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Monday, May 9, 2011

Mayor: City Should Start Paying for Surgeries and Other Treatments for Transgender Employees

Posted by on Mon, May 9, 2011 at 10:49 AM

When most of the city's approximately 10,000 employees seek mental health care, steroid treatments, or a variety of other services, they don't need to prove medical necessity to be covered under the city's employee benefits plan. But once an employee has been classified by the city's insurance carrier as transgender, those services are "universally denied," says the Seattle LGBT Commission in a letter to city officials. "First and foremost, transgender medical treatment is not cosmetic. It is necessary medical treatment. Psychological care, hormonal treatments, and surgical procedures are all medically necessary for transgender-identified individuals."

The discrimination is, in fact, quite explicit for the city's trans employees: The benefit plan for city workers says insurance won’t cover “Any treatment, drug, service or supply related to changing sex or sexual characteristics, including: Surgical procedures to alter the appearance or function of the body; Hormones and hormone therapy; Prosthetic devices; and Medical or psychological counseling." The commission, which advices the mayor and city council, says these exclusions should be removed when the city writes the new employee contracts in 2013.

Mayor Mike McGinn agrees.

“This is something we should be working to improve,” says McGinn, who only learned about the exclusions last Thursday. “This is not frivolous issue. It’s a fundamental issue about the effect on a person’s physical and emotional well-being, and this exclusion means that you are denying appropriate health services to people when they are in need.”

In response to the letter, which was first reported by Seattle Gay News, Seattle City Council member Sally Clark tells The Stranger she didn’t know about the exclusion, either, until the letter. Clark says, “I’ll be looking at how we can change what we should cover.”

The commission will be meeting tomorrow with Council Member Bruce Harrell, chair of the council's civil rights and technology committee.

The commission says officials should modify those contracts by both removing exclusions for transgender employees and explicitly covering care relating to and including transitional surgeries. “This fact of medical necessity is no longer open to debate,” writes the commission, citing opinions of the American Medical Association, American Psychological Association, and other authorities. Employees who are denied coverage can have "debilitating secondary medical conditions, have substantially higher risk for suicide, and experience increased psychological distress."

Extended coverage comes at a higher cost, but employees probably won't rush to obtain expensive procedures. For instance, San Francisco began covering trans employees in 2001. The commission writes, "During the period 2001-2006, the City of San Francisco increased premiums for transgender coverage totaling $5.6 million, but only paid out $386,417 in claims."

“This is a pretty modest issue compared to the significant issue we have of health care costs of the city as a whole,” says McGinn. But he adds: “This is a fairness issue, it’s not about costs.”


Comments (66) RSS

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Baconcat 1
Councilmember Clark caught uninformed on LGBT issues? Oh, okay.
Posted by Baconcat on May 9, 2011 at 11:09 AM · Report this
Councilmember Clark is a great example of why gay politicians are not automatically good on gay issues. Barney Frank has been a roadblock to queer equality for three decades now, but a whore for Goldman Sachs. It's not the sexual orientation or the political party of the politician that matters: it's their politics. Pretty words are not politics. Don't vote for Sally Clark because she's a dyke. Vote for her because she's a dyke with good politics. And then demand she prove it with her record. Really, queers, stop being so damn EASY.

This is Gay Politics 101. Finally.
Posted by Zepol on May 9, 2011 at 11:18 AM · Report this
Will in Seattle 3
I'm kind of torn on this one. I understand the intention, but we're not even paying full freight on reconstructive mastectomies for women with breast cancer right now.
Posted by Will in Seattle on May 9, 2011 at 11:40 AM · Report this
Ziggity 4
@2: Not that I'm their biggest fan, but can you explain how Goldman Sachs has anything to do with gay issues?
Posted by Ziggity on May 9, 2011 at 11:41 AM · Report this
rob! 5
The missing link.
Posted by rob! on May 9, 2011 at 11:54 AM · Report this
@Will in Seattle -if that's what you care about, organize to get it changed!
Posted by queerdo on May 9, 2011 at 11:58 AM · Report this
Question: has there yet been any sort of consistent longitudinal follow-up study assessing the effectiveness of SRS versus other therapies (and/or no treatment at all) that was not conducted by someone in the process of obviously grinding some ideological axe?

