operative status, or anything else, individuals can self-determine their gender identity, that identity does not have to fit within our convenient male/female binary, and it can change over time? In a world where that binary, and transphobia, do not exist, would gender reassignment surgery be readily available as a medically necessary procedure--or in some cases, would it not be necessary at all? Do we go for advocacy (the slow, tedious process of systemic change, whereby perhaps laws governing surgery, bullying, and discrimination are altered) or activism (sit-ins and demonstrations outside of insurance companies who deny services)?

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