August 2009


Straight from the aerospace medical division of the FAA came my official airman’s medical notification a couple of days ago, and while it’s a very good thing that ends a long chapter of frustration, the document is not without thorns.

The good news is that I do have a medical certificate (below), but it carries more restrictions than my previous certificates — I have to carry a letter of authorization with me whenever I fly, for example. Here’s what the medical looks like:

medical certificate

medical certificate

But more interesting is the letter of authorization, which invokes the regulations, parts 67.113, 67.213, and 67.313, which are simply identical and parallel subparts covering first-, second-, and third-class medicals, and deal with general medical conditions that aren’t generally specified in the rest of the part:

(b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds—

(1) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
(2) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

(c) No medication or other treatment that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the medication or other treatment involved, finds—

(1) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
(2) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

I don’t know where the FAA gets the idea that gender issues (or the medications, if any, related to gender issues) would “make a person unable to safely perform the duties of the airman certificate,” and I find the suggestion pretty insulting.

The letter (below) also mentions 67.401, which deals with the letter of authorization. The rationale given in this section is largely public safety with language like this: “…capable of performing airman duties without endangering public safety.” This stands in contrast to the aforementioned sections, which appeal to the airman’s ability to perform duties. To its credit, this section recognizes that holders of 3rd class medical certificates are private pilots:

[The FAA needs to] consider the freedom of an airman, exercising the privileges of a private pilot certificate, to accept reasonable risks to his or her person and property that are not acceptable in the exercise of commercial or airline transport pilot privileges, and, at the same time, considers the need to protect the safety of persons and property in other aircraft and on the ground.

Despite this “freedom” paragraph, my letter makes no mention of the fact I’ve sought a 3rd class medical (for private pilots versus commercial ones), and I’m curious why a private trans*pilot can’t just be left alone, using this paragraph as FAA rationale.

So anyway, we have these twin rationales, a) that people with gender issues may not be able to perform their duties as pilots and b) that people with gender issues may pose a threat to public safety. These two dubious claims lie at the core of the “conclusion” stated in my letter, namely that gender identity disorder is inherently a disqualifying condition that causes trans* pilots to have to go through this nonsense in order to keep flying.

I would certainly agree that people who can’t perform their pilot duties and/or who pose a public threat probably should be automatically disqualified, but what I’d like to know is just where those two assertions about trans*people come from. They cannot be based in empirical facts — I’ve looked through the NTSB accident reports and can find no mention of transgendered pilots as the cause of any incidents or accidents. Where is the hearing or the memo or the commentary that glued these twin falsehoods onto trans* people? I would love to read that rationale.

Notice on page two that an olive branch is held out: next year, if I have no changes in my current medical condition, they’ll consider removing the requirement for a letter of authorization. Fair enough, but my question is Just what is my current medical condition? I’m healthy, productive, and capable. I’m already bound to ground myself if I develop a medical condition that hampers my ability to fly, and I would think that such a rule would already apply to trans*pilots (as well as all other pilots). Does the letter mean to say “my current psychological condition,” or does it mean to include everything? The second paragraph says, “Because of your history of GID and GRS, operation of an aircraft is prohibited at any time new symptoms or adverse changes occur.” The word “history” is instructive here — maybe the FAA means that my history makes me suspect, and not necessarily my current state as a fairly normal pilot. If that’s the case, then how long does that “history” stick with me and compel me to carry around this letter when I fly and when I go for my next aviation medical exam?

I feel as if I’ve been branded as someone we need to watch, someone who might “get sick” again. I’m not sure what that would look like, but the GRS is a done deal, and the GID has gone away. What if I take up cabaret singing? Or take a turn towards butch-dom? Just what are these relapses that the FAA imagines might happen to me? These recurring conditions constitute a third area that I’d like to understand better — did the FAA approve trans*people for flying some time in the past, but their behavior or demeanor led them into an accident, and thus triggered this rule that they have to be watched in case gender issues return? If so, where are those records, those stories that would provide grounding for the current rule? If they don’t exist, then does the FAA just make up random nonsense to justify argumentative nonsense arrived at via non-existent data about public safety and pilot abilities? I’m starting to think this is precisely how it works.

medical authorization, p. 1

medical authorization, p. 1

medical authorization, p. 2

medical authorization, p. 2

I have arrived at an interesting point, a place that feels unusual for me and it may strike my friends as incredible. But after visiting Trinidad for GRS, after scores of laser hair removal sessions, after hundreds of hours of electrolysis, after almost three years of therapy, after reconfiguring my body to be my new self, after throwing away all my old clothes and buying all new ones, after telling everyone in the world that I was becoming Joyce, and after being Joyce for long enough that it’s becoming hard to remember not being Joyce — after all of this, I suddenly feel almost as if it’s all been unnecessary. And by “unnecessary,” I don’t mean to suggest that I have any regrets — what I think I mean is that whatever was driving this incredible change within me has vanished, that I don’t feel any urge or necessity to make any changes. And if I could imagine myself three or four years ago feeling like I do today, then I probably wouldn’t have had to make all these changes.

But there’s the rub, isn’t it? Because I was NOT at this point three or four years ago. Back then, I was eaten up with shame and guilt and anxiety and despair and couldn’t possibly imagine (no matter how hard I might try) arriving at today’s place of stasis. At this point, I don’t feel anything — I don’t have a single gender, I don’t belong to a sex, I don’t have a firm history or identity. It’s as if this huge turmoil of the past few years erased — no, burned or grinded away — the bumps and ridges of my surface like an industrial acid or a giant grinding wheel of my re-formation, leaving me smooth and finished in only once sense of meaning. I can also be seen as raw and unfinished, a jewel that’s half-way complete, not quite a stone, but not glittering, either.

