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When transphobia interferes with quality healthcare
January 13, 2010 11:24 PM   Subscribe

"Melissa" (name changed for privacy) is a transwoman who was badly injured in a car accident and is in hospital in critical condition. While in treatment, some of the medical staff and her family decided that since she still had a "male" body, to make things "less confusing", they will erase 4 years of her female identity by referring to her as a man and taking her off her hormone therapy. (Warning: possible triggers) As little light puts it:
And if she woke up as from a deep sleep, she’d wake up into a world where her best friend was dead, where her body had been forcibly edited back to its pre-transition state and given a few more years of the influence of testosterone to boot, where her memory and self were hazy and confusing and nobody was calling her by the right name and pronouns, they were in fact pretending four years of her life, the four years she finally got to be honest and true to herself, those had never happened, and shh, she’s just confused, shhhh, calm down, let’s work on fixing your memory some more.

Some of the commentors have set up TransProtect, to find legal avenues for transpeople to decide what sort of care they want in cases of emergency, such as Power of Attorney or living wills. However, with cases like these, their hopes might be in vain.
posted by divabat (147 comments total) 17 users marked this as a favorite

 
Gaslight, the hospital drama
posted by infini at 11:25 PM on January 13, 2010 [2 favorites]


> forcibly edited back to its pre-transition state

Is that actually the case? From what I read, it seems that they didn't continue to provide hormone therapy. Not that they actively worked against it. I could be missing something though
posted by mulligan at 11:37 PM on January 13, 2010


Not that this is an unimportant topic, but this would be a lot more impactful if it weren't a mostly anonymous story filled with semi-hysterical hearsay and breathless "trigger warnings."
posted by dhammond at 11:38 PM on January 13, 2010 [14 favorites]


This is a horrifying story. I sometimes work with folks with traumatic brain injuries. It's horrible to think someone's life could be subverted in this way. This is identity theft.
posted by dchrssyr at 11:44 PM on January 13, 2010 [6 favorites]


dhammond, the writer's tone does border on hysteria, but I can kind of see why.
posted by dchrssyr at 11:50 PM on January 13, 2010


What the hell is a "trigger" in this context?
posted by pracowity at 11:53 PM on January 13, 2010 [13 favorites]


Not continuing the hormone therapy, in this case = reverting back to male hormone physiology. Yes, that is an active destruction of her transition. And I imagine that if you are a trans person, it's not hysterical to think that a story like this might be utterly terrifying to you.

Thanks for posting this, divabat. I hope that it encourages people who don't understand much about the trans experience to learn more.
posted by so_gracefully at 11:54 PM on January 13, 2010 [1 favorite]


dhammond, the writer's tone does border on hysteria, but I can kind of see why.

As can I. And it's sad that someone so young should have to think ahead so far about legal documents to support their wishes. Most people with so-called "normal" lives don't have to worry about this stuff.
posted by padraigin at 11:55 PM on January 13, 2010 [1 favorite]


Man, four years of hormone therapy is hard work that they are erasing by not continuing it. This is wrong.
posted by dabitch at 12:01 AM on January 14, 2010 [4 favorites]


Would it be that difficult for the author to provide some simple details, like:
* what were this woman's injuries
* how long has it been since the accident, and how much improvement has she made
* what is her current state and prognosis

The fact that she uses this strange hypothetical voice, "And if she woke up as from a deep sleep..." makes me wonder whether this woman is in fact still comatose/MCS

The entire post is written in the same sort of self-righteous hysterics used by the "TSA stole my baby" lady, and its hard for me see her as a reliable narrator
posted by crayz at 12:01 AM on January 14, 2010 [15 favorites]


When a trans person starts hormone therapy, how long do the physical effects take to get established and be constant? In other words, if Melissa went right back on the hormone therapy, how long would it take to get (physically) back to where she was before the accident?
posted by fatbird at 12:06 AM on January 14, 2010


Most people with so-called "normal" lives don't have to worry about this stuff.

Anyone who has any kind of serious disease or disability needs to think hard about who is going to be making decisions for them if incapacitated, and take steps to make sure someone they trust can make medical decisions on their behalf.

The post would be a lot more believable if the author posted any medical facts whatsoever about the case, or some sort of motive for the medical practictioners. Are there any valid health arguments for taking someone horribly injured off of estrogen? Do the doctors not want to get sued over a drug interaction? It seems very odd that the docs would just decide "oh, f*** this person's medical history" - but I suppose they might have wacky religious reasons.
posted by benzenedream at 12:20 AM on January 14, 2010 [6 favorites]


Not that they actively worked against it.

The hospital staff were apparently instructed to call Melissa by her pre-transition name-- which, if you're trans, is actively working against you being who you've worked this hard to be all along. It's not physically interfering with the process, but it is psychologically interfering.

It's very hard to tell what people do and don't hear and how much they can understand in comatose/ vegetative states, but if you won't or can't call someone by the name they prefer and, in waking life, respond to positively and immediately, I question how much good it does to call them anything.
posted by fairytale of los angeles at 12:38 AM on January 14, 2010 [11 favorites]


I haven't read TFA because things like this get me quite angry. Transitioning is a long process , not unlike puberty and it takes quite a few years to psychologically get your head around it and accept yourself.

Whether the story is true or not , when it comes to people changing sex, we live in medieval times. If the story is true I hope she has enough courage ti sue the institution that did this to her because I think she will likely collect enough settlement money to complete what she needs.

I don't know about the "triggers" crap - I just know that stories like this get me quite angry. It happens. We all need to grow up a bit.
posted by Poet_Lariat at 12:49 AM on January 14, 2010


If she was in her hometown, where here doctor is, wouldn't they contact her primary care physician and/or her regular pharmacist? Especially in emergency circumstances to find out what she'd been taking?

My mom-in-law is an ER doc and her first concern is keeping the patient alive, but keeping them healthy afterward seems to have layers of care not mentioned here. If someone has been on a medication for a long time, that's a concern of their caregivers, regardless of the situation, right?

I guess I'm asking something similar to, "If the patient is diabetic and doesn't wear a bracelet, are the medical staff going to not give insulin based on the family's say?" But then, maybe hormone treatment won't be ok for bone healing. I don't know.

This seems like a good cause for some sort of legal paperwork stating the patient's intentions and wants, like a DNR.

I understand the anger of the blogger at the disrespect of the patient's wishes and needs. If there were health reasons involved, and they're may be, I could see both points of view.
posted by lilywing13 at 12:54 AM on January 14, 2010 [1 favorite]


Fatbird said :.When a trans person starts hormone therapy, how long do the physical effects take to get established and be constant? In other words, if Melissa went right back on the hormone therapy, how long would it take to get (physically) back to where she was before the accident?

Usually perhaps 2 or 3 years tops but the mental harm done to your self image is pretty awful. Imagine if you woke up tomorrow as a different sex and everyone refused to acknowledge your prior identity? It would be pretty crappy to say the least. Gender is such a focal point of most of our identities. Being transsexual doesn't make it necessarily more easy to switch that essential part of our identity around. I know for me it took maybe 5 or ten years after the start of my transition before I really accepted myself for whom I professed I needed to be.
posted by Poet_Lariat at 12:55 AM on January 14, 2010 [1 favorite]


The fact that she uses this strange hypothetical voice, "And if she woke up as from a deep sleep..." makes me wonder whether this woman is in fact still comatose/MCS

I would prefer that a hospital not change my name or gender identity on my behalf, regardless of whether or not I am conscious.
posted by cotterpin at 1:06 AM on January 14, 2010 [25 favorites]


"What the hell is a "trigger" in this context?"

People with PTSD or complex PTSD can be "triggered" into panic attacks or other uncontrollable negative emotions if they inadvertently and unexpectedly stumble across something that evokes memories of whatever it was that originally traumatized them. So it has become a common courtesy on many support group type sites to preface material likely to upset members of that site's community with "trigger warnings" so that the more sensitive members can then choose either to not read the material or to mentally steel themselves before encountering it. This is similar to the warnings to "sensitive viewers" that precede many violent television shows, but more tailored to the specific concerns and mores of each site's community.
posted by Jacqueline at 1:19 AM on January 14, 2010 [36 favorites]


his seems like a good cause for some sort of legal paperwork stating the patient's intentions and wants, like a DNR.

That's exactly what the author says she's going to do and exhorts her readers to do the same. Really, everyone should do this, queers more so, and hoo-boy trans-people even extra more. Yikes.

What the hell is a "trigger" in this context?
A trigger warning is to alert readers that the material they're about to read may (in lay terms) totally freak their shit out, in a bad way. I've mainly seen it attached to material related to violence, mostly real-life violence against women. For people who are, say, having a lot of anxiety about transitioning it's probably not out of place, especially since the author said she's gotten feedback on it (see the intro).

While I have a lot of questions about the medical issues (not to mention insurance issues) involved in maintaining someone's hormone therapy while in a coma, this is a pretty nightmarish scenario. Even if Melissa is never expected to recover, the idea that her family is just not referring to her as the person she's been for the last five years is... ugly. And uglier is she comes out of the coma.
posted by smartyboots at 1:20 AM on January 14, 2010 [1 favorite]


If this is accurate, if there are no medical reasons for delaying the transition, then the linked post is a worth reading. But it seems incredibly alarmist.