In 1979, Johns Hopkins shut down its gender clinic and stopped performing reassignment surgeries, based on a study that followed up with many of their former patients and concluded that SRS had on average not improved their psychological functioning or quality of life. Unfortunately, the two people most associated with that study are both raving lunatics: Paul McHugh is a cheerleader for people who shoot abortion doctors, and Jon Meyer is pretty much the last living, breathing Freudian psychoanalyst, which means he's about as much of an actual scientist as the person running your nearest fortune-telling storefront.

...but my admittedly brief googling around on the topic hasn't led me to any other serious work done on the question, which makes it pretty hard to come up with a reasonable opinion about whether the state should be paying for this.

Pointers to more up-to-date research would be highly appreciated.

(Actually the story at Hopkins is even more insane than you'd think given the above context, since the person representing the pro-SRS side was the notorious and dangerous quack John Money. Must have been a weird time to be a student there.)
Posted by The Kenosha Kid on May 9, 2011 at 12:05 PM · Report this
rob! 8
I don't know jack about benefits planning and administration, but something is very wrong with paying out that much in premiums for that little in claims. Nobody seems to be expressing astonishment about that. Would anyone fork over nearly $6 million for fire insurance over five years to protect a $400k home? Does any other discrete coverage element offered by a group insurance carrier involve such a warped ratio?

I believe in the value and fairness of this kind of medical treatment. But the numbers suggest that enlightened and compassionate employers should self-insure for such coverage.

I'm guessing that government entities could not self-insure without suffering screaming headlines that taxpayers are paying for sex-change ops for government employees, even though the expenses are tiny, and they're buying Bentleys and Gulfstreams for insurance executives instead.
Posted by rob! on May 9, 2011 at 12:12 PM · Report this
wilbur@work 9
tax spending for downstream medical side-effects of elective surgery? Hell no!
Posted by wilbur@work on May 9, 2011 at 12:17 PM · Report this
Damn, they don't even cover counselling? That seems totally backward to me. I mean, it seems pretty obvious to me that medical and psychological expenses should be covered, but if you're going to withhold coverage for surgery, at LEAST give your employees the opportunity to talk to someone and hopefully at least try and treat the kind of pain and psychological trauma that could lead to suicide, no?
Posted by KayElle on May 9, 2011 at 12:17 PM · Report this
Amazing. The city is cutting back on basic public services, maintenance of infrastructure and laying off public servants but there's money to lop off cocks? That's some stomach turning political pandering right there. Gotta stay on the up and up with the LGBT lobby though, he'll need them to knock on doors and raise money next election cycle.

"Sorry we couldn't afford to keep you on Bob, John wants a fake vagina."
Posted by Stunned anon on May 9, 2011 at 12:23 PM · Report this
AmyC 12
civil rights and technology committee? wtf?
Posted by AmyC on May 9, 2011 at 12:38 PM · Report this
rob! @8, thanks for linking to the SGN story. Its extensive excerpts from the Commission's findings shows SF deliberately overestimated in order to be absolutely sure no one would go uncovered, and we're lucky they showed the way, if expensively - now that SF is able to readjust their premiums, other cities like Berkeley and Seattle have the proof adding coverage for this isn't particularly costly after all, a common reason for delay in earlier years...

And kudos to Bruce Harrell for appointing a fine crop of new members to the LGBT Commission this year. And look at the result! Their careful work created a spotlight bright enough to attract even a mayor today! Good job.
Posted by gloomy gus on May 9, 2011 at 12:46 PM · Report this

-1 for busted logic.

just because we don't know all of the causes for cancer, heart disease or any other name your medical condition. . we do have in place EVIDENCE BAESED TREATMENT for all kinds of things that are covered and practiced and make people better.

This is no exception.

Yes. People transition under established Standards of Care and get better. end of story.

As far as Hopkins? Google David Reimer.
Posted by Lady Ga Ga on May 9, 2011 at 12:51 PM · Report this
@14: I think you're reading more into my question than is there, and I seriously apologize if it came off as hostile. I am not questioning the existence of trans people, nor that SRS can improve the quality of life for some number, possibly the majority of them. What I'm curious about is whether it is the only way to make such improvements.

Let me try and restate this: the one follow-up study that anyone ever seems to know about is the Hopkins one. It cast some doubt on the value of SRS, but it was performed by right-wing lunatics and witch doctors, so there's good reason to in turn doubt the veracity of the study. But surely someone has done a reasonable longitudinal study of this, right? Google isn't turning it up, so I'm hoping someone here has a medline or a psychlit account and can cite it easily.