I don’t feel elation, excitement, despair, or depression — just mundane rawness.

It’s a paradox because I’ve just returned from a fairly important surgery of transformation, and yet instead of feeling transformed, I feel normal. My body’s just a body. Maybe that’s what feeling all right in your skin feels like. Or maybe I’m just settling into my new parts. Does this mean I’ve lost my feeling of gender-variance? I don’t know — I don’t feel terribly variant right now, but maybe I need time to heal. On the other hand, maybe I’m on the cusp of being perfectly normal for the rest of my life (history notwithstanding).

This feeling of nothingness may seem familiar. In fact, I wrote about 9 months ago that I seemed to have arrived at a point of nothingness, but if this transition has taught me anything, it’s that just when you think you’ve reached a plateau, there always seems to be another bit of interesting geography ahead. Maybe it’s a gentle settling into a certain valley of peace or maybe it’s a completely-unforeseen peak of difficulty, but the important thing is that one is never finished.

Maybe that’s the obvious and natural way to perceive life. We’re never really finished learning or growing or experiencing life’s rough blows, so why would a transsexual believe that there is some kind of flat stasis waiting him or her after settling a huge piece of life’s unfinished business? The very act of settling that business gives rise to new insights, complications, ambitions, does it not?

Will this current feeling of nothingess, of being utterly mundane, give rise to new terrain of physical, emotional, or psychological complexity? Who knows? Probably, but there’s really no anticipating what’s over that next rise, that undiscovered country.

I received my new pilot’s license a couple of days ago, and it correctly lists my ratings and my sex as “F.” I also just received the following email from Dr. Salazar, as well, saying that my medical certificate nightmare is over:

Ms. Bailey – Oklahoma City finished the administrative processing and we picked up your case today. I have directed my staff to issue a medical certificate under special issuance. All that implies is we would follow your case for at least a year primarily to ensure no post-op problems have occurred.

The context for this entire episode can be found at the following posts:

New Aviation Medical visit
Gender Issues “Disqualifying Conditions” for FAA
FAA Bureaucracy and Web Misinformation
Name and Sex at the FAA
Just Following Regs
Surgeonocracy

While I’m happy that I’m thought of as female and am legal to fly again by the FAA, I am nevertheless baffled about why the FAA needs this level of scrutiny about my genitalia (at least the passport office has some sort of need to identify its citizens, even though I think their fetish about what’s between its citizens’ legs is also uncalled-for).

In the case of the FAA, there are two distinct issues. First is their refusal to change the gender marker (the “M” or the “F”) until the pilot produces a surgeon’s letter. The FAA regulations never mention sex, nor does the Airman’s Information Manual (AIM) — it’s telling that the bureau’s “rules” about the surgeon’s letter come from an unpublished circular that field inspectors are supposed to follow. It’s just like my passport experience, where there are no written rules about changing gender markers, and thus it just falls to lore or to secret documents.

The second issue is this vexing assertion that gender identity disorder, or “gender issues” in general, are disqualifying conditions for holding a valid aviator’s medical exam. “Gender Issues” is so broad as to include drag queens, occasional crossdressers, and deeply closeted transsexuals, among others, and if these conditions are disqualifying, then thousands or tens of thousands of pilots are technically violating the law when they do not disclose these feelings to their AME (Aviation Medical Examiner), and I simply don’t think that’s right.

First, I don’t see why any gender issues should be disqualifying. It is certainly true that GID is characterized by depression, especially as the transgender person grapples with their fate and struggles to accept him/herself. But depression is already a condition that must be reported in an aviation medical exam, and I would think that this type of disclosure would be sufficient (assuming you think it’s any business of the FAA’s if a pilot is depressed). Whether a woman feels like a man and is thinking of changing sex automatically disqualifies him from flying is another matter (and an irrelevant matter, I’d argue).

In any case, I have my new medical certificate, albeit one that requires I be monitored for a year, just in case I flip out. Dr. Salazar’s note mentions monitoring surgery, but I’m unaware of any other surgeries that require a year’s worth of monitoring — I would imagine that this is a veiled language to allow the FAA to monitor trannies in the sky.

I received my new passport today, having followed the guidelines written up at the National Committee for Transgender Equality (NCTE) website. It’s worth noting that these procedures cannot be found at the passport office’s website, http://travel.state.gov/passport/, so if you’re not using trans-friendly resources, I don’t know how trans* folk are supposed to submit the proper paperwork.

So I sent a cover letter in case the clerk working on my application didn’t understand:

Following the guidelines published by the NCTE (National Committee for Transgender Equality), which detail the somewhat unwritten rules of your office regarding passports for transgender people, I’m sending your office my paperwork to get a new passport with my new name and sex. I enclose the following:

  • Form DS-82
  • re-issued state birth certificate
  • driver’s license
  • notarized letter from my surgeon
  • certified copy of the court order granting name and gender change
  • current passport
  • 2 passport photographs
  • check for $75

Please reissue my passport using my new image, new name, and new sex. If I am missing any documentation, I trust you’ll contact me.

I felt it was utterly critical to have a new passport — even though I could get a new name and a new photo, but there is no way to change the gender marker without a surgeon’s letter. And I cannot fathom traveling around the world looking the way I do with an “M” on my passport. I know the government wants good, positive identification, and I don’t have any problems with that general philosophy, but no one knows what’s in any traveler’s pants, and in this respect, the requirement to show a surgeon’s letter is a little like the crazy bathroom rules that propose some sort of genital police.

New Passport Photo

New Photo

The best thing about the passport incident was that I got a really good photograph for the new passport, and that is something that simply doesn’t happen to me very often. :)

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