Wednesday, November 04, 2009

Women's Day of Action for Health Care Reform: The Choice Movement and [Trans] Women's Health

The choice movement is not about babies or fetuses. It's about women* and their bodies.

It's about a woman's right to medication and medical care.

For the majority of women, meaning hetero cis women, "medication" translates into birth control and "medical care" translates into pregnancy care: how to have a healthy one, how to terminate one if needed, and how to avoid one in the first place.

When we talk about "women's health" we are, sadly, talking about hetero cis women, and we usually end up talking about birth control and pregnancy, even though hetero cis women do have other medical needs, not related to their reproductive organs.

Now here's the newsflash: not all women are hetero cis women. And guess what? They have medical needs too.

I am pro-choice because I have a right to tell my body what to do, not the other way around. I have a right to use birth control to make my periods regular, to reduce my cramps and other PMS symptoms, and to avoid unwanted pregnancy.

Now, for me personally, I'm lucky that my periods are pretty regular, and I don't really suffer from cramps. (I did have that one issue with the unwanted pregnancy, though.)

For me personally, I'm also lucky that what's between my legs (i.e., my sex) matches what's between my ears (i.e., my gender). That's another medical need I personally do not have. But millions of trans people do.

Just as I have a right to tell my body what to do and what not to do (by using birth control to regulate my periods or keep me from getting pregnant), a trans woman has the same right to control her body and tell it what to do and not do. And, if anything, I'd say a trans woman's needs trump my own; if worse came to worst I could control my body by not having sex or trusting the rhythm method. But a trans woman doesn't have another choice.

Disclaimer: I am new at this. I am probably going to screw up language and I know I am talking with little knowledge of trans medical needs and care. If I do screw up, please let me know, and I will correct myself.

A trans woman's body tries to act like a man's body. It tries to grow hair on her face and have a deep voice and not grow breasts or have the proper curves. Her body betrays her. The only way she can control this is with medication and/or(?) hormone therapy. She needs this medication just as much as, if not more than, I need birth control.

When we talk about women's rights and women's basic health care we need to make sure we also talk about trans women's rights and trans women's basic health care.

They may not need access to birth control, but they need access to hormone therapy (and/or other medical treatment of which I'm ignorant) if they choose to do that.

Then there's the day-to-day medical care. For me, it's things like my yearly well-woman exam, breast exams, so on and so forth. And those other things that come up randomly, like yeast infections, UTIs, etc. When any of those things comes up, I have the right and the ability to go to a doctor to get the care I need to fix the problem. Even if I don't have health insurance to help me pay for it, I know I can go to a clinic, such as Planned Parenthood, and get the care I need.
A trans woman also has the right to this, but at the moment, she does not have the ability to go to a doctor or a clinic to get the medical care she needs. Mainly her medical needs don't "match," according to cis standards, with her gender.
It's been decades now since we cis women have had to resort to the coathanger in a back alley. But for trans people, a back alley butcher with homemade tools is the only medical care they have access to. Part of the reason, I'm sure, is that insurance companies don't approve claims for Pap smears for men, or testicular cancer screenings for women. Part of the reason is doctors' offices don't know how to file paperwork for someone who was born a "man" but is now a woman. (This is a damn stupid reason, but it happens, and it's a barrier to medical care.) Part of the reason is probably that your average doctor or even your average OB/GYN doesn't know how to treat a trans person's needs.
Cis women have a specialist they can go to who knows all the details of their bodies. Why can't trans people have a specialist, a trans doctor, who specializes in treating their medical needs?
Do they even teach this stuff in medical school? I know a while back we pro-choice feminists got all up in arms about an anti-choice bill that wanted to remove the "abortion" pages from medical textbooks. Do those textbooks have any "trans" pages in them to begin with? Is this part of a med student's training? My very uninformed guess is NO.
I know it's easy for us cis women to say we're not qualified to speak up on trans issues because we don't know enough about it. We don't know what their needs are, we don't know what it's like to go through a gender transition. If we don't know what their needs are, how can we campaign for their needs? How can we advocate for their rights, when we don't know that much about the issue?
Do we allow cis men to get away with that cop-out when we're talking about cis women's reproductive rights?
So, guess what. If you don't know, learn. Find out. Ask. Engage trans women in the conversation. They're out there, and I bet they have a lot to say.
Ask your doctors and other medical professionals. They should be the experts, right? Find out if they are.
Does your primary care physician serve trans people? Are they welcome in your PCP's office?

Does your OB/GYN know how to serve the needs of trans women seeking hormone therapy? Does your OB/GYN treat trans men?

Does your local clinic offer services to trans people? Are they made to feel welcome there?

All women have a right to basic health care. This includes access to medication and medical treatment. This includes yearly exams, regular checkups, and any other specific diseases, infections, maladies, or concerns that pop up in-between. This includes birth control, pre- and post-natal care, labor, and abortions. And it also damn better include trans people's needs.
Even if the details of the execution (birth control v. hormone therapy) are different, the moral principle is the same. If you are pro-choice, as I like to proudly call myself, and fight for your right to basic medical care specific to your body and reproductive organs, then you need to also fight for a trans person's right to do the same.
We are feminists. We fight because the patriarchy has oppressed us for years, and we're not going to take it anymore. But we need to be aware that we are not the only group who has been and is oppressed, and I for one want to make sure that I am not oppressing anyone else. I don't want to do to others what has been done unto me.

If we leave trans women out of the discussions of and demands for women's health, then we are oppressing that group of people. And that goes against everything feminists fight for.

The health care reform debate has been hijacked by talk of abortion, which is sad because women's health care is so much more than that, even if we're only looking at the limited cis woman's definition of health care. But in all these talks, in all these calls and letters and petitions, can wen please include trans women? Can we let their voices be heard? They need health care reform more than any of us.
*See fourth paragraph from the end. But first, read all the paragraphs between the asterisk and the fourth paragraph from the end. And then read the last three paragraphs. All that to say, "women" means different things to different people; we need to be inclusive of all women.


  1. Oh my gosh, this is such an important post and brought up all kinds of things I hadn't thought about. Thank you for writing it.

  2. I'm glad you're getting involved in this cause, since so many of us have never even thought about the problems and needs of transgender people.

    I recently started following a mom on twitter who has a 6 year old child who was born a boy, but is transitioning into a girl. (@todayyouareyou also I cannot imagine what it must be like to go through that as a mother, not to mention looking ahead at what both she and her daughter will go through over the years.

  3. Anonymous8:41 PM

    I agree chris...

    The needs of all of us MUST be met or we will never overcome the true health crisis which is ignoring members of our society.

    Sadly though, Im thinking that we'll have to take our secular goverment back from the bible thumpers first.