I imagine there's little or no medical data about hormone supplementation during coma, and it doesn't seem terribly unlikely that doctors managing a brain-damaged patient in a coma wouldn't want to avoid the complications or interactions that would attend administering estrogen to a comatose patient. In particular, estrogen reduces muscle mass, which you'd probably not want to add to the general muscular atrophy resulting from disuse during coma.

But beyond that, the author of the piece sounds like one of those busybodies who perpetually needs something to be upset about. This subject is, supposedly, something very important and personal to her, but rather than come to the point about it, she instead employs a hackneyed, pseudo-Edwardian opening: "My dears, you know who I am. Let’s dispense with the formalities." Is this a call to action, or an invitation to high tea with the Vicar?

But even then, she doesn't get to the point. Instead, there's this vague yet overwritten warning about "triggers": "As per often, I’m going to give you a trigger warning first". As per often?

Then before she tells us how personal this is to her, and what a threat it is to "Melissa" to discontinue her transition, we are first told "It has taken me weeks to get this written [....] please just…[sic]consider not reading at all, because you don’t need to be any more upset." So it's such a great threat that you've delayed for weeks telling us, and you melodramatically caution that maybe we'd better not read it even now?

Then we lean that, well, it appears "Melissa" never much wanted the author's intervention in her life: "Five years ago, I met a younger trans woman, not out yet, just coming to terms with herself, and I decided to be our college’s welcoming committee.[...] Melissa and I never managed to be close, in the end; we had nothing much in common beyond being young trans women at the same school, and even less once we graduated. She was an irreligious libertarian, and I was a socialist looking at seminary; she struggled with the concept of empathy, with which I was overburdened. " So you tried to mentor "Melissa" her freshman year, she pretty much blew you off, despite your both being transwomen, and she managed to get through at least four years to graduation without much help from you -- even though you're "overburdened" with empathy. I see.

And she notes that "Melissa's" "family came around" to her transitioning. And that our over-empathetic author never visited "Melissa's" sick-bed, as "Melissa's" family presumably did, if they are making decisions about her treatment: "I didn’t visit. I’m not proud of it, but I was overwhelmed, and was never close to her." Never close to her. Didn't visit. But now, standing on trans-person principle, willing to question th choices of "Melissa's" family and doctors. Based, as far as I can tell, on accounts that the author heard at third hand.

There may be something alarming here, but if there is, it's entirely obscured by the author's hysterical* presentation.

*Yes, I know "hysteria" comes from the Greek for "uterus".
posted by orthogonality at 1:32 AM on January 14, 2010 [41 favorites]


Oh, and the author calls herself "little light"; as a seminary student, she knows that's an allusion to the gospel song "This Little Light of Mine", and thus to both Jesus and to the civil rights movement in the US, either of which is just a bit twee and pretentious.
posted by orthogonality at 1:40 AM on January 14, 2010 [2 favorites]


Instead, there's this vague yet overwritten warning about "triggers": "As per often, I’m going to give you a trigger warning first". As per often?

Several people on this thread have brought up the concept of "triggers" as if it's bewildering or worthy of disdain -- why? It's common parlance within online communities that deal with sensitive or emotionally affecting topics, particularly in communities where people choose to be vulnerable and share personal stories. Hell, we even use it on Metafilter from time to time.

If you find the tone of the article alarmist or melodramatic, fine, but I don't think the trigger warning exists to amplify the melodrama -- it's a social convention, displaying courtesy to readers who are engaging with you on a personally difficult topic.
posted by brookedel at 2:21 AM on January 14, 2010 [9 favorites]


The author's a seminary student, a trans and feminist activist, and a person of color. I'd kind of hope Jesus and the civil-rights movement meant enough to her to be worth calling back to in her chosen online identity.

Funny how this comes back to identity and the right to claim it for oneself, over and over.
posted by fairytale of los angeles at 2:28 AM on January 14, 2010 [11 favorites]


From now on I'm putting (Warning: possible triggers) in all my comments on economic news stories.
posted by clarknova at 2:31 AM on January 14, 2010 [8 favorites]


Considering that she received enough feedback about how the trigger warning didn't show up on the RSS feed (thereby shocking quite a few readers who weren't expecting something so confronting) to actually make another post to address it, I'd say that there was plenty of "triggers" there.
posted by divabat at 3:01 AM on January 14, 2010 [2 favorites]


Sick. I understand (but don't tolerate) the family's views, but the hospital staff? Whatever happened to "First do no harm?"
posted by mccarty.tim at 3:34 AM on January 14, 2010


How long as "transwoman" been a word? This post is the first I've seen it. It sounds like the name of a mid-run superhero. Is it what we are supposed to say now?
posted by Slap Factory at 3:42 AM on January 14, 2010


Serious issue? Hell yes.
Serious article? Less so.
posted by DWRoelands at 3:47 AM on January 14, 2010 [7 favorites]


I don't understand the dimissal of her concern just because she was never personally close to this person. So what? She knew this person, and Melissa's situation touches on an issue close to the author's heart. So the sincerity of her concern is questioned just because she and Melissa weren't BFFs? Her writing style is "Edwardian"? Her user name invoking a hymn is "twee and pretentious"? What? Going to address the Wordpress template she chose as well? Seems you're going an awfully long way to punch holes in the credibility of the author.

The one thing that matters is that there are a number of details left out. I think the details being left out might be an effort to keep Melissa's identity concealed as much as possible, and perhaps little light is erring on the side of caution by being overly omitious. I don't know. Hopefully the author will provide more details as time goes on.
posted by Marisa Stole the Precious Thing at 4:39 AM on January 14, 2010 [5 favorites]


This is a billing/advance directive issue, no?
posted by The White Hat at 4:46 AM on January 14, 2010


This really puts things into perspective for me.

On one hand, I'm really (selfishly) glad this probably won't ever happen to me. Sure, I could be in a car accident, I could be in a coma and nearly die, but I won't ever wake up and find that my family and the doctors have turned me into a guy. It's not going to happen. Nobody does that sort of thing.

On the other, I am really ... sickened, angry, there are no words ... that this could happen to anyone. Everyone has the right to be happy with who they are, and trans people already have to put so much more effort into getting there than the rest of us that to reverse it just like that is so cruel. Sure, maybe the doctors had good reason not to add estrogen to the mix of drugs on top of everything else that was wrong, and maybe that was a difficult decision, whatever - but actively refusing to call her by the right pronouns and the right name? What the hell?

It isn't right.
posted by Xany at 4:56 AM on January 14, 2010 [3 favorites]


However, with cases like these, [link to story about Janice Langbehn/Lisa Pond] their hopes might be in vain.

Both cases involve hospitals. Both cases involve non-straight people. That's pretty much all they have in common.
posted by one more dead town's last parade at 5:06 AM on January 14, 2010


one more dead town's last parade: That link came from a commentor on the original post. The idea was that any attempt at POA or living wills for queer people would be heavily difficult since hospitals have the option to effectively ignore them. So what's the point in drafting up such documents if the people that need to read them _don't bother_?
posted by divabat at 5:12 AM on January 14, 2010 [2 favorites]


So what. Life is unfair. We are all constantly denied our true selves and frustrated in the full blooming of our flower. Some of us have it harder than others. Anyone who can get estrogen drug therapy has it better than most. Marking your space in the world always involves struggle, hurt and disappointment.

I empathize with the suffering of this person, which is a tragedy. But I don't see the need for outrage at every slight that life throws at you.
posted by eeeeeez at 5:13 AM on January 14, 2010


But I don't see the need for outrage at every slight that life throws at you.

That would make sense, except it's a little disingenuous to say that "life" threw this at her. According to the article there were very specific people who threw this "slight" at her. Where "slight" is a complete violation of her identity and right to medical choices. Thus the outrage.
posted by Salvor Hardin at 5:22 AM on January 14, 2010 [11 favorites]


eeeeez, the "so what" point here is that this is an issue medical professionals will have to learn to address. It's interesting, and part of a larger pattern of trans folks having to fight for basic acceptance of their identities in many arenas others get to take for granted. If the only reason the doctors stopped the hormones was because "it was confusing" to them (an assertion that may or may not be true, we can't tell from what's provided here), then that's bullshit. Either way, instructing caregivers to call her by her male name is *definitely* bullshit even if the hormones were stopped for valid medical reasons.
posted by mediareport at 5:27 AM on January 14, 2010 [3 favorites]


And, you know, the memory reconstruction part is horrifying no matter what.
posted by mediareport at 5:28 AM on January 14, 2010


For those questioning the tone and truthfulness of the article, I know the author. I am not going to out her or explain how I know her, but I can speak to her character. She is incredibly strong and incredibly truthful. While I understand the tendency to have doubts about this, the way she is writing is because she believes is necessary to convey the seriousness of the situation. The trigger warning is because she knows several trans people who are not in the greatest of mental health states, as during transitioning, one goes through puberty again, which, as far as I understand, is a form of mental illness. (There are probably other reasons that are present, but I don't know them. I do know that she wouldn't use that warning lightly.)

This is scary for trans people. Imagine being injured, in the hospital, and upon recovery, being told that you were someone else, not who you remember you were. No matter how much you insisted you remembered your name, your age, your address, etc. you were told you were wrong. That people looked at you funny when you insisted you be called by your right name. Now increase that to realizing that you just woke up in a stranger's body (the effects of discontinuing the hormone therapy). That is why this is so worrying and disturbing.
posted by Hactar at 5:43 AM on January 14, 2010 [17 favorites]


The idea was that any attempt at POA or living wills for queer people would be heavily difficult since hospitals have the option to effectively ignore them.