"end of story" -- citation needed, as the wikipedians say.
Posted by The Kenosha Kid on May 9, 2011 at 1:00 PM · Report this
Hawke 16
It should be noted that SF lowered their premiums for all employees after they had an idea of how much of the benefit for their trans employees were actually being used. Here is an excellent whitepaper on the cost-benefit analysis of providing coverage for trans issues.…
Posted by Hawke on May 9, 2011 at 1:01 PM · Report this
p.s. Yes, I know precisely who David Reimer was: hence my reference to John Money as a dangerous quack.
Posted by The Kenosha Kid on May 9, 2011 at 1:01 PM · Report this
In other news-

Groundbreaking health care for oppressed minorities in Seattle will soon include elective surgery for those convinced that they are hedgehogs born in human bodies. Post surgical treatment will include consultative veterinary services, and alteration of selected employee workspaces to be ergonomically friendly to the former humans, now hedgehogs.
Posted by Seattleblues on May 9, 2011 at 1:24 PM · Report this
Margaret Dumont, ladies and gentlemen.
Posted by gloomy gus on May 9, 2011 at 1:29 PM · Report this
Asked for comment on the effectiveness of the hedgehog as an employee McGinn said "Well, I really don't see how you can ask such a bigoted question. And it isn't as if these employees were doing anything anyway. I mean, they're nuts, bonkers, lunatics. They can't even recognize physical reality, never mind process building permits or sort mail. Wait... Did I say that last bit out loud"
Posted by Seattleblues on May 9, 2011 at 1:30 PM · Report this
Great! I always wanted to be a fish. Maybe I should get a city job? I imagine my case could be argued along these lines:
Posted by Loreta on May 9, 2011 at 1:31 PM · Report this
Gloomy Gus will be heading the petition drive for that most oppressed of minorities, the hedgehog who thinks itself human. How long will we allow this terrible injustice to degrade our democracy, he cries! How many hedgehogs must committ suicide by walking accross busy highways, simply because we lack the common hegdehogity/humanity to help them, he wants to know!
His bravery in facing the open bigotry of hedgehog bashers is to be commended.
Posted by Seattleblues on May 9, 2011 at 1:35 PM · Report this
Actually, hedgehog bashing would be kind of painful, what with the quills and all.

Hedge-hate? Hedgehogitry? Hedge-ophobic? Never mind, I'm certain Savage and the usual suspects here will come up with some apt phrase.
Posted by Seattleblues on May 9, 2011 at 1:40 PM · Report this
Matt from Denver 24
You're trying way too hard, SB (18, 20, 22, 23).
Posted by Matt from Denver on May 9, 2011 at 1:42 PM · Report this
@15, there have been quite a few better-designed studies in the past couple of decades, hence the American Psychological Association (…) and the American Medical Association (…) having called for adequate treatment and insurance coverage for gender-confirming surgeries and medical treatments for trans people (the studies are cited within those links).
The other important point is that treatment for trans people is highly individualized--not everyone requires the SAME treatment, but everyone requires adequate access to support and counseling to identify the best combination of treatments to suit their needs. And then the access to pursue these. None of which are currently available to transgender City employees.
Further, "transgender exclusions" like that of the City's are often used by insurers to deny coverage for care completely unrelated to gender identity (for example, saying that an illness or condition is "due to hormone use for gender transition" and is thus linked to transgender status--and therefore not covered). There's anecdotal evidence of this happening for everything from the flu to cancer and in between.
All in all, plenty of good reason for the City (and others) to toss this antiquated and discriminatory policy out the window.
Posted by CB1 on May 9, 2011 at 1:47 PM · Report this

Ah well, I'm amusing myself, at any rate.

But you're right. Monty Python covered this much better in Life of Brian, the clip linked at 21.
Posted by Seattleblues on May 9, 2011 at 1:49 PM · Report this
Yay! This is a great move forward!!
The virulent transphobia some comments are displaying only highlight the need for this kind of insurance coverage to support trans folks!
Posted by queerdo on May 9, 2011 at 1:50 PM · Report this

Unfortunately 'transphobia' isn't particularly catchy either. It's tough to find a word villifying sensible and sane people in defense of crazy ones, isn't it. Poor fella.
Posted by Seattleblues on May 9, 2011 at 1:55 PM · Report this

Don't know the link, but in college psych classes there was a study I found hilarious. A group of students had themselves admitted to a psychiatric hospital. Their professor knew about the project, as did the hospital administrator. The staff did not.

The only ones who couldn't tell these students were sane were inmates. Doctors and nurses were unable to diagnose them accurately.

