Dr Oz, did a a terrific job presenting the issue of Transgender Children.
part one http://bit.ly/dugXIz
part two http://bit.ly/aOl5Fe
Dr Oz, did a a terrific job presenting the issue of Transgender Children.
part one http://bit.ly/dugXIz
part two http://bit.ly/aOl5Fe
Posted on Advocate.com February 16, 2010
Dr. Oz Tackles Transgender Children
By Advocate.com Editors
The Dr. Oz Show Thursday will air “one of the best 15-minute segments
on transgender children to ever appear on national television,” the
Gay and Lesbian Alliance Against Defamation announced on its blog
Dr. Mehmet Oz, who rose to fame as a regular medical correspondent on
Oprah, talked with two transgender teens and their families about
their experiences growing up and their parents’ decision to support
Representatives from GLAAD and Trans Youth Family Allies attended the
taping. Click here
for more information.
© 2010 Here Media Inc. All Rights Reserved.
ID Reform Weblog by Kelley Winters, USA
February 6, 2010
A Taxing Question of Medical Necessity
Kelley Winters, Ph.D.
GID Reform Advocates
Many trans and especially transsexual Americans were relieved this week by
the U.S. Tax Court decision<http://www.glad.org/work/cases/in-re-rhiannon-odonnabhain/>to
reverse earlier IRS positions <http://www.irs.gov/pub/irs-wd/0603025.pdf> and allow costs of
hormonal and surgical transition care to be deducted as medical expenses.
The ruling concluded:
Petitioner has shown that her hormone therapy and sex reassignment surgery
treated disease within the meaning of section 213 and were therefore not
cosmetic surgery. Thus petitioner’s expenditures for these procedures were
for “medical care” as defined in section 213(d)(1)(A), for which a deduction
is allowed under section 213(a).
However, this recognition of the legitimacy of medical transition came at a
cost to the dignity of transsexual women and men. It relied on the flawed
diagnostic nomenclature of Gender Identity Disorder (GID) in the *Diagnostic
and Statistical Manual of Mental Disorders* (DSM) and its implication of
mentally “disordered” gender identity. Paradoxically, this case fueled
opposition to medical transition access, based on the current wording of the
very same GID classification and its more virulent companion diagnosis of
Transvestic Fetishism. While the Tax Court decision underscored the utility
of some kind of diagnostic coding for those who need access to hormonal or
surgical transition care, it also illustrated the urgency of reforming the
GID diagnosis and removing the Transvestic Fetishism category in the next
revision of the DSM, published by the American Psychiatric Association
Ms. Rhiannon O’Donnabhain underwent corrective genital surgery in 2001 and
claimed a tax deduction for surgical and hormonal treatment expenses as well
as the cost of a breast augmentation procedure. Her courageous nine year
battle with the IRS to affirm the medical legitimacy of her transition care
took a tortuous off-again, on-again path among the potholes of politics and
Although the IRS initially issued a full refund to Rhiannon, a tax examiner
denied her deduction in July, 2002. He declared her surgical and hormonal
care to be “cosmetic” and therefore excluded as a deductible medical expense
under section 231(d)(9) of the Internal Revenue Code. She appealed,
represented by Gay and Lesbian Advocates and
Defenders<http://www.glad.org/>(GLAD). Attorney Karen Loewy argued
Any notion that medical treatment for a transgender person is purely
cosmetic is based on misunderstanding and prejudice, not medical science.
In November, 2004, the IRS reversed
<http://www.ftminfo.net/041130glad.html>the examiner’s decision and
allowed Rhiannon to deduct her surgical expenses
as medically necessary and professionally prescribed. However, political
extremist groups responded by pressuring the Bush Administration to deny tax
deductions for all medical transition care. They based their arguments on
the same psychiatric classification of GID that GLAD cited to win the
appeal. The following month, Rev. Louis Sheldon, chairman of the Traditional
Values Coalition (TVC),
IRS Commissioner Mark Everson:
[B]y giving this tax deduction, your agency will be encouraging other
mentally disturbed individuals to consider such surgery as an unneeded
surgical procedure for what is a troubled mind–not a troubled body.
