The average life expectancy of a transgender person in the United States is 30 to 32 years.
Just hang on to that for a minute.
Unless you literally live in a cave, I’m sure everyone here has seen the Vanity Fair cover released June 1st, featuring Caitlyn Jenner. #CallMeCaitlyn began trending world-wide, and there was an enormous outpouring of love and support on social media.
It is amazing that when a trans person can present her authentic self to the world for the first time, that it can be celebrated so universally. There’s no question that Caitlyn is beautiful, which led to many people commenting on how gorgeous she looked in the photo spread, which as Jon Stewart pointed out on The Daily Show, quickly spiraled into objectification:
“It’s really heartening to see that everyone is willing to not only accept Caitlyn Jenner as a woman, but to waste no time in treating her like a woman. You see, Caitlyn, when you were [Bruce] we could talk about your athleticism, your business acumen. But now you’re a woman and your looks are really the only thing we care about… So Caitlyn Jenner, congratulations. Welcome to being a woman in America.”
The incredible Laverne Cox released an encouraging statement for Caitlyn wherein she commented, “Yasss Gawd! Werk Caitlyn! Get it!” then went on to reflect critically on what it truly means to be transgender today. She notes that in addition to Caitlyn’s newly revealed outer beauty, her heart and soul and ability to let the world into her vulnerabilities are the most beautiful things about her.
The actress and spokeswoman then spoke about representation. “I have always been aware that I can never represent all trans people,” Cox said. “I am able to embody certain cisnormative beauty standards…there are many trans folks who will never be able to embody these standards. More importantly, many trans folks don’t want to embody them…I started #TransIsBeautiful as a way to celebrate all those things that make trans folks uniquely trans.”
She also emphasized that transgender people come from all races, gender expressions, abilities, sexual orientations, classes, immigration statuses, employment statuses, and transition and genital statuses, hoping that Caitlyn understands that the current support she is receiving can translate into “changing hearts and minds about who all trans people are, as well as shifting public policies to fully support the lives and well-being of all of us.”
Cox brings up several good points, including the fact that there are several acceptable problems to have with Caitlyn Jenner as a mainstream narrative:
- As a wealthy, white celebrity, the experiences of Caitlyn Jenner are not representative of most trans women
- Many trans people do not conform to cis beauty standards, which often affects their acceptance by society
- The narrative of visibility as a goal is problematic for many trans people who are placed in danger by hypervisibility
- “Trans Media Moments” such as the Vanity Fair spread don’t help very much by focusing on one successful trans person instead of the systematic oppression they face
- Caitlyn has described herself as conservative, which, even though she hopes to make the Republican Party more trans-inclusive, implies some other oppressive views
All of those issues are legitimate, thoughtful critiques of an imperfect system.
Unfortunately, most of the problems being raised around the Internet are of the transphobic, transmisogynistic, and generally shitty variety. Many people have continued to misgender Caitlyn, and make extremely offensive and distasteful comments about her and her experience.
Perhaps the worst displays I’ve seen of this are of the op-ed pieces that attempt to invalidate the unique and varied experiences of transgender people all over the world, typically with unsupported claims and pseudoscience. Most notably is this article, which I’ve seen posted on several social media platforms and in one case created a literal firestorm of comments on my Facebook newsfeed.
The article, titled “Sex Change” Surgery: What Bruce Jenner, Diane Sawyer, and You Should Know, was published over a month ago after Caitlyn (still referring to herself as Bruce at the time) sat down with Diane Sawyer to discuss what she was going through.
The author, Walt Heyer, who “suffered through ‘sex change’ surgery and lived as a woman for eight years” tells a tale of “the dark and troubling history of the contemporary transgender movement, with its enthusiastic approval of [sexual reassignment surgery (SRS)], [leaving] a trail of misery in its wake.”
His claims are mostly founded in his experience, where the surgery fixed nothing, but instead amplified and hid deeper psychological problems. He also cites the history of the movement, which was founded by three men — most notably Dr. Alfred Kinsey, a biologist and sexologist — who believed all sex acts were legitimate and were activists for pedophilia, bestiality, sadomasochism, incest, adultery, prostitution, and group sex.
