(originally posted on my personal blog 4/4/13). Content advisory for language and an image of blood.
“It was much pleasanter at home,’ thought poor Alice, ‘when one wasn’t always growing larger and smaller, and being ordered about by mice and rabbits. I almost wish I hadn’t gone down that rabbit-hole — and yet — and yet — it’s rather curious, you know, this sort of life! I do wonder what can have happened to me! When I used to read fairy-tales, I fancied that kind of thing never happened, and now here I am in the middle of one! There ought to be a book written about me, that there ought! And when I grow up, I’ll write one.” – Alice’s Adventures in Wonderland
As a transgender woman I’ve thought a lot about the idea of myself being flawed. I struggled for 24 years overexamining every tiny indicator of “maleness” that I saw in the mirror. I carry the flaw of having identification, documents, and records in a name other than my own. I carry the flaw of genitals that are seen as incompatible with my gender. I still feel flawed in my fashion choices and the fit of the clothes I wear on my body despite not looking or feeling right in men’s clothes, either.
Simply put, I have felt for most of my life that I’m caught in a perpetual state of being flawed – caught in the inbetweenness of “not” and “not quite yet”. I’ve been always expected to measure up to a standard that as a deviant I can only approach, but never attain. A human asymptote.
Nevertheless, these “flaws”, due to nothing but blind luck, were something that I could hide and bury from the world, because they saw me as physically beautiful and thus somehow more worthy of owning the identity that I had fought for. I would tuck, powder, and blend away the flaws, hold my head up high, and walk with a confidence that I was very much privileged to have, simultaneously freed from my own mental prison and dragged down by the guilt of knowing that there were prisoners like me not so lucky to happen to fit into socially constructed beauty standards.
Though I would often ruminate on this and try not to, there were times when I took my identity for granted. Thinking about it, that seems like something anyone should be able to do, and cis people, no matter how conventionally attractive, do so all the time. Yet in my case, this was something I had to feel guilty for. I tried to minimize my cognitive dissonance and live for the first time proud of who I was and how I looked and how others saw me – attractive and unflawed.
Then, yesterday, it happened.
I got out of bed and wrote a little bit of an essay and decided to take a shower. I felt a little lightheaded, but I ignored it. I took for granted that I would wash my hair and my skin and then dry off and head for the store. I took for granted that I’d be able to go print off the poster I had made for a class assignment and get coffee with a friend. I took my health and lack of visible flaws for granted. I took for granted my consciousness and the wholeness of my identity, until I lost it.
I passed out when I stepped out of the shower and was in the process of putting on my bathrobe. I don’t remember the fall, only waking up covered in blood surrounded by shards of a broken full-length mirror that once stood on the floor.
“Oh, fuck,” I said.
“Fuck, fuck, fuck.”
I looked in the mirror above the sink, which was unbroken, and it revealed to me that I had suffered hideous gashes across my forehead and nose and deep into my cheek. I would later learn that the forehead gash was 3cm deep and my nose had a trench 1.5cm deep. I was bleeding profusely, and the amount of blood already on the floor combined with the still-woozy dehydrated feeling that I had made me wonder if I would lose consciousness again as I frantically dug through the cabinet for something, anything, to stop the bleeding. I tried to apply the 1 piece of gauze we had left, but it was small and drenched in blood before it had any shot at being effective. I tried to apply bandages but they slid off my face, unable to adhere to my skin in the viscous blood flow that would not stop. I finally applied all 3 of the towels I own to my face in rotation as each of them became covered in my blood.
With my bathrobe on, I managed to amble into the kitchen and get a drink of water in preparation for what came next. Little crimson droplets left a trail behind me with each frantic footstep.
“Okay, I can’t go naked… FUCK, I can’t afford this, I don’t have insurance! Maybe I should just try to stop the bleeding myself… No, then it won’t heal right and I’ll be a scarred mess… FUCK, I’m going to be hideous…”
I was sobbing, my blood mixing with my tears as they fell to the floor and I frantically searched for a bra and my black V-neck to throw on. I pushed my still wet hair aside and called my parents, who advised me to go to the emergency room and “not to worry” about having no insurance, which was of course impossible. I then called my roommates. They were at work, so I just left a voicemail and told them that I was going to the hospital. Once I was dressed, I actually took the time to scribble a note for them so that they knew the house was not a murder scene and apologized for the mess.