Lisa Pond died in 2009, after Florida's Amendment 2 passed. Amendment 2 made it so that "the substantial equivalent" of marriage could not be treated as marriage, and so Janice Langbehn had no more rights with respect to Lisa Pond than you or I did. It doesn't sound like Melissa had any sort of advance medical directive.

Until Amendment 2 and its ilk disappear, it may be safer for some people to leave their powers of attorney in the hands of their attorney.
posted by one more dead town's last parade at 5:47 AM on January 14, 2010


when it comes to people changing sex, we live in medieval times.

Think about what you just said right there.

I agree with everyone that it's awful that if this lady wakes up she'll all of a sudden be a man again, and referred to by her male name and all her work will have evaporated. This is a tragedy. Even if she doesn't wake up and she dies, she'll be remembered as a man. That's pretty messed up.

Of course, since we don't have any details on the medical prognosis we don't really know what's happening at all. It could be that this person is simply never going to wake up. In that case the family may have come to a decision to stop hormone therapy based on monetary considerations alone (or at least they could have justified it as such). I don't know anything about the process specifically, other than it costs money. The reason that hormone therapy could be discarded is that it is simply not looked upon as something vital to the health of the individual - by the family members or the doctors - since the person won't die from a loss of hormone therapy. I'd imagine that in these cases it's viewed as a cosmetic treatment and not a vital treatment. For example if a comatose patient had diabetes, you bet your ass that some nurse would be regularly checking their insulin and injecting more or less to keep levels at their proper amount. It's hard to imagine this happening with hormone therapy without the specific request of the patient.

As a final comment, it seems to me that most people dislike drastic changes in their loved ones, and don't understand that such changes are necessary for the ones they love to be happy. And now, in this article, when this lady's life is put in the hands that think they know what's best for her, they decide to change her back into a man. This is wrong, but I also think that it's not something that's going to change anytime soon. These parents may have loved their little boy, and accepted when their boy became a woman, but I'm sure they didn't understand it. They were never convinced that this is what she needed and that they knew what's best for her. Several other people have said so already, but having a living will, or some legally appointed person to vouch for you is crucially important if you want to prevent other people from working their designs on your body "in your best interest."
posted by scrutiny at 5:48 AM on January 14, 2010 [4 favorites]


Sick. I understand (but don't tolerate) the family's views, but the hospital staff? Whatever happened to "First do no harm?"

This is the dilemma that the hospital gets stuck in. They need direction on a patient who is not able to give it themselves, and their only option is to go to the family. If the family is not on the same page as the patient, what's the answer? "The message came through from her family once she was far away: they were changing up some of the treatment protocols, for Melissa’s sake. "
posted by smackfu at 6:20 AM on January 14, 2010 [1 favorite]


Several people on this thread have brought up the concept of "triggers" as if it's bewildering or worthy of disdain -- why?

Because it's impossible to know what may or may not be a trigger for someone else. Something I might think is totally mundane might contain details that relate specifically to your trauma. Considering the highly varied experiences of PTSD sufferers, there is no useful way that this label can be applied -- so as long as the proper context clues are provided, it's up to the reader to decide if something is liable to upset her/him. In this case, the summary in the post gives you all the information you need to decide whether this story is something you need to "steel yourself for" or maybe not read at all.
posted by hermitosis at 6:30 AM on January 14, 2010


My comment, of course, refers to the application of "trigger warnings" and not to the concept of triggers themselves.
posted by hermitosis at 6:31 AM on January 14, 2010


People wake up after horrible accidents with missing limbs and permanent loss of sensation that are incredibly traumatic. I don't see a valid medical opinion here that a comatose patient post trauma, in critical condition, would not be harmed by continuing to artificially support, via hormonal supplement, a sex change.

Not that there are not legitimate issues with discrimination against transsexuals. But there are too many factors not being represented here to know what actually informed the medical decision-making in this case.
posted by troybob at 6:41 AM on January 14, 2010


It's her body. Someone other than herself decided to do things with it that weren't according to her wishes. That's plenty enough reason for outrage, eeeeeez. Or are you the sort of person who loves being manipulated and forced, and can't understand anyone who doesn't like it?
posted by Goofyy at 6:42 AM on January 14, 2010


For those questioning the tone and truthfulness of the article, I know the author.

The issue for me isn't truthfulness; I'm just noting the author's lack of access to the patient's medical information.
posted by mediareport at 6:49 AM on January 14, 2010 [1 favorite]


@Marissa stole the precious thing: "I don't understand the dimissal of her concern just because she was never personally close to this person. So what? She knew this person, and Melissa's situation touches on an issue close to the author's heart...The one thing that matters is that there are a number of details left out..."

See, I think the dismissal of the author's concern is precisely because she was never close to Melisssa.

The author doesn't appear to be close enough to Melissa or her family to have gotten actual details of her medical treatment and why these decisions were made. The author never cites any sources for her info; we don't know if she ever spoken to Melissa's family or closest friends or . Most upsettingly, the author also admits to having what amounts to a busybody, interfering nature in the case of Melissa--which means that even though she doesn't have all the facts, she feels free to reach conclusions about what's happening to Melissa, form opinions about it, and broadcast them.

Unreliable narrator, my black fanny. This author is an interfering gossip, pure and simple, and nearly everything in her piece comes across as the repeating of rumors and assumptions, packaged in language designed to push emotional buttons and discourage rational analysis of what's she claims actually happened.

This doesn't mean that the author's message--which is that transfolk may be at risk for being forced into unwanted genders if they should ever be incapcitated--isn't important. But it's certainly undercut by her admission that she doesn't know Melissa and her family well enough to have gotten the specifics.
posted by magstheaxe at 7:09 AM on January 14, 2010 [2 favorites]


It would be very useful to have a secondary source for this story, if nothing else, to cut through the bad writing in this post.

While I certainly don't condone "editing someone back to their pre-transition state" if that would not have been their wish, it may be the case that there were legitimate reasons for not continuing hormone therapy and not calling the patient by her chosen female name.

Specifically, hormone therapy is known to increase the risk of blood clots in the legs and lungs, and the patient may not yet have legally changed her name yet. There may have been issues with patient medical history continuity to consider as well. As very few administrative systems that I've encountered can cope with the idea that a husband and wife might not share the same last name, I would sincerely doubt any headway has been made in less common situations, such as gender transitions.
posted by Zinger at 7:09 AM on January 14, 2010 [3 favorites]


I think I'm having trouble understanding all the perspectives here but I have to ask: is it accurate to call this "waking up in a stranger's body" when the person inhabited said male body for 18 years and the female one had been constantly changing in the course of therapy? Some things said here and in the link sound like exaggerations or hype-ish and so I don't know quite what to think.

Also, the writer talks about Melissa "doing her paperwork", so do we think that Melissa had already legally changed her name?
posted by XMLicious at 7:10 AM on January 14, 2010 [2 favorites]


About five years ago after an episode of projectile vomiting and a funky blood test, I found myself admitted into hospital for a week-long stay with no solid food. I was tethered to a bag of saline solution, and bled on a daily basis to check my progress. I was sick, miserable, and about 48 hours into the whole thing, my doctor was disturbed at my electrolyte balance and ordered an IV that felt like they were shooting me up with lemon juice. My much-abused vein didn't particularly like this, so I found myself prodded again by a nurse trying to find a new home for the IV drip, when my dear mother comes in with the minister of her church. I don't remember what I said other than I was less than receptive and in ill temper, and quite thankfully, he excused himself and left me to the slow and painful process of being drip-fed potassium.

I think this was the last straw in regards to an extended give-and-take regarding my (a)religious identity that started about a decade before. She knew that my sporadic visits where only to attend musical performances my family participated in. I did not take communion or say the lord's prayer, apostolic creed, or doxology during services. I don't participate in grace at family dinners, and we had spoken at length, quite respectfully, about how our beliefs diverged. I didn't share her faith and pastoral changes meant that her current minister was a total stranger to me.

I found it really insulting at the time. When I was admitted, I was given the option to have my name released and receive pastoral visits. I declined both. I had made my wishes plainly clear to my partner and my parents. So I found it extremely annoying that my preferences and identity were ignored, I suspect on the basis of the no atheists in foxholes myth.

The reason I brought this up, is that we probably wouldn't have this conversation regarding issues of religious belief and identity. We would reasonably call foul if a person was suddenly declared a Southern Baptist or Roman Catholic in his or her infirmity, and medical decisions were made on this basis. And we are justifiably squeamish when Holocaust victims are posthumously baptized. We recognize rights to self-identification as important when we make military dog tags and grave markers.

A reason why people are justifiably bothered by this is because our legal system offers very few protections should someone decide to treat a transsexual person according to cissexual assumptions. It is entirely legal in many jurisdictions for employers to actively discriminate against transsexual people. Transsexual people are often called by pre-transition names and genders when they are victims of crime. And in the criminal justice system, they are likely to be made particularly vulnerable when incarcerated.

Transsexual people (and queer people in general) are especially dependent on having a community of like-minded and supportive people. If you fall outside of the community that's willing to support your self-identity, you can expect to see all of that erased.

And people who style themselves after geometric concepts with connotations of correct behavior and thinking have no business engaging in pseudonym wank. Glass houses and all that.
posted by KirkJobSluder at 7:12 AM on January 14, 2010 [41 favorites]


There's an interesting response in the comments:

little light, this is a beautiful and a worthy post. But, as someone else acquainted with Melissa, I want to respond to a couple of things that other commenters are saying.

