I walked out of a surgeon's office in San Francisco last week feeling completely defeated. After having my first sexual reassignment surgery consultation, I am well aware that my hope to have a breast reduction operation this summer is unrealistic. The surgery I need to form a male chest is $8400 and would be a hefty addition to the student loans I will start paying back after I graduate from college in May. As I walked to the bus, I remembered myself in third grade at the exact moment that I realized, horrified, that I would soon go through puberty and develop breasts. Had I realized how much removing my breasts would cost back in third grade, I probably would have spent the next ten years spending my piggy bank savings a little more frugally.
An article last month in The New York Times reported that, in the last six months, some of the most elite colleges and universities in the United States have approved the inclusion of gender reassignment surgeries under their student health care plans, a move that both private insurance companies and the Affordable Care Act have failed to do. Institutes of higher education like Brown University and University of California have listened to the demands of their student body and realized that sexual reassignment surgeries are anything but optional.
As a student at a university that does not cover transgender care in its student health care plan, I can confidently say that, if I were four years younger now, I would not even consider applying to a school without a trans-inclusive health care program. Explaining to a cisgender person why surgery is so important for transgender people is difficult, but it helps to start the discussion with the cisgender person's own genitalia. I asked a skeptical female friend what she would do every morning if she woke up and had to corral an unwanted penis into submission. She admitted she probably would not ever want to leave her house.
The reality for transgender people is that gender expression can only go so far. I bind my breasts every day and have three different phallic objects that I put in my pants at various times for various reasons, but these temporary remedies for extreme genital dysphoria do not keep me from needing a self-pep talk every time I take a shower or give me sufficient excuses for why I cannot go swimming at the gym with my friends.
I completed my legal transition a few months ago, and now have a letter "m" on my social security card and driver's license. My voice has dropped enough from hormone therapy that I pass as male in most settings. I even received a summons from the federal government identifying me as a man who, therefore, must register for the selective services. The same government who will not provide me a health insurance option to cover sexual reassignment surgery is also expecting me to register for an armed forces riddled with sex crimes and transphobia? There's something wrong with this system.
There is little hope that private insurance companies will start covering transgender surgeries because of their consistent argument that the procedures are "cosmetic" or "unnecessary." The Affordable Care Act has been falsely identified as a progressive and inclusive program for transgender individuals when, in reality, the act only limits discrimination by medical providers. Under ObamaCare, an insurance company cannot consider my transgender identity a "pre-existing condition," but they sure as hell can refuse to cover my surgery.
The new health care plans at universities, however, present the issue of transgender care in a new, hopeful light. Universities, the ongoing beacon of progress in the realm of gender and sexuality in the United States, are asserting that our health care system is both deeply flawed and directly discriminatory. Students have seized power in an exciting and revolutionary way in their pursuit of health care reform at the local level, and I can only hope that students will continue to mobilize in an effort to combat the structural injustice in the United States health care system.
Though I am at a loss now, I will keep fighting the system to get the surgeries that are necessary for my livelihood. My goal to be swimming shirtless by August probably will not be achieved, but in the interim, all I can do is dedicate myself to advocating for affordable and inclusive health care for transgender students at my own university and beyond. I hope the next generation of transgender kids, who are panicking the way I did in third grade about impending puberty, will not have to limit their college applications to only those schools that recognize sexual reassignment surgeries as legitimate and necessary and, instead, will approach college with confidence knowing that every school is ready and willing to offer coverage of transgender health care needs.
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