Does It Get Better?

This post is intersex-related, but is more broadly addressing LGBTI issues that arose in conjunction with Wear Purple Day events in the U.S.

On October 20th, thousands of Americans wore purple as part of the campaign to show support for young people who are being bullied because they are perceived to be lesbian, gay, bisexual, transgender or intersex. I am grateful to all of those who put on purple as a show of solidarity. Thank you for caring and for making this gesture of support. In the homophobic and transphobic cauldron of many American schools, large numbers of LGBTI teens are driven to despair, and some to its ultimate expression in suicide.

The Wear Purple Day campaign is affiliated with the “It Gets Better” project, in which adults record video messages to LGBTI teens to tell them that while they may despair now, they should keep hope alive, because life will get better when they get older. This too is a project that is well-intended, and I appreciate all the people who have made and contributed videos intending to support our youth.

But there is a problem with the framing of the “It Gets Better” project. Living with homophobia and transphobia does not magically disappear when one is handed a high school diploma. The title of the project implies that dealing with harassment and disrespect and violence is a phenomenon of childhood, as if “kids will be kids” and act immaturely, so we just need to wait it out and things will be fine. It focuses attention on the victim’s “not giving in” to mistreatment—which frames despair and depression as a sort of failure of the victim’s spirit, as weakness. (Notice that it is not a video campaign entitled, “Don’t Be a Jerk” aimed at homophobic, transphobic bullies.) It tells us to “be strong,” and we’ll be granted the prize of acceptance and respect when we grow up.

And that, I’m sorry to say, ain’t necessarily so.

There have been some dramatic incidents of anti-LGBTI violence against adults in the press of late. I think especially of the brutal homophobic beating and gang rape with baseball bats of three gay men in New York this month. These incidents are horrible and we must decry them. The possibility of being subject to such hideous attacks keeps many LGBTI people living in fear. But to focus our attention on hyperviolent acts like this directs the public eye away from the more quotidian experience of disrespect and veiled threat that many of us live with every day. While the number of us who will be gang-sodomized, let us pray, is few, thousands upon thousands of us continue to face, as adults, the sort of sneering and bullying that are common in high schools. And we too suffer low self-esteem, depression, despair. It is this that I want to address.

For some of us, being LGBTI in America today is not that bad. Those who are white, and middle-class, and gender conforming, and live in major urban areas may feel pretty comfortable. Even those in this privileged group still have to deal with people nudging one another and tittering at times, with marriage prohibitions denying them benefits, and with the insecurity of never knowing when they’ll be treated with disrespect—at a parent-teacher conference, or at a tax-return preparation service, or at a gas station. Even the conventionally attractive, young, white, churchgoing, well-educated suburban homeowners among us, apparently iconic ideal Americans, are usually aware of being second-class citizens. To say that this group’s lives got better after high school may be true, but it’s sad for the definition of “the good life” to be, “Well, I haven’t been subject to constant fear of violence since high school.”

And that’s the privileged group.

Let us be honest. The LGBTI youth who are subject to the most bullying are the ones who are less privileged. A middle-class gay white male high school jock is likely to face less maltreatment than an androgynous, poor kid of color. If you are a feminine boy (no matter what your sexual orientation), you are at high risk of bullying. If you are out as trans gender, you are at high risk. If you are marginalized already because you have a visible disability, or you wear out-of-style secondhand clothing because you are poor, or you are one of the only kids of your race/ethnicity at your school, your risk of maltreatment is much higher. And sadly, this does not magically melt away when you graduate from high school.

I’ve been thinking about this a lot today because yesterday was not a good one for my family in terms of LGBTI mistreatment. So I’m going to share this story with you. My family is suburban and middle class and middle American. My spouse and I are white (though our kid isn’t), I’m employed as a professor, we own a house and we keep the lawn mowed. My spouse and I are both trans gender, but as a trans man married to a trans woman, we have privileges many trans folk dream of. Our lives are supposed to be in the “it got better” category. But we still live with daily trouble with antiLGBTI bias.

It was my spouse who suffered directly yesterday. She’s intersex by birth, was surgically assigned male as an infant, but knew by the time she was four that she did not identify with her sex assignment. Rather than reassigning her female, however, she was treated with years of "gender therapy" intended to change her gender identity to fit her sex of assignment. This involved requiring her to do a lot of pushups, play football, and be physically punished for crying and other "girly" behavior. The “treatment” did not change her gender identity, but it did make her childhood miserable. She was not able to begin to gender transition until she was a legal adult, and by that time, without medication to postpone pubertal changes from testosterone, her body had masculinized. Starting hormone therapy did not reverse changes such as her having grown to be 6’3” and broadshouldered. (Because she has uterine tissue, however, it did start her menstrual cycle, made awkward by the masculinizing genital surgery she had as a child.) As a result of her history, my spouse must live her life in a body that will forever be androgynous, and here where we live, in the supposedly polite Midwest, this means constant street harassment.