So much for psychiatry.
Posted by Seattleblues on May 9, 2011 at 2:00 PM · Report this
Apology and correction "The only ones who COULD tell...."
Posted by Seattleblues on May 9, 2011 at 2:01 PM · Report this
Backyard Bombardier 31
@28: Fuck off, asshole.

Yes, it's crude and rude. You deserve no less, you hateful piece of shit. "Crazy ones," eh? Why stop there, SB? Let's roll back the clock and lock them all up - the trans folk, the queers, the insane, and of course the vulgar women who say "fuck" in public.

Posted by Backyard Bombardier on May 9, 2011 at 2:03 PM · Report this
CB1@25: sigh, slog ate your links. Feed 'em into, maybe?
Posted by The Kenosha Kid on May 9, 2011 at 2:04 PM · Report this
Backyard Bombardier 33
@29: Learn to google: Rosenhan Experiment.

So, one experiment, from 1973, conducted in one institution, invalidates the entire field of mental health, does it? Fascinating.
Posted by Backyard Bombardier on May 9, 2011 at 2:08 PM · Report this
Backyard Bombardier 34
@34: Further to the above, here's the experimenter's own paper: "On being sane in insane places."

It's an interesting read - far more interesting than your use of it as a crude club to beat up on the mental health profession. Rosenhan's point was not that mental illness did not exist. His point was that what is normal and what is abnormal in mental health exist on a continuum, and there is no bright line distinguishing sanity from insanity:

To raise questions regarding normality and abnormality is in no way to question the fact that some behaviors are deviant or odd. Murder is deviant. So, too, are hallucinations. Nor does raising such questions deny the existence of the personal anguish that is often associated with "mental illness." Anxiety and depression exist. Psychological suffering exists. But normality and abnormality, sanity and insanity, and the diagnoses that flow from them may be less substantive than many believe them to be.

He also observed that 1973-era mental institutions were unhealthy places for the mentally ill:

It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals. The hospital itself imposes a special environment in which the meaning of behavior can easily be misunderstood. The consequences to patients hospitalized in such an environment -- the powerlessness, depersonalization, segregation, mortification, and self-labeling -- seem undoubtedly counter-therapeutic.

Posted by Backyard Bombardier on May 9, 2011 at 2:16 PM · Report this

My my. A bit testy this afternoon. Weather a bit off in the far north?

I'll see your 'fuck off' and douche' and 'hateful piece of shit' and raise you a 'Have a pleasant afternoon.' I'm off to run the dogs. Or cats, if that's how they see themselves. I wouldn't want to oppress them.
Posted by Seattleblues on May 9, 2011 at 2:19 PM · Report this
Backyard Bombardier 36
@33: In the interest of intellectual honesty (try it sometime SB, you may find you enjoy it) I confess to a total reading comprehension fail in the above post - there were twelve institutions involved in the Rosenhan experiment, not one.

Still don't think it can in way be read as invalidating psychiatry.

@35: Weather here is beautiful. And I call 'em as I see 'em. Be as genteel about it as you like: you are a hateful bigot.
Posted by Backyard Bombardier on May 9, 2011 at 2:25 PM · Report this
@29: At the not-inconsiderable risk of apparently agreeing with seattleblues about anything and thus inadvertently encouraging the little wanker... if the Rosenhan experiment doesn't give you considerable pause, I submit that you're not thinking about it very hard.

The defense mustered for psychiatry on that wikipedia page is pretty weak sauce indeed: to be sure, you could probably con an ER doctor into immediately diagnosing a bleeding ulcer if you tried really hard, but they'll rule it out pretty quickly by endoscopy, and they are unlikely to commit you for months based on your unwillingness to admit that you've got a gastic bleed.

The ugly reality is that organized scientific study of mental pathologies is a very, very young science indeed: we're at about the same place in psychology that the science of physics was during the age of alchemy. That doesn't mean that we toss out the entire field, but you'd be a fool not to evaluate its more expansive claims with some healthy skepticism.
Posted by The Kenosha Kid on May 9, 2011 at 2:27 PM · Report this
Backyard Bombardier 38
@37: There is a world of difference between "Evaluate its more expansive claims with some healthy skepticism" and "So much for psychiatry."

Rosenhan absolutely gives me pause to consider how we define what is abnormal and what is normal, to think about confirmation bias, to wonder if mental institutions really help people, and many other things. What it doesn't make me do is throw out the whole field of study.