Heyer also tells harrowing tales of SRS gone wrong and unethical doctors, such as the case of David Reimer. As a two-year-old, David’s parents brought him to Dr. John Money to repair a botched circumcision. Instead, Money decided to experiment with his theories of gender, and surgically changed David’s genitalia from male to female, ordering his parents to raise David as a girl. Unsurprisingly, David — called Brenda — was suffering from severe depression at age 12, and at age 14, after learning the truth, chose to undo the gender change and live as a boy.
The rest of the article is peppered with similar horror stories and suicide statistics, claiming that SRS does not alleviate severe psychological problems, and that choosing SRS is a disastrous decision that leads only to danger.
It’s clear that Heyer has led a life full of traumatic experiences and possibly quite a bit of internalized transphobia. However, his own experiences, while valid, cannot pretend to represent every trans person in the world without causing harm.
If the sole point he was trying to make is that SRS does not wholly fix the years of psychological trauma caused by gender dysphoria, I could get on board with that. It’s actually an important message to know; SRS isn’t a magic cure for all of your problems any more than any other surgery could be. It’s certainly a step towards healing, but there are other factors involved that must be taken into consideration and treated independently.
However, if that was the message Heyer was attempting to convey, he did a fantastically horrible job.
Bringing up that the founders of the movement were also proponents of things like pedophilia and incest not only isn’t relevant information, but mis-categorizes the transgender movement and perpetuates false stereotypes that trans people are choosing a life of perversion.
Heyer maintains that “it is intellectually dishonest to ignore the facts that surgery never has been a medically necessary procedure for treating gender dysphoria and that taking cross-gender hormones can be harmful.”
Interesting that he brought up medical facts, as I decided to do the same thing with much help from EM Orstad, current PA student at the University of Iowa, co-author of this post, and generally excellent human being.
Everybody hang on, we’re about to talk crazy science.
A 2014 study on psychosocial adjustment to sex reassignment surgery of six transgender individuals in Croatia found that despite facing numerous social and medical obstacles throughout their transition process, the transitions were ultimately successful:
“Despite the unfavorable circumstances in Croatian society, participants demonstrated stable mental, social, and professional functioning, as well as a relative resilience to minority stress. Results also reveal the role of pre-transition factors such as high socioeconomic status, good pre-morbid functioning, and high motivation for SRS in successful psychosocial adjustment. During and after transition, participants reported experiencing good social support and satisfaction with the surgical treatment and outcomes. Any difficulties reported by participants are related to either sexual relationships or internalized transphobia.”
(Jokić-Begić, Korajilija, Jurin 2014)
In addition to successful adult transitions, another 2014 research article discusses the rationale behind the current standard of making individuals suffering from gender dysphoria wait until age 18 to undergo SRS, as evidence supporting waiting until 18 is weak from a scientific standpoint. Currently, the main reason to wait is to prevent postoperative regret as illustrated by Heyer; however, there is not a large enough sample size of people who have experienced SRS before age 18 to provide enough support for that argument.
Based on this study, there are many reason trans girls desire SRS before age 18, particularly centered around being able to continue “passing” as girls after puberty and fear of peer reactions. From an anatomical standpoint, girls who start hormone therapy before puberty would be unlikely to have the standard penile inversion surgery to create a vagina due to the penis being pre-pubertal sized, but there are alternatives available, such as taking a portion of the sigmoid colon to create the vaginal canal.
The David Reimer case, which is fully evident of postoperative regret in a minor, is not representative of a typical trans experience. Money’s actions were completely unethical and took place in 1967, long before any regulations had been put in place:
“They changed his external genitalia before he was old enough to even have a concept of gender. They essentially gave him gender dyspohria; statistically speaking, [he] was more likely to have matching external genitalia and gender identity, so to reassign his sex at such a young age and then say that SRS for trans individuals is bad is such a flawed argument. This was not SRS chosen by a trans individual, this was SRS on a baby who had no autonomy in this choice. It would never happen now. Some babies do undergo genital remodeling surgery, such as in cases where they are born with both male and female genitalia, but that is not what happened in [David’s] case, and not analogous to trans SRS.”