The IRS caved to political pressure in October, 2005. IRS Branch Chief
Thomas Moffitt issued a Memorandum of Chief Counsel
Advice<http://www.irs.gov/pub/irs-wd/0603025.pdf>that reversed the
decision of the appeals officer and once again denied
Rhiannon’s deduction of medical transition expenses. Moffitt demeaned
Rhiannon with maligning pronouns of her assigned birth sex and concluded,
In light of the Congressional emphasis on denying a deduction for procedures
relating to appearance in all but a few circumstances and the controversy
surrounding whether GRS is a treatment for an illness or disease, the
materials submitted do not support a deduction.
Astonishingly, Moffit based his ruling, not on respected medical literature,
but on a political magazine called *First Things*, published by the
Institute on Religion and Public Life. He cited an
psychiatrist Paul McHugh, known for employing false stereotypes of
mental pathology to terminate gender confirming surgeries at John Hopkins Hospital
in the 1970s . McHugh mocked post-operative transsexual women as
“caricatures” and invoked the current classification of mental disorder to
discredit medical transition care:
Once again I concluded that to provide a surgical alteration to the body of
these unfortunate people was to collaborate with a mental disorder rather
than to treat it.
Finally, Chief Moffit erected an addition political barrier, unprecedented
for other minorities, to transsexual citizens seeking equal treatment under
the tax code:
Only an unequivocal expression of Congressional intent that expenses of this
type qualify under section 213 would justify the allowance of the deduction
in this case.
Civil justice advocates were outraged at such tactics by the Bush
Administration. Professor Lynn Conway
To deny such people medical deductions for the medical correction of their
bodies – people who often face extreme financial and employment difficulties
during their transitions – is unfair and inhumane. The claim that such
people require a special “act of Congress” before being treated fairly
exudes not only ignorance and intolerance, but also open Executive Branch
hostility towards gender variant people.
Berkeley tax attorney Donald Read commented in the *San Francisco
The IRS should not allow religious views to impact the administration of our
tax laws… We all should be concerned about the politicization of the IRS,
not only against gay and transgender people, but in all its forms.
Rhiannon’s suit was heard by the U.S. Tax Court in July, 2007. She was again
represented by the GLAD legal staff as well as co-counsel from the Boston
firm of Sullivan & Worcester.
Senior IRS attorney John Mikalchus repeated the party line from the TVC and
Paul McHugh that transition in itself represents psychopathology, citing the
current GID diagnosis. He stated<http://www.edgeboston.com/index.php%20ch=news&sc=glbt&sc2=news&sc3=&i…>that surgery, hormones and other transition treatments do not cure cross-gender identification but “reinforce” it.
Mikalchus also invoked the second gender diagnosis of Transvestic Fetishism,
speculating that many transsexual women seeking corrective transition
surgeries are afflicted with a paraphilic sexual preoccupation with dressing
as women. The APA fueled this false stereotype with publication of the
DSM-IV in 1994, where TF was expanded<http://www.gidreform.org/blog2008Nov02.html>to specifically
include transsexual women who are attracted to other women.
Mikalchus further belittled
with the term, “autogynephilia,” an unsupported derogatory
theory<http://www.gidreform.org/blog2008Nov10.html>promoted by Toronto
sexologist Raymond Blanchard, associating male-to-female
transition with a narcissistic sexual arousal at “the thought or image of
oneself as a woman.” Dr. Blanchard was largely responsible for the current
Transvestic Fetishism diagnosis in the DSM-IV. As chairman of the
the pending DSM edition, he has recently
proposed <http://www.springerlink.com/content/9267212375m4n40r/> expanding
the TF diagnosis with the title, Transvestic Disorder, and adding
“Autogynephilia” as a diagnostic specifier.
Despite these barriers, the Tax Court ultimately rejected the IRS portrayal
of transition as pathological and its associated medical care as “cosmetic.”
