Wednesday, October 20, 2010

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.


  1. I think this is excellent and I'm sharing it with my friends.

  2. Excellent write-up and an insightful critique of the "It Gets Better" campaign frame.

  3. Thanks for this posting. I think my family is finally ready to read something like this, so I will try to forward it to them.

    I send my hugs to Beta and you, too. I'm not sorry about what I said when we parted in SL, but I am sorry that you didn't acknowledge what I was going through. I saw the both of you, day after day, just loving on others, and I never spoke up because it was never directed at me. Sharing experiences wouldn't have killed anyone, and it would have made my life much easier. After my horrific worsened depression when I felt abandoned by the only people who would understand (you and my so-called "family"), I think I just gave up on people in general. I still think humanity is destined for utter failure, but I'll get over it.

  4. This is a great post. It's well thought out and well written, and it conveys a message that needs to be heard. I'll forward it to the members of my family who do understand English.

    And why only today? I wear purple every day :]

  5. Thank you for this. It's wonderfully written and states the issues with clarity and consideration. All the best to you and yours.

  6. Thank you so much for this post. It really left me speechless.

  7. Thank you for this. I came here via FB, and have been reading through your archive. I am ashamed to admit how ignorant I was of the lives of intersex people, and I want to thank you for enlightening me. I have two little kids, and we live in a rural area (though with a pretty big LGBT community, for the sticks, anyway.) For whatever it's worth, thanks to you, I will be able to better educate them about the many forms humans can take, and hopefully engender in them the kindness and "good neighbor" behavior everyone should expect. I remember you from Yale, though I don't think we really knew each other, and am really glad to have had this small introduction to your important work. Again, thank you.

  8. P.S. I am so sorry for what your wife went through at the doctor. Shame on them, not for their ignorance, though one would like to think doctors would be more aware than the Walmart crew, but for their insensitivity.

  9. Thanks you for your support, friends.

    Paige, I'm very glad to hear that following a link led you to learn more about intersex people. Raising the next generation to be accepting of the whole sex spectrum, so that they will accept their own intersex kids, is a project that gives me hope.

  10. Fantastic. My daughter showed this to me, and she had written you when she read it on Fb. I've shared it with my friends too...

  11. This is so well written there isn't really much for me to say. I have my own doctor hassles as you know and it sucks. I did link to the FB note on my FB to spread the word. Love you.

  12. The problem with re-addressing the campaign toward the perpetrators is that it is not going to help our youth survive the now. None of the bullies and, likely, few of their parents are going to care what, in their eyes, a bunch of fags and liberals have to say about those effing queers in our schools. Surely you were a target in school... I question how human some of them were because they had no sense of compassion or human decency as children. One of my teachers even took part in the harassment. Such a proposed campaign needs to be addressed to the government where it belongs, to legislate what should already be basic human rights for our youth.

    Reaching our youth with the "It Gets Better" campaign, we are helping in whatever small way to get them through the reality of their present lives-- not some dream of how we wish the world to be. The Jews surviving HaShoah had to come up with strategies to help them get through the sufferings threatening their very existences.

    I totally agree with the rest of your essay. I am blessed that, having been born intersex, I am totally passable even while transitioning at such a late age. My current roommate is more like your spouse and I have to see her go through the same torments.

    Perhaps surviving the torments of school somehow gives us the ability to get through the rest. I have lost what family I had before simply through ignorance and fear. That institutions fail us results from the same ignorance and fear that pervades society. We have to get those in power to understand just as civil rights campaigners and feminists did a generation ago. Like them, we are a cohort of the powerless seeking justice denied.

    Thank you for a wonderful essay.

  13. Beautifully said. Thank you.

  14. This is a wonderful essay and I learned a lot. Thanks for writing it. I just shared it on Twitter.

    Like you, I've wondered why there isn't a campaign to educate bullies. It's very well meant, but the It Gets Better campaign sometimes makes me feel as though it's putting the burden of managing bullying solely on the victim.

    I was bullied at home and at school for looking and acting differently--I was called names and my appearance was criticized pretty much daily. We were on welfare for a bit, I was very sickly, and I went to 12 schools by the time I graduated high school, which compounded things. I had insomnia for decades, and I blame my molestation and rape on a childhood of "victim-grooming." In my 30s I was finally diagnosed with Major Depressive Disorder, Baseline Dysthymia, PTSD, and Passive Suicidal Ideation. I've worked through all but the PTSD at this point, and that's improving.

    Now that the worst is over for me, and that with the help of a therapist I've learned how to present as "normal," the ONLY challenge I have is the sharp disconnect I feel socially from people assuming I've had a charmed life because I have a job and nice clothes and live in a nice neighborhood. I have all the trappings of a "normal" life. People end up getting confused as they get to know me, and I get dropped. I can't reminisce about fun memories of growing up because they don't exist. I can't sustain a relationship. I'm always afraid I'll be found out at work as someone who doesn't belong in a group. So I hide who I am deep inside. It's lonely, but at least no one is cruel to me. And I'm so grateful that I made it through and that I've at least figured out how to hold down a job, though that took many many years.

    I'm very aware of the social privilege that being white and hetero gives me. It almost feels like a performance. If I didn't look attractive and if I hadn't figured out how to pretend to be confident, I feel sure I would have been squashed and lost. As it is, I feel like I'm always on the edge of being found out that there's something wrong with me.

