August 2008

To provide documentation requested by government organizations in the course of changing legal sex, what exactly does a transsexual announce, document, or certify? Isn’t something as fundamental as sex relatively easy to document? As it turns out, it’s not as simple as one would think, not only because “sex” can be defined in different ways (chromosomes, hormones, secondary sex characteristics, genitals), but because I don’t think the requesting agencies have thought through just what they want to know, and therefore are not consistent in the documentation they request.

Bear in mind, we’re talking strictly about legal change of sex, or erasing the letter “M” from my records and replacing it with the letter “F.” The implications are mostly minor except for laws related to marriage and for health insurance. Everything else, including enabling various officials to identify people positively, is really irrelevant because what matters is how you look, what you call yourself, and how people know you, and these layers of knowledge work independently of whether you have the letter M or the letter F on your official documents.

Social Security is quite straightforward in saying that to correct the “sex” field in a person’s record, the evidence needed is a “Sex-Change Operation: The surgeon or attending physician must provide a letter verifying the sex change surgery has been completed” (bold in the original). The Internal Revenue Service relies entirely on Social Security data, and thus have no separate procedure for changing name and sex.

The Federal Aviation Administration (FAA) asks for one of the following (and I’ve explained in previous posts about conflicting information from them):

a) court order saying applicant has changed gender and/or letter from physician or clinical psychologist verifying that the applicant is undergoing treatment that has altered or will alter the gender,

b) court order saying either that applicant has changed gender or that individual’s gender is male/female and a physician’s statement clearly indicating that the individual is physically the gender noted on the court order

c) court order saying applicant has changed gender OR statement from a physician or clinical psychologist identifying the applicant by name and address or verifying that the applicant is undergoing treatment that has altered or will alter the applicant’s gender.

For the Passport office, according to the NCTE,

“Sex change documentation consists of a letter from a surgeon or hospital that performed surgery and a detailed statement from a medical surgeon regarding the surgery. If your request of prior to surgery, the documentation consists of a detailed statement from a surgeon with whom you have plans to undergo surgery. This statement must outline the plans for your surgery. If you are traveling to undergo it, the passport agency will issue a temporary passport valid for one year.”

Looking only at the federal government, there are two areas that interest me.

First is the authorizing party, or the one who documents a transsexual’s change for the government.

  • Passport Office = surgeon or hospital
  • SSA=surgeon or attending physician
  • FAA=physician, psychologist, or court

There is no doubt that these people or entities are authorities, but their specialties and their scope of knowledge hardly overlap. Surgeons cut patients. Hospitals and physicians treat patients. Psychologists listen to people and help them solve their problems. Courts resolve disputes and issue verdicts or orders. Nowhere in this list of authorities is any prerequisite of specializing in mental or physical issues related to sex or gender. The list assumes — but refuses to mention— such activities and knowledge. It’s as if the words “sex-change” or “changing gender” are so widely known that there is no need to discuss what they mean in official regulations.

The second (and perhaps more interesting) issue is what, precisely, these parties are documenting or certifying. The social security’s surgeon or attending physician is certifying that sex change surgery has been completed. The passport office’s surgeon or hospital is documenting an outline of a plan for surgery or the nature of the completed surgery (of some sort, but it’s not specified). The FAA’s myriad authorities (physicians or psychologists) document treatment that has altered, or will alter, gender, or a statement that the applicant is the same gender as the application requests. The FFA uses “gender” exclusively, while social security and passport offices use “sex” exclusively. Does the federal government intend to use “sex” and “gender” in unique ways, or are they just being used interchangeably? Which is it, sex or gender?

Gender. Is it possible for someone to say objectively that someone is one gender or another? If the FAA means something like “Joyce presents herself full time as a female,” then that’s quite different from “Joyce had genital surgery.” What does it mean for someone to alter their gender, and how long does “alter” imply? Does dressing in drag for a weekend, which certainly counts in my book as altering your gender, qualify? Or does the FAA mean to document that a person shifts permanently from masculine to androgynous? Since gender is both felt and expressed, how is anyone truly supposed to document a change in gender to the FAA?

