After looking through the records of my name change and noticing a spot where my local FAA office (read the history here, here, and here) had recommended I call Washington for more help on changing the “M” to an “F,” I decided to call that number. I spoke with a very helpful fellow named Bruce Lansford (who has a column in the AOPA magazine, by the way), who told me that no, surgery wasn’t necessary to change the gender marker. What I needed was a letter from my doctor saying I was in the process (or had completed the process) of changing gender, and that was about it. He said they do this all the time, and it shouldn’t be any trouble.

This was quite a pleasant surprise, so I wrote my local FAA office and said I would like to re-initiate contact with my local FAA officials so that I could proceed with a name and sex change.

Nothing is ever easy with bureaucrats, of course, and I received the following note from the FSDO, which pasted a copy from a manual into the email, explaining that I needed the following documents:

A complete FAA Form 8710-1 Airman Application for the name change and gender change. For the name change you will need appropriate documentation acceptable to the Administrator, which substantiates the validity of the requested change.

For a change of gender on an airman certificate, the original copies of two documents must be provided. After examining and verifying these documents, we will photocopy the documents and attach the photocopies to Form 8710-1. In Block I, under Other, we will note 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.

Surprised, I wrote back:

I’m a bit confused as to how to reconcile what you’re telling me with what Mr. Lansford told me, and I asked him quite directly about this when we spoke on the phone. I asked if I needed to be “physically” female, as your request of my physician suggests, or whether my process of becoming and my daily existence as female was sufficient, and he said very forcefully that it was the latter, not the former, that the FAA cares about. He said I needed to present a letter to the FAA from my physician stating that I have been undergoing treatment (psychological and medical) that has altered or will alter the gender and he specifically said that I did NOT have to undergo surgery in order to change my airman’s certificate.

The reason I ask is that only about 5% of all transgendered people choose to change their genitals, either because of preference or because of funding issues, so I suspect there must be hundreds of transsexual pilots out there who are living in their new sex roles, but who haven’t had surgery, and who really, really ought to have identification that matches their name and appearance.

Second, and this relates to the previous point, just what does “physically the gender noted on the court order” mean for the purposes of my physician’s letter? Does the FAA mean genitals? chromosomes? hormones? All three of these can be considered physical aspects of sex. My physician can write you a letter saying I’m hormonally female, but I’ll always have XY chromosomes and I have not had genital surgery. My psychologist can write you a letter saying that I am permanently female, physically, mentally, and socially, having transitioned about a year ago. But I just don’t know what the FAA means by “physically.”

I would like to change my name on the airman’s certificate in any case, but I would also like to change the gender marker from M to F if I can do this within the constraints outlined above. I’ve got all the paperwork necessary for the name change, and I really don’t feel comfortable flying around the country with all my ID saying Joyce and female, and my FAA license saying [oldname] and male.

My next email came from Gordon’s supervisor, Steve:

We have contacted Mr. Lansford of AFS-760 to determine if he had other guidance we should follow. Our discussion with Mr. Lansford revealed he had provided you with guidance from a superseded Inspector Handbook (FAA Order 8700.1) which was replaced by the 8900.1 in 2007. After further research with our regional Technical Support Branch, we were informed that the physician’s statement must be from a Designated Medical Examiner or a Regional Flight Surgeon’s office. If you have additional questions regarding the medical information and applicable documentation please contact Dr. G.J. Salazar, Regional Flight Surgeon, Southwest Region at (817) 222-5300.

We will be obligated [sic] to process your request once you can submit the required documentation.

OK, I thought. We’re going backwards. Now it’s not just my physician, but an FAA physician. I replied:

Thanks for your reply. I guess we’re getting somewhere, even if it feels like it’s going backwards. Can you point me to the AME or FAA manual that is going to give the FAA medical examiner guidance as to this statement: “A physician’s statement clearly indicating that the individual is physically the gender noted on the court order?” In other words, my previous questions as to what “physical” means are still unanswered, and I would hope that the FAA, which defines everything, right down to the arc-minutes below the horizon the center of the sun needs to be as a definition of “sunset,” would be able to clarify for me and for its AME’s.

Seeing as how this is clearly going to take a long time, I would like to set up an appointment ASAP to submit to you my name change documentation.

