Above all else, I always try to be a practical woman. Maybe it's my Hoosier upbringing; maybe it's my family's small-business, by-the-bootstraps mentality; or maybe it's just my interactions with money in a time of recession; but I have always thought of things in terms of practicality over all else. Abstract concepts are nice, but there's something about the down, the dirty, and the practical that always catches my attention.
I've seen a lot of brouhaha about the recent tax court decision to make transition-related expenses tax deductible, and to be honest I don't get the uproar. Namely, I read one article in particular here on Bilerico that springboards from the tax court decision into a call to move the transgender treatment and identity from a disease model to an identity model. My primary contention with the position is the assertion that transgender people should be seen as a salient identity instead of a medical condition; thus the tax court decision is a bad precedent that codifies GID as a medical condition, complete with all the issues that come with being labeled as diseased. I disagree with this position; the very foundation of a trans identity - at least in the classical, medical-model sense - is that of a disorder that needs correction.
What's so bad about needing medical help?
For sake of argument and comparison, I don't want to start by talking about my views on transition, medical gatekeepers, and our position within society's gender binary. See, this isn't my first time to the medical-disorder rodeo, and I think that talking about my other disorder may give us a new framework with which to explore the issue of transition, medical disorders, and our identities.
I have a visual handicap caused by a little-known genetic disorder called X-linked Juvenile Retinoschisis, and it has shaped the way I approach transition.
What is XLRS?
X-Linked Juvenile Retinoschis is a rare eye disorder, passed along the x-chromosome, that affects vision from an early age. Cysts form between the retina and optic nerve and fill with fluid, eventually separating the rods and cones from the nerve. This macular degeneration is slow and progressive, and eventually causes severe visual impairment. The only treatment at this time is observation and low vision aids: no cure for the disorder exists.
What does this mean for me? I'm 25 and I wear progressive lenses. I need a letter from my ophthalmologist when I try and get a new license, as I sometimes fail the vision test. All in all, I have 20/70 vision with my glasses on, and have to make some significant adjustments to my workspaces to to make basic, everyday tasks livable. A few examples:
- My computer monitor is positioned approximately 9 inches from my face, and my entire desk is arranged around that setup. (Any further and I find myself leaning in close to read the screen.)
- My living room has chairs for everyone else, and then a chair for me near the television.
- My friends know to read far-away texts for me - however, most times I simply listen to conversation and try to figure out the text by context clues.
- I had large-print books and tests in elementary school. (Once I got better about adjusting my behaviors for daily tasks I moved to regular-print books.)
- I avoid driving at night whenever possible.
- I have been told on multiple occasions to consider my vision when looking at potential careers. ("You may have trouble with that when your eyes start to go.")
- I live with the eventuality of going blind. (Point of fact: I'm actually overdue for a loss of acuity, according to case studies I've seen.)
People act strangely when they discover you have a visual impairment. Some of this is curiosity - what can you see? - and some of this is simply trying to understand what you need to get by. However, there's a strand of pity running through the reactions of many people. I tire of hearing the "you poor thing!" chorus whenever my impairment gets brought up: I'm not a poor thing, and if I didn't tell you that I have 20/70 vision they wouldn't have been any the wiser. I have a visual impairment, yes, but I don't want to identify as visually impaired.
I don't want pity. I want equality. Thus, I don't often tell people I'm visually handicapped. I'll tell people if they ask, but it's not something I offer up on a daily basis.
Transgender through an "impairment" framework
Asking around, I find that there are two major ways to approach transgender identities. On one hand: transgender is an identity to be proud of. Often found in online groups, trans-exclusive spaces, and other sympathetic avenues, these people see our transition as exempt from the medical model, and wish that more decision-making power could be put into the hands of the transitioner. On the other hand, we have the medical model, where therapists, doctors, and care-givers act as gatekeepers to transition resources, and the goal is to correct a sort of "cosmic irony" such that the transitioner can lead a mainstreamed, normal life in the role of their chosen gender. Both models have their merits, and both models have their downfalls.
I've talked to a few sympathetic medical professionals about this debate, and the answers are quite telling of the climate this conversation has brought to bear. Few people are willing to wade into the discussion - there is far less tolerance of lexicological missteps in trans-related conversations than there are in more mainstream issues. (As I said to a friend: in trans debate, stick yourself out there and there's a good chance you'll get cut down to size.)
However, the conversation about visual impairments acts as a great metaphor for this discussion. I never wanted to be visually impaired. I never wanted to deal with the eventual fact that I'll be legally blind, or that my entire workspace has to be modified to accommodate my vision needs. In much the same way as a visually impaired person never wanted their condition, I never wanted to be trans in the first place. I am, and yes it's part of my identity, but if I'd had my druthers I'd have been born female. Simple as that.
Reality, however, dictates that I need medical help to achieve my transition goals. Do I like it? No. Is it cheap? No. However, practicality rules the day here. This isn't my first time to the "It's not fair!" rodeo, and I'm sure it won't be my last. I don't want to buy expensive progressive lenses, or look ahead to expensive low-vision aids, or consider braille lessons, but that's the way my cookie crumbles. More and more, I see transition in a similar way: a necessary evil, predicated on medical gatekeeping, with the end of being a run-of-the-mill girl in mind.
My agreement or disagreement with the GID diagnosis is immaterial to tax breaks, psychology scholarship, or my medical treatment. By the same token, I'd love to hear about a cure for XLRS, but I fully understand that there just isn't enough need for a cure to finance the research. In the meantime I simply accept that some things will be more expensive for me, and while that's not morally okay it's just the way things work right now.
Going back to practicality, I have spent a lot of money on my transition, from hair removal to hormones to wardrobe, not to mention the long-term losses that unfortunately come with the disparity between male and female pay rates. I've played by the medical gatekeepers' rules, gone through my pain and suffering, and I have just as much right to define my trans status as a disorder as others have to define it as an identity. Furthermore, I feel that I've earned the right to be low-key about my transition; I don't wear the "I'm trans!" pin everywhere I go, and for the most part I get along just fine as a woman.
I am visually impaired, but I am loathe to center my identify on this fact. The same applies to my trans status. My goal from the very start of my transition was to be a woman. It always has been, and always will be my ideal end result. While transgender is part of my identity, it is not me: I am not third gender, and despite the fact that our medical establishment requires the diagnosis of a disorder to meter treatment I am not a "broken" person because of the diagnosis.
"Disordered" doesn't mean broken
The tl;dr here is simple: the system sucks, but that's not going to change just because we lament the sentiment of transgender as a disorder. By society's medical, legal, and financial definitions, we are disordered: we are people whose gender doesn't match our sex and whose condition requires medical correction. That's the definition of disorder: something that is out of order. Plain and simple, clear as crystal. Does the fact that our condition is a disorder mean that we, as people, are disordered? As a genetic-disorder laden, visually-handicapped woman, I say no.
People sometimes ask me why trans people can't get it together, lobby-wise. I think part of the answer lays in the definitions of the group: some of us never wanted to be trans in the first place. Many will find ways to come out of the end of the tunnel, completely mainstreamed and comfortable with being their target sex, despite their history. For many - myself included - that is the end-goal: integration, not salient identity. I'm a half-blind girl that used to be a boy, if you have to know, but we don't talk about it that often.
Are we perfect in the gender of our choosing? Hardly. But then again, nobody in this world can afford be so blind as to ignore their imperfections.