I grabbed the least visibly blood-soaked towel and my purse and keys and got in my car. Somehow I was able to drive to the emergency room where I checked in. It was normally uncomfortable any time I had to take out my identification with an outdated picture of myself and a name that was now foreign to me, but with the entire room focused on my bleeding face and thrown-together appearance, I felt suffocated.
Once checked in, I took a seat and my roommate called to let me know she was on her way. She soon arrived and comforted me, holding me in her arms.
“I’m… sorry…” I said.
“Don’t you even.” She replied. “It’s going to be okay. Don’t apologize for this.”
I heard my birth name called out. Embarrassed, I got up and sat down in front of some woman who asked for basic health information.
“Now… your name is…” She said.
“Katharine.” I replied. “That’s just my birth name.”
“So are you male or female?”
“I’m a woman. I’m… I’m trans.”
Always a scary admission to make in East Tennessee.
After talking to her, they admitted me back into a room. I disrobed and put on a hospital gown as strangers laid me onto my bed, uncovering my body to examine it and determine what was wrong with me. They then wheeled me out and into a dark hallway where I waited to be thrown into the CT scanner. A woman came out and asked my name as they wheeled out an old man and prepared to wheel me in. I told her, and her reaction was accepting, but in a way that seemed as if it were more to humor me than actual acknowledgement of who I was.
They strapped me onto the stiff, phallic bed of the CT machine and slid me into the alien womb. I remember feeling totally helpless, disoriented, exposed, and alone as the machinery whirred, scanning me until finally it had finished and I was birthed back into the world. The woman from before gave me another robe to more fully cover myself where the first had been pushed aside. She seemed more concerned with my exposure than I did, but I put it on and slid back over in my bed so they could wheel me back.
Once I was back in my room, the doctor finally saw me. They said that I’d done a hell of a job injuring myself. Congratulation on my wounds, still dripping blood on my face, was not exactly the most comforting thing to hear. I asked him if I would be permanently disfigured and he told me that with the severity of my lacerations there would likely be permanent scarring. Tears again welled up in my eyes.
As they prepared to give me my stitches, I talked with my roommate and my aunt, who had just arrived, and the conversation seemed to revolve around how I would learn to accept these flaws and eventually forget about them. How there were people who were once beautiful, but then learned to live with being damaged. I did not want to hear that. I didn’t want to be formerly beautiful. I didn’t want to be damaged.
It felt like the actual process of being stitched took an eternity, but I am glad that the doctor seemed to be meticulous. I was talkative with him as the blood and anesthesia fluid dripped down my face, trying to find humor in my situation to deal with the emotional and physical pain I was feeling.
“I’m just like a little stuffed rabbit with its stuffing falling out.” I said.
I received 30 stitches, and the doctor said that I looked good. I still hadn’t seen how bad I looked, but relative to when I walked in the doors I suppose that was true. My aunt took a picture to send to my mother so that she wouldn’t be as worried. Everything still felt like a bad dream. Soon after, a strange man who fittingly had a voice that I would describe as “Mad Hatter-ish” came in to confirm that I was uninsured and unemployed, and they wrote me a prescription for antibiotics and sent me on my way.
In my friend’s car, I saw my reflection for the first time since I was stitched up. I remarked that I looked like a “last girl” from some horror film who had just fought with Jason and emerged victorious. I didn’t feel triumphant, however. I realized that I could no longer hide my flaws. That I would have a permanent marker upon my face, the defining characteristic of my identity to others, that I was to be categorized under words like “damaged”, “lacking”, “inferior”.
I was not whole, so I was not beautiful.
I never really thought much about that feeling, and the way that our society views bodies and faces which deviate from a “norm” apart from the feelings that I experienced as a transgender woman. Even then, however, I could hide my “flaws”. I could conform to the standard with relatively small effort. I could do “beautiful”. Now that isn’t an option. Defective is written on my face.
I know I shouldn’t be feeling this way and I see now that beauty is more something that is done than something that one is, and that those who cannot do beauty as well as others are marginalized for it through no fault of their own. I know now that I had a lot of internalized shit that made me value those beauty norms in myself and it very likely colored my perception of others.