The regional FAA Flight Doctor, who had been cc’d on this exchange wrote me back:

Dear Joyce — I have been asked to address some of your questions with respect to medical information that may be required with individuals who have requested a reclassification of gender identity to the FAA. Although I prefer not to discuss specifics on anyone’s medical information over an email I will try to respond to your email queries. I also noticed you do not have a current medical application on file so my response will be very general and it will only apply to aeromedical certification and not to the pilot license issue being addressed by the Bedford Falls FSDO.

The Guide for Aviation Medical Examiners does not have every possible medical condition listed in the contents — that would be an impossible undertaking. The Guide is exactly that, a guide and not policy. An Aviation Medical Examiner is expected to defer these cases to Aerospace Medical Certification Division (AMCD) in Oklahoma City for issuance of the medical certificate, which in part explains why there is no specific guidance in that publication. I would suggest that no medical reports be provided to the AME at the time of the FAA physical — AMCD will send the applicant a letter making it very clear as to what medical information is needed.

AMCD has considerable experience with requests for medical certification of individuals involved in the gender identity change process. It is rare for the agency not to medically certify an applicant who has made that request. In general terms the process the agency follows varies for every applicant depending on the specifics of the case. When a new deferred medical application is received and the applicant has identified that they are in the gender change identity process AMCD will ask for additional medical information from their treating physician(s). This request is initially general in nature, i.e., stage in the process, medications and dosages, any underlying medical problems, is surgery anticipated, etc. They will likely ask for a current psychological assessment to make sure no stressors may be present that could preclude issuance. Depending on what information is received additional requests for information will be made. When the agency is satisfied medical standards are met, a medical certificate is granted most likely under the special issuance process, with follow up reports requested. Again this is a very general description and each case will vary.

If you are interested in obtaining medical certification, please visit your AME and start the application process. They will defer issuance and AMCD will notify you what is needed. I have taken the liberty in forwarding a letter today to you explaining the need to start the medical application process.

There were many good things in his email, including the statement that the FAA has lots of experience in gender-changes, and several troubling things, like his statement that there is no current medical certificate for me on file even though I did a new one last August, and the waffling answer that the medical guide can’t possibly answer everything. In other words, “physically the gender indicated on the certificate” can mean whatever the physician wants it to mean. Since I do have a current medical certificate, I wrote back thusly:

Thank you very much for your mail. I do, in fact, have a 2nd class medical, but you’ll need to look up my old name in the FAA records, as I was advised to wait by the Bedford Falls FSDO to do the gender/name change all at the same time: [oldname], private pilot, cert #99999999. I passed my 2nd class physical a year ago — as a woman — with flying colors, so what’s being requested at this point is not a new medical, but rather a change in my pilot’s airman’s certificate noting the sex is F, rather than M.

I am visiting our FSDO on Monday to initiate my name change, as it appears this sex-change request may take a while. I will show Gordon my 2nd Class medical certificate at that time and ask if that document is sufficient to get the ball rolling on changing the M to an F.

And he replied:

Joyce — now I am confused. I had been given the name [oldname] by the FSDO and looked you up in the system prior to emailing you. The date of the last exam I have on file is July 12, 2006, which would make that certificate expired for all classes. If you had a physical in 2008 (or 2007) and your AME did not transmit it as required that is worrisome — the agency would have no way of knowing you have a valid medical in your possession and that can cause a problem during a ramp check. Could you please identify your latest AME and the exact date on the certificate — the last AME on record for you is Dr. KF in Bedford Falls and he did your 2006 exam.

And I replied:

Yes, I’m looking at it right now, a white certificate, second class medical, signed by KF, examiner number 99999-1, and we did the exam in the late afternoon of August 7th, 2008. I do know that he had some traumatic medical events in his life shortly after my exam last August, and maybe it’s the case that some of his last bits of paperwork didn’t get filed? I don’t know.

And he ended the conversation thusly:

Thank you — please ask him to provide you or us a copy of the physical if he has it — but you would be better off to get a new physical when you decide you wish to pursue medical certification under a different name. That way there is no confusion with regards to the nature of the application. Simply for information, Dr. KF no longer is an AME.

In addition, it would be helpful if you could fax a copy of that certificate (and the physical if you obtain it) so we have it on file. Our fax is 817-222-5965.

