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Should taxpayers pay for gender reassignment surgery?

June 11th, 2011

There’s a subject on which I’m completely torn, and I don’t talk about it because I’m not really sure whether or not I have the right to talk about it, and I can’t tell you how utterly stupid that is. Because they are the minority and they need the support of the majority. Without the support of the majority, the movement raised in support of equality will fizzle and die. Yet, parts of this group continue to tell those of us not within the parameters they deem worthy that we have no right to an opinion, and certainly shouldn’t be trying to force our opinion, whatever that may be, upon those of us who don’t share our position in life. Whatever that means.

I get the notion of privilege, and the idea that I’m more privileged than a black woman simply because of the color of my skin disgusts me, but I won’t pretend I don’t see it every day when I’m mingling among the masses we call society. It’s apparent in the way people of every color trust me more than sometimes people of their own race or nationality. It’s noticeable in the ease with which people slip into conversation with me, and aren’t uncomfortable if I stand too close, and don’t mind leaving me with their prized possessions while they do something in another room.

For all intents and purposes, I am a cisgender white woman (My Swedish genes are far more obvious than my Native American ones.), which makes me only slightly less privileged than a cisgender white man, and even though I’m bisexual, and often dress more like a man than a woman, I’m not affected by most of the issues that face LGBT people today. Right now. Who knows what the future holds? M could die tomorrow, and I could end up with a woman for the rest of my life. But right now I am part of what the U.S. considers a “normal” family. If you exclude the fact that between the two of us we have 11 kids, and we’re kinky as all hell. But no one who meets us for the first time guesses either of those.

Some would say that because I am cisgender, I should not formulate an opinion about issues that affect transgender people. Some qualify that belief with “without speaking with a transgender person and understanding how the issue affects them.”

Poppycock, I say. Granted, I have room to say “poppycock” because I stand firm on the side of equality, but even if I were on the other side –and maybe especially if I were– I would call it poppycock.

How issues surrounding transgender people affect each individual transgender person is completely subjective. Some transgender (gay, bisexual, heterosexual, black, white, whatever) people have never really dealt with discrimination or bullying. Some have and weren’t really affected by it. Some are devastated by it. Some just don’t care. Just like with every other walk of life.

In the news recently, there have been a number of lawsuits in which incarcerated transgender people are suing to be allowed to have gender reassignment surgery. In some cases, the inmates were already on hormone therapy treatment when they were incarcerated. At least one had implants and hip injections to give her a more feminine form. And yet, they’re incarcerated in the men’s prison just like any other man even though the only thing that makes them a man is what’s between their legs.

The most recent case is that of Ophelia De’lonta, an inmate in a Virginia prison, who has repeatedly tried to remove her own penis. She and her therapist say it’s a compulsion. Something she can’t control. And we’re still calling this “Gender Identity Disorder”. Especially in Ophelia’s case. And this is where I start to have an issue.

Why are we still calling this a disorder? Or are we just calling it a disorder when it benefits transgender people? So that instead of paying out of pocket for hormone treatment and body modifications, their insurance will cover them? Or is it that some transgender people still believe it’s a disorder, while others have embraced it as just the way things are? Maybe it’s that we haven’t quite figured out how to classify it?

In Ophelia’s case, we’re absolutely calling this a disorder to force the state’s hand and allow her to be “treated” with gender reassignment surgery on the state’s dime. Or, rather, the taxpayer’s dime. Which is more costly? Medicine, therapy and a bed in a state ward, or giving them the surgery? And are we talking monetarily, or the possibility of other people with vision of self issues suing for surgery to treat them?

Here’s my thing. Sometimes I don’t recognize myself in the mirror. My vision of self is nothing like the person staring back at me. It’s not my weight. It’s that I expect a completely different face. This causes me distress sometimes. So much that I avoid mirrors and have, in the past, considered plastic surgery. I could, I’m sure, achieve the face I expect to see through surgery. But should you, Joe Taxpayer, be paying for that? What if I was trying to perform the procedure myself? And what if once I achieve that face, I begin to see myself as someone else and decide I need another surgery?

My first instinct is to say surgery shouldn’t be the answer to a mental disorder. This is why I no longer consider plastic surgery, and have, instead, decided to work on accepting that the face the world sees doesn’t match the one I see in my head.