Seattleblues' point, writ small, was "Psychiatrists make mistakes and can be fooled; therefore psychiatry is bunk." And that's crap.

(He also walks an interesting line - he calls transgender folk "crazy" while at the same time attacking the field of mental health. So - they are nuts, but we can't diagnosis or treat them? Come again?)
Posted by Backyard Bombardier on May 9, 2011 at 2:39 PM · Report this

Seattleblues point writ small was nothing of the kind. Psychiatry can be a means for helping people. I know someone abused by a family member for whom professional help did a great deal of good. I have an aunt whose mental condition precludes living outside of institutions since the death of my uncle. She's happy and able to function with psychiatric help and neither without.

But psychiatry is tinkering with a machine whose fuctions we're only beginning to guess at, never mind understand. Add to that the fact that each individual is a different machine biochemically and with respect to how their own psyche developed. With that psychiatry is at best a benign guess, at worst a stab in the dark.

To some degree this is true of medicine generally. The difference is that cancer or pregnancy aren't subjective. Whatever the patient is able or willing to see, the physical condition is as it is. While some mental disorders fit this category, the vast majority are mostly subjective in diagnoses, and therefore in treatment.

So, if you want to use psychiatry as a helpful tool to make lives better with a full awareness of its limitations that's one thing. If you want to use it to prove anything at all, thats quite another.
Posted by Seattleblues on May 9, 2011 at 3:21 PM · Report this
Writing in support of the insurance change. It costs nothing, as we have seen in other jurisdictions. Answering other insipid questions raised here, people transition and perform gender in any number of ways whether medically aided or not, AND the question on the table is a not a moral one (re: one's gender and how they experience, express, perform or otherwise embody it), unless the question is whether or not we should provide healthcare to all our citizens. And then it is a moral one and the answer is yes.

The question on the table is about access to medically necessary procedures that are currently excluded. Not only are these procedure prohibited, but often trans people find themselves and their bodies excluded from health coverage simply for being trans.

Ok. Done. Access to healthcare for all. sure are spending a lot of time on this topic. If it pertains to you...I truly hope you find some peace.
Posted by hejemonster on May 9, 2011 at 3:26 PM · Report this
Writing in support of the insurance change. It costs nothing, as we have seen in other jurisdictions. Answering other insipid questions raised here, people transition and perform gender in any number of ways whether medically aided or not, AND the question on the table is a not a moral one (re: one's gender and how they experience, express, perform or otherwise embody it), unless the question is whether or not we should provide healthcare to all our citizens. And then it is a moral one and the answer is yes.

The question on the table is about access to medically necessary procedures that are currently excluded. Not only are these procedure prohibited, but often trans people find themselves and their bodies excluded from health coverage simply for being trans.

Ok. Done. Access to healthcare for all. sure are spending a lot of time on this topic. If it pertains to you...I truly hope you find some peace.
Posted by hejemonster on May 9, 2011 at 3:28 PM · Report this
Healthcare? No, it's elective surgery. No more needed than a breast enlargement for a woman who hates her small tits or a rhinoplasty for a Long Island JAP 'tormented' because she wants to look like Gywneth Paltrow.

Fly to Bangkok where they'll make you a women for less than the price of the flight plus you can spend a few weeks on the beaches in Koh Samui with all the katoeys 'recovering'.

Every Stan can be made into a Loretta....

“This is not frivolous issue."
Actually it is, which is why it's important to you.

Good to see McGinn expanding his base from Critical Massholes and bums to now include Trannies. The man's a shoe-in in 2012 I tell ya.
Posted by Loreta on May 9, 2011 at 3:59 PM · Report this

sigh. . . it's hard to sort out all the trolling since then. . . but #25 basically said what I'd say. Medical (and legal) transition is totally individualized based on the patient's needs and the state they live in. The Standards of Care allow for many different paths. It is not unusual for a woman to not have a vaginoplasty. . . especially since laws for changing ID's etc. are not requiring it. It's just not all about the penis.

As far as people deciding to have "healthy skepticism?" *sigh* pick any aspect of trans lives and you'll find people undermining them for any reason. . . It's really, really tiring to be dehumanized into someone's abstract, intellectual debate. That's why so many just "woodwork," "blend" or "go stealth."
Posted by Lady Ga Ga on May 9, 2011 at 4:20 PM · Report this

yup. . . getting breast cancer. . . and having coverage denied 'cause someone was trans and *took hormones. . . is pretty scary.