Sex. My questions about sex are even thornier. Depending on how you define sex, it either is possible or it is impossible to change a person’s sex. XX chromosomes will always be XX chromosomes, no matter how many surgeries one undergoes and no matter how many hormones one injects. But if we are talking about hormones, we could speak of a generally accepted range of hormones to define changing from one sex to the other, but this approach would eliminate tens of thousands of perfectly “normal” people with hormone imbalances. And what about intersex individuals who have chromosomes, hormones, and/or genitalia of both sexes? What about secondary sex characteristics? If you add or subtract breasts, does that count for changing sex? Perhaps, but tens of thousands of women undergo mastectomies, and are no less female after surgery, and lots of men develop gynecomastia (or man-boobs) and are legally no less male because of this change.

Since “surgery” is used in several legal requirements, what surgical procedures, precisely, constitute changing sex? Frustratingly, these procedures are not defined. Is this to be left to the applicant and his/her surgeon or physician? Would a feminizing nose job count (it’s surgery undertaken to change one’s sexual appearance, but is that the same thing as sex change surgery)? Would a FTM’s mastectomy count (I certainly think so)? And speaking of breasts, what about a MTF’s boob job (I don’t see why not).

Or maybe the regulations mean to imply reproduction, and want to count castration (orchiectomy) and hysterectomy. If so, doesn’t this sound a bit like eugenics? But ethical intentions aside, hundreds of thousands of sterilizations take place every year, and they do not constitute sex changes.

I suspect that what is unspoken is the requirement that the penis or vagina be modified, but whether the external genitalia need to be merely removed (penectomy/phallectomy, in the case of MTF’s, and what? clitorectomy/clitoridectomy/vaginectomy? for FTM’s?), or modified (vaginoplasty for MTF’s and phalloplasty for FTMs) is unstated and unclear. With such major surgeries costing tens of thousands of dollars, taking the patient out of the workforce for months, I would think that their necessity would be more rigorously defended and more specifically defined as a prerequisite for federal change of sex.

Overall, I don’t think they know. Does the government mean to imply genital reassignment as a prerequisite for erasing one letter and typing another? Or do they mean the obliteration of birth genitals? Or do they mean sterilization? Or secondary sex characteristics? Or generally accepted features of a target sex, like muscles, noses, beards, and skin?

If you’re skeptical, you’re shaking your head and saying, “Joyce, any fool knows what they mean — they mean sex change surgery,” and I would agree with you that that’s what they think they mean and what they’re either stating plainly or implying. But “Sex Change Surgery” is not defined, and changing sex involves so much more than surgery, like beard removal, hormone treatment, hair transplants, that to focus strictly on genital surgery seems quite narrow. However, this narrow focus is not accompanied by a narrow definition, which is usually the hallmark of regulations, thus leaving everything implied and subject to interpretation and persuasion, and even passability or general aesthetics of the transsexual, which is a horrid thought.

Ultimately, I am not sure why the federal government is in the business of letters F or M. For transsexuals, the issue is personal, psychological, spiritual, and essential to our identity, and the state really has no business getting involved. I suspect we are probably just collateral damage from the much bigger marriage wars, with the Defense of Marriage Act and various other initiatives to define marriage definitively as one M and one F. What would happen if those M’s and F’s weren’t authoritative, but were fluid? It would be impossible to define marriage as anything more than the wedding of two individuals, without the M or the F — but given today’s climate, such a fluidity seems unthinkable.

Way back in college, when I first started figuring out my gender issues and felt I needed to pick a name, I tried to find one with the same initial as my boyname, L—- (I’m talking about my real name, not my blog character’s name, just so you don’t get confused). So for a while I used Linda and sometimes Lynda (because this was when Wonder Woman was on TV), but really only because I felt I had to have a femme name go to a TG support groups. But it didn’t feel like me. It felt completely artificial.

