Navigating the Red-Tape Jungle During Gender Transition
One of the less appreciated aspects of trans life surrounds the paperwork required to legally establish ones gender. If you’re born with a body unambiguously male or female and you never have any doubts about it (I’m looking at you, 95% of the population) this is little more than an afterthought which you’d only ever encounter if someone has made a clerical error. For trans people establishing their gender identity in legal paperwork its a daunting challenge. It’s frequently expensive and generally frustrating due to constantly changing and often contradictory rules.
And suddenly it’s becoming newsworthy.
Yesterday, in regard to the Nikki Araguz case, I quipped that… “…if Nikki wanted to get re-married to a woman does anyone seriously believe the State of Texas would be groovy with that? I’m pretty sure they’d see that as a same-sex marriage as well even through it would require a total contradiction of the reasoning in the current case.”
Right on cue comes an article today talking about the same thing in the Austin American Statesman:
“Something for Texas legislators’ 2011 to-do list: Take another stab at defining which government-issued documents can be presented by marriage license applicants.
Seems simple enough, doesn’t it? It’s not. Buckle up for a bumpy ride through the current confusing situation.
Under current law, revised in 2009, marriage license applicants can have officially recognized forms of identification that offer diametrically opposed declarations of gender. That can be a problem because to get married in Texas, couples have to include one of each.”
The article goes on to mention how lesbian couples including a trans partner have applied for marriage in Texas based on a “male” birth certificate. Some have succeeded. Some have not. It’s a bit of a crap-shoot at the moment, because those who work in the state bureaucracy are widely confused. Need an illustration?
“That leaves El Paso County officials confused as to what to do in situations such as the one encountered in February when Sabrina J. Hill and Therese Bur sought a marriage license. Hill’s New York birth certificate certifies birth as a male. Texas law says a birth certificate is an acceptable form of identification for marriage license applicants. Sign the forms, throw the rice and wish the couple well, right?
It’s not that simple.
Hill also presented an Arizona driver’s license (also an acceptable form of ID in Texas for a marriage license, as are all out-of-state driver’s licenses) that lists her as female. Hill, born a hermaphrodite [in modern terms we’d say “intersexed” rather than the h-word -D] (with male and female sex organs), also submitted a Washington state court order from the name-change petition granted after gender reassignment surgery that made her a female.”
I would like to note that there is nothing unusual about Ms. Hill’s situation in regard to the paperwork surrounding her legal gender identity. If she followed the Standards of Care, as defined by The World Professional Association for Transgender Health (WPATH), this is a more or less “normal” state of paperwork for a trans woman based on the competing requirements of various state and federal agencies.
Currently in the U.S. the laws covering gender marker changes on most documents are covered by state law, but sometimes the state laws require federal documents (e.g. Social Security) before they will modify a gender marker. Furthermore, different federal and state agencies (e.g. the DMV) often have their own policies further defining the requirements necessary to implement gender marker changes. These are remarkably inconsistent and frequently contradict one another. And that’s even before you get to the standard way in which gender transition is governed in the medical and mental health world.
The current WPATH Standards of Care require the following key steps to complete gender transition after a rather rigorous set of eligibility criteria have been satisfied:
- Hormone therapy – This alters the appearence (sometimes radically), giving the transitioner the secondary sexual characteristics of their target sex. In so doing it makes it increasingly difficult for the transitioner to function in society as ones birth sex.
- Real Life Experience (RLE) – This is a period lasting a minimum of one year in which the transitioner must “prove” that they can successfully manage their life in their new gender role, in terms of relationships, employment, social role, etc.
- Gender Reassignment Surgery (GRS) (a.k.a. Gender Affirmation Surgery, Sexual Reassignment Surgery) – This is “the surgery” which non-trans people seem so fascinated by and place so much emphasis on as THE act which changes ones sex, (trans people generally don’t agree on its singular importance in this regard, but it’s still pretty important).
It’s generally during the Real Life Experience (Step 2 above) that gender marker changes are important on legal documents for all sorts of practical reasons (e.g. you no longer physically appear to be your former gender which leads to identification problems; there are employment and legal contract implications; etc.). This is the point at which – as far as the rest of society is concerned – you are now the sex opposite of your birth. The Standards of Care, in fact, require this to be a full time thing in all phases of your life or else you may not qualify for gender reassignment surgery.
However some of the most important paperwork required for changing gender markers on legal documents relevant to the Real Life Experience (birth certificate, social security number) require proof that GRS has been completed in order to change the gender marker. Remember, the Standards of Care says GRS should take place no sooner than one year after the Real Life Experience begins so there as at very least a significant time lapse between these two events – and the sequencing is the opposite of the legal requirements for making the change.
Timelines aside, there’s another tremendous problem here, as gender reassignment surgery is generally not covered by medical insurance. That means a great number of transitioners may linger for years – or even permanently – living completely as the sex opposite of their birth but lacking the financial means to attain GRS. Requiring someone to spend tens of thousands of dollars on a surgical procedure regardless of income level in order to update basic government paperwork is at the very least problematic.
Think about the situation here. The mental and medical health professionals insist you must be on hormones and living full time as your target sex for a long while before you qualify for surgery. Government officials insist you must show proof of surgery before they’ll change your legal gender marker to recognize you as your target sex. And the insurance companies insist this surgery is all just a cosmetic procedure anyway – like a nose job, or liposuction – and they won’t pay for it. And that’s a best case scenario. Usually this gets further complicated as things vary from agency to agency, state to state, so an individual transitioner has to figure out which hoops they personally need to jump through and in which order. Meanwhile the paperwork inconsistency results in continual problems with employers, medical providers, interactions with government agencies, and much more.
I hope that the visibility these issues are starting to receive will lead to some common sense reforms in the near future. In the meantime, I hope those who aren’t personally affected by this red-tape tangle can begin to appreciate how it affects real people and help us make some noise to get things put right.