Today, people who identify as transgender — particularly minors — need psychological evaluation by multiple professionals to ensure that SRS is appropriate.
As for Heyer’s claim that SRS leads solely to misery, while there is a statistically significant proportion of the trans community who do not feel that SRS improved their quality of life, the main majority feel a significant improvement:
“We systematically reviewed the literature to determine the benefits of hormonal therapies given to individuals with GID as a part of sex reassignment. We found 28 studies with fairly long follow-up duration that demonstrated improvements in gender dysphoria, psychological functioning and comorbidities, lower suicide rates, higher sexual satisfaction and, overall, improvement in the quality of life. Individuals with early onset transsexual manifestations and those with homosexual tendencies may have better prognosis. Individuals with pre-existing psychopathology tend to have worse prognosis. Limited data suggest that [male to female] transsexuals may have worse outcomes than [female to male] counterparts… It is also important to recognize the impact of cultural factors and treatment availability on the outcomes of reassignment therapies. Cultures that reject gender atypicality would subject transsexuals to more victimization and social stigma, which may worsen pre- and posttreatment social and psychological functioning levels. Individuals in countries without access to treatment may also have worse outcomes. Therefore, cultural differences should be considered when applying the results of this review, mostly derived from European studies, to other populations.”
It is important to note that the study quoted above was based more on observational studies than clinical trials or case control, meaning the level of evidence garnered is weaker; nonetheless, the studies do not find that transitional therapies are overall harmful, rather the opposite.
This concludes crazy science with EM Orstad.
You may be wondering what the point of all this is, or if I have any plans of a conclusion in the near to immediate future, but I’m bringing it all back around, I promise. As you may recall, I told you earlier that the average life expectancy of a transgender person in the United States is 30-32 years. For some perspective, during the Dark Ages, even during the time of the Black Death, a person could expect to live a couple of years longer than that.
While support of transgender people like Caitlyn Jenner and Laverne Cox may offer evidence that society is a more hospitable environment today than it has been in the past, the fact remains that a transgender person is still 20 times more likely to be assaulted than their cisgender counterparts. They are 16 times more likely to be murdered, often legally due to “trans panic” being an actual legal excuse for murdering a human being in broad daylight.
Eight known transwomen have been murdered so far in 2015 in the United States, the first seven of which occurred before March. The figure may be even higher, as trans and gender-nonconforming victims often get misgendered in news and police reports.
According to a 2011 report from the National Center for Transgender Equality and the National LGBTQ Task Force, 41% of trans respondents reported attempting suicide, compared to 1.6% of the general population. Rates were particularly high for trans people who reported job loss due to transphobic bias (legal in most states), bullying or harassment at school, or surviving physical or sexual assault.
The same report notes that the combination of structural racism and transphobia severely hampered the lives of trans people of color, who fare worse than their white counterparts across the board.
The trans community is facing deadly levels of social and institutional bias and the staggering numbers of trans women of color being killed and other trans people committing suicide makes it clear that there’s a larger problem that can no longer be ignored.
We need to stop debating the existence of transgender people and the why’s and the how’s of the transgender movement. Instead, we need to start paying attention to and valuing trans lives — all trans lives.
Leave any questions or comments below, and see you next week!
Nataša Jokić-Begić, Anita Lauri Korajlija, and Tanja Jurin, “Psychosocial Adjustment to Sex Reassignment Surgery: A Qualitative Examination and Personal Experiences of Six Transsexual Persons in Croatia,” The Scientific World Journal, vol. 2014, Article ID 960745, 12 pages, 2014. doi:10.1155/2014/960745
Emily Orstad, “THIS WOULD NEVER HAPPEN TODAY: A Modern Medical View of David Reimer,” Time Ladies, vol. 2015, June 2, 2015
Milrod, C. (2014), How Young Is Too Young: Ethical Concerns in Genital Surgery of the Transgender MTF Adolescent. Journal of Sexual Medicine, 11: 338–346. doi: 10.1111/jsm.12387
HUGE thanks to Emily, I could not have written this article without your research prowess and understanding of all things medical and sciencey.