OK, at least I’m still legal to fly because I’m in possession of a medical certificate. I think Dr. Salazar’s argument that I should get a new medical for the new name rings a bit false — I don’t recall anywhere that changing your name due to marriage, etc, requires a new medical examination. I don’t know if this is progress, but the dialog is productive and, more importantly, it’s moved beyond the local FSDO’s domain and includes the regional flight medical examiner.

On December 2, 1959, at 10:22 p.m., I was born in the hospital that my great-great grandmother built with oil money 25 years earlier. Both my mother and father were born in this hospital 20 and 21 years before this evening. I am told I was delivered in a blizzard.

hospital

A few days ago, I received a crisp new birth certificate stating (contrary to the facts stated above) that it was not George Bailey, a boy, but rather Joyce Bailey, a girl, who was born in that hospital. On the one hand, I am happy to have the document — it is one more piece of paper that legitimizes my existence. On the other hand, I feel a bit odd about it because (let’s face it), that’s not the way things happened.

In the delivery room on that dark December night, as far as anyone present knew, I was a normal newborn boy, and that’s what the attending doctor certified. I have the old certificate, the birth announcements, the blue clothes, to prove it. This boy was surrounded by love and expectations from the beginning, imbued with male privilege and power and family history.

This new document erases that fact and replaces it with something that simply didn’t happen. If my parents’ first-born had been a girl, would she have ended up where I am now, or would social and family expectations be such that she would have aspired to something very different? It’s an impossible thing to consider.

But one doesn’t have to ponder this impossibility — the new birth certificate doesn’t undo my life, but just documents it differently. In the UK, they don’t replace your birth certificate when you’ve changed sex, but they issue a Gender Recognition Certificate, supposedly indistinguishable from a normal birth certificate, and when you think of it, this approach more accurate because it leaves the original document untouched. In other words, there are two birth certificates, the original and the new one. In 100 years, when UK genealogy-hunters go back, they can find that John Barleycorn was born on a certain date and that he became Jane Barleycorn 30 years later. What will my progeny find when they go looking for George’s birth certificate? Nothing but a changeling swaddled in pink and left in the little boy’s place.

If the legal documentation doesn’t leave a trace, then it’s up to us to make the past intelligible through telling our life stories.

When Diane Schroer won her court case against the Library of Congress based on sex discrimination, it seemed to me that this was a perfect bit of logic to help solve the argument about the wage gap between men and women. Arguments about wage discrimination in the past have had to argue by an analogy: that a hypothetical man and a hypothetical woman, identically suited for the same hypothetical job, should receive equal preference, treatment, and salary. And it makes perfect sense.

However, argument-by-analogy always leaves open the stark fact that we don’t live in a hypothetical world and there are never identical people vying for jobs. There is always a bit of difference, and that difference is the loophole through which sex discrimination occurs.

But what if you didn’t have to argue by analogy? What if one minute, you had a man who was perfectly suited for a job, praised by all his references and drooled over by his employer, and then the next minute, after he explained he was transitioning into a woman because he is a transsexual, she was no longer perfectly suited for the job and was either fired or the job offer was withdrawn? That was precisely what happened to David Schroer, and 10 minutes later, Diane Schroer, in seeking employment at the Library of Congress.

I have talked to friends about this as a solution to not only transgender discrimination, but also plain old sex discrimination, and I am happily surprised to learn of an academic study in economics that takes this exact methodology. Kristen Schilt and Matthew Wiswall report in “Before and After: Gender Transitions, Human Capital, and Workplace Experiences,” from the The Berkeley Electronic Journal of Economic Analysis & Policy, that “average earnings for female-to-male transgender workers increase slightly following their gender transitions, while average earnings for male-to-female transgender workers fall by nearly 1/3.”

Please take a minute to read their abstract and also the Time article, “If Women Were More Like Men: Why Females Earn Less,” which reports on their academic study.

My partner, Mary Jo, has commented frequently that studying transsexuals represents an extremely clever approach to exploring sex-difference research problems like wages, cognition, and performance. She argues that researchers ought to work with their human subject review boards to ethically take advantage of the opportunity to study sex differences that transsexuals make literal by their experiences.