*as opposed to any other woman on HRT and then getting cancer. . .diff.
Posted by Lady Ga Ga on May 9, 2011 at 4:23 PM · Report this
Basehead 45
So taxpayers have to contribute to some perv getting their willie whacked off?
Posted by Basehead on May 9, 2011 at 6:21 PM · Report this

Geez, where to start-

First, I don't agree with your moral assumption. I have no moral or financial responsibility for the health care of anyone but myself and my family.

Second, a sex change isn't ever medically necessary. Surgery on breast cancer, or a malfunctioning heart might be, but surgery to match the delusions a person has of reality with reality is a violation of the Hippocratic oath.

And yes, if you choose an elective surgery which might itself cause you to be a health risk, your insurance company has a right to exclude you.

Finally, I'm very happy as the man I was born. This is in part because I'm sane. I recognize, for instance, that I must open a door to effectively pass through the opening between the jambs. I recognize that I must either swim or wade accross a river, but won't make much headway walking on the water. It's called reality, the recognition of which is one of the necessary elements of sanity.

Transgender, in short form, is insane. My 6 year old recognizes that if a person has a penis, by God they are male. If not, they aren't. When an adult can't perform this fairly elementary feat of deduction they need mental help, not surgery.
Posted by Seattleblues on May 9, 2011 at 6:30 PM · Report this
Catalina Vel-DuRay 47
Don't mind Seattleblah. He's just afraid that if trans people become more accepted, cross-dressers will become even more marginalized, and he won't be able to find lingerie that fits him.

I've given him some of my old Lane Bryant catalogs, and pointed out that Mrs Seattleblah wears the same size he does, but apparently it's the principle of the thing.

I really wish he'd stop beating himself up over this, or at least lay off the trans people, most of whom have been really supportive of his cabaret show. After all, He's really quite striking when all dolled up, and his Totie Fields is nothing short of genius. When he comes out on that stage, you would swear you're back in 1968.
Posted by Catalina Vel-DuRay on May 9, 2011 at 6:40 PM · Report this
I fully support trans-gender people to outfit themselves medically to change their sex.

But when the hell has insurance covered everything? They even turn down life-saving operations at times, I'm not saying they should, but they do.

Although people may kill themselves from depression related to sexual identity crisis, I doubt anyone actually dies because they're a man trapped in a woman's body.

Jeez, I know I'll catch hell for this but:

To call a sex change procedure a "need" goes way beyond the definition of the word...

Humans only "need" the following:

1. Air
2. Water
3. Food
4. Shelter
5. Clothing

That is truly all humans "need". We can even live without medical treatment for a very long time, and indeed some do.

I'd add compassion, companionship and affection to the list, but I saw Tom Hanks in "Cast Away" recently, so I now know you can go on without those things too...

Posted by scratchmaster joe on May 9, 2011 at 8:02 PM · Report this
@48: yes they do sometimes die.

A recent survey of 6,000 men and women reporting an attempted suicide rate of 41%.…

Since you are using tired old tropes of 'sex change' and 'trapped in a body' tells me you have no clue what you are talking about.
Posted by Lady Ga Ga on May 9, 2011 at 9:25 PM · Report this
Backyard Bombardier 50
@46: Fortunately, the current state of medical thinking is a little more advanced than your six-year-old.

I'm glad you are happy as the man you were born. I too am happy as the man I was born. I am also capable of understanding that just because I feel that way - just because the vast majority of men born men and women born women feel that way - it doesn't mean that everybody does.

Your opinion on this is unsurprising. Your fundamental failing is that you mistake your opinions, experiences, and preferences for universal truths. You say "I as a man do not wish to have sex with another man. Therefore, same-sex orientation doesn't exist." You and your six-year-old both identify with the physical bodies you have; therefore, everyone does.

Well, everyone doesn't. And you can't make that go away by simply saying that they shouldn't.
Posted by Backyard Bombardier on May 9, 2011 at 9:27 PM · Report this
Backyard Bombardier 51
@50: Er, "should."
Posted by Backyard Bombardier on May 9, 2011 at 9:49 PM · Report this
venomlash 52
@45: Actually, they don't cut it off. Rather, they cut it open, scoop out the erectile tissue, and turn it inside out in order to make it into a vagina.
FTM transsexuals have it a bit rougher; a biologically female body doesn't have enough erectile tissue to make a wang out of.
Posted by venomlash on May 9, 2011 at 10:55 PM · Report this
53 Comment Pulled (Spam) Comment Policy
All I'm really sure about after reading this conversation is that Seattleblues is kind of a dick, and I would really like to know what a Coach Purse is.

