In the United States, while we continue to watch the battle in Congress over what remains of the proposed health care reform bill, we need only look a few miles south to see what universal health care for all people can really look like.
In Cuba two weeks ago, the country began offering state-sponsored gender reassignment surgeries. That is, the costs of surgical procedures to change one’s sex from either female to male or male to female are covered under the country’s universal health care system.
Cuba is also seeing a push toward greater inclusion of lesbian, gay, bisexual, and transgender people in politics and for the legalization of same-sex unions.
What Is Gender Reassignment Surgery
Historically, such medical processes have been called “sex changes” or “sex reassignment surgeries.” Many, but not all, people who are transgender, that is their sense of their gender does not match with their physical sex (e.g., anatomy, especially genitals, chromosomes, hormones), seek medical procedures to alter their bodies to become consistent with their gender identity.
The process of transitioning from female to male or male to female is often not limited to simply surgically altering one’s genitals, but often includes “top surgery” (the removal of breasts or getting breast implants), hair removal, and taking hormones (usually testosterone for transgender men and estrogen for transgender women).
Today, however, because of the high costs of transitioning (both financial and physical pain) and the loosening of the idea that female = vagina and male = penis, more and more transgender people are opting not to seek surgery (including “bottom surgery” or altering one’s genitals surgically).
Also, some people are now identifying as genderqueer, which means that their gender identity is neither “woman” nor “man” and they typically do not seek to transition to either male or female.
Will The US Join Cuba?
I do not mean to be a pessimist, but considering how ugly the health care reform debate has gotten in the United States, I cannot imagine that our health care system will be covering the high costs of gender reassignment surgeries any time soon.
For example, a few months ago in Fort Worth, Texas, a proposal to have the local government cover the costs of such surgeries with tax-payer money (as it could and does for other medical treatment) was met with hostility directed toward the lesbian, gay, bisexual, and transgender community.
With little mass awareness of the experiences of transgender people, many people are resistant to supporting such initiatives as they do not view one’s treatment to transition from female to male or male to female as necessary or urgent. However, given the severe health consequences people face when they experience an inconsistency between their gender and their sex, between their heart and mind and their body, it is important that we recognize the importance of medical options to allow individuals to feel comfortable in their own bodies.
I would recommend watching Transamerica and Normal to get a better idea of what gender reassignment surgery is like. Also, the National Center for Transgender Equality has many great resources and information for and about the transgender community.