[ethics] Sex Change, No Surgery Required
Sex Change, No Surgery Required
Randy Dotinga
http://www.wired.com/news/technology/medtech/0,72174-0.html
02:00 AM Nov, 29, 2006
Creating a new outpost in the battle for transgender rights, both New York City and Spain are expected to soon allow people to officially change their gender without actually undergoing a sex-change operation.
Transgender people are fighting on many other fronts, pushing for free access to public restrooms and insurance coverage for gender-reassignment operations. But the proposed liberalization of sex-change rules brings the movement into uncharted territory.
If people can switch genders in the eyes of the government with only some documentation from a doctor, will fewer feel the need for surgery? And what about military service, marriage and the supposed threat of cross-dressing peeping toms?
The answers to some of the questions are unknown. But to one activist, one thing is clear: The United States is developing "a much more accurate representation of how people actually change sex."
"For a lot of folks, surgery is not a part of their transition, because they have health problems that make it unfeasible or financial issues, or it's just not how they understand themselves to be," said Christopher Daley, director of the San Francisco-based Transgender Law Center, which focuses on California. "They don't need surgery to feel complete as a man or woman."
New York City appears to be on the forefront when it comes to transgender rights. Last month, the agency that runs the subway system agreed to allow transgender people to use the restrooms of their choice. Now comes news that the city will probably allow people born there to switch the gender on their birth certificates.
According to a proposal that's expected to be approved next month, the city will allow the changes if a person brings documentation from a doctor and meets some other criteria. No surgery is necessary.
Meanwhile, the lower house of Spain's parliament has reportedly approved a bill that would allow people to officially change their sex without surgery, although many would be required to have undergone some kind of medical treatment. (Spain also allows same-sex marriage.)
Currently, New York City will revise birth certificates for anyone who provides evidence of a sex-change operation -- but the city will only remove the gender from the document. It will not switch the gender from male to female or female to male.
Essentially, the city currently declares transgender people to be "genderless," said Gabriel Arkles, a staff attorney with Sylvia Rivera Law Project, which has pushed for the proposed regulations for years.
The rest of the United States has a hodgepodge of policies regarding the official recognition of sex changes. According to a compilation of U.S. and Canadian laws, three states -- Idaho, Ohio and Tennessee -- don't allow gender changes on a birth certificate, surgery or no surgery. Almost all the other states and all Canadian provinces require proof of a sex-change operation; Iowa recently allowed official gender changes without surgery.
As for other forms of identification, Dr. Becky Allison, a transgender cardiologist who compiled the list of laws, said passport officials allow gender changes without requiring surgery, as do most state departments of motor vehicles.
The proposed New York City regulations raise plenty of issues.
Will the regulations allow same-sex marriage? Some state laws are murky regarding marriage involving one or two transgender people; one legal analyst reports that a pair of men were able to marry in Ohio because the state refused to recognize that one of them was no longer a woman following a sex-change operation.
On the other hand, some transgender people may be unable to marry because their states recognize their new sex but don't allow same-sex marriages.
Either way, the proposed New York City regulations won't change state laws.
Will fewer people undergo sex-change operations because they don't need to? That's unclear. But financial hardships prevent many transgender people from going under the knife.
Male-to-female surgeries, the most common, can cost $37,000 or more, according to one estimate, while the rarer female-to-male surgeries run closer to $77,000. (One surgeon lists prices for both kinds of procedures.) In addition, surgeons require patients to have undergone therapy and to have lived as the opposite gender.
Guidelines should prevent sex offenders from using the new regulations to gain access to the restrooms of another gender, Allison said.
"Confirmation from a therapist of the person's mental status and intention to live 24/7 in the desired gender should screen out these people," she said. "Sadly, if a true sex offender wants to do something like this, he won't let a legal document stop him."
Randy Dotinga
http://www.wired.com/news/technology/medtech/0,72174-0.html
02:00 AM Nov, 29, 2006
Creating a new outpost in the battle for transgender rights, both New York City and Spain are expected to soon allow people to officially change their gender without actually undergoing a sex-change operation.
Transgender people are fighting on many other fronts, pushing for free access to public restrooms and insurance coverage for gender-reassignment operations. But the proposed liberalization of sex-change rules brings the movement into uncharted territory.
If people can switch genders in the eyes of the government with only some documentation from a doctor, will fewer feel the need for surgery? And what about military service, marriage and the supposed threat of cross-dressing peeping toms?
The answers to some of the questions are unknown. But to one activist, one thing is clear: The United States is developing "a much more accurate representation of how people actually change sex."
"For a lot of folks, surgery is not a part of their transition, because they have health problems that make it unfeasible or financial issues, or it's just not how they understand themselves to be," said Christopher Daley, director of the San Francisco-based Transgender Law Center, which focuses on California. "They don't need surgery to feel complete as a man or woman."
New York City appears to be on the forefront when it comes to transgender rights. Last month, the agency that runs the subway system agreed to allow transgender people to use the restrooms of their choice. Now comes news that the city will probably allow people born there to switch the gender on their birth certificates.
According to a proposal that's expected to be approved next month, the city will allow the changes if a person brings documentation from a doctor and meets some other criteria. No surgery is necessary.
Meanwhile, the lower house of Spain's parliament has reportedly approved a bill that would allow people to officially change their sex without surgery, although many would be required to have undergone some kind of medical treatment. (Spain also allows same-sex marriage.)
Currently, New York City will revise birth certificates for anyone who provides evidence of a sex-change operation -- but the city will only remove the gender from the document. It will not switch the gender from male to female or female to male.
Essentially, the city currently declares transgender people to be "genderless," said Gabriel Arkles, a staff attorney with Sylvia Rivera Law Project, which has pushed for the proposed regulations for years.
The rest of the United States has a hodgepodge of policies regarding the official recognition of sex changes. According to a compilation of U.S. and Canadian laws, three states -- Idaho, Ohio and Tennessee -- don't allow gender changes on a birth certificate, surgery or no surgery. Almost all the other states and all Canadian provinces require proof of a sex-change operation; Iowa recently allowed official gender changes without surgery.
As for other forms of identification, Dr. Becky Allison, a transgender cardiologist who compiled the list of laws, said passport officials allow gender changes without requiring surgery, as do most state departments of motor vehicles.
The proposed New York City regulations raise plenty of issues.
Will the regulations allow same-sex marriage? Some state laws are murky regarding marriage involving one or two transgender people; one legal analyst reports that a pair of men were able to marry in Ohio because the state refused to recognize that one of them was no longer a woman following a sex-change operation.
On the other hand, some transgender people may be unable to marry because their states recognize their new sex but don't allow same-sex marriages.
Either way, the proposed New York City regulations won't change state laws.
Will fewer people undergo sex-change operations because they don't need to? That's unclear. But financial hardships prevent many transgender people from going under the knife.
Male-to-female surgeries, the most common, can cost $37,000 or more, according to one estimate, while the rarer female-to-male surgeries run closer to $77,000. (One surgeon lists prices for both kinds of procedures.) In addition, surgeons require patients to have undergone therapy and to have lived as the opposite gender.
Guidelines should prevent sex offenders from using the new regulations to gain access to the restrooms of another gender, Allison said.
"Confirmation from a therapist of the person's mental status and intention to live 24/7 in the desired gender should screen out these people," she said. "Sadly, if a true sex offender wants to do something like this, he won't let a legal document stop him."