Thursday, 19 January 2006

Manslaughter, Marriage and Medicine

From a support group I'm on :
Late 1997, I was corresponding with a girl called D..... She wrote to me about the HBSOT, when I queried the typo, she replied it wasn't a mistake, the "T" stood for torture. She was attending Charing Cross. She took her own life after they insisted she spend at least one year of RLT in employment before they would prescribe hormones.

Early 1998, another girl C...., said she had been with Russell Reid for two years, but following unemployment, and being unable to afford Russell, had transferred to the Nottingham Gender Clinic. A Dr F.... told her she had to stop all treatment whilst they assessed her, which could take a year. She also took her own life, mid 1998. These are not unsubstantiated rumours, I have the archived messages from both.

HBIGDA - Harry Benjamin International Gender Dysphoria Association - the international group that has determined how Transsexuality should be treated.
HBSOC or SOC - The "Standards of Care" put out by the HBIGDA. Basically they state that before treatment can begin, there's a 3-month+ psychiatric evaluation, then perhaps treatment with hormone replacement therapy (HRT), and a 12 month + long "Real Life Test" (RLT) (usually 2 years in Australia) before any surgery is authorised.
RLT - "Real Life Test" - living successfully 24/7 in the social role of the desired gender. That means inter alia in gainful employment, fulltime study, or doing volunteer work.

To insist that someone even before hormone treatment, and so looking unmistakeably male (OK, I'm an exception) should start a "RLT" looking like an obvious "transvestite freak", and that they somehow keep down a normal job while doing so... is sadism of the worst kind. It is a perversion of the already restrictive SOC that could only have been dreamt up by a sick mind.

To insist that someone who had previously been under the care of a private hospital discontinue the treatment that was keeping them functional for a whole year - at least - while they were being "assessed" to see if treatment could be allowed to continue, that is bureaucratic incompetence and inhumanity of the worst sort.

These people were slain, just as surely as if they had had their throats cut in surgery.

Now I'm no activist. I just want to live my life as best I can. I'm not about to complain overmuch about legalistic trifles that affect a tiny minority, when there are more important issues to be resolved. Things like the liberation of 50 million people in Afghanistan and Iraq. Or disarming the Iranian Mad Mullahs before they start lobbing Nukes Hither Thither and Yon. Neither am I going to complain overmuch about well-meaning and highly professional people who are genuinely doing their best, however paternalistically, to help others.

But there comes a time when you have to say ENOUGH. To point out the petty injustices that wreck people's lives. To plead that legal insanity should cease.

Case in point:

In Australia and the UK, some people's legal sex depends entirely on whether they're married or not.


Difficult to believe, I know, but true.

A Transsexual woman who has been made somatically female can have this fact recognised, and a corrected birth certificate issued, in all states of Australia. She is recognised for all purposes as legally female.

But not if she's married. Then she's legally male, and cannot change that status, no matter what treatment she may have.

In the UK, in order to "protect the sanctity of marriage", they have a special procedure, where a couple (legally male and female, respectively) who are married, but where one partner has an "interim gender recognition certificate" can get both divorced and "re-married" (still legally male and female) in a "civil relationship" AKA "Same Sex marriage" on the same day, without having to go through the pain and nausea of division of property, children's custodial arrangements, etc.

They have to destroy the marriage to save it, you see.

Then, and only then, can the transsexual partner have their actual gender legally recognised, also on the same day.

This is not protecting the sanctity of anything, it is making a mock of it. A farce, a grotesquerie, involving happily married couples having to formally part just so they can stay together, and reality be legally recognised. See Guidance For Married People Or Those In Civil Relationships (PDF).

Of course in Australia, the couple don't have this option. The only grounds for dissolution of a marriage is "irretrievable breakdown". One partner or the other must formally swear to the Court that the marriage had broken down beyond hope of repair, and evidence must be presented that they had formally separated at least 12 months previously. To then immediately request that they be re-married in a "civil partnership" would be a legal, as well as actual, nonsense. So instead, legally, black is white, 2+2=5, and someone obviously and medically of one gender is legally of the other. This has very real and terrible implications should they be arrested in a case of mistaken identity, or attempt to travel overseas with a passport with obviously false information on, or a host of other matters.

Currently, to the Australian Department of Health, I am legally Female, as evidenced by the code number on my Medicare Card.
To the Australian Electoral Commission, I'm Female, as evidenced by my Electoral Registration.
To the Australian Department of Foreign Affairs and Trade, who issue Australian passports, I'm legally Male, and would be unable to change that status while still married.
To the UK Passport Office, on the other hand, I'm female. Good, I can use a UK passport to travel to Thailand in November for my corrective surgery. Of course, getting back into Australia is another matter. I'm still awaiting a reply from DFAT on that one.
To the Australian Capital Territory Registrar General, who regulate marriages, I'm Male.
To the Australian Tax Office, as evidenced by my Tax File, I'm Female again.

