Dorris ’15: The misinformed oppositon to transgender health care

Opinions Columnist

Cheryl K. Chumley of the Washington Times recently asked her readers, “Looking for a free sex change operation?” Her answer was simple: “Enroll at Brown University.”

She is talking about the Brown Student Health Insurance Plan’s decision to cover sexual reassignment procedures, beginning in August.

She is not the only one fuming.

“Fox and Friends” co-hosts Steve Doocy and Brian Kilmeade have mocked Brown and its transgender students on television. Newspapers around the country have released hateful op-eds, accompanied by a slew of transphobic comments. Even The Herald’s own readers have expressed their indignation toward the decision.

There are two popular arguments against this type of coverage:

1. Now that treatment is essentially free, more students will be motivated to undergo the surgery.

2. The policy is unfair to other students who are “unhappy” with their bodies but cannot have their surgeries covered.

Both of these are more illogical than they are offensive.

First of all, one must meet rigorous requirements before undergoing sexual reassignment surgery. It is not something one decides to have on a whim. There are years of counseling. There are letters of recommendation from mental health professionals and numerous consultations. Many patients have been waiting for years, unable to afford surgery, while living full-time as the opposite gender. Doctors are extremely reluctant to operate, and there are few providers.

The surgery itself is a multistep process from which it takes years to recover. It is extremely painful and does not even prevent transgender individuals from being targeted. After surgery, they may encounter job loss, intimacy issues and rejection from friends and family.

Consequently, sexual reassignment surgery is not comparable to “cosmetic” surgeries like rhinoplasty or liposuction. This surgery does not update or modify. It aims to create something that was never there: the correct biological sex. Adversaries will argue that these individuals already have a perfectly good sex. But they do not understand the pervasiveness of gender.

We live in a divided world. We may not like the gender binary, but we cannot deny its existence. Everywhere you turn — the bathroom, the clothing store, the changing room — you are constantly reminded of your gender.

Imagine committing a crime and ending up in the wrong prison. Imagine wearing the opposite sex’s swimsuit to the beach. Things on the surface — your clothing, your hairstyle — can be modified, but everything underneath belongs to a stranger. The depth of this dysphoria: In a dream you can feel your body as something else but you will never wake up like that.

Now imagine waiting, working and saving money for 20 years of your life — not to fix your problems, but just to face the problems someone of your correct gender would face.

Many of us do not know what this feels like and thankfully never will. It is easy to be insensitive if you are not aware that 41 percent of transgender individuals have attempted suicide, according to a survey by the National Gay and Lesbian Task Force and the National Center for Transgender Equality. To put this in perspective, the general population average for attempted suicide is 1.6 percent.

It is shocking that it is 2013 and transgender individuals are casually mocked on national television. The same hosts would be fired for mocking homosexuality, but in this case they do not lose their jobs. Meanwhile, 90 percent of transgender individuals have been harassed and discriminated against in their own jobs, according to the previous survey.

No, we cannot ignore the cost. Yes, the surgery has to be subsidized somehow. But the number of candidates is miniscule. According to the Gay and Lesbian Medical Association, in 2010 there were between 1,600 and 2,000 people who underwent the surgery in the entire nation.

And keep in mind that Brown is far from the first school to cover sexual reassignment procedures. Top universities — like Harvard, Stanford University, Cornell, Northwestern University and Penn — are among 31 others to already do so, in addition to 26 that cover partial treatment.

As of now, the Brown Student Health Insurance Plan covers a myriad of procedures. If you want to stop smoking, Brown will cover cessation treatment. If you are a woman and become sexually active, Brown will pay for oral contraceptives. If you become pregnant from unprotected sex, Brown will cover an abortion. If, for some reason, you need a CAT scan, an MRI, a speech test, a physical therapy session and up to $100,000 per policy year of prescription drugs, Brown will pay for that, too. But until recently, if your biological sex and gender did not match up, Brown would not cover surgery.

We need to remember that transgender individuals already face discrimination. Their lives are not easy. We do not all have to support Brown’s coverage of sexual reassignment surgery, but we need to be tolerant of those seeking it.