I don’t know why her parents made the choices they made — from the information I have, it seems like the decision was made in consultation with (and possibly at the behest of) medical professionals. I want to underscore that I’m not saying it was the right choice. But every time they’ve spoken of her since then, to the best of my knowledge, both of her parents have referred to her only as “Melissa” and “she” — never by her earlier name or as “he.” As far as I can tell — as someone who is not close to the family, but has been closely following Melissa’s condition — her parents still think of her as a woman and don’t wish for her to be otherwise.

I needed to say this because I hate to see her parents referred to as “obviously transphobic” and “guilty of abuse.” I don’t think it’s at all obvious that her parents are transphobic or abusive. They may absolutely be guilty of making a horrible and tragic mistake, but from everything I can see, it was a mistake made because they thought it would offer the best chance at saving their daughter’s life.

little light, this is a miserable and horrific situation, and I hope you know I’m not trying to undermine anything you’ve said. I just don’t want to see the — evidently unwarranted — condemnation of strangers added to this grieving family’s burden.

posted by magstheaxe at 7:25 AM on January 14, 2010 [15 favorites]


Let's not forget that it's quite rare to recover from a long coma: after 4 months of coma caused by brain damage, the chance of partial recovery is less than 15%, and the chance of full recovery is very low.

We don't know if it's medically desirable or safe to keep giving the patient hormone treatment in the coma.

Regarding the name on the charts, the parents may find the new name and sex on the charts to be distressing. "Melissa" was male for 18 years, and female for 4. The parents probably still think of their child as male.

Right now "Melissa" is not conscious and can experience no distress at being called male. It seems unlikely that "Melissa" will ever regain consciousness.

So to maximize human happiness, there is a case that the wishes of the parents about the name and sex on the chart should take precedence.

The writer seems to be automatically casting the parents as reactionary Bad Guys. She seems to feel that as another transwoman, she's entitled to speak on behalf of "Melissa". But she was never very close to "Melissa", and doesn't seem to know anything about her relationship with her parents. Maybe if "Melissa" had predicted this situation, she would have been OK with letting her grieving parents hold on to their illusions.
posted by TheophileEscargot at 7:26 AM on January 14, 2010 [2 favorites]


How long as "transwoman" been a word? This post is the first I've seen it. It sounds like the name of a mid-run superhero. Is it what we are supposed to say now?

If you think that sounds like a superhero, wait until you hear the current preferred nomenclature for a woman who was born a woman: biowoman.

In seriousness, though: yes, this is now the "correct" terminology: transman, transwoman, bioman, biowoman. Personally I think it serves to clarify and I like it.
posted by i'm offended you're offended at 7:31 AM on January 14, 2010 [2 favorites]


Someone claiming to be Melissa's best friend has responded in the comments.

.
posted by magstheaxe at 7:32 AM on January 14, 2010


Two points, and read this carefully before you decide I mean it offensively, because I don't (and for those who think I mean everything offensively, just skip to the next message please).

First, the mere fact that you have parents making these decisions rather than the adult patient pretty much cinches the short-term prognosis. If s/he may remain "semi-conscious" forever, continuing hormone therapy amounts to a waste of money and an unneeded stress on the body.

Second, depending on the relationship with the family (and based on TFA, I'd say they didn't have a very close one), they may well have believed their actions for the best rather than intending the sort of malicious psychological torture some of you make it sound like. Consider this from the parents' point of view - Their son goes off to college, they rarely see him, they have a huge fight when "she" comes out to them as a trans, and next thing you know, they have to make decisions about long-term medical care for the person they raised for 18 years as a boy.

Doesn't make it "right", but I find it hard to blame anyone in this situation, except the legal adult who lacked a well-defined medical power of attorney.
posted by pla at 7:39 AM on January 14, 2010


In seriousness, though: yes, this is now the "correct" terminology: transman, transwoman, bioman, biowoman. Personally I think it serves to clarify and I like it.
posted by i'm offended you're offended at 7:31 AM on January 14 [+] [!]


Can I just call all parties involved a man or a woman and drop the bio and trans labels. If a man becomes a woman then there shouldn't be a trans about it. He is now a she. Also if a person is born a certain sex there shouldn't be a bio label either. It all sounds like really crappy terminology from a really crappy 80's future apocalyptic movie.
posted by Mastercheddaar at 7:44 AM on January 14, 2010 [6 favorites]


KirkJobSluder : we probably wouldn't have this conversation regarding issues of religious belief and identity. We would reasonably call foul if a person was suddenly declared a Southern Baptist or Roman Catholic in his or her infirmity, and medical decisions were made on this basis.

Depends on the religion and why.

Doctors frequently ignore religious proscriptions (and the courts tend to support them, particularly when the situation involves a parent making decisions for their child) when honoring them would interfere with effective treatment. Classic example, JWs and blood.

Now, you mention Baptist and Catholic, but I think that glosses over the real issue by considering two basically-identical religions. As a less silly example, imagine someone raised as a Christian for 18 years, converted to Islam in college, had a stroke, and the doctors wanted to use Lovenox (derived from porcine intestinal mucosa). That takes it from a nuisance to an outcome-threatening restriction on treatment.

Personally, I look at this from my POV as a vegetarian - I don't eat meat because I don't need to, and consider it "wrong" to cause other creatures to suffer needlessly. But if I have a clot in my brain, fuck Bambi, and give me the drug derived from the tears of a thousand tortured cute baby animals.
posted by pla at 8:00 AM on January 14, 2010 [2 favorites]


I find it sad that many of us sit here judging the situation, the author, her credibility, and her story. Some people aren't fantastic writers, especially under stress. Besides, all of that is not the point. It's completely forest for the trees whether or not this is 100% true, or that we've all been provided enough information for assessment.

I don't know about you, but before this post, it had never occurred to me the horrible prison of identity stripping that a trans person could find themself in, were something tragic like this to happen. It's absolutely terrifying, unacceptable and inhumane.

I wish we were discussing more of that, how to combat it and change the system, as well as taking a hard and direct look at some of the other issues transpeople face. Not this insensitive 'well, I don't believe her' or 'this doesn't add up' type crap.
posted by iamkimiam at 8:15 AM on January 14, 2010 [7 favorites]


Slap Factory said How long as "transwoman" been a word? This post is the first I've seen it. It sounds like the name of a mid-run superhero. Is it what we are supposed to say now?

My experience (as someone who Changed 20+ years ago) is that no matter what you call anyone in that subculture you're going to find someone in some ever so slightly different situation who wants to be called something else :( . Losing battle

I did my thing and got over it 20+ years ago. It's not a part of my core identity any more than having my tonsils out. Personally, I only wanted to be thought of and viewed as a woman and that's all I need to identify with.
posted by Poet_Lariat at 8:19 AM on January 14, 2010 [6 favorites]


Can I just call all parties involved a man or a woman and drop the bio and trans labels. If a man becomes a woman then there shouldn't be a trans about it. He is now a she. Also if a person is born a certain sex there shouldn't be a bio label either. It all sounds like really crappy terminology from a really crappy 80's future apocalyptic movie.

"All parties involved" are REAL PEOPLE who have their own opinions about what they want to be called. Sometimes a man becomes a woman and that's it, she's a woman; sometimes a man becomes a woman, but she wants to acknowledge, maybe just every once in a while, that she was born a man, so: transwoman.

"Crappy"? Jeez, sorry. Some friends of mine think that only being able to be called "man" or "woman", no other options, is crappy to the point where it's painful. Language can be crappy for describing real life, I know, but I think it's crappy that my friends, who are extremely nice people, feel hurt on a regular basis, just because people don't want to use a couple of new words.
posted by clavicle at 8:23 AM on January 14, 2010 [3 favorites]


I'm confident that this woman, who is in no way a trained physician and who has little knowledge at best of the medical facts of the case, has made an informed and clinical determination that continuing the hormone treatments on this critically injured patient won't adversely affect the person in question's recovery.

And of course, by "confident" I mean "skeptical to the highest possible degree".
posted by Aquaman at 8:24 AM on January 14, 2010


clavicle : "All parties involved" are REAL PEOPLE who have their own opinions about what they want to be called.

I, as a REAL PERSON, have the opinion that you should all call me "My Lord and Master".

Let me know when you decide to honor that. ;)
posted by pla at 8:33 AM on January 14, 2010 [1 favorite]


Someone claiming to be Melissa's best friend has responded in the comments.

Grrrrrr. It's that "TSA took my baby away!!!" all over again. I mean, it's not that mean-spirited, obviously, but what you have is someone blogging about bold and unverifiable claims that should outrage us, then later in the blog comments it's revealed that the blogger's take on the situation isn't 100% accurate. It makes me upset at myself that I didn't listen harder to the voice in my head that says "why should I believe that's the truth", and in the end makes me less sympathetic towards her situation just because it's not AS bad as it might have been.

Busybodies blogging about people that they barely know should stop doing that.
posted by 23skidoo at 8:37 AM on January 14, 2010 [1 favorite]


Aquaman said : I'm confident that this woman, who is in no way a trained physician and who has little knowledge at best of the medical facts of the case, has made an informed and clinical determination that continuing the hormone treatments on this critically injured patient won't adversely affect the person in question's recovery.

And of course, by "confident" I mean "skeptical to the highest possible degree".


