CmdrKing wrote: ↑Sun Jan 19, 2020 11:40 pm
The tl;dr on the old "trans people have to be sterilized" is the folks who wrote those laws were kiiiinda eugenicists.
It's worth noting that hormone therapy also has that effect in practice, large quantities of estrogen will suppress testosterone production and vice versa, which will shut down sperm production/menstruation. Going off hormones for a few months can sometimes reverse that... and sometimes not, or at least not enough for reproductive function.
All of that assumes that you went through your assigned puberty of course, so far as anyone can tell if you do hormone replacement as your first puberty it prevents the reproductive organs from hitting full functionality. Which is yet another reason the first line of medical intervention for trans kids of puberty
blockers, not hormone therapy: they're making a much more permanent decision at a much younger age than adults and consequently need to be a lot more certain about the matter.
This actually gets into the larger question of why self-ID is so important though. The laws on the books now are either outdated or don't exist, depending on where you are, so trans folk are collectively butting heads against a lot of barriers and the common thread between all of them is the people behind them a) don't know anything b) don't care and c) as often as not don't want you to exist.
In general, if it's possible to prevent someone from getting the right documentation/medical treatment they need, it will be prevented for a good long while and there's no recourse except spending the money to cast a wider net and find someone who gives a fuck.
But let's get into some specifics. Just to pull an example I know off the cuff, here's a relevant bit from the Michigan government website:
"Michigan statute says that Vital Records will issue a new birth certificate upon receipt of "a request that a new certificate be established to show a sex designation other than that designated at birth. The request shall be accompanied by an affidavit of a physician certifying that sex-reassignment surgery has been performed." Michigan Public Health Code §§ 333.2831.
To apply for an amended birth certificate the applicant should submit:
The application form signed by the applicant
A medical affidavit signed by a Physician, stating that the applicant has had "appropriate surgical procedures completed for gender transition to the new gender"
A copy of their photo ID
A copy of the court order for name change, if applicable
Any applicable fees"
Aside from preemptively excluding the portion of trans people who a) don't seek medical intervention for dysphoria, b) aren't a binary gender, and c) want hormones or other procedures but
not genital surgery, even for a more-or-less binary trans person who gets genital dysphoria... well that's onerous isn't it? The steps to get to the court issuing you a new birth certificate, which will let you get proper ID anywhere, would be
1) Get a PCP referral to a qualified psychiatrist
2) Get psych diagnoses of Gender Dysphoria
3) Psych referral to endocrinologist
4) Endocrinologist prescription of hormone replacement, with associated revisits for monitoring and adjustments.
5) Followup once hormone levels are stable with psychiatrist for assessment of surgical intervention
6) Psych referral to surgeons for genital reconstruction
7) The Surgery *scare chord*
8) Secure medical affidavit
9) Get proper birth certificate from vital records
10) get proper photo id from state government
The shortest speedrun of that path of transition I've ever seen is just under a year, and closer to 3-4 is far more likely. Assuming you have the ~$100,000 to do it*. During which time you're basically using a bunch of id cards and soforth that will have an increasingly mismatched name and picture on.
Obviously some states have less dire laws (and some have more!), but Michigan is a useful average of the US in several ways (social norms, population, demographics) and also I knew roughly what they were even before looking it up so.
So how would we actually make a compromise version of that exactly? Like, no step of that process is even up to date, let alone useful. Increasingly endocrinologists and supplemental gender specialty clinics are moving to an informed consent model, wherein essentially you say "I have The Gender", they give you some waivers and explain how hormones work (and in particular the bit where you'll probably become infertile), and you go on your way. So if I say I'm in favor of self-ID for government purposes, I'm basically saying that getting up to date legal documents should work on the same model. And if we were keeping some sort of medical documentation saying "yes this person has The Gender, give them new ID" as the main qualifier, well... you only added one new step that's about as easily circumvented by a bad actor. I mean, I guess we could do that as an intermediary step to get people educated on how gender works? But even then it's a bad plan that excludes non-binary people (because another thing we should be doing, and a few states have done, is include non-binary markers for state ID). And any steps
beyond that are increasingly prohibitive.
Do we separate the medical transition from the ID entirely, but keep in the requirement for a Dysphoria diagnosis? It's probably the least exclusionary option (still
is, but substantially less, sure), but it has a fuckton of logistical issues. Gender Dysphoria was only added to the DSMV, which was published in 2013, so the majority of practicing psychiatrists aren't going to be familiar with it or able/willing to diagnose it properly. The other issue here is it makes legal protections difficult to create or apply, because a small handful of people can decide to simply deny you classification and thus deny your ability to seek redress even in the eventuality laws were created were trans people
could seek redress from bigotry.
When I say self-ID the only ethical practice, what I'm getting at is any other standard either a) makes getting new documents inaccessible to many, indeed probably most trans people or b) provides an easy and clearly defined avenue to exercise bigotry against trans people. And more often both.
Essentially, I don't think the sort of 'compromises' that resulted from second wave feminism or the marriage equality movements will be effective for trans rights. Achieving something meaningful for the majority requires some very substantial reexamination of how we look at society regardless, so approaching problems in a holistic way is not just best practice but necessary.
*Non-US countries don't have this particular problem. But also last I knew the NHS waiting lists for gender care clinics was "get back to us after the Johnson administration" and had been 3 years before that, and that's to even START. So.
