The Riddle of Gender - Deborah Rudacille [124]
“If you talk to post-op transpeople, most are what you would call conservative on this question,” says Chelsea Goodwin of Transy House. “I’m conservative in the sense that I accept the medical model but I believe that anybody who needs to see a doctor should, and anyone who needs surgery should be able to have it reimbursed. I’m a pragmatist really. In the 1970s and 1980s the argument was that the transsexual community looked down on cross-dressers because transsexuals got legitimacy from the Benjamin medical model. Well, that legitimacy made it possible for us to exist. Nobody likes to look at the fact that Christine Jorgensen managed to do this [sex reassignment] at the height of the McCarthy era. There was still this incredible respect for scientists among the public back then. If a doctor at a time when medicine was the most respected profession in America said that this was okay, then the public believed it. That was the only way that this revolutionary act of sex change could be done at the time. To throw that legitimacy away now is crazy.”
Therapists and other professionals who work with gender-variant clients express many of the same reservations. Christine Wheeler says, “My fear is that it [the GID diagnosis] will get thrown out of the DSM because of some of the strident views coupled with malpractice issues that continue to frighten physicians. I’m afraid that we will see a time when people won’t be able to get the help they need.” Wheeler, who is on the APA task force for DSM-IV and is one of the drafters of the HBIGDA Standards of Care, says that both committees are “looking at standardizing the child and adolescent GID definitions and reexamining the protocol for intersex conditions around the world, as well as the protocols for intervention in GID.” She admits that there are problems with current definitions. “Sometimes the language is archaic, and I apologize for that,” she says. However, the essential point to remember when discussing the value or lack of value of the diagnosis, she says, is that “something has to be wrong in medicine in order [for it] to be fixed.”
Dylan Scholinski articulates this conundrum from the perspective of the trans activist, admitting that whereas “initially most people were advocating the straight-out removal of GID from the DSM,” a more nuanced position is now developing because “you don’t want to fuck with people’s access to health care, not till there’s something else in place. You can’t just leave the community with nothing.”
Not only does the GID diagnosis ensure continued access to surgery and hormones for those who require them (even if they are not covered by insurance), but it is also used as a legal tool. Those states that permit transsexual people to change their sex of record on birth certificates, driver’s licenses, and other legal documents often require letters from psychotherapists and other health care providers attesting to the medical validity of the claim. Some require proof of genital surgery; others do not. The broad definition of GID ensures that even those who have not undergone genital surgery (as most FTMs do not) qualify for such legal remedies. Attorneys Collin Vause, Shannon Minter, and Karen Doering relied heavily on the medical model in the case oiKantaras v. Kantaras, a child custody lawsuit argued in the state of Florida in 2002. In this groundbreaking case, Florida Circuit Court judge Gerard O’Brien ruled in February 2003 that Michael Kantaras, a transman, was legally male, and that his marriage to Linda Kantaras