Thanks to sarasnavel, who corrected one of my citations in my blog post “Surgeonocracy,” I found a lot of new legal resources dealing with trans*people:

Transgender Law and Policy Institute
http://www.transgenderlaw.org/index.htm

The Williams Institute, a think tank at the UCLA School of Law (the whole thing, but especially the publication section on Gender Identity Issues Studies:
http://www.law.ucla.edu/williamsinstitute/publications/Policy-GenderIdentity-index.html, which includes an excellent article by Dean Spade about the legal complexities involving legal sex and name changes.

Sexuality, Gender, and the Law: National and International Bibliography. University of Chicago.
http://www2.lib.uchicago.edu/~llou/sexlaw.html

Sexual Orientation, Gender Identity & the Law: A Research Guide. University of Tulsa.
http://www.law.utulsa.edu/library/research/pathfinders/so

Sexual Orientation, Gender Identity and International Human Rights Law (special issue of the journal Human Rights Law Review Online)
http://hrlr.oxfordjournals.org/cgi/reprint/8/2/207

The Association of American Law Schools, Section on Sexual Orientation and Gender Identity Issues
http://www.aals.org/services_sections_gl.php

There’s a nice piece in today’s New York Times about how gender identity is protected more and more these days, leading to smoother and smoother transitions for trans* people.

Here’s a snippet — go and read the whole thing when you get a chance:

Across the country, particularly at larger companies, transgender workers are being protected and assisted in ways that were hardly imaginable a few years ago.

And although this little piece is not in the business section or the news section, but instead appears in the Life and Style section, it’s a mistake to ignore it, especially when it comes to arguing for non-discrimination language in our own firms, universities, and other organizations. I know from talking to my university administrators that statements like “This Fortune 500 company protects transgender workers” have an impact on them, so I keep these little fluff pieces to use as small arms fire in the bigger battles.

“I would like to change my name,” I said, “as well as my sex.” How’s that for an introduction? That’s the scene from today’s visit to the Social Security Administration. Even though I knew from some hard-to-find webpage at their website that they wouldn’t change “sex” without a letter from a surgeon, I figured I’d visit my local SSA office today to change at least my name.

I arrived about 11:00 and waited in a medium-sized room filled with what appeared to be mostly people of color and age waiting to file claims or correct paperwork related to their social security benefits. The only people I would put in my obvious category (name change, not sex change) was a young woman and her mother, who sat a few rows in front of me babbling happily about being newly married and examining a checklist of places to go and offices to inform of her new name.

After waiting for perhaps 30 minutes, they called my number and a Hispanic woman opened the door to usher me into the large room containing perhaps 15 cubicles of SSA caseworkers. Diane showed me to her desk, brightly personalized with pictures of her family and artwork, asking me as I sat down, “What can I do for you?”

“I would like to change my name,” I said, “as well as my sex. Here is my court order for both, along with my form requesting for a new social security card.”

Before she began reading the court order, she looked warmly in my eyes and said, “First of all, congratulations.”

“Thanks,” I said, “That’s awfully nice of you to say, by the way.”

She smiled and read the court order softly to herself, looking briefly at my driver’s license to check that I was who I said I was. When she reached the end, just about when I expected her to say she could change my name but not my sex, she said, “OK — this won’t be any trouble.” She began keying the information from my application into her computer, pausing to complain that she simply couldn’t type today for some reason. She shredded my old social security card and printed the official change paperwork for me to examine, and sure enough, it was what I asked for.

She said I ought to be receiving my new card in a couple of weeks and then asked about my nail polish: “Is that clear or is there a little bit of color? I really like how that looks.”

“Thank you,” I said, looking at the nails and wondering where all those chips in the polish came from and thinking that it really is time for a manicure. “I think it’s a color called Bamboo and this one might be from Sally Hansen, but I’m not really sure.”

“I used to have one just like it that I wore all the time,” she offered, “but they quit making it.”

She said we were finished and wished me good luck.

Even though it was a pretty shallow conversation, it seemed to me Diane made a serious effort at humanizing the experience, making a gesture of inclusion, and the whole visit to her office — warm, friendly, and helpful — stands in contrast to the needlessly bureaucratic and officious attitude I encountered at the FAA the other day.

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.

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