Article by The Editorial Board/ May, 2015/ Source: NY Times/ URL: https://www.nytimes.com/2015/05/04/opinion/the-quest-for-transgender-equality.html?mtrref=undefined&assetType=opinion
Being transgender today is still unreasonably hard, but it is far from hopeless. This is the first in a series of editorials looking at the challenges ahead.
A generation ago, transgender Americans were widely regarded as deviants, unfit for dignified workplaces, a disgrace for families. Those who confided in relatives were, by and large, pitied and shunned. For most, transitioning on the job was tantamount to career suicide. Medical procedures to align a person’s body with that person’s gender identity — an internal sense of being male, female or something else — were a fringe specialty, available only to a few who paid out of pocket.
Coming out meant going through life as a pariah.
Being transgender today remains unreasonably and unnecessarily hard. But it is far from hopeless. More Americans who have wrestled with gender identity are transitioning openly, propelling a civil rights movement that has struggled even as gays and lesbians have reached irreversible momentum in their fight for equality. Those coming out now are doing so with trepidation, realizing that while pockets of tolerance are expanding, discriminatory policies and hostile, uninformed attitudes remain widespread.
They deserve to come out in a nation where stories of compassion and support vastly outnumber those that end with a suicide note. The tide is shifting, but far too slowly, while lives, careers and dreams hang in the balance.
Many of the heartening stories have unfolded out of sight. Some employers in the public and private sectors have begun to openly support people making the transition. At the Central Intelligence Agency, a young analyst who transitioned on the job in 2013 worried that coming out would end her career. She realized that fear was unfounded when colleagues got her a gift certificate to Ann Taylor after she transitioned at work and senior agency officials made it their mission to ensure she could continue to thrive at her job. Yet at the same time, thousands of American troops who are transgender serve in anguish because the military bans openly transgender people from joining the service. Those who take steps to transition can be discharged under the current rules.
In several states, transgender people are courageously battling efforts to bar them from using public restrooms. In West Virginia, transgender women have been at war with the Division of Motor Vehicles because officials are refusing to give them new licenses unless they stop “misrepresenting” their gender when they have their photo taken. A recent federal government survey found that one in five transgender people reported having been denied care by a health care provider as a result of their gender.
These indignities and abuse account for the alarmingly high rates of homelessness, unemployment and suicide for transgender people. Leelah Alcorn, a 17-year-old from Ohio, wrote a harrowing suicide letter before leaping in front of a tractor-trailer last December.
“The only way I will rest in peace is if one day transgender people aren’t treated the way I was, they’re treated like humans,” she wrote. “Fix society. Please.”
Three years before a police raid of the Stonewall Inn in New York in June 1969 galvanized the gay rights movement in America, transgender women rioted after being expelled from Compton’s Cafeteria in San Francisco. The restaurant had become one of the few safe gathering spots for the city’s community of transgender people, who at the time were not welcome at gay bars. That same year, physician Harry Benjamin published “The Transsexual Phenomenon,” a groundbreaking book that outlined how transgender people could transition medically. The two developments helped give rise to an arduous fight for societal acceptance.
Over the decades, the transgender movement has been part of the broader quest for equality for sexual minorities, but while gays and lesbians have achieved far-reaching legal and political victories in recent years, transgender people, who may be gay or straight, remain among the nation’s most marginalized citizens. They face distinct challenges, including access to transition-related medical care, which have not always been a focus of the broader struggle for gay rights. Gays and lesbians are visible in all walks of life today, and many are celebrities and role models. Transgender Americans, meanwhile, remained largely unseen until fairly recently.
As prominent transgender people have come out in recent years, their revelations have been a source of fascination, much of it prurient. There was the actress Laverne Cox, the Army whistle-blower Chelsea Manning and most recently, Bruce Jenner, the gold-medal Olympian. Their stories have brought attention to the plight of a segment of the population that continues to confound many Americans. One challenge lies in semantics, a complex and fraught subject given the extraordinary diversity of experiences within the transgender community. The term transgender covers a broad range of people who do not identify with the gender listed on their birth certificate.
Scientists have no conclusive explanation for what causes some people to feel dissonance between their gender identity and aspects of their anatomy. In 2013, the American Psychiatric Association updated its manual, replacing the term “gender identity disorder,” with one that is less stigmatizing, “gender dysphoria.”
The options for those who take steps to ease the distress has expanded significantly in recent years. Some opt to wear clothes typically associated with the sex they identify with, legally change their names and use new pronouns. Many also undergo hormone replacement therapy and have surgery to transform their bodies. Surgical procedures include chest reduction and augmentation as well as sex-reassignment surgery. Some people have just one type of procedure, others undergo both, and some choose to have none. While many transgender people identify with one gender, some feel their identity lies somewhere in between. The spectrum of experiences and identities is complicated, but taking basic steps to ensure that more transgender people lead healthy and fulfilling lives is not.
Expanded formal recognition is a fundamental first step. The size of the transgender community in America has always been unclear, since many people wrestle with gender dysphoria in silence. The most widely-cited figure, 700,000, comes from a 2011 study by the Williams Institute at the University of California, Los Angeles. The United States Census Bureau should give transgender Americans the chance to be formally recognized as such on forms, if they choose to.
Having more detailed information about the demographics of the population is crucial to the evolution of stronger legal protections and expanded access to health care. There has been significant progress on both fronts. Last year, Medicare, which has a big influence on the industry standard for insurance coverage, lifted its ban on covering gender reassignment surgery. More states and insurance providers are following that lead, heeding the call of medical experts who say transgender-related care must be viewed as “medically necessary,” rather than elective.
There have been hard-won victories on the employment front, too. The Department of Justice last year began taking the position that discrimination on the basis of gender identity, including transgender status, constitutes sex discrimination under the Civil Rights Act. That memo adds to the growing body of case law and Equal Employment Opportunity Commission rulings that have strengthened legal protections for transgender workers. Yet, many jurisdictions lack local laws that protect transgender people and discrimination remains commonplace even in places that do.
President Obama has advanced transgender rights more than any American president. But there is a glaring form of discrimination that he has the power to end. The Pentagon continues to ban openly transgender people from joining the military, even though many of America’s closest allies have integrated them seamlessly in recent years.
The lack of legal protections and access to necessary care in the military system has made thousands of transgender troops extraordinarily vulnerable. Some have been discharged for being transgender, while others have opted to quit, forgoing pensions and career advancement, because delaying their transition has become unbearable.
At the Department of Defense, a handful of senior officials have quietly met with active duty transgender troops to study how that segment of the force could serve openly. The officials have become convinced that lifting the ban would unlock the service members’ unfulfilled potential. Defense Secretary Ashton Carter should ask these officials to lead a swift review of the steps the Pentagon needs to take to formally integrate transgender troops. While that review is underway, Mr. Carter should instruct service chiefs to stop expelling transgender troops who are in the process of being discharged.
A generation from now, scientists will most likely know more about gender dysphoria and physicians will undoubtedly have found better ways to help people transition. This generation should be the one that stopped thinking that being transgender is something to fear or shun.