For those of us who are gender-transgressive in appearance, whether we have chosen to be seen as genderqueer or would like nothing better than to be able to be gendernormative, but must live with physical androgyny, harassment does not end in high school. Especially when we are read as androgynously male, we are the butt of endless jokes and the subject of constant hostile stares. All my spouse and I have to do is go to our local Midwestern Walmart, and it’s like the circus came to town. People stop, and stare, and shake their friends’ elbows, and point. Sometimes there’s a supportive smile, and sometimes people pay us no mind at all, but we can never go without some people snickering and staring. Walking around in our suburb, my spouse has had to deal with parents yanking their children away from her as if she were about to abduct them on her afternoon constitutional. If she goes out walking at night to avoid these encounters, the police often curb crawl in a car behind her until she gives up and comes home. Going out to a restaurant we have to listen to people at the next table have an open conversation speculating on our genders and asking one another what’s wrong with people today. Every trip to a public bathroom exposes my spouse to danger of outrage or violence or police intervention, so she rarely ever uses one.

Gender transitioning has in some ways made our lives infinitely better than it was in high school. Living in a gender one does not identify with, with a body that gives one gender dysphoria, is terribly painful. But we are not now free from maltreatment and harassment, and my spouse suffers daily indignities. I’m androgynous too, but since I grew a beard I have more “passing privilege” and am usually read dyadically male, at least from the front. Also, I’m only 5’2”, and my spouse at 6’3” seems to trigger in young men out to prove their masculinity a lot more competitive transphobia.

But it’s not just individual harassment we have to deal with—it’s institutionalized transphobia. Yesterday, my spouse went to see her doctor to get her prescriptions refilled. It was not a good office visit. First, the receptionist loudly called her “Ma’am? Sir? Ma’am? Sir?” in front of the crowd of waiting patients. Of course, she was then subject to a sea of stares while she waited. And then the doctor refused to refill her prescription for estrogen, because her cholesterol was at 201, a point above the “normal” range. So my spouse has suddenly had the rug pulled out from under her medical therapy—medical therapy that is vital to her wellbeing.

I respect our doctor a lot, but she has never had a trans gender patient before (that she is aware of). Her reference point for estrogen therapy is menopausal women getting HRT. With them, denying a refill as a goad to lower cholesterol might be a nuisance, but that’s not the appropriate analogy. This is more like taking a person who was suicidal and is now doing better on antidepressants, and saying “I refuse to prescribe you any more antidepressants until you quit smoking.” But our doctor has had no training in dealing with caring for trans people, a failure of our medical schooling, and doesn’t understand how vital hormonal therapy is for a trans person. In a way, the doctor acknowledged that the issue was her lack of training. She said that she could not in good conscience continue to prescribe estrogen for my spouse, but that she’d give her a referral to see an endocrinologist with more expertise in hormone therapy.

The thing is, there is no endocrinologist our doctor knows of with training in dealing with trans people. There is no such endocrinologist in our health plan. Our health plan, in fact, refuses to pay for any trans gender care, and even though my spouse is intersex, and gets a menstrual period, they say she is “male” because that was what was put on her birth certificate—yet another example of the way we as LGBTI people are failed by institutions. There is no LGBTI health clinic in Wisconsin that can take over care. So, suddenly, we are caught without appropriate health care and a ten-day supply of estrogen left in which to fight to get access to someone who will treat my spouse with knowledge and respect. I’m staring at the number of the endocrinology office the nurse gave us. I asked the nurse if she could inquire if anyone there had ever treated a trans person, and she just sputtered uncomfortably and told me I could do that if I wanted to.

Would you want to be referred to a doctor who had never treated anyone like you, not knowing if that doctor in fact thought that people like you are “sick” and treating your condition a mistake? Not knowing if you would be sent home having been humiliated, with no treatment, and a large doctor’s bill your insurance plan refuses to cover? If as long as you didn’t get beaten up on the way home, would you say life is now good?

So, I wore purple on the 20th, and I extend appreciation to all the others around America who did so as well. But I have this to say: if you really want to help out, don’t just send smiling messages that life for LGBTI folks is fine after high school. Teach your children to respect all gender expressions and sexual orientations. Speak out against the way we are maltreated by institutions. Confront people on the street when you see them harassing us. Challenge school officials and parents and police officers who do nothing to stop the harassment. Be our good neighbors. Demonstrate your respect for all of us—not just to middle class married gay white suburban couples with 2.3 dogs. When you see someone who is visibly LGBTI on the street, smile at us. Advocate for same-sex marriage, yes, but remember the “T” and the “I” and also advocate for an end to sex assignment surgery on intersex infants, and for the respectful provision of medical care to trans folk. If you employer gives you health insurance, ask your HR department to negotiate for coverage of gender transition services. Take a step to ensure that life really does get better for your LGBTI fellow travelers. Please. . . wear purple, but do more than make a fashion statement.