14 May 2014

What Chuck Hagel Still Needs To Understand

Secretary of Defense Chuck Hagel recently said the ban on transgenders serving in the US military "continually should be reviewed.

He hasn't stated that the ban should be lifted. However, he has stated his belief that "every qualified American who wants to serve our country should have the opportunity if they fit the qualifications and can do it".

So far, so good, right?  Well, it is, except when you consider what he said about the repeal of Don't Ask, Don't Tell.  Letting gays, lesbians and bisexuals serve in the military is all well and good, he opined, but that the issue of transgenders serving is "more complicated" because sometimes we "require medical attention" that can't always be provided in the remote (or "austere", as he put it) locations  in which armed forces members often find themselves.

Now, some of you might say, "He has a point".  And you'd be right.  What if I were in some desolate area of, say, Afghanistan and ran out of my prescribed hormones?  Or, more important, what if the medical supervision needed to ensure safe hormonal therapy wasn't available.  Then, of course, there is the question of what to do if someone in such a setting were to develop complications related to surgery or other aspects of transitioning.

I would like to say that it should be possible to overcome such difficulties.  It probably is, but I couldn't tell you how.  Nor, for that matter, could most health care providers.

At least, most in this country couldn't.  I'm guessing that, perhaps, someone in Australia, the United Kingdom, Canada or Israel has answers to those questions:  Those nations allow trans people to serve in their Armed Forces.

But having to consider that question leads to another:  Is transgenderism primarily a medical condition?  Or, at any rate, should it be classified as such?  Almost all current definitions used by health care and insurance providers, as well as researchers and policy-makers, are based on medical and physiological criteria, and the "treatments" are pharmacological and surgical ones.  

While some trans people exhibit physical traits and mannerisms of the "opposite" sex, being trans is as much a state of mind and spirit.  Some would argue, as I would, that a trans person doesn't become trans by putting on the clothes of the "opposite" gender, taking hormones or getting surgery.  Doing such things merely allows trans people to live more easily as their true selves.  At least, it does for some:  There are trans people who don't do any of those things but live as the gender in which they identify, whether or not their physical characteristics and behaviors conform to their culture's ideas about maleness or femaleness, or of masculinity and femininity.

Thus, some trans activists like Pauline Park denounce the "medicalization" of transgenderism.  She, and her fellow activists (including yours truly) believe that people should be allowed to live as the gender to which they identify, whether or not they choose, or are able to, take hormones or undergo gender reassignment surgery.   Some cannot afford the surgeries or even lack medical insurance; others are unable to avail themselves to those options because of other medical conditions.  Still others simply do not want to risk the possible complications of hormones and surgeries.  Ms. Park thinks--as I do--that no one should feel forced to do these procedures simply to have the right to live and work as his or her true self.

But the ability to get coverage for hormones and surgeries--to those employers and insurers who offer it--and the struggle for equality has been predicated on the notion that transgenderism is mainly, if not entirely, a medical condition.  While that may have helped to decriminalize wearing the clothes of the "opposite" gender or remove a little bit (though certainly not much) of the stigma attached to being a trans person, it also limits us.  And it will limit the military, who will deny themselves some talented, intelligent individuals who want to live as the women or men they actually are rather than by the "M" or "F" that was checked off on their birth records.  That is what Chuck Hagel and the military brass need to understand in "reviewing" the ban against transgenders serving in the military.