@25/CB1, could you post those links again?
Posted by Park on May 10, 2011 at 11:02 AM · Report this
Lissa 55
@54: It's a very nice brand of handbag and accessories, if indeed you didn't already know that and weren't just being facetious.
I have already emailed The Stranger Staff and have been informed that they are in the process of weeding out all this purse spam.
Now if Seattleblues were to swept up as well during said housecleaning, I, for one, would not shed a single solitary tear.
Posted by Lissa on May 10, 2011 at 11:41 AM · Report this
Lissa 56
were to be swept up I mean.
Posted by Lissa on May 10, 2011 at 12:18 PM · Report this
KaraC 57
@48 SRS is a life saving operation to most people who have it.
@18 Why do people ALWAYS compare us to animals in this sort of thread? "Hey, if I said I was a dolphin, should insurance pay for blah blah". It is highly insulting. We are human beings, and not delusional, and a growing body of research suggests that brain gender identity is most likely due to gender dimorphic brain differences. Since we don't yet know how to change brain gender identity (not that that is something I would advocate even if we could) then trying to match the body is the next best option.
Posted by KaraC on May 10, 2011 at 4:04 PM · Report this
@57 Because some of us think our limited healthcare dollars should be spent to save, say, kids with cancer, or women with breast cancer rather than men who want to be women or visa versa. It's called priorities, something you must have when resources are limited. Just buy yourself some ABBA albums and start saving to pay for your own surgery.
Posted by Pay for your hobby yourself on May 10, 2011 at 8:11 PM · Report this
Seriously people, wtf? The decision to have SRS is clearly not something a person goes into lightly, but a decision made carefully over time, with full awareness of permanence and the change it will bring to that person's life. So treating it frivolously seems as bullshit as treating, say, the decision to adopt, just as casually. It's also not some kind of weird sex thing. People may choose to crossdress as a fetish, but if you're talking about permanently surrendering your gender role in society, that's a serious thought that lasts longer than your boner in girly panties.

I know trans-ness seems crazy, but have you ever lived as the other sex? Hell, have you even read Norah Vincent's "Self Made Man?" She's not trans, but she lived as a man for a year, and towards the end, the experience nearly broke her psychologically. She is a woman inside, and play acting at something else wouldn't work, no matter how much the external world decided she was "Ned." Similarly, a transwoman may intellectually understand that she has a penis, and other markers of manhood, (she's aware of her physiological reality) but it does not make her psychologically a man, nor does it make her experience the world as a man, and belong in that role. It is a psychologically inappropriate mismatch.

Seriously, how is it that the same group of people who say that gender roles are inborn when we're talking about female engineers and male nurses are also the first to say trans-people just need to learn the right gender role? Learned or inborn, pick a team.
Posted by JudT on May 11, 2011 at 11:52 AM · Report this
Will in Seattle 60
So, is the Mayor showing up at the Trangender Film Festival this weekend, or any of the Council?

That would be great time to talk with them about this.
Posted by Will in Seattle on May 11, 2011 at 4:42 PM · Report this
I'm disappointed to see that there are so many people opposed to this extremely important and necessary item.

This September, my cousin, a 23 year-old transgender woman, committed suicide. Throughout middle school and high school, when she presented as a male, she was shy and reserved, and some other students believed she was gay—as a result, she endured verbal bullying every day, with taunts of "fag" and "faggot" all the time, and occasionally even physical abuse. (This was all committed by students who at the time considered themselves to be "Christians.")

Later, she went on to college at Dartmouth and graduated in 2009. While at Dartmouth and in the time after graduation, she didn't face the same type of abuse—but she did face a lack of understanding and, from some quarters, bigotry. She wasn't an activist—she wanted no part of the transgender rights movement. Ever since she began coming out to herself as trans when she was 10, and to others when she was 19, she just wanted to be a woman, period. In appearance, in mannerisms and with the help of hormones, she worked hard to "pass" as a woman every day. When anyone detected that she was transgender and/or discriminated against her because of that, she felt horrible, and her depression worsened, until, this September, she killed herself.

Folks who oppose transgender-inclusive non-discrimination legislation often use (a) the "choice" argument and, even more extreme, (b) use "a man in a dress" to refer to transgender people (and specifically to transgender women). Transgender people do NOT choose to be transgender. Remember, these are real people, not some outlandish caricature made-up by opponents, and they don't deserve to be degraded in that way. Whether they're closeted as transgender or out about it, they might be your neighbors. They might be your friends. They might even be your family.