That's really a good point that you and a few others have made. Hormone therapy at the levels needed for a pre-op does greatly increase the chances for blood clotting and is always either contra-indicated or else very closely monitored in cases where clotting is an issue (diabetes and other conditions) . Someone prone 24x7 must have a greatly increased risk of clotting just like people inactive on airplane trips - so perhaps it was, at least in part, a valid medical decision.

With that said it doesn't surprise me that the family would take the opportunity to deny and/or attempt to reverse the patient's gender choice. Such denial happenns more times than not :(
posted by Poet_Lariat at 8:39 AM on January 14, 2010


I think it's a terrible thing that her transition may be undone, but I hope the parents made the decision after receiving the entire medical picture from their daughter's physicians. It may have been a necessary but unfortunate cost to "Melissa" recovering. It may be they know already that nothing will recover her and they are deciding their next course of action. We do not know.

As a parent, I like to think that the decisions I make for my child are the best I can with the information I have at the time I have to make the decision. I like to think that if my son ever decided he was going to become my daughter that I'd be accepting of that, but I also know if he were in an accident of this sort and the medical professionals handling his care really believed stopping hormonal treatments gave him, or her rather for the example, the best chance of survival, I wouldn't hesitate to stop it. From the comments from people who know Melissa, it sounds like this could possibly be the case --- at least for one of her parents. I'm willing to give them the benefit of the doubt at the moment because when faced with the possibility of going from having a child to no longer having a child, what wouldn't a parent do to improve the odds of keeping that child?
posted by zizzle at 8:40 AM on January 14, 2010


her body had been forcibly edited back to its pre-transition state

If you have to be taking hormones to maintain a "female" state, how is allowing what male centric hormones are still in existence in the body "being forcibly edited"?

If anything the external force was regular injections of female hormones.

Oh, and who's paying for the female hormones while in the hospital? As "the nation" has "fought hard" for the "right" to not have "government interference" in medicine - if some insurance firm who's paying for the accident care - should that firm pay for the care that has nothing to do with the accident?

You might wish to start the argument without "been forcibly edited back".
posted by rough ashlar at 8:41 AM on January 14, 2010 [2 favorites]


I don't know about you, but before this post, it had never occurred to me the horrible prison of identity stripping that a trans person could find themself in, were something tragic like this to happen. It's absolutely terrifying, unacceptable and inhumane.

It's an issue that should be given some attention, but this is a poor example. I'm bothered by the lack of perspective that accidents can be traumatic and life-changing for anyone. This woman's best friend is dead; she is not. Lifetime competitive runners have their legs amputated, and talented pianists become quadriplegic; she has the opportunity to rebuild her life in ways they do not.

I think the 'trigger warning' thing is kind of strange, as I can't imagine that someone so unprepared to hear this story would meet the psychological standards for sex reassignment.

In any case, I'd say the little pull-quotish thing in the upper right corner of the page, "My gender is rage," indicates that this article is more about the author than the victim.
posted by troybob at 8:45 AM on January 14, 2010


What the hell is a "trigger" in this context?


Well, for instance, suppose you're a transsexual man who finds that someone at the hospital where you're staying has changed your name on your charts to a female version of your name, as happened to my best friend.

Or, suppose you're the pregnant partner of a transsexual man, and you find yourself naked and vulnerable in a room with a nurse who thinks this is her chance to interrogate you about the state of your partner's body and the details of how you have sex, as happened to me.

It is a bit breathless and, I think, unnecessary to post "trigger" warnings (the headline is enough to make me know I don't care to read the article), but it's just meant to give transfolk a head's-up that something in the article might re-stimulate unpleasant feelings related to their own past bad treatment, for instance.
posted by not that girl at 8:45 AM on January 14, 2010 [6 favorites]


TheophileEscargot: "Right now "Melissa" is not conscious and can experience no distress at being called male. It seems unlikely that "Melissa" will ever regain consciousness."

Is that really true? I don't know a whole lot about comas, but I would imagine that the actual physical and emotional environment that a comatose patient is living in could have some positive or negative implications for their recovery. I'm now a bit curious about the perception of audio, emotion, human presence, etc. for those people who are unconscious or in a coma. Does anybody have some insight on this they mind sharing?

Point being, I wouldn't want to return to a place where there was no sign or acknowledgment of my identity existing there anymore.

Also, I really hope that Melissa in quotes is highlighting the fact that this is a pseudonym, and not that this is a questionable name choice for her gender as others deem it. I personally would prefer to see the quotes dropped altogether. We generally don't do this when referring to pseudonyms used in AskMe questions and such, and this here is a particularly sensitive issue. The quotes carry an evaluative judgment that, I believe, perpetuates the rejection of identity, which seems to be the core issue in this post.
posted by iamkimiam at 8:47 AM on January 14, 2010 [1 favorite]


I read this article the other day, and basically thought the same things: that the author had perhaps less than enough information, and presented it in a way that didn't really do justice to the complexity of the situation. It was overtly moralizing, and not conciliatory enough to the idea that some of the actions, such as stopping hormones, may have been in her best interest.

I initially thought it was roughly similar to the problem that same-sex couples have encountered, with next-of-kin being parents or siblings rather than long established partners. But it's not really about who should or shouldn't have the power to make decisions for you, as it may be that only her parents are in the position to think about the long term and permanent problems of disability, and in any case it's not clear she has anybody else willing or able to take their place. The problem lies in what they're able to decide for her, and why. Stopping hormone treatment might be entirely reasonable, as there are medical aspects to HRT, but where's the medical aspect of a name or an identity?

Transsexual people have pathologized for a long time along with other LGBT people. But unlike others, trans people need to maintain a level of engagement with medicine, and can't say "fuck you, I'm not sick!" in quite the same way. There are strong movements against the current medical model of transsexualism, but there's no escaping the need for "disgnosis" and "treatment" because you have a "condition". Many part of transition, such as hormones, surgery, and legal documents, are controlled by doctors and require the adherence to protocols. Which brings transsexual people - their bodies and their identities - under the view of doctors in a way that makes whether somebody should be transsexual a seemingly valid medical decision. That the next-of-kin are handed the power to change names, pronouns, presentation, and so on, is thus not really surprising.

I think legal protections are probably necessary for some, but they will only be transferring the power to make decisions from one person to another, not removing their transsexuality from the realm of medical decisions entirely.
posted by Sova at 9:05 AM on January 14, 2010 [3 favorites]


iamkimiam,

You seem very sensitive to perceived judgments in how people use language; this is a lot like the misunderstanding in the thread about the Economists' use of "Ms," where you spent a lot of time wringing your hands over a gender bias that was rather easily proved not to exist with a few clicks to other articles or a Google search for their style guide.

I'd suggest that you give people the benefit of the doubt and not immediately assume that a usage that's unclear or unfamiliar to you is an attempt to marginalize or diminish someone.
posted by mpbx at 9:06 AM on January 14, 2010 [1 favorite]


I have an FTM trans friend who has to go on and off of female hormones sometimes. When she changes her hormones, she has short-term issues like mood swings and depression, and also lasting cumulative changes, like male pattern baldness and body fat distribution in a more male pattern (she'll get "male fat" on the front of her belly, where as on F hormones the fat sticks lower on her belly, more like hips). So yeah, "Melissa" will probably wake up with sharper, more masculinized features and irreversable hair loss at the least- not sure what else.
posted by pseudostrabismus at 9:19 AM on January 14, 2010


"...I wish we were discussing more of that, how to combat it and change the system, as well as taking a hard and direct look at some of the other issues transpeople face. Not this insensitive 'well, I don't believe her' or 'this doesn't add up' type crap."

It's precisely because of the author's questionable credibility and melodramatic approach to Melissa's situation that she's being judged. From where I sit, this woman's taken an already horrible event and made it worse by spreading unfounded accusations about Melissa's family, just to support her point.

She's also being judged because others in a better position to have the facts have since replied to the author's original post and gently clarified what's going on, and yet her original post remains uncorrected.


You're right, this is an important issue, one I'm sure at least a few of us had never thought about. But the author's approach to promoting it is...a concern. I certainly hope no member of Melissa's family reads it or some of the comments it prompted.
posted by magstheaxe at 9:21 AM on January 14, 2010 [1 favorite]


Ah, I take your points about the quotation marks around the name Melissa, iamkimiam. I meant mine only to highlight the pseudonym. The person in this story read as female to me, and I did not intend to suggest otherwise.
posted by pseudostrabismus at 9:21 AM on January 14, 2010


oh man, oh man. okay. i know little light and "melissa" and i am irritated that this fucking blog post has ricocheted around the internet with a loud spanging noise because boy howdy, light does not know melissa's parents and the insertion of the self into m's narrative when i know they didn't have much to do with each other sticks in my craw. the accident and its aftermath have been so fucking hard for the people close to melissa and the other girl in the accident, who died onsite. traumatic brain injury is fucking hard. melissa is not doing well. it does not look like she is going to recover. light's post veers hard and early off into speculation and that is messed up and i am pretty angry about it, and this isn't the place for me to be angry in a complex way but i feel like this issue of etiquette is something we need to talk about as internet people.

light could have used the issue with m. as a jumping-off point to discuss the importance of keeping your papers in order and your stuff prepared in case you are not able to direct your own treatment for whatever reason. instead she editorialized heavily and made hurtful and unfounded presumptions about the motivations of people in a situation she admits she is removed from. this kind of tone seems to be more common on blogs than in other mediums and i think this is a valuable reminder for all of us internet speculating machines to consider not just the issue that a story represents, but the people involved in the story, and to remember to be respectful of those people as individuals and not just as object-lessons or things for us to debate, particularly when the story is about private individuals and not politicians or celebrities or others commonly subject to the public eye, with the mechanisms in place to protect themselves from that gaze.

any of y'all feel free to memail me about this stuff, i'm sorry that this post is not very sensical.
posted by beefetish at 9:46 AM on January 14, 2010 [29 favorites]


This author is an interfering gossip, pure and simple, and nearly everything in her piece comes across as the repeating of rumors and assumptions, packaged in language designed to push emotional buttons and discourage rational analysis of what's she claims actually happened.

