New York Plans to
Make Gender
Personal Choice
By DAMIEN CAVE,
NYTimes on the Web, November 7, 2006
Separating anatomy from what it means
to be a man or a woman, New York City is moving forward with a plan to let
people alter the sex on their birth certificate even if they have not had
sex-change surgery.
Under the rule being considered by the city’s Board of Health, which is likely
to be adopted soon, people born in the city would be able to change the
documented sex on their birth certificates by providing affidavits from a doctor
and a mental health professional laying out why their patients should be
considered members of the opposite sex, and asserting that their proposed change
would be permanent.
Applicants would have to have changed their name and shown that they had lived
in their adopted gender for at least two years, but there would be no explicit
medical requirements.
“Surgery versus nonsurgery can be arbitrary,” said Dr. Thomas R. Frieden, the
city’s health commissioner. “Somebody with a beard may have had
breast-implant surgery. It’s the permanence of the transition that matters
most.”
If approved, the new rule would put New York at the forefront of efforts to
redefine gender. A handful of states do not require surgery for such birth
certificate changes, but in some of those cases patients are still not allowed
to make the change without showing a physiological shift to the opposite gender.
In New York, the proposed change comes after four years of discussion among
health officials, an eight-member panel of transgender experts and vital records
offices nationwide. It is an outgrowth of the transgender community’s push
to recognize that some people may not have money to get a sex-change operation,
while others may not feel the need to undergo the procedure and are simply
defining themselves as members of the opposite sex. While it may be a
radical notion elsewhere, New York City has often tolerated such blurring of the
lines of gender identity.
And the proposal reflects how the transgender movement has become politically
potent beyond its small numbers, having roots in the muscular politics of the
city’s gay rights movement.
Transgender advocates consider the New York proposal an overdue bulwark against
discrimination that recognizes an emerging shift away from viewing gender as
simply the sum of one’s physical parts. But some psychiatrists and doctors
are skeptical of the move, saying sexual self-definition should stop at
rewriting medical history.
“They should not change the sex at birth, which is a factual record,” said Dr.
Arthur Zitrin, a Midtown psychiatrist who was on the panel of transgender
experts convened by the city. “If they wanted to change the gender for all
the compelling reasons that they’ve given, it should be done perhaps with an
asterisk.”
The change would lead to many intriguing questions: For example, would a
man who becomes a woman be able to marry another man? (Probably.)
Would an adoption agency be able to uncover the original sex of a proposed
parent? (Not without a court order.) Would a woman who becomes a man
be able to fight in combat, or play in the National Football League?
(These areas have yet to be explored.)
The Board of Health, which weighs recommendations drafted by the Department of
Health and Mental Hygiene, is scheduled to vote on the proposal in December, and
officials say they expect it to be adopted.
At the final public hearing for the birth certificate proposal last week, a
string of advocates and transsexuals suggested that common definitions of
gender, especially its reliance on medical assessments, should be abandoned.
They generally praised the city for revisiting its 25-year-old policy that lets
people remove the sex designation from their birth certificate if they have had
sexual reassignment surgery. Then they demanded more freedom to choose.
Michael Silverman, executive director of the Transgender Legal Defense and
Education Fund, said transgender people should not have to rely on affidavits
from a health care system that tends to be biased against them. He said
that many transgender people cannot afford sex-change surgery or therapy, and
often do not consider it necessary.
Another person who testified, Mariah Lopez, 21, said she wanted a new birth
certificate to prevent confusion, and to keep teachers, police officers and
other authority figures from embarrassing her in public or accusing her of
identity theft.
A few weeks ago, at a welfare office in Queens, Ms. Lopez said she included a
note with her application for public assistance asking that she be referred to
as Ms. when her turn for an interview came up. It did not work. The
woman handling her case repeatedly addressed her as Mister.
“The thing is, I don’t even remember what it’s like to be a boy,” Ms. Lopez
said, adding that she received a diagnosis of transgender identity disorder at
age 6. She asked to be identified as a woman for this article.
The eight experts who addressed the birth certificate issue strongly recommended
that the change be made, for the practical reasons Ms. Lopez identified.
For public health studies, people who have changed their gender would be counted
according to their sex at birth.
But some psychiatrists said that eliminating identification difficulties for
some transgender people also opened the door to unwelcome advances from
imposters.
“I’ve already heard of a ‘transgendered’ man who claimed at work to be ‘a woman
in a man’s body but a lesbian’ and who had to be expelled from the ladies’
restroom because he was propositioning women there,” Dr. Paul McHugh, a member
of the President’s Council of Bioethics and chairman of the psychiatry
department at Johns Hopkins University, wrote in an e-mail message on the
subject. “He saw this as a great injustice in that his behavior was
justified in his mind by the idea that the categories he claimed for himself
were all ‘official’ and had legal rights attached to them.”
The move to ease the requirements for altering one’s gender identity comes after
New York has adopted other measures aimed at blurring the lines of gender
identification. For instance, a new shelter policy approved in January now
allows beds to be distributed according to appearance, applying equally to
postoperative transsexuals, cross-dressers and “persons perceived to be
androgynous.”
The Metropolitan Transportation Authority also agreed last month to let people
define their own gender when deciding whether to use the men’s or women’s
bathrooms.
Joann Prinzivalli, 52, a lawyer for the New York Transgender Rights
Organization, a man who has lived as a woman since 2000, without surgery, said
the changes amount to progress, a move away from American culture’s misguided
fixation on genitals as the basis for one’s gender identity.
“It’s based on an arbitrary distinction that says there are two and only two
sexes,” she said. “In reality the diversity of nature is such that there
are more than just two, and people who seem to belong to one of the designated
sexes may really belong to the other.”
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