On February 2, 2010, the Court ruled that Rhiannon’s hormonal and surgical
transition treatments –
were for the treatment of disease within the meaning of § 213(d)(1)(A) &
(9)(B), I.R.C. and thus not “cosmetic surgery” excluded from the definition
of deductible “medical care” by § 213(d)(9)(A), I.R.C.
A 69 page majority
by Judge Joseph Gale, once again reversed the IRS denial and
allowed Rhiannon to deduct her expenses for hormonal medications and
corrective genital surgery (although it denied a deduction for her breast
augmentation expenses). Their decision rested upon an interpretation of the
GID diagnosis as “a serious, psychologically debilitating condition,” rather
than a demeaning indictment of “disordered” gender identity. Although
political extremists and the IRS attempted to exploit conflicting and
ambiguous language in the current GID nomenclature, the GLAD legal team and
expert witness Dr. George Brown successfully clarified that severe
persistent distress with current physical sex characteristics (often
dysphoria <http://www.gidreform.org/wpath2009EWG.html>) is the true focus of
medical transition treatment. In spite of the shortcomings of the current
Gender Identity Disorder and Transvestic Fetishism diagnoses, they persuaded
the Court that the necessity and efficacy of these treatments in relieving
this debilitating distress is well established. Jennifer Levi, Director of
GLAD’s Transgender Rights Project,
In this landmark ruling, the Tax Court affirmed the consensus position of
the medical establishment that transition-related medical care is essential
for many transgender people.
However, the political fragility of this ruling and the contradictory role
of the GID and TF diagnoses in establishing the medical necessity of
transition treatments are underscored by the dissenting opinion (p.
Judge David Gustafson. Joined by four other judges, he opposed
deduction for transition surgeries, stating:
One could analyze the GID patient’s problem in one of two ways: (1) His
anatomical maleness is normative, and his perceived femaleness is the
problem. Or (2) his perceived femaleness is normative, and his anatomical
maleness is the problem. If one assumes option 2, then one could say that
SRS does “treat” his GID by bringing his problematic male body into
simulated conformity (as much as is possible) with his authentic female
mind. However, the medical consensus as described in the record of this case
is in stark opposition to the latter characterization and can be reconciled
only with option 1: Petitioner’s male body was healthy, and his mind was
disordered in its female self- perception.
In its present form, the diagnostic criteria and supporting text of the GID
diagnosis can all too easily be inferred in Gustafson’s second context of
“disordered” gender identity, in contradiction to the medical necessity of
hormonal and surgical transition treatments. If the intention of the
Internal Revenue Service was to punish transsexual people for nonconformity
to their assigned birth roles, the American Psychiatric Association,
inadvertently or not, handed them blunt instruments of oppression with the
current GID and TF diagnoses. Rhiannon herself said
It’s a Catch-22. I have to accept the stigma of being labeled as having a
disorder [or] a mental condition … in order to get benefits. I haven’t liked
this diagnosis from the very beginning. But I’ve got to play the game.
This week, on February 10, the American Psychiatric Association is scheduled
to release draft diagnostic criteria for the Fifth Edition of the DSM for
public review. In the DSM-V, the APA has an opportunity to correct the
shortcomings and ambiguities of the GID diagnosis that pose barriers to
civil justice and access to medical care: (1) clarifying distress as the
diagnostic focus rather than nonconformity to assigned birth sex roles; (2)
excluding from diagnosis those who suffer no distress or impairment with
their bodies or ascribed social gender; (3) clarifying that transition is
therapeutic and not pathological; and (4) removing maligning pronouns and
terms that disrespect the affirmed identities of transitioned individuals.
The APA also has an opportunity to remove the Transvestic Fetishism category
that is purely punitive and defamatory to many transwomen.
An American hero in the struggle for dignity and equality, Rhiannon
O’Donnabhain deserves better from mental health policymakers. We all do.
This is reposted From the Bilerico Project…
On Monday morning February 1st, janitorial staff at the University of Oregon discovered the Lesbian, Gay, Bisexual, Transgender, Queer Alliance had been broken into computer screens and the TV were spray painted over and a swastika had been spray painted on the carpet. Being former staff at the student organization, myself, I was one of the many people deeply impacted.