At the time, I was really into the Irish author James Joyce (still am, but in a non-professional way these days), reading, enjoying, and doing research in Ulysses and Dubliners particularly and his play Exiles in a bibliographic way, and I think it was my friend Honoria who said, “You ought to use Joyce since he’s such a big deal to you.” And I initially thought that was a horrible idea, but it planted in my head and grew and kept coming up every time I thought about what to call myself, Joyce was at the top of the list.

It’s been my femme name for so long (since the mid-, or perhaps late-80’s) that I would turn my head when people called “Joyce” in public, even well before I transitioned. When, a couple of years ago, Mary Jo and I began talking seriously about my transitioning, we bounced hundred of names around, but Joyce felt (and still feels, fortunately) completely natural, that all of these other names sounded quite fake. As a result, the name is one of the few things that hasn’t felt incredibly weird to me these past months.

For your statistical edification, let’s look at the Social Security Administration’s database of baby names. You will see that the name was ranked 837th in 2007, and as you go backwards in time, it was considerably more popular, a whopping 50th in my birth year of 1959, and 21st ten years before that, and peaking in popularity at 11th (!), in both 1937 and 1938. So if I had been looking for a generation-appropriate name, I think Joyce qualifies.

Year Rank
2007 837
2006 830
2005 802
2004 760
2003 738
2002 703
2001 677
2000 669
1999 676
1998 685
1997 663
1996 651
1995 605
1994 603
1993 561
1992 539
1991 526
1990 479
1989 481
1988 478
1987 406
1986 410
1985 415
1984 382
1983 359
1982 353
1981 340
1980 330
1979 320
1978 298
1977 285
1976 248
1975 219
1974 200
1973 209
1972 206
1971 182
1970 164
1969 147
1968 128
1967 116
1966 100
1965 90
1964 87
1963 83
1962 74
1961 62
1960 58
1959 50
1958 46
1957 40
1956 30
1955 29
1954 28
1953 26
1952 27
1951 28
1950 27
1949 26
1948 21
1947 20
1946 20
1945 18
1944 18
1943 16
1942 13
1941 13
1940 13
1939 12
1938 11
1937 11
1936 12
1935 12
1934 12
1933 12
1932 12
1931 15
1930 18
1929 23
1928 30
1927 35
1926 44
1925 59
1924 83
1923 103
1922 126
1921 137
1920 153
1919 173
1918 170
1917 185
1916 221
1915 238
1914 247
1913 290
1912 305
1911 339
1910 337
1909 378
1908 350

You will recall that in the aftermath of my visit with the FAA, when I began looking at different regulations, I felt there were conflicting bits of information regarding changing one’s gender from different parts of the FAA. Having pinpointed three of the inconsistencies, I decided to write the FSDO officer I met this morning, asking for clarification:


Thanks for taking time to meet with me about name and sex information on a new airman’s license. In looking at the FAA website ( I see that the language is a little bit different from the 5-317 regulation you showed me this morning, specifically in using “one or both” documents instead of “two,” and specifying more broadly what 5-317 calls “a physician” to the more general language “physician or clinical psychologist” who can state that “applicant is undergoing treatment that has altered or will alter the gender.” I also note that for airframe mechanics (5-1138), the language is also different, saying “or” and taking a much looser approach than the airman’s procedure, requiring either a court order "stating that the applicant has changed his/her gender, or a statement from a physician or clinical psychologist treating the applicant that ... verifies that the applicant is undergoing treatment that has altered or will alter the applicant’s gender."

I’m just wondering if 5-317 is necessarily the final word, or if it’s just a case of the web language being written by someone different from the FSDO regulations, and thus introducing incorrect information – I mean, one of them is wrong, right? I’m sure this is not a pressing issue, but I would like to get some clarification on just what the FAA’s procedure actually is.

Sincerely yours,

And this afternoon, I received the following non-reply:

The document I proved to you is FAA Order 8900.1. This order provides procedures that all FAA Inspectors are required to follow. If obtaining a physician statement is not possible I advise you to contact FAA Airman Records at 866-8782498. They may be able to provide you with additional information. Please contact us if need to make another appoint to complete your request. you may also contact this office if you have any questions.