As long as we're all speculating on the personality of the author, I guess it could go the other way; that the author is close friends with people who are close to Melissa. Guess we don't exactly know, as she is scant on the details. I just generally think it's best to assume the better nature of people in situations like this, where they're expressing concern about another human being.
posted by Marisa Stole the Precious Thing at 9:47 AM on January 14, 2010


Aaand now that we have someone in this thread who knows both of them, maybe some more light can be shed on the situation.
posted by Marisa Stole the Precious Thing at 9:49 AM on January 14, 2010


All points taken, thanks. :)

mpbx, I do give people the benefit of the doubt, but perhaps I should work on softening my statements so not to appear like accusations. I am sensitive about language, and I don't mind being on the extreme end of pointing out subtleties if it can raise others' awareness about how they use language in ways that can carry unintended evaluative judgments that they may or may not align with. Bringing these things up gives others an opportunity to clarify their stance.

And just to be clear, because you brought it up, in The Economist's thread, I was objecting to how the general public who doesn't have knowledge, time or interest to pursue the style guide might initially perceive the use of Ms. as unnecessarily highlighting gender, and inconsistently so. I don't think that there was a gender bias in the article, but it appeared that way, due to strictly following style guide conventions (despite their rules that say to break convention when it would appear ugly or cause confusion). I tried to make that distinction clear in that thread, which probably sounded like hand-wringing and whatnot. Eh, semantics and better luck for us all next time. :)
posted by iamkimiam at 9:51 AM on January 14, 2010


Or are you the sort of person who loves being manipulated and forced, and can't understand anyone who doesn't like it?

You must have forgotten all about the fact that the author of this piece is not close to the situation or the family, doesn't have all the information, and is writing everything based on hearsay and third-party information.

If you're all gung-ho about believing the author without any evidence at all, the person who's being manipulated (and just looooooves it) would be you. Doesn't the righteous outrage feel good? Sad that it's completely baseless though.
posted by splice at 9:59 AM on January 14, 2010 [1 favorite]


maybe some more light can be shed on the situation.

it seems like someone has coopted another persons personal, private tragedy without their permission to service a possibly well meaning yet self serving agenda. I think this family should be left alone. They are not public figures, their story is not a talking point, it's a tragedy in progress.
posted by mpbx at 10:02 AM on January 14, 2010 [4 favorites]


"just because people don't want to use a couple of new words."

Your friends can choose whatever terms they like for their gender and sexual orientation, but I personally object to being conversely labeled a "cissexual" and "biowoman."
posted by HopperFan at 10:06 AM on January 14, 2010


Well, a few things I take away from this blog entry are:

a) Advance health-care directives are important for everyone, even young people in good health;
b) They may be especially important to people whose gender is not the same as their gender assigned at birth;
c) People project a lot of their own anxieties onto horrifying events involving acquaintances and friends of friends.
posted by Sidhedevil at 10:07 AM on January 14, 2010 [1 favorite]


There's a whole lot of "seems like" in this thread, and some pretty ugly crap is starting to simmer. Think I'll step away from this trainwreck waiting to happen.
posted by Marisa Stole the Precious Thing at 10:07 AM on January 14, 2010 [1 favorite]


I personally object to being conversely labeled a "cissexual" and "biowoman."

What? Why?

Why would you object to being "labeled" accurately as a cis woman (if your gender assigned at birth and your current gender are identical--which is what "cis woman" means)?

It's not like people go around calling other people "cis woman" and "trans woman"--it's useful in, for instance, a medical context. (For example, the statement "Cis women and trans men should be screened for cervical cancer; cis men and trans women should be screened for prostate cancer" provides an additional layer of information, not just "labeling".)

As for "biowoman," that's not a term I've encountered.
posted by Sidhedevil at 10:11 AM on January 14, 2010 [5 favorites]


"Why would you object to being "labeled" accurately as a cis woman (if your gender assigned at birth and your current gender are identical--which is what "cis woman" means)?"

"Accurately" is a matter of opinion. I'm a woman. Female. That's it. What you choose to call yourself is your own business.
posted by HopperFan at 10:15 AM on January 14, 2010


For those saying "It's her wishes", do you realistically think anyone had the conversation with her about what happens if she ends up in a coma with medical complications and associated risks with therapy? Why would you assume that her opinion would not, could not, change as the facts change? That to me gives her surprisingly little credit, and elevates her status, her issue, above her choices and ability to make them. She is more than just somebody's cause -- but maybe not more than that to this author, which I think is the point made upthread.

On preview, that seems according to beefetish exactly what's happened.
posted by Durn Bronzefist at 10:16 AM on January 14, 2010


Also, if I understand the term correctly, cissexual is somewhat different than you described, "if your gender assigned at birth and your current gender are identical" That's biowoman. [or biomale]

Cissexual = "people who are not transsexual and who have only ever experienced their subconscious and physical sexes as being aligned."
posted by HopperFan at 10:29 AM on January 14, 2010


HopperFan, I gotta tell you, BioWoman sounds pretty damn cool to me.
posted by Mister_A at 10:37 AM on January 14, 2010


You may have a point, Mister_A.
posted by HopperFan at 10:39 AM on January 14, 2010


HopperFan, you're picking nits here. If you were assigned a female gender at birth, and currently identify as a woman, you are a cis woman. You have some different healthcare needs from trans women, and some similar healthcare needs to trans men, and it's helpful to spell that out in a medical context.

In almost all circumstances, you're a woman and Alexis Arquette is a woman and the fact that the two of you were assigned different genders at birth doesn't enter into the picture; Matt Haughey is a man and Chaz Bono is a man and the fact that the two of them were assigned different genders at birth doesn't enter into the picture.

But Alexis Arquette is a woman who needs to be screened for prostate cancer; Chaz Bono is a man who needs to be screened for cervical cancer. Because that can sound confusing to some people, the additional specification of "cis" and "trans" can be helpful in some cases.
posted by Sidhedevil at 10:43 AM on January 14, 2010 [2 favorites]


No, I don't think I'm nitpicking. If a transwoman wants to be called a female, I'd happily go along with that. If they chose trans, or some other term, same thing. If they said, "Hey, I really don't like that term, please call me X" that would be fine, too.

I expect the same respect. I said I'm personally offended by the term and would rather not be called that. I didn't say that other people couldn't use the term if they so chose.

I think you realize that cis and trans are used far more often in LGBT forums, not as medical terms.
posted by HopperFan at 10:51 AM on January 14, 2010


(I just want to make the point that trans woman don't need to be screened for prostate cancer. Otherwise, carry on.)
posted by Sova at 10:52 AM on January 14, 2010


Nthing that my perception is that ciswoman/man is preferred to biowoman/man.

I can see the slight difference in definition between those quoted, but I guess I don't see the utility of difference in the terms. I guess that technically, a bio(gender) could be a person with transsexual...what, unresolved trans-feelings who is therefore not "not transsexual" but also is the gender assigned at birth? But I don't know why we would refer to that person as a bio(gender), which doesn't seem to fit the need to be able to differentiate the gender of non-transsexuals by a neutral term.

As for the need for such a term, it's an absolute necessity if we are to have any reasonable discourse about transsexuality. Otherwise, we get stammering references to "y'know, whatchacallist NORMAL women. Oh, you know what I mean." Outside of such discussions, however, of course we can simply refer to people by their gender, without the need to differentiate between trans- and cis-.
posted by desuetude at 10:54 AM on January 14, 2010


That makes sense, desetude. I admit that identifying terms like that would be very useful in such discussions, if they're used neutrally. Sometimes they're not, though, like this post discusses.
posted by HopperFan at 11:00 AM on January 14, 2010


Sova said : (I just want to make the point that trans woman don't need to be screened for prostate cancer. Otherwise, carry on.)

Actually they may need to be screened. Two examples:
1. A fifty something transgendered person who decided to go MtF at that age should be screened for at least several years after hormone therapy starts.

2. An MtF transsexual who decides to stop hormones at fifty or sixty ( it happens sometimes for a variety of health reasons ) should also be screened .

Oddly enough my current doctor decided to ask me for such a screen a couple months ago when I had a physical and I declined. Thinking about it a bit afterward I think I declined as much for self-identification issues as medically valid ones . Bad reason but it happens as well :)
posted by Poet_Lariat at 11:03 AM on January 14, 2010


I’d say this was a lousy post for MetaFilter.
posted by joeclark at 11:09 AM on January 14, 2010


the additional specification of "cis" and "trans" can be helpful in some cases.