I imagine many people will argue that my issue is much different than living inside a body that has the wrong genitals for my vision of self. And I don’t disagree. They’re apples and oranges on the surface. For sure they’re apples and oranges underneath. But I’m still not really sure I’m comfortable with taxpayers paying for body modification. Private insurance companies? Whatever. But public institutions? Should they also pay for breast implants and labiaplasty for cis women? Penile implants for cis men? Liposuction or gastric bypass for people who want the easy way to a thinner them? A nose job or facelift? I dare say all of these procedures could be considered “treatment” for severe issues with a person’s vision of self.

But if gender identity issues aren’t a mental disorder, than what are they? Proof that gender is nothing more than what’s between your legs? Proof that true gender lines don’t exist? The exception to the rule? I really don’t know the answer to that.

But you really can’t have your cake and eat it, too. (I still think that saying makes no sense.) Either it’s a mental disorder that, if severe enough, needs surgical intervention, or gender is fluid and sometimes people are wired to switch sides, or ride the line, or reject the idea of any line at all, or… whatever.

I reject the idea that any and all different behavior is, by its nature, deviant and thus a mental disorder. Personally, I think we all just go with what feels right to us. Whether that’s doing what someone else tells us is right, or doing the opposite of what someone tells us is right, or whatever. (I say whatever a lot.)

I empathize with transgender people. I know I can’t possibly know what it’s like to feel like you are the wrong type of gender. I’m just not really sure what’s “the right thing” to do. Knowing what I know about what it’s like in what’s considered the underbelly of our society, I’m not sure I’m comfortable diverting anymore funds from the people who really need it right now to body modifications for prisoners.

And Ophelia needs far more help than gender reassignment surgery. Because really, there are countless transgender people who can’t get gender reassignment surgery, for whatever reason, who are not trying to cut their genitals off on a regular basis. That, to me, screams that there is something much deeper to her mental illness.

I dunno. Just my two cents. Not meant to be offensive. I’m really just thinking aloud, here. I’d love to hear what you think.

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  1. June 11th, 2011 at 16:11 | #1

    I don’t feel that tax payers should have to pay for the surgery. It’s not a medically necessary procedure. Giving them therapy to help deal with it would be one thing, but not the whole surgery. It’s still a cosmetic procedure, now matter how you look at it.

  2. June 11th, 2011 at 22:45 | #2


    There was a time when I felt like I wanted to be a woman instead of a man. Those feelings didnt come from a sense that I was trapped in the wrong body, but that I, thanks to a shitty dad, hated the idea of becoming just like him. Needless to say, I got over those kinds of self loathing and am comfortable being who I am today.

    I say this becaise there has to be, lime you said, something far beyond believing s/he is in the wrong body to drive someone to castrate themselves. There is some kind of self hatred going on there, and I doubt reasaignment surgery is going to take that hatred away. This person needs taxpayer paid psychiatiric help, not taxpayer paid surgery. Believing you’re the wrong gender, physically, is one thing; trying to destroy one’s self is another.

    Of course, I’m coming from the point of view that all self destructive acts and desires come from a place of psycholigical problems and need therepy, at least. My one caviot is for those who feel drawn cutting for non-destructive reasons (erotic, relaxation, stress reducing) may well have already found the best form of therepy for their actual issues. It’s the ones truly trying to destroy themselves in some way (suicide, mutilation, etc.) that need the help.


  3. June 12th, 2011 at 21:01 | #3

    I have to agree that the state should not pay for gender reassignment surgery. It really isn’t necessary to live, and while I do empathize with those who want the surgery, it really isn’t something that should be on the tax payers backs. It’s one of those things that if were allowed, would create a snowball of problems because there would be no reason to say no to any other surgeries that aren’t for life threatening purposes.

    Also, it does kind of suck that if you’ve started hormone therapy and then become incarcerated. Unfortunately, you really can’t put them in the jail for the gender they feel they are because then there’s no definitive marker to make the choice. Then anyone could abuse the system and say they feel like they’re in the wrong body and need to be switched. It just kind of sucks.

  4. Camryn
    May 15th, 2014 at 23:18 | #4

    Well this is interesting. I see where you’re coming from and I understand you mean no offense.

  5. May 16th, 2014 at 10:58 | #5

    @ Camryn This post is rather old. There are a few things here that I would not say or think today, now that I understand transgender issues a little better. I’ve changed a lot in the past three years. As much as I hate the place, that store gave me the tools I needed to learn and grow…and to keep learning and growing without them.

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