Sunday, July 22, 2012

Letter of Safe Passage


I now have in my purse a "letter of safe passage" from my healthcare provider. That phrase evokes in my mind those "letters of transit" that Viktor Laslo and Ilsa Lund so desparately needed in Casablanca - absolute guarantees that they could get where they wanted to go which "cannot be rescinded". Or maybe something that the great Khan gave to Marco Polo so that he could travel to new and mysterious destinations. Jeez, why didn't I get one of those sooner?

Unfortunately my letter of safe passage isn't quite so glamorous. In its several somewhat stilted and awkward paragraphs it does its best to explain why the bearer might have one name and gender on their official ID and yet be going by another name and presenting as the other gender. It gives a rough physical description to reassure the confused and it claims that (contrary to what the reader presumably will expect) I am a sane and "highly functioning and emotionally stable" adult. It further asserts that I have the "right" to be called by a feminine name and pronouns, to not be beaten up, and to use the appropriate bathroom. Wow. I think I'd rather have a guaranteed seat on that evening plane to Lisbon.

I have to admit I'm happy to have this letter - it represents a major step forward and gives me at least some claim to official status as I start to venture out into the world. On the other hand, it's really just a permission slip, a hall pass from the teacher, a note from my parents. A permission slip explicitly giving me permission to go about my business without hassle, and to do things that most adults would never even think of asking permission for.


One of the most striking thing about my current process is that if one is trans, particularly a trans female, and trying to do something about it, one needs permission for everything. From everyone. Almost any time I meet someone else who is trans and they find out I'm married, their first question will be, "And your wife lets you do this? Wow, that's great!" I used to internally bristle at that - thinking, "look, buddy, she's not letting me, I'm able to decide." But of course the more I thought about it, the more I realized that she is letting me, that without her permission (and support) I wouldn't be where I am now. I never before felt that anyone else had such veto power over who I am... and she's not the only one... 

The process of even thinking about transition is a maze of permissions. First you need to see a therapist and, in effect, get permission to explore transition. Assuming that you get that permssion (and I have known some who have had problems with that part) the next step is to see a physician for the physical side of things. In my case, I go to a very enlightened informed consent clinic, but even there you need to convince the doctor to write the prescription, in effect getting his permission, to start hormones. And yes, I know that there are very sound medical reasons for that, but the person granting the permission has an enormous amount of power over you, should they decide to use it. And surgery takes even more permissions, from multiple people, who may or may not have the same standards. And it's not just the physician - I talked to one voice therapist who would not offer therapy unless I "dressed" for it in a way that she approved as sufficiently feminine. Beyond that, one needs the permission from one's family, one's friends, and one's employer.

If any of those withhold permission, we are faced with a dilemma - either one's progress comes to a halt or pay the price for ignoring that lack of permission. In some cases, that price can be prohibitively high, and that leads to the desparation behind so many suicides, so many ill starred attempts at DIY treatment, and so much agony in general.

I know that I personally don't have a lot do complain about. I've been extremely lucky so far - most of my permission givers have been reasonable and their permission has been granted without hesitation. But the fact that they've said yes doesn't mean that I don't need to ask, and at every step of the way. As do all of us.

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