Gene Morehead
FAA, Flight Standards District Office

So what Gene is telling me is a) I have no idea where the other language comes from because there is only one set of documents I follow, b) Hey, I’m just following orders, and c) Please go seek your answers somewhere else because I have done all I can do, but if someone else comes up with something that does my job for me, maybe I’ll listen. It’s not terribly helpful, but at least the Airman Records phone number is a new piece in the puzzle. I am disappointed in the fact that Gene did not take up the gauntlet of figuring out contradictory information coming from his own organization because, approve of me or not, I would think that a bureaucratic regulator would be concerned about misinformation.

Having looked up rules for changing name and gender at the FAA website, I called my FSDO (Flight Standards District Office) for an appointment, and walked in this morning. Although the FAA website says all I needed to bring with me to the FSDO was my identification and my court ordered name and gender change, I arrived to find the FSDO representative presenting me with a page from their internal manual (section 5.317) that says I need the court order AND a physician’s letter:

D. Change of Gender. For a change of gender on an airman certificate, the original copies of two documents must be provided to the certifying ASI. After examining and verifying these documents, the ASI photocopies the documents and attaches the photocopies to Form 8710-1. In Block I, under Other, the ASI notes gender change reissue. The file is then forwarded to AFS-760 for processing. The required documents are:

1) A court order, issued by a court of the United States or its territories, stating that the individual has changed his/her gender to ___, or a court order stating that the individual’s gender is ___; and
2) A physician’s statement clearly indicating that the individual is physically the gender noted on the court order.

In looking for this form online this morning, I found different language covering airframe mechanics, and this language says that only one piece of documentation is necessary:

C. Change of Gender. Application for a change of gender on a certificate must be made
in person at a FSDO.
1) Application is made by completing FAA Form 8610-2 as specified in the note under paragraph 5-1138. The application package should include a court order issued by a court of the United States or its territories stating that the applicant has changed his/her gender, or a statement from a physician or clinical psychologist treating the applicant that contains:
a) Identification of the applicant by name and address, or b) Verification that the applicant is undergoing treatment that has altered or will alter the applicant’s gender.
2) The applicant’s current certificate should accompany the application.

It may be the case that the FAA’s rule carefully thought out the difference in mechanics and pilots, thereby creating two different ways of changing gender for their records, but I suspect it’s the result of quick rule-making and web-writing without any overarching philosophy within the FAA, or the federal government in general. Regardless, I was sent away and told to come back when I had a surgeon’s letter. I have written a follow-up email asking for clarification based on these FAA inconsistencies, and we shall see if the query results in any action.

The FAA isn’t the only federal office to require medical/surgical authority before it will change your gender. The Social Security Administration only has one rule as far as I can find, requiring a for medical documentation to change gender:

Sex-Change Operation: The surgeon or attending physician must provide a letter verifying the sex change surgery has been completed.

The Department of State has detailed guidelines for reissuing passports with a changed name, but changing your sex requires good old fashioned correspondence (according to the NCTE) with letters from a surgeon detailing either surgery or plans for surgery.

The Transgender Law Center has a nifty summary of federal policies about name and sex change requirements, as does the NCTE.

To summarize, the federal bureaucrats tend to prefer letters from surgeons, or perhaps some sort of plan for surgery, while each state, locality, and employer takes a completely different approach, usually requiring something less then completed genital surgery.

What is frustrating is the assumption that all gender-variant people are seeking genital surgery, or any surgery at all, for that matter. The slightly better request of a physician’s letter, or even better, a psychologist’s letter, still places gender variance into the category of medical, surgical, or psychological problem, and while this category may hold true for some, there must be a vast group of gender variant people who are unable to obtain identification that matches their presentation. What if you are perfectly healthy, born male, but live as female, and have lived as female for 10 years? Because of a lucky genetic break, you don’t have a beard, don’t need to take hormones, and don’t plan on genital (or other) surgery. Are you destined to forever have “M” on all your identification documents issued from the federal government?

If you are legal-minded, you might find Dean Spade’s “Documenting Gender: Incoherence and Rulemaking” useful as a tool to show how arbitrary governmental policy can be.

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