I feel a lot of emotions about my face right now. I know that it will “get better” and that it will heal but my face is likely permanently changed and I can’t help but feel the tears welling in my eyes writing that. I wish I could be like Alice through the looking glass and say that I’ll come through it stronger. I wish I were in a wonderland that I’ll return from or a fairy tale with a happy ending but I don’t think that’s the case and I don’t really deserve it to be. Other people have to deal with a lot worse than this and I was privileged beforehand being seen as beautiful. If I’m honest, I don’t know if I’m strong enough to leave the house and venture out of this world beyond the looking glass. I don’t know if I’ll be stronger. I don’t know yet if I destroyed the mirror or if the mirror will end up destroying me.
If I am stronger, however, I can’t help but think about how great the metaphor of a trans woman destroying a mirror and coming out the other side to self-acceptance despite her “flaws” is. I was selfish, though, in being okay with the idea of being able to avoid that adventure to a much greater degree than some other trans women that I know. Maybe I needed to be humbled. I’m not really sure, and if my life has taught me one thing, it’s that I will be learning lessons from this fall through the looking glass for years to come.
Maybe it will make me stronger and a better person.
Maybe I should just think of it like Alice did.
“After a fall such as this, I shall think nothing of tumbling downstairs!”
Yesterday, the Arkansas state legislature used their ability to override a veto by Gov. Mike Beebe to implement the harshest abortion restrictions in the nation. The restrictions, which prohibit abortions after 12 weeks, and the latest in a string of incidents in which state legislatures, dominated by (male) republican politicians, are assaulting women’s access to healthcare.
In the 50 states combined, legislators introduced more than 1,100 reproductive health and rights-related provisions, a sharp increase from the 950 introduced in 2010. By year’s end, 135 of these provisions had been enacted in 36 states, an increase from the 89 enacted in 2010 and the 77 enacted in 2009. (Note: This analysis refers to reproductive health and rights-related “provisions,” rather than bills or laws, since bills introduced and eventually enacted in the states contain multiple relevant provisions.)
Fully 68% of these new provisions—92 in 24 states—-restrict access to abortion services, a striking increase from last year, when 26% of new provisions restricted abortion. The 92 new abortion restrictions enacted in 2011 shattered the previous record of 34 adopted in 2005.
2012 kept up that feverish pace, and 2013 is off to its own awful start. All states except for Oregon now limit abortion access, and along with the Arkansas legislature’s action, we also saw Idaho’s ban on abortions after 20 weeks (which was just struck down, thankfully) and the last abortion clinic in Mississippi in danger of closing. Mississippi’s 2011 personhood bill failed, but another personhood bill, crafted by the very same backers, has just been filed again for legislation. Virginia adopted restrictive regulations for facilities providing abortions and for those wishing to receive abortions, including:
A woman must receive state-directed counseling that includes information designed to discourage her from having an abortion and then wait 24 hours before the procedure is provided.
Health plans that will be offered in the state’s health exchange that will be established under the federal health care reform law can only cover abortion in cases when the woman’s life is endangered, rape or incest.
Abortion is covered in insurance policies for public employees only in cases of life endangerment, rape or incest or fetal impairment
The parent of a minor must consent and be notified before an abortion is provided.
Public funding is available for abortion only in cases of life endangerment, rape, incest or fetal impairment.
A woman must undergo an ultrasound before obtaining an abortion; the provider must offer her the option to view the image. If the woman lives within 100 miles of the abortion provider she must obtain the ultrasound at least 24 hours before the abortion.
Let’s be clear about this: these restrictions are blatantly unconstitutional because they place an undue burden on women in obtaining access to abortion. Planned Parenthood v. Casey, which has been consistently upheld, forbids any restriction of abortion prior to viability. They fail to take into account the hurdles that women, especially poor women and women of color face in obtaining access even if abortion is still technically legal. It’s not an accidental oversight, either. Politicians are crafting these restrictions in a deliberate effort to undercut women’s access to healthcare. In the aftermath of a presidential election defined by women’s ability to access reproductive healthcare and in a social environment where the issue is still hotly debated, there can be no doubt of this fact.
These restrictions are not in line with any desire to protect life, as the chart below illustrates.
Furthermore, if these policies are crafted from a desire to legislate their interpretation of Judeo-Christian morality, whose official stance on the issue is hardly consistent and has changed greatly over time, that only speaks to the unconstitutionality of these measures. The concept of freedom of religion, the implicit freedom from religion, and the preclusion of the governmental establishment of religion are enshrined in our bill of rights.
