Two weeks ago, I had a gender-affirming surgery called an orchiectomy (google it if you’re curious). It’s rude and not a good idea for cisgender people to ask trans people, “Have you had x, y, or z surgery?” – you will probably get an answer along the lines of “Take a long walk off a short pier.” But I’m choosing to talk about mine publicly to make a point.
Bodily autonomy is an issue that is core to all women, cis and trans, living under this patriarchal capitalist system. It’s essential for all transgender people and to every person, really. It encompasses everything from gender-affirming care and reproductive freedom to piercings, tattoos, and hair styles. It’s the simple, basic right to feel at home in the body you were saddled with at birth.
Until the end of 2022, I was undecided about whether I wanted any gender-affirming surgeries. The gender dysphoria (again, google it) I felt about certain body parts retreated a great deal after I started hormone replacement therapy and began living as my true self – as a woman. But the vicious attacks on trans rights, especially on trans health care, convinced me I should at least get this one operation – to eliminate my need for one of the medications I might soon be banned from acquiring legally and making forced detransition by the state somewhat more difficult.
So, in a very real sense, it wasn’t my choice to get surgery. But I’m glad I still could take necessary preventive action to protect myself against genocidal transphobic laws.
If you’ve never had to think about having surgery to put a roadblock in front of politicians who want to rob you of your identity – well, this International Women’s Day might be a good time to reflect on how that would feel. Similarly, you might consider how it feels to be a cis woman, trans man, or nonbinary person who needs an abortion in the U.S. today.
Surviving while trans
I know that I’m lucky to have health insurance paid for by my employer, which allowed me to get my operation despite the exorbitant copays and deductibles that come out of my pocket. So many trans people have no insurance at all. And yet, my access to gender-affirming care is immediately threatened, even though I live in a so-called Blue State. In this case, I have lost access to my doctors and specialists as of Feb. 29.
Like many thousands of New Yorkers, trans and cis, I’m a casualty of a battle between two corporate giants: UnitedHealth Group, the country’s largest private insurer, and Mount Sinai Health System, one of the largest health care providers in New York City.
Last year, United and Mount Sinai couldn’t agree on who should get a bigger cut of profits through obscene health costs, and United declared all Mount Sinai-owned hospitals and affiliated doctors out of network. A New York State law requiring 60 days continuing coverage expired at the end of February. It’s one of the largest mass expulsions of providers ever but has barely been reported by the corporate media.
Many affected New Yorkers who have Mount Sinai-affiliated providers may not even know what has happened until the next time they get sick and try to schedule an appointment.
This profit-driven attack has an outsized effect on trans New Yorkers. Mount Sinai’s Center for Transgender Medicine and Surgery is a national leader in trans medicine, and its doctors have a policy of “informed consent” for trans adult patients. This minimizes the gatekeeping that the medical industry has traditionally used to prevent trans people from getting gender-affirming care, which is still all too common.
It took more than a year of appointments, invasive questions, and scheduling headaches to arrange my orchiectomy. But then I had to fight tooth and nail to reschedule my surgery before the Feb. 29 drop-dead date, after which my insurance would no longer cover it.
Now, thousands of trans people who relied for our care on doctors affiliated with the Center for Transgender Medicine and Surgery are unable to see our caregivers and will have to struggle to find gender-affirming care experts among the very limited pool of qualified providers available in the city.
New York State and City politicians brag about providing a safe haven for trans people. But state and local officials have done nothing to prevent or address this transphobic attack by two capitalist monopolies.
Solidarity and revolution
Across the country, the health care system is in freefall, accelerated by the pandemic (which is still ongoing, despite what Genocide Joe and his CDC say). The rental and housing market across the U.S. is untenable. Food prices have driven millions more to already overwhelmed food banks while right-wing governors and Democratic mayors slash school lunch programs. Boeing’s dangerous, underfunded, and outsourced aircraft are a symptom of the utter chaos that engulfs U.S. airports daily.
When my spouse and I ride the subway or walk home at night, we have to be alert and prepared to fight. Like all women, we face the threat of sexual violence; as trans women, we face the added threat of transphobic violence, which grows by the day, prodded by the hateful rhetoric of politicians, social media “influencers,” and the New York Times. Black trans women – always the majority of those we have to mourn on the annual Trans Day of Remembrance – face racist violence, too.
All of the infrastructure of daily life that workers depend on is one good push away from complete collapse. We all know it but are engulfed in trying to survive our own daily life-and-death crises. Likewise, the left and progressive movements are maxed out trying to oppose the genocide in Palestine. How do you fight on every front at once?
This International Women’s Day, solidarity is more important than ever. Personal solidarity, woman to woman, cis to trans; of men toward women; of white people toward BIPOC communities; of all workers, against the bosses and politicians that seek to keep us divided.
Solidarity isn’t just mutual aid, though those efforts are critical for trans people and other marginalized communities – for what the Black Panthers called “survival pending revolution.”
There’s the key word: revolution.
Women need a revolution that overturns the capitalist social system and its political institutions. Trans people, immigrants, Black, Brown, and Indigenous communities, people with disabilities and the homeless, LGBTQ+ and youth – all workers – need a revolution.
To get it, we need not only a vision of a better world to fight for but also the crucial ingredient to actually make it happen: solidarity — in the streets, in our workplaces, in schools, in our communities and homes — the kind of solidarity that spurred students at Nex Benedict’s school to walk out of classes in defiance of the far-right government of Oklahoma.
Stop the genocide in Gaza! No trans genocide in the U.S.!
Melinda Butterfield is a member of Women in Struggle-Mujeres en Lucha, an organizer of the Coalition to Protect Trans Lives, and co-editor of Struggle-La Lucha.
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