Probably so, but mainly, I suppose, when talking to and about transmen and transwomen. In the US, 99.99+ percent of all females were born that way and will die that way. Isn't qualifying her sex with "born that way" a bit like specifying that she has two legs? It's a given. If she wasn't born female, or she has some number of legs other than two, she should of course let the doctor know.
posted by pracowity at 11:21 AM on January 14, 2010


So, if I'm male and have always thought of myself as male, that means I'm a cisman? That is, the prefix is used for balance and cisman and transman (or whatever) are then the two subsets of "man". Is this correct? I speak out of ignorance and a desire to remedy the situation.
posted by sciurus at 11:34 AM on January 14, 2010


Poet_Lariat: I accept that in the two cases you mention, screening might be beneficial, as I can imagine they have a higher risk than normal. But even though trans women in general can develop prostate cancer, it's rare and they don't need to be screened. The official advice is that trans women are screened, but I know the general community advice is that it's not worthwhile.


So, if I'm male and have always thought of myself as male, that means I'm a cisman? That is, the prefix is used for balance and cisman and transman (or whatever) are then the two subsets of "man". Is this correct? I speak out of ignorance and a desire to remedy the situation.

Yeah, and "cis male", or just "cissexual". It's really not used just for balance, but to highlight the fact that when cissexual people speak about trans issues, they're coming from a position of privilege, never having experienced what it is to be trans.
posted by Sova at 11:40 AM on January 14, 2010


Okay, great. that makes much more sense. Thanks very much.
posted by sciurus at 11:42 AM on January 14, 2010


In a TV fantasy world where people wake up from traumatic brain injuries after years of coma and walk out into complete (if interrupted) lives, it shouldn't be difficult to understand the writer's horror at the possibility of their hard-won gender transition being reversed by people who think the transition shouldn't have happened at all. If you don't get why that would be so horrific, perhaps shutting up and listening more could help.

As far as "cisgender", I think it's as reductive and ultimately dismissive as "monosexual" is when used by some bisexuals.
posted by gregography at 12:12 PM on January 14, 2010


I've always felt like I'm a dolphin in the inside.
Linky
posted by CarlRossi at 12:26 PM on January 14, 2010


As far as "cisgender", I think it's as reductive and ultimately dismissive as "monosexual" is when used by some bisexuals.

No, "monosexual" is unnecessary and (IMO) prissy, inventing a problem where there is none. (IAAB.)

When you're discussing transsexuality, how do you refer to non-transsexuals? "Non-transsexuals" is clunky and negative. "Biological women/men" defines transsexuals as not biological, which is both insulting and hilariously incorrect. "Women-born-women" is over long and dismissive of the concept of transsexuality.
posted by desuetude at 12:34 PM on January 14, 2010 [3 favorites]


Hi CarlRossi,

Welcome to MetaFilter. Your opinion about the transgendered is as valid as any other. Indeed, perhaps transgendered people are all just delusional freaks. However, on this website we prefer to express our opinions in civil and respectful ways. You can feel free to be snarky when the thread is about something that merits snark. However, when the thread is about a comatose woman whose body is being physically changed against her will by her family's intolerance, we'd prefer you to express your opinion about the transgendered with the seriousness that the context merits.

Or maybe you can just buzz off.

Yours, Shii
posted by shii at 12:38 PM on January 14, 2010 [3 favorites]


When you're discussing transsexuality, how do you refer to non-transsexuals? "Non-transsexuals" is clunky and negative. "Biological women/men" defines transsexuals as not biological, which is both insulting and hilariously incorrect. "Women-born-women" is over long and dismissive of the concept of transsexuality.

I think this is the point. No one is telling "born that way and feel that way" men or "born that way and feel that way" women that they need to readjust their self-referenced pronouns or gender terms or whatever. I think the term is used as needed (and others have highlighted some perfectly legitimate needs, i.e. in a medical context) to make a distinction when, to clarify discussion, a distinction needs to be made.

I don't think anyone is trying to entrench upon your non-trans rights or identities by horrifically imposing a new and different name. But just that sometimes, a distinction needs to be made, and for the reasons highlighted above, "bio" and "normal" might not be appropriate.
posted by bunnycup at 12:49 PM on January 14, 2010 [1 favorite]


"I don't think anyone is trying to entrench upon your non-trans rights or identities by horrifically imposing a new and different name."

Oh good grief. I never said it was horrific, or anything about my non-trans rights. I simply don't like it in general use, and I'm not the only one. Try googling "cissexual debate."
posted by HopperFan at 12:53 PM on January 14, 2010


Hmm, I missed the vote when "monosexual" became a dismissive and reductive term. Maybe I was too busy trying to not get edged out of serious discussions about the sexuality continuum by non-bisexuals at the time.
posted by _paegan_ at 12:54 PM on January 14, 2010 [2 favorites]


I've been reading this thread all day, just not knowing what to say. Separating from the details of this particular story and the comments made over the course of the thread by people who know the folks involved, I haven't known what to say. I think regardless of the details and the medical justification for stopping hormone therapy, it is worth taking a moment to empathize with individuals who have to worry about similar things happening to them. Who, basically, have to worry that they will not receive equal legal or respectful social treatment because of gender identity or sexual preference. I don't know what to say about Melissa, but I am sure there are lots of people who really do have to be concerned about these issues and don't know if all their responsible actions (paperwork, legal steps) will be respected or not.

I never said it was horrific, or anything about my non-trans rights. I simply don't like it in general use, and I'm not the only one.

I never said you did? Feeling a little defensive? I guess you misinterpreted my editorial/general 'your' to mean cismen and ciswomen (including myself), generally. By not referencing back to you, quoting you or giving any indication at all that I was speaking to you, personally, I thought that would come through. Guess not...
posted by bunnycup at 1:01 PM on January 14, 2010 [2 favorites]


Ahhh, total screw up. Summary: meant people generally, not you. Chill out. (too much cold medicine here in bunnycupland)
posted by bunnycup at 1:02 PM on January 14, 2010


No, I simply assumed you were referring to the discussion that I started. Have a nice day, ciswoman.
posted by HopperFan at 1:02 PM on January 14, 2010


And now I should say that what I think about the term(s) means diddlysquat in the greater picture of people trying their best to discuss trans issues clearly and diplomatically, and I recognize that. It's just a personal peeve.
posted by HopperFan at 1:05 PM on January 14, 2010


Trans woman. Two words.
posted by avocet at 1:06 PM on January 14, 2010 [3 favorites]


When a term only has meaning as "not-", what's wrong with saying "not-"? By inventing a new term you're implying a more specific definition, no? So that (as evidenced by the ongoing discussions on the subject) people start using it as though there are clear features and qualities that can be associated with it - which is not the case when it starts as a "not-" term.

As a non-trans person you can say that I don't share the experience of a gender/body mismatch. You can't make _any_ other assumptions about me in that context. Doesn't making up a new term support just that?

Same with "monosexual"- as though the personal sexuality experiences of all non-bi people, gay and straight, were reasonably lumped and discussed with a single term. It's just stupid, and responding to objections to it by stating you're a bigger victim is just not helpful.

posted by gregography at 1:12 PM on January 14, 2010


Avocet - I have tranny friends in a variety of forms and whenever I've seen them use trans it's always been a single term. For some reason (shortness?) "transman" seems to be a lot more common. Or maybe I know more FTM people...
posted by gregography at 1:24 PM on January 14, 2010


shii : Or maybe you can just buzz off.

Way to completely miss the joke, to which Carl even kindly linked for those who didn't already get it.

CarlRossi, welcome to MeFi. You will quickly learn that MeFi has a number of sacred cows that it discourages eating, which includes every genetic, memetic, and/or lifestyle non-normative trait you can ever possibly think of, up to and including how such people choose to self-identify.

If someone feels that they came into this world a member of the wrong species, well then where do you get off mocking such a poor, tormented soul? Not like they chose their inner-dolphin-ness (unless they did, in which case don't you dare say they didn't have a choice). And even though they asked us to call them "Delphinically inclined" last week, you need to understand that this week it counts as a hateful, derogatory term.

Stick to the safe topics for a few weeks, like your favorite flavors of cookies, or the current weather where you live (not that where you live, or its weather, whether cis- or trans-seasonally inclined, counts as in any way better or worse than anywhere else and their weather patterns).

Oh, and Libertarians, you can safely ridicule them. ;)
posted by pla at 1:24 PM on January 14, 2010 [4 favorites]


I don't know what to say about Melissa, but I am sure there are lots of people who really do have to be concerned about these issues and don't know if all their responsible actions (paperwork, legal steps) will be respected or not.

bunnycup: this is true for more than just queer or trans people. for example, inheritance, visitation, and power of attorney have been really complicated for my little pile of people because if you are unmarried and someone's life insurance beneficiary in oregon, you cannot be their medical power of attorney.

if your lifestyle or household in any way deviate from the norm, it is extremely important for you to be on this shit, because much of this paperwork is written up with the assumption that you're married straight monogamous types. The More You Know.
posted by beefetish at 1:35 PM on January 14, 2010


bunnycup: this is true for more than just queer or trans people. for example, inheritance, visitation, and power of attorney have been really complicated for my little pile of people because if you are unmarried and someone's life insurance beneficiary in oregon, you cannot be their medical power of attorney.

Agreed, and although I nearly stated that I am much more bothered when there are those who would choose to legally define their relationships and obtain equal treatment, but are more or less forbidden to do so by law. You are without-a-shadow-of-a-doubt right to remind me that it is very important to stop and think that there are so many good ways to build a family that don't always include marriage (whether it is permitted in the situation or not), and to respect that.
posted by bunnycup at 1:52 PM on January 14, 2010


Oh, and Libertarians, you can safely ridicule them. ;)

Well that goes without saying.
(wtf is it with Libertarians anyway? Last week I had some self-described Libbie tell me that he was against child labor laws. I just walked away from him but I wanted to say so much more ...)
posted by Poet_Lariat at 1:54 PM on January 14, 2010


"...I just generally think it's best to assume the better nature of people in situations like this, where they're expressing concern about another human being."