Cara Dorris ’15 can be reached at



  1. One may also want to remember that the City of San Fransisco was left with so much financial surplus from their decision to cover gender surgery for their employees, that they just voted 7-0 in favor of repealing bans for their low income citizens health program.

  2. Sex binary. Gender is not a binary, It is a hierarchy, with women on the bottom.

    • Melanie Davis says:

      Gender is a problematic term. In the anthropological sense, it’s a cultural construct partially based on physical sex and partially based on social definitions which are in modern societies designed to reinforce patriarchal power structures. It’s also used colloquially by people to discuss their affiliations with others usually of the same perceived sex because of perceived commonalities. In this case it’s definition is based on the cultural understanding and the personal experiences – internal and external – of a person, and this becomes the understanding of a personal gender identity. I believe the cultural definitions of gender are oppressive and artificial, but the experiences of people who have grown up with whatever definitions and experiences they may have, cannot be erased or dismissed.

      Sex is not a binary, either. Your unwillingness to understand this as fact is akin to denying the existence of the sun and moon. You are, of course, free to do so, but it would only show you to be severely delusional. I am intersex, millions are, including transsexual men and women. That is real, and isn’t about colonisation of any particular sex, but an expression of each person. Gaining a greater understanding of humans will not necessarily diminish your righteous anger, but it may provide greater focus for your efforts.

      And women will be on bottom as long as we keep saying we’re on the bottom, so drop that victim identity shit unless you prefer the station you’ve been offered by those who have no right to offer it.

  3. your biological sex and gender did not match up = made up magical bullshit

    • A sex difference in the human brain and its relation to transsexuality. by Zhou et al Nature (1995) 378:68–70.

      Our study is the first to show a female brain structure in genetically
      male transsexuals and supports the hypothesis that gender identity
      develops as a result of an interaction between the developing brain and
      sex hormones

      Cathy, I know you don’t believe in any of this science-ey stuff, but it’s true anyway, belief isn’t necessary.

      Your submission to the UN advocating for the withdrawal of all human rights from Trans and Intersex people is world famous. At least you’ve now dropped the pretense that you’re doing it “for their own good”.

    • Note to people who may be tempted to respond: Catherine Brennen is a Manhatten corporate lawyer who has sued people in the past for saying things like “they would spit on her” (which can be classified as a threat of assault, especially if you have a lawyer with tons of money).

      Similar to the Wesboro Baptist Church, she aggressively pursues legal action against people who ‘threaten’ her.

      I recommend not engaging.

    • Please don’t feed the troll, bugbear, or bugbrennan.

  4. Sex reassignment surgery, as you mentioned, is not akin to plastic surgery. Such comparisons are only made by those ignorant of the subject (why don’t they read wikipedia just once?) Very well done in pointing out the overwhelming issues that transgender individuals face. It is interesting how these discussions always divide those who understand transgender and those who are only reacting to fear without a frame of reference, which is a jab at the 3 previous comments which in my view are entirely transphobic and discredited observations.

  5. Cara Newlon says:

    great article.

  6. Wonderful column!

  7. Nice work. Thanks, Cara!

  8. Do most insurance policies cover reconstructive surgery following burns (especially to the face) or following mastectomies? I genuinely don’t know and feel that these are “cosmetic” surgeries that are closer to the scale of necessity of sex reassignment than rhinoplasty or liposuction which are easy to pick off as not being in the same realm.

  9. The Admiral says:

    Great perspective! Well done!

  10. well done !!!!!

  11. Congratulations to parents and alum donors. 40+K a year and look how they are using their intellect, all pointing inward.

    • Actually as a donating parent to an alumni they are doing exactly as I was hoping, using science and analytical thinking to create a better world for all of humanity! Keep it going Brown University!

  12. If someone wants an operation I have no problem – but let them pay for it. My wallet is running out of money paying for others. I am broke and would like and need a lot of things but can no longer accord them because I am paying for everyone else’s sex live

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