Trans Oppression Revisited

Sam Bradd

Dear Editors,

When I found myself saying “that’s right” and “me too” as I turned each page, I knew Dan Irving’s interview “Trans Politics and Anti-Capitalism” in the last issue of Upping the Anti was going to be over too quickly.

Irving makes a compelling case for a Marxist understanding of trans oppressions. Like him, I think we need to increase our understanding of how capitalism and the state exert dominance over transgender and transsexual bodies and lives. I’d like to expand on a couple of Irving’s points about capitalism’s enforcement of rigid gender categories, the state’s refusal to take responsibility for providing health care to trans patients, and the best way to resist this domination.

The medical system expects trans people to have normative (mis)genders until they begin to transition. Then, they are supposed to transition quietly with private funding and personal support before returning to the workforce (with greater or lesser earning power) in rigid – but opposite – post-transition gender roles.

Although each Canadian province uses a different bureaucracy for accessing trans-specific health care, doctors are expected to follow the Harry Benjamin International Standards of Care for determining “suitability” of a trans person wishing to medically transition (receive hormones and/or Sex Reassignment Surgery). Before you can get SRS-specific health care, the medical system needs to know that you’re employable (or enrollable in school). This is called the “Real Life Test.” The name is a slap in the face. The exercise exposes people to the risk of violence. According to the Standards of Care, trans people must get qualifying letters from an employer, volunteer supervisor, or teacher testifying to their proven ability to live in the “opposite gender from birth” for two years before they can access hormone therapy. Letters need to use the right pronouns and/or verify a coherent (read: appropriate) gender-based appearance based on clothing, hair, washrooms, etc.

Let’s set up the hoops and start jumping. First, one must be employable or have the financial resources to be enrolled in school. Second, one must have basic needs met before volunteering: employment, adequate food, shelter, childcare, stable housing. Let’s assume that one has citizenship and is able to work, has jumped the systemic barriers to employment, and/or that one has the ability to volunteer. One option is to try to “pass” for two years and survive as best one can, hoping one’s birth identity is not discovered by a student attendance list or by the human resources department. Alternately, one can risk one’s employment by coming out to supervisors or teachers, hoping for the best, and getting the letter backdated two years in order to begin treatment right away. Of course, this letter still has to be accepted by a qualified psychiatrist who will recommend hormone therapy.

In order for this to happen, one must demonstrate to the psychiatrist that being trans is an ongoing psychological and emotional hardship that will be ameliorated with medical intervention, but that this same hardship has not prevented them from working or going to school. The “Real Life Test” prioritizes employability over health care, even though labour opportunities for trans people impact the level of violence they may experience. The “Real Life Test” also requires that one’s gender at work or school is acceptable to others, and that one’s sexual orientation is appropriate to the “desired gender.” Finally, the “Real Life Test” expects that one can function at work or school as mentally and bodily whole, despite being denied the health care one is seeking. Hoop, hoop, hoop. In a context such as this, we need to insist that everyone be able to get health care on demand, regardless of employability before or after medically transitioning, period.

Irving makes a solid point about how trans people are also expected to fund their own medical transitions. In British Columbia, the publicly-funded Medical Services Plan has been unable to provide SRS options for some trans patients because there has been a shortage of qualified surgeons. Although SRS is free, the waiting lists are indefinite. There are only a few state-endorsed psychiatrists who approve people for SRS, and they aren’t taking new patients, so that waiting list is indefinite, too. Private health care providers are often out-of-province, which adds substantial costs. Those who are able to save up for the private system, while poor people are left waiting and remain unable to access healthcare. I’ve seen working-class trans people hold community fundraisers for their health care needs. Can you imagine someone doing this for chemo treatments? The fight for public health care is a trans issue, too. Those with access to health care should be fighting for those who are marginalized in the health care system.

What can anti-capitalist organizers do around trans issues? Like Irving says, many gains have been made in feminist, union, and queer movements to address trans oppressions. Organizations that do anti-capitalist organizing should expand their definitions of “trans-inclusion” beyond “participation” in order to include addressing trans oppressions as part of analyses, strategies, and campaigns. For example, violence against MTFs is gender-based violence; it is a women’s issue, a trans issue, and a class issue. I encourage people to read Julia Serrano’s new book, Whipping Girl: A Transsexual Woman on S exism and the Scapegoating of F emininity and her articulation of how trans-phobia around trans women is really trans-misogyny. Our organizations need to broaden definitions of gender-based oppression to include trans people.

Organizations should carefully examine the alliances they make with other groups that reject trans people from participating as full members. Irving brings up Rape Relief in Vancouver, BC, which refused to allow Kimberly Nixon, a post-transition male-to-female transsexual, to volunteer. The case went to the Supreme Court of BC, which upheld Rape Relief’s perspective. Any trans-inclusive group must decide whether to ally themselves with Rape Relief on women’s issues – a decision that requires clear analysis. Rape Relief runs the only non-government funded rape crisis centre, and there are strategic arguments both for and against allying with them. If groups choose to work with Rape Relief, they should be public about the clear limitations of their alliance: be it situational, targeted, strategic, short term, or otherwise.

Transgender and transsexual issues are rooted in class, gender, racial and sexual struggles. We are all working towards mutual liberation. The liberation of trans people is bound up in anti-capitalist struggle.

In hope and solidarity,
Sam Bradd Vancouver