It would be easier to make that assumption if the writer had removed her accusations once information arrived from persons who had interacted with Melissa's family.

As it stands...well, the road to Hell is paved with good intentions. I doubt the writer set out to make a bad situation worse, but she's had a few days to withdraw the accusations she made towards Melissa's family and she's not done so. Meanwhile her original post is picking up speed around the internet.

It's hard to assume the better nature of someone when she's at best being callously thoughtless.
posted by magstheaxe at 2:02 PM on January 14, 2010


When a term only has meaning as "not-", what's wrong with saying "not-"?

Personally, I think it's awkward to keep referring to a subset of people as not-not-not-not-not.
posted by desuetude at 2:04 PM on January 14, 2010


Try googling "cissexual debate."

I just did, and there were like, four links to the same person's twitter feed.
posted by PhoBWanKenobi at 2:09 PM on January 14, 2010 [2 favorites]


in this situation bunnycup i feel that making sure that everybody's taking care of business trumps being bothered by the fact that i, my lover, and a grip of my friends and fellow-citizens are second-class citizens according to the Man. but it does add a special wrinkle to the proceedings for sure.
posted by beefetish at 2:12 PM on January 14, 2010


If you were assigned a female gender at birth

not the same as their gender assigned at birth

if your gender assigned at birth and your current gender are identical

If you were assigned a female gender at birth

the fact that the two of you were assigned different genders at birth

I guess that technically, a bio(gender) could be a person with transsexual...what, unresolved trans-feelings who is therefore not "not transsexual" but also is the gender assigned at birth?

I'm a bit perplexed by the passive voice being used in these references. Can anyone shed some light? Thanks.
posted by The World Famous at 2:20 PM on January 14, 2010


Saying "don't call me a cis sexual" is like saying "don't call me a biped" or something. It's not like people are going around flinging the term willy-nilly, but there are some contexts in which it is useful to talk about the different needs of trans men and cis men, and trans women and cis women, just as there are some contexts in which it is helpful to refer to humans as bipeds.
posted by Sidhedevil at 2:22 PM on January 14, 2010 [1 favorite]


beefetish, I'm not sure that you and I disagree. I have none-to-no personal experience with these issues, as a run of the mill heterosexual married woman so I hope I'm not saying anything or using language that is divisive or disrespectful. I don't intend to say anything further than showing respect and acceptance.
posted by bunnycup at 2:28 PM on January 14, 2010


oh hell bunnycup no worries, i was just clarifying my own stance.
posted by beefetish at 2:42 PM on January 14, 2010


Cis-whatever reminds me of how the internet autism-spectrum community uses the word 'neurotypical'. It's perfectly understandable that they needed to coin a shorthand term to describe the group of people that aren't them, and trans people certainly are allowed to save a few keystrokes in the same manner. But outside of their worlds expecting people to follow your chosen jargon is a shade on the demanding side.
posted by Space Coyote at 2:52 PM on January 14, 2010


But outside of their worlds expecting people to follow your chosen jargon is a shade on the demanding side.

Who's doing this? The vast majority of people are utterly unaware that the terms exist.
posted by desuetude at 3:57 PM on January 14, 2010


mpbx, I'm really glad that iamkimiam chose to voice her misgivings about the use of quotation marks around the pseudonym. My initial knee-jerk reaction was to get offended as hell by them, and I might have been a lot less diplomatic in my response/flagging. iamkimiam saved me from the risk of some serious foot-in-mouth disease.

Can we say "entirely inadvertently offensive, which makes it OK, sorta"?

No. On second thought/re-reading, let's call it "theoretically plausibly inadvertently offensive supposing you have a serious aversion to pronouns in the case of this one person but not others in the story and also happen to have a beef with pseudonyms".
posted by tigrrrlily at 5:23 PM on January 14, 2010


Cissexual debate:

1

2

3

People are talking about it. It's not just a Twitter feed.
posted by HopperFan at 5:43 PM on January 14, 2010


I thought the use of "cis-" was to indicate that transexuals et al are just as normal as "normal" people. Kinda like the difference between saying "I'm straight" vs. "I'm het". The latter lacks the subtle nuance of "and not only that, but that's the correct way", and so do the "cis-" words.
posted by rubah at 6:12 PM on January 14, 2010


The World Famous, my understanding is that the "gender assigned at birth" language is meant to reflect the fact that the initial 'it's a boy/girl!' decision usually reflects doctors/parents observations or judgment calls about external genitalia at birth. This is true when chromosomes, genitalia, and eventual chosen gender are all male or female, and includes cases where the infant is known (or not known) to be intersex, and cases were the child in the end doesn't identify with the gender they're raised as. And in general, the language reflects the distinction between "sex" - the state of one's chromosomes, hormones, genitalia, etc.- and "gender" - the cultural and societal roles associated with male and female - sex is inborn, gender is (sometimes incorrectly) assigned.
posted by heyforfour at 7:07 PM on January 14, 2010


Also, I really hope that Melissa in quotes is highlighting the fact that this is a pseudonym, and not that this is a questionable name choice for her gender as others deem it. I personally would prefer to see the quotes dropped altogether.

I used quotes because "Melissa" is a pseudonym, and because the linked article did. Had I wanted to dispute "Melissa's" gender preference, I'm have used scare quotes around pronouns refering to her.
posted by orthogonality at 7:29 PM on January 14, 2010


Hm. I don't like the passive voice use there, then.
posted by The World Famous at 7:38 PM on January 14, 2010


The main link (to Questioning Transphobia) is now a password protected post.
posted by crataegus at 9:05 PM on January 14, 2010


crataegus : The main link (to Questioning Transphobia) is now a password protected post.

Well now, we can't have that, now can we? Here ya go.
posted by pla at 10:04 PM on January 14, 2010


The Google Cache link doesn't work for me any more. The best I can find is this. Don't know whether it's the full text though.

(FWIW I found it with this simple Google Search)
posted by mattn at 12:38 AM on January 15, 2010


On why that post was password-protected.
posted by divabat at 1:18 AM on January 15, 2010


I'm glad to see that the writer has apologized for unintentionally publicizing Melissa's situation.

I really hope Melissa's family never sees that original post, though. Those were ugly, ugly accusations to make, especially given that the writer admitted that she wasn't close to the people in question.
posted by magstheaxe at 7:48 AM on January 15, 2010


Jeez, this is airport-babystealer to the letter. Lock the original blog post? Check. Start calling people trolls instead of apologizing? Check.

There should be a name for this series of events.
posted by 23skidoo at 7:58 AM on January 15, 2010 [1 favorite]


You will quickly learn that MeFi has a number of sacred cows that it discourages eating, which includes every genetic, memetic, and/or lifestyle non-normative trait you can ever possibly think of, up to and including how such people choose to self-identify.

Yeah, we like to treat people outside the normative status quo with a modicum of respect. What a bunch of nitpicking little sissies we can be sometimes.
posted by Marisa Stole the Precious Thing at 8:50 AM on January 15, 2010 [9 favorites]


Marisa Stole the Precious Thing : Yeah, we like to treat people outside the normative status quo with a modicum of respect.

What counts as too far? What counts as so far "outside the normative status quo" that people don't deserve your respect? Sex outside marriage? Homosexuality? Ephebophilia? Bestiality? That line does exist, in each and every one of us, and you lie to both of us by pretending that it doesn't.
posted by pla at 8:59 PM on January 15, 2010


The reasoning for closing the post is unclear to me. If the comments are troublesome to the subject of the post, can't the comments just be closed (and old ones deleted)? I am grateful to mattn for tracking down something similar. It's a story that needs to be told, IMO - taking it away hurts many more people than leaving it up does. Not that anyone should be hurt - the comments should be closed.
posted by etoile at 9:04 PM on January 15, 2010


What counts as too far?

Consent, surely. If no consent is given, or is able to be given, then that's too far.
posted by ArmyOfKittens at 12:59 AM on January 16, 2010 [1 favorite]


I find the idea that they would have withdrawn the hormone treatment in order to make things "less confusing" very depressing indeed, and indicative of the kind of black-and-white thinking that seems to plague our society (and human beings in general) when it comes to topics like this. You're a man or you're a woman, don't "confuse" things! People still seem to have such little tolerance for anyone who doesn't fit neatly into one of two acceptable boxes, but you'd think (or hope) the medical profession would be aware that this is an oversimplification of gender.
posted by lady in black at 4:54 AM on January 16, 2010


That line does exist, in each and every one of us, and you lie to both of us by pretending that it doesn't.

Consent, pretty much, as ArmyOfKittens said. But that should be really obvious. I don't know if your bemoaning of the oh-so-sensitive Mefites is because of your call-out last month, but it seems way off base to mock people who ask that respect be shown for a hospitalized transsexual (or for transsexuals in general) or to moan about those thin-skinned Mefites when one person called out a pretty tasteless joke and moved on. Transsexuals may well fall under your personal category of People Not Deserving of Respect. Don't expect a consensus on that.
posted by Marisa Stole the Precious Thing at 5:21 AM on January 16, 2010 [1 favorite]


So I don't get to read this? Geez.
posted by agregoli at 5:53 PM on January 19, 2010


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