The degradation and discrimination that transgender people face takes its toll. In a recent study, the suicide attempt rate for transgender people is shown to be at an all-too-real 41 percent—26 times the occurrence in the general population*. Many conservatives seem to have no concern for what transgender people face. But this is serious—there are real lives at stake, and discrimination is proven in the same study and elsewhere to increase the likelihood for depression, and suicide.

Finally, even if the public weren't in support of equal rights for transgender folks here, it shouldn't make a difference—civil rights for a minority group should never be subject to what the majority wants. (If civil rights for African-Americans—which as a racially mixed person, is what I identify as—had been put up for a vote in the South during the '50s and '60s, it would've failed horribly.) But public opinion in the city of Seattle has been shown to be very supportive of transgender equality.

The cost of this City proposal negligible, so it shouldn't be about that; it should be about fairness and compassion.

*Extracted from "Injustice at Every Turn: The National Transgender Discrimination Survey," found at:…
Posted by ajc84 on May 11, 2011 at 8:49 PM · Report this
Sorry about those links. The American Psychological Association statement is here:, and the American Medical Association's resolution is here (pdf):
Funny, people don't tend to complain about insurance covering surgeries to remove non-trans men's breasts when they develop gynocomastia, or griping about how ridiculous it is for non-trans girls with vaginal agenesis (absence of a vagina at birth) to seek surgery to create one.
Glad to see that aside from the Mars Hill mini-sermons and rage-fests in this thread, people are getting a clue about trans people benefitting from (gasp!) respectful and competent health care. That includes primary care as well as gender-confirming care. Again...neither of which trans people currently have access to. Not much of a tall order, people.
Posted by CB1 on May 11, 2011 at 10:23 PM · Report this

yes to all of what you said. . . it seems at every turn, it's always about the women.

Every time some right-wing nut proposes legislation to make sure "transgender" people are excluded from using public bathrooms (I'm looking at you Maryland) they do so because they feel it opens the door for pervs to dress-up as women or simply declare themselves "women" to prey on their daughters. . . they never think about making sure Buck Angel uses the women's room!

and. . . there's the stripe of feminism that have been bashing trans women 4'evea'. . . if there's an epidemic in the trans community, it's doing everything possible to just go live as stealthy as possible. . . and then people wonder why so many are not too keen to be "out and proud." sigh.
Posted by Lady Ga Ga on May 12, 2011 at 6:39 AM · Report this
I am in support of providing adequate health care coverage for everyone, including transgender folks. here's why:

- everyone deserves healthcare coverage.
- as a society, we all work together to provide each other with the necessary food, water, clothing, shelter, healthcare, education, etc. We ALL rely on one another for the things we need, transgender individuals should not be left out.
- coverage of gender affirming procedures not only provides health care to the individual, but saves money in the long run. not providing care increases mental health issues, mental health is a major indicator of health and good mental health can lead to fewer sick days taken.
- the cost is low, the benefit is high. this will have little impact on non trans people (if any), and a huge positive benefit for those who can use gender affirming coverage.
- providing the health care transgender people need means that there is a little less injustice in the world, and that helps everyone to live with a little more love and a little less hate.
Posted by owlwingsfemme on May 12, 2011 at 12:10 PM · Report this
"as a society, we all work together to provide each other with the necessary food, water, clothing, shelter, healthcare, education, etc."

...and vaginas? What about nose jobs for suicidal Long Island JAPs who want to look like Gywneth Paltow? I knew a few in college who driven nuts by that urge. Should we pay for breast implants for women depressed over their small tits?

Sorry Little Johnny, no health care dollars for your cancer treatment, we're spending them making Little Stan into Loretta:

Posted by Loreta on May 12, 2011 at 9:58 PM · Report this
KaraC 66
@58 and @ 65: Read 61. This is not just "a whim" to get big boobs and a vagina or look like Gwyneth Paltrow, nor is it a "hobby". The cost is miniscule comapared to the health dollars spent on alcohol abuse, smoking related ilnesses or obesity, all of which you could argue are self-inflicted. Gender dysphoria is a condition you are born with. Not being able to be your true self can lead to severe problems, and it is treatable at relatively low cost compared to other life saving treatments or drug regimes.
Posted by KaraC on June 3, 2011 at 3:00 PM · Report this

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