We physicians sign a mind-boggling number of forms. One of my favorites is an attestation that a person’s gender marker has changed, which allows them to change their gender marker on official documents. (Although I question why this is delegated to medical providers.) It is an honor to play a role in someone’s gender affirmation. When signing I pause to acknowledge the joy, significance and sanctity of this moment.
Due to current increased discrimination against trans people, gender markers are fraught. Is it safe to renew a passport? With what gender marker? How can one travel safely? People who had previously celebrated the matching of their documents’ gender marker to their gender identity now are frightened, betrayed by the very government that could be protecting them. Stressed patients ask for advice regularly. Parents of gender-diverse children agonize about how to affirm their children without placing them in harm’s way. It is difficult to reply reassuringly.
Recently a patient told me about his vacation to a foreign country. The trip had been planned for months as a celebration of the graduation of his middle child. His children counted down the days until vacation, since they had never been to Europe. One stressor – his nonbinary child has gender marker X on their passport. He and his wife lost sleep, wondering whether their child would encounter any difficulties at customs. They debated cancelling their trip. But why should they be punished for discrimination by the government? But should something go awry, how could they forgive themselves? If their child was detained? Questioned? Searched? Or worse?
Their trip into Europe went smoothly. As their trip wrapped up, their apprehension grew. The patient and his wife slept poorly. They maintained a positive front in front of their children. The evening before their departing flight, they encountered a problem checking into their flight electronically “due to governmental regulations.” Everyone except their nonbinary child received a boarding pass. My patient and his wife slept fitfully that night.
At the airport the following day, they met with an airline agent and requested the remaining boarding pass. The agent appeared confused and asked a colleague for assistance. The two employees whispered for several minutes before printing a boarding pass for my patient’s child.
The problem at check-in remains unknown. Their celebratory family vacation was marred by worry. And yet, this is only one tiny aspect of being trans in America.
Pam Adelstein
Newton, Massachusetts