Transition is hard enough, spiritually, psychologically, socially and medically, without this legal insanity. My partner and I are by no stretch of the imagination still Husband and Wife, yet we remain together, still just as much in love as we were the day we married, and co-parents of a little son who means more to us than life itself. She's not Lesbian, and neither, to my discomfort, am I now. I really was a "Lesbian trapped in a Man's body", but neither is true any longer.

The solemn vows we took "in sickness and in health" could not reasonably be expected to include fantastically rare and ill-understood medical conditions that cause one partner's body to partly change gender without external intervention. Yet we're staying together anyway, at least, as long as we can. The Law in its Majesty, and its Insanity, is not helping one little bit.

With the Law as it stand now, should we divorce, I could get re-married. But only to another woman, as I'm legally male. The pressure groups attempting to preserve the sanctity of marriage, and prevent same-sex marriage, have by their efforts and legal convolutions achieved exactly the reverse.

Meanwhile, in a Universe not very far away from this one....

The HBICPA Standards Of Care are being attacked.

"Hawing a Cweff Pawar iw wor a wenaw iwneff" said one sufferer.

Another, who had had "The Op" stated "Why should we be stigmatised for what is basically a physical problem easily surgically correctable"

Historically, Cleft Palates have been treated by a combination of analysis and psychotherapy to make those who have this condition become comfortable with, and adjusted to, their situation. Proponents of the psychiatric causal theory point out the high incidence of co-morbidity of depressive illness, substance abuse, and body dysmorphia. They also refer to "denture fetishists" who usually secretly insert prostetic palates for eating in the privacy of their own homes, sometimes concealing this for many years from their partners.

Cleft Palate Sufferers themselves assert that many of their problems stem from feelings of rejection by society at large, and in particular lack of socialisation during their formative school years. Their "body dysmorphia" they see not as a psychiatric illness, but a natural consequence of having an opening from their palate to their sinuses, and a disfiguring gap from their nose to their mouth. They see this as being wrong and uncomfortable. When surgically corrected, the body dysmorphia has been shown to disappear in more than 95% of cases.

Religious groups have countered with arguments that such "corrective surgery" is in fact, only cosmetic. "Nothing can replace the teeth that God in His Wisdom has seen fit not to provide" said one. "The artificial constructs of jawbone used by some so-called 'surgeons' will never replace real teeth: they are a mockery."

But most of those CP Sufferers who have had reconstructive surgery differ. "It's not just about eating, or being able to speak normally", said one. "It's about being able to look in the mirror and see someone whole, and normal. It just feels right".

Many CP suffers have critised the HBICPA "Standards of Care" that require 12 months of "Real Life Experience" wearing a prosthetic denture, and demonstrated success in chewing and speaking normally, before surgery is authorised. "Thome people can never 'path'" said one. "Our Lithp never quite goeth away. Thure, plenty of NP's altho have thlight speeth imperfecthions, but to a Thee Pee Thufferer, being 'clocked" ith devathtating. But we live with it. Why thould thith preclude uth from Thurgery?"

Some radical CP support groups have stated that in an ideal world, CP should be treated in a similar way to another common developmental anomaly whose cause isn't clear, Trannssexuality. Infants are routinely screened at age 5 to determine their gender, and any necessary corrective surgery performed before they incur social stigmatisation. This is covered by normal health insurance. Yet many insurance providers have specific clauses excluding treatment for CP as being "cosmetic" or "experimental". Many people today are asking "why the difference"?

Even without such discrimination, the life of the CP sufferer is not easy. Some whose operations resulted in physiogamy that looks so normal, only a dentist can tell, live in 'Stealth', concealing their past, and always afraid that they will be "outed" and suffer shame and humiliation. Others just live their lives, neither concealing nor emphasising that once they had a Cleft Palate. "No one cares if you were born with innappropriate genitalia" said one "I treat my former Cleft Palate state in the same way - part of my life history, nothing to be ashamed of, just a little unusual, that's all."

Other still are "out and proud", activists in the cause of CP rights, braving the scorn and derision of much of society in order to agitate for change.

But the attitude of most CP sufferers can be summed up by one so-called "pre-op" : "I jutht want to live thomething like a normal life. Not a freak, or a weirdo, just a normal human being. To be myself."

(c) 2006 Zoe E Brain.

1 comment:

Anonymous said...

Great blog I hope we can work to build a better health care system as we are in a major crisis and health insurance is a major aspect to many.