    I wish there were a way to educate people about the damage they do to children, how lasting it is. I'm one of the lucky ones, but it's been a long road, where at times it hurt simply to breathe because it meant I was still alive. I do think if there had been videos like the It Gets Better videos when I was growing up, that it would have made a difference, that I wouldn't have felt like such a freak. It would have given me courage to go on, to hope that some day it might be different. So I think the It Gets Better videos though troubling for the reasons noted above, at least are doing some good by giving hope to people who truly might be on the brink of killing themselves. It's a step. It's visible.

    I made it through thanks to social media. It was my lifeline when I was in so much pain.

    Thanks again for writing this. I hope it's okay that I've shared so much of my own story, when I do not officially belong in the LGBTI community. I can't imagine how difficult and emotionally trying this all must be for you and your spouse, and I hope you find some peace and support.

  15. Anyone want to help inform some people? The is a story that's being posted on this website, and the writer, as well as many of the reviewers, are not exactly knowledgable about intersex issues. The writer was attempting to write an intersex character, and failed miserably by using the term "hermaphrodite" among other things, and when an intersex reviewer called her on it, things got ugly fast. Normally I wouldn't bother posting something like this here (or anywhere else), as it never does any good in my experience, but for those of you who want to actually stand up like you claim we all need to do... here's the link to the review section.

  16. great post, like always. :)

  17. Excellent post, I'm really enjoying your blog. I too have had the horrible experience of a doctor cutting me off from my HRT due to a minor deviation on my part from his "plan". Completely dropped me as a patient without a chance to explain or discuss anything. At the same time, my shrink retired in the 4 month gap of my therapy appointments due to insurance issues, with no forwarding information. It drove me to the dangerous path of self-medicating via foreign internet pharmacies. I had to do that for about 18 months before I could find a doctor that would treat me. No one wanted to take me seriously because I was only 23. They all said that I had to wait until I was older. I was enraged that as an adult I was denied the right to make such an important decision for myself. I had been dealing with my body/gender dysphoria since I was six or seven years old, and I wanted it to end, NOW. Once I had reached a point of no return in my transition, I found a doctor sympathetic to my needs and got proper HRT again. I went for a few months during that time with no hormones at all and my body issues came back full force.

    Now, twelve years later, I'm finished with "the process" and living a stealth life, raising my daughter as a single mom. Here in the south, land of big farm girls, I pass very well. None the less, I always feel different and odd when in large groups, as I lack significant shared experiences with most men and women. I can't be open about what I've been through, as my 12 year old daughter has no idea that Mom is actually Dad (her birth mom, my ex-wife, is very distant and transient, having given up all three of her children). Only a couple of people in my day to day life know the truth, as they are open-minded and trust-worthy, but it's not a subject matter they have any experience with beyond myself. I don't think I need to see a therapist or anything like that, my life is pretty stable and enjoyable, but I would really like to connect with some other transgendered folks again.

  18. This is what bothers me. I see this and ask "WHEN does it get better?". There are so many groups where it isn't getting better and probably won't for some time. I'll believe it's truly better when I can raise a child my gender at birth and not be accused of abuse. (not that I would, I don't think assigning neutrois will do any less damage than anything else)

    I also can't help but feel that the "It gets better" is dismissive of the pain these kids are or were in. It's hard to hold onto the glimmer of hope that it'll get better in 3 or 5 or 20 years when you can barely get through a day. Hope will only get you so far.

  19. The problems of 'it gets better' is as Dreki says above and that often, it doesn't, depending where you live. If you can afford to move to one of the 10 'friendly' cities (or in the Uk, 2), you still have levels of harrassment, vandalism, violence, rape, and murder.

    I started cutting at 5, regularly from 11-16 (oh, wait, puberty years!), then attempted suicide over and over and over again.

    My parents avoided going to the doctor for any think including having impacted knees stopping my being able to walk from the post birth surgeries until I left at 19. Now that I am having a rare disease rip up my life, and all of me is examined, they moved away, and disconnected the phone, and not a single family or extended member allows contact. Is this the 'better'? Abuse in the hospital from RN's and Doctor about gender when I am throwing a heart and lung failure? My GP waited until my ovary got to zero (due to an autoimmune disease wipeout of it, adrenal and thyroid), before I could get HRT, the previous doctors simply dropped me - as I live where there is no obligation to take on patients. Two doctors dropped me due to 'religious conviction', one due to 'personal beliefs' based on that fact I was using the pill as HRT, and one said that they would feel emotionally uncomfortable every touching me, anywhere, as my GP.

    The comment that bothers me the most as an adult is, 'Well, what did you expect.' - when making a complaint against someone bigoted in an organization, making a bigoted statement, act, etc. That by NATURE, I and we deserve this.

    I appreciated the articulation of your article. I empathize with your wife. Females over six feet tend to be objectified in all sorts of ways, from fetishes, to simple, 'Oh my god!' - Then try getting care as a disabled/ill individual (I had to ask for someone to be sent over 5 foot, as after the first 7 or 8, I handn't had any females yet).

    People ask what our relationship is, and we ask them where we are, 'Oh, this state, I think we are 'good friends'