The issue is not whether or not life begins at conception, although there’s hardly a consensus on that, anyway. The issue is women having autonomy over their own bodies and being able to access the health that they need to pursue a happy, healthy life, which is defined as a universal human right. And while certainly those whose life is in danger or who were victims of rape or incest should receive special attention, we should not frame the debate around which circumstances are acceptable for a woman to exercise control over her own body – she always has that authority and no one else can claim it. Period.
Bills like this are unacceptable and their harm is immense and immediate even if abortion technically remains illegal. These restrictions are not hurdles which prevent women from making rash decisions (which is a sexist, paternalistic thing to assume of a woman seeking an abortion anyway) but rather they are brick walls erected by bureaucrats to cut off access that women need to essential reproductive healthcare – access which is their right as a human being.
Last week, the New York Times posted article about more universities’ healthcare plans beginning to cover transition for transgender students, at least to some extent. As someone who has long thought such measures needed to be implemented, I was pleased.
Unfortunately, a number of the universities involved, which is only a handful to begin with, only help to cover hormone replacement therapy, which is just one part of the equation necessary for health for many transgender individuals. As the article notes:
“…since 2008, the American Medical Association has advocated the same thing, for treatment of gender identity disorder. Other medical groups, like the American Psychiatric Association, have taken the same position. Several major insurers have taken the stance that the treatment, including surgery, can be considered medically necessary. The Internal Revenue Service considers the expenses tax-deductible.”
Even though “gender identity disorder” has been removed from the DSM in an effort to stop “pathologiz[ing] all expressions of gender variance just because they were not common or made someone uncomfortable,” for transgender individuals, transition remains the only viable option for treatment of their gender dysphoria. It is absolutely a medical necessity; the attempted suicide rates for transgender individuals are nearly 41% according to a survey by the Lesbian Task Force and the National Center for Transgender Equality.
Medical transition, usually including sexual reassignment surgery, an often prohibitively expensive procedure that is difficult to access even with sufficient funds, is also quite often required for transgender individuals to be legally recognized as being the gender with which they identify. While universities are, on the whole, becoming more inclusive and accepting of transgender individuals, the lack of means to access proper identification that matches their identity and expression not only keeps the avenue open for uncomfortable situations and unnecessary hurdles that transgender students would have to face – not only on campus but after they graduate and enter the workforce.
At a time in their lives when most people are realizing their own identities, transgender individuals must come to terms with theirs in a social arena which has conditioned them to repress theirs, or feel shame because of it, or simply to deny it altogether. The gains in equality at universities have been largely due to transgender visibility and transgender students asserting their rights to live fulfilling and healthy lives and to be safe in their environments. The coverage of transition is thus not only a necessarily medical component of transgender health, but a necessary component of transgender inclusion in the university.
“It is often more a knowledge and will gap than a mechanics and cost issue,” said Deena Fidas, deputy director of the Human Rights Campaign’s workplace project. “You have to start with Transgender 101, if you will, and demystify.”
”Demystification” of the transgender experience, muddled by a social narrative in which gender variance is viciously stigmatized, ridiculed, and even made into a justification for violence, requires visibility, and for transgender individuals to be able to be healthy, comfortable, and visible as they are, they must have access to the healthcare that they need. We have to close this knowledge and will gap, and part of that involves targeting the destructive narrative that stigmatizes gender variance in society at large.
We have to recognize the sexist gender essentialism in our discourse which stigmatizes the feminine, the rejection of a prescriptive, dominant form of masculinity, and forces women into narrowly defined patriarchal gender roles. We have to stop the sexist objectification of women which reduces them to their sexual instrumentality, cis and trans women alike. We have to combat the culture of sexual violence in which women, and to a greater extent transgender women, and to an even greater extent transgender women of color are likely to become victims. We have to value the gender expression and sexual orientation of all individuals, be they cis or trans, and work to end the gender policing which leads to bullying and hate crimes. To “demystify” what we view as deviant we have to “demystify” what is familiar to us – which means understanding and analyzing it critically and in turn working to change the system.
The United Nations recognizes access to healthcare as a universal human right, and our universities of all places should aspire toward meeting that standard. If we intend to better the world around us through promoting education, we have to make sure that we promote a safe and healthy environment for that education in the process.
NYTimes article: “College Health Plans Respond as Transgender Students Gain Visibility”