And to anyone who has been mistreated or marginalized or otherwise let down in the insurance/medical process, that is really rotten, and I’m sorry. I do hope that you are not hurt by the actual confusion it causes (foul behavior yes; confusion, hopefully not.)

I know it’s one more negative thing to have to deal with, but I hope you know in your heart that sometimes it’s just the same administrative complication shared by people with common names, people who share unusual names, (non-transitioning) girls named Brian and Kevin, men who have breast cancer, people who have routine cosmetic procedures done as a matter of medical necessity (blepharoplasty, etc.) — lots of people have to go through the claim confusion, chaos, and vindication process. Admins are not clairvoyant, and a good deal of the time we deal with typos. And fraud. And mistaken identity. And identity theft.

I’m not saying there isn’t far, far too much inexcusably bad behavior; only that it’s not always a personal attack. Even in a perfect world, there would still be certain kinds of confusion, and I hope folks don’t let the broader administrative issues get them down.

Travis, when you wrote this: “I do often get weird looks when I need to visit a doctor for “woman” things, like an OB/GYN, generally I mostly get looks from people in waiting rooms not so much from doctors.”

My ob/gyn practice added a male doctor somewhat recently, and I saw him when my regular doctor wasn’t available, and he was okay, but if having him in the practice makes it easier for men and women to show up in the office and be seen, I’m all for it.

and not to say that life in the medical community is totally peachy where I’m at, I face more discrimination in Emergency rooms than anywhere else, which is the worst I think. As, if I am in an emergency room I generally am having some sort of dire medical emergency, and my gender should have nothing to do with severe shoulder pain, or whatever.

I see another problem: gender presentation, like sex, can be fluid, not a binary. What do you do if your gender presentation changes, sometimes on a daily basis? I’m sexed female, so have cis privelige in terms of answering questions about sex on medical and government forms, but am genderqueer. Depending on what I wear, people in the past month alone have read me as:
- female
- male
- “is that a guy or a girl?” (I felt like turning around and saying “yes/no!”, but didn’t really want to run the risk of a problem in the grocery store checkout line).
- there was one situation where two employees at my gym both simultaneously gendered me differently; one referred to me as she and the other referred to me as he; I didn’t correct either of them, as both and neither of them were correct.

A blank would force genderqueer people to put down one, unchanging, gender presentation and deny genderqueer people the ability to explore different gender presentations.

In response to the argument, “but you could just leave the blank unfilled,” then people would just gender me as my sex, and deny me my own genderqueerness. Not only is that unacceptable for me, but it would leave my doctor or other healthcare professionals in the dark about the fact that I’m genderqueer. That might be incredibly relevant to my health issues. Stress affects overall health, as well as definite medical conditions like hypertension. You can bet that you’re going to experience some stress if you’re trying to present–or being read by others as presenting–as some of these things: androgynously gendered, the “opposite” sex from your birth sex, “neither” sex, “both” sexes, no sex, or “all” sexes [God, even these terms are problematic; apologies all round]. I’ve been aiming to present gender presentations such as those, depending on how I feel that day. When I talk with my doctor about the causes of that stress, and possible treatments, I don’t want my gender identity/identities to be invalidated–especially if the stress from those identities is causing the problem. Nor is it acceptable to make my genderqueerness the scapegoat: “well, just stop presenting as genderqueer, because it’s causing you stress” isn’t an option. While presenting as genderqueer causes stress and poses real dangers, it’s relieving other, deeper stresses I’ve had about my own gender and gender roles in general, and I find that incredibly valuable and freeing, enough to risk the social and possible physical dangers).

Another argument is “what difference does it make what your presentation is on any given day? Put ‘genderqueer’ in the blank and female in the sex box.” This would probably be what I would do given the form, but I feel like it’s the best of a set of bad options. If I come in presenting as androgynous one day, and male another day, and female another day, my doctor and all the staff would at least know they might haeve to recalibrate their expectations of my presentation each time–in that sense, it’s probably better than the form which I currently have to fill out at my doctor’s–but what would that process look like?
- When nurses call my very feminine name so that I can go in to see the doctor, they’re not expecting to see someone who presents as male or something else entirely stand up. Would they call me on it? Would I have to argue for my gender presentation in front of 20 other patients?
- Would I be denied care until my health insurance provider confirmed my sex and other ID details? Would my HMO add some kind of damning note to my file? Would I be denied care, period, because my HMO was convinced I was scamming?
- How much time would it take out of the appointment time carved out of my workday? How much time would it take out of the HMO-allocated 15-minute doctor visit, time that could be better spent giving me healthcare?
- Would my doctor avoid me because I make them uncomfortable, or become obsessed with my gender presentation while giving me healthcare, or give me a lecture, forcing me to switch to a less medically competent doctor so that I might have a socially competent one?
- This is the situation where I live now, which is a very socially permissive, gay- and gender-variant friendly area. What happens if, God forbid, I need or want to move?

I am very tempted to go to my next OB/GYN checkup dressed androgynously, because it would make me less stressed about the medical problems I have surrounding my reproductive system–and a more proactive patient, better able to take care of my own health and listen to my doctor’s medical suggestions for those problems–if I had a genderqueer presentation during the appointment, because I would feel less like my body’s sex was the sole definer, or indeed any definer, of my mental gender. I think this is especially valuable during an uncomfortable and necessarily invasive procedure into my genitals and sex life. Unfortunately, I also think that what is valuable for me might freak out my doctor. Unsure of what’s the best course.

Thanks for a valuable post, Queen E.

If the issue is with individual organs, than maybe we should have “cervix y/n” and “prostate y/n” or something instead. (Okay, probably not.)

Why not? In the very specific instance of medical care related to specific organs, why not ask people to just list what they have? For example, the person above who needed prostate check and a cervical smear.

The other issue is sort of healthcare related: the FDA is still behind the times and against the desire of all major bloodbanking organizations still bans any man who has ever had sex with men from donating blood, and your permanent deferral sticks with you even after the gender confirmation surgery, unfortunately. Not sure how to work that on the forms (#1 is to change FDA’s mind.)

And other than that, I agree with chucking it entirely off of forms. We’ll have to refigure out how to deal with calculations for Title IX funding and the like (or rework all of those social systems), but that has to be doable somehow.