Students responded by swiftly organizing a series of rallies. Only one day after the vandalism was discovered, 300 community members turned out for a vigil and speakout – an impressive number considering Eugene’s relatively small size. Many community members came up to the mike to speak, including the mayor.
Finish reading this story at here.
Anyone waiting for the Toy Store video, I apologize, there has been major technical difficulty and I have to go back and re-tape it, so for today I thought I would share some thoughts.
For you Facebookers out there a few weeks ago someone started the trend of putting up ‘old school’ pictures. I posted one and then my dad asked about his favorite so I went back into the picture box, started walking down memory lane, and noticed a few things.
First, in many of the pictures I look like a boy and I am dressed like a boy. As a 6 year old I am loving my new Levi jacket and jeans, JUST LIKE DAD’s! As far back as high school I started wearing polo shirts and jeans, my style has not changed much, I have even had short hair most of my life. Now, not any of these things on there own say much to me but together…my mind was wheeling. Then the coupe de resistance, a picture of me, the first day of 8th grade, in my brown corduroy 3-piece suit! Oh, how I loved that suit, AND it was bought in the GIRLS department, so it was OK to WEAR! Throughout 8th grade I am seen many times in that suit.
Also in 8th grade was the play. I was in the acting class at school, the instructor liked me, and as most 8th grade musicals go, we had way more girls than boys wanting to participate. So, the instructor asks me to play a man’s role in the play. OH I WAS EXCITED! It was the perfect role; I had several lines, two costume changes, and appeared in most of the play as background. So for costume I, of course, wore my 3-piece suit, and had ‘work clothes’ to change into. The pants on the work clothes were too big for me, so my bright idea was to wear a pair of ‘shorts’ under the pants. To me it was like wearing boxer shorts, I felt good.
We were rehearsing hard, and it was coming up to the big show night, when all our parents would arrive. During a rehearsal the shorts were spotted as I changed. I will never forget the words “Are you wearing boxer shorts?” then the big laughter as she announced to the room that I was wearing boxer shorts, and maybe I should change in the boys dressing room. Honestly, I would have loved to, but the shame I felt was overwhelming. I protested over the laughter that the pants I was wearing were too big, but I don’t remember anyone hearing me. I shut down my gender expression at that moment, I tucked it away, and I forgot about it.
Last thing about the 8th grade, I found the graduation picture with all my friends in it. At the time, 1981, you may remember that gunnysack dresses were all the rage. In that picture all my friends were wearing them — each one different. I remember shopping for my outfit, my mom and dad took me, we had to go out of town, because we couldn’t find anything that was not a gunnysack, which I was refusing to wear! Nothing that ‘girly’ was getting put on me. Remember folks back in the day, there were not as many store choices. Anyway, we finally settled on a sun dress with a little red jacket over it. THEN I wanted to wear my Birkenstocks, but no they insisted on shoes, so funky rainbow sandals it was! A friend just reminded me, I was pissed about the shoes, there was no reason not to let me wear the birks….well no reason other than I must fit in and look like a girl!
So, posting these picture on Facebook, and sitting with the forgotten information around my 3-piece suit, graduation, thinking about getting caught shoplifiting at 16 (Yes a dumbass move) but I was shoplifting from the MENS department. It hits me; I was a gender variant kid. I always wanted the football, orange race track, a boys’ bike, I wanted to go in the creek with the boys, and climb trees. I was not allowed to do any of this. My parents did what they could, having no idea about gender variance at the time. My dad bought me a motorcross set for my girls’ bike, so a green with flowers girls’ bike, with boys stuff attached to it — Thanks dad for trying. I was allowed to play sports, girls’ sports, but still. My dad coached softball, soccer, and supported my high school years of volleyball, and softball.
I was an abused child. I had a mother who was mentally unbalanced, and extremely volatile. I was constantly told what I felt was wrong. No you are not: sad, happy, hungry, mad, playful, bright, loving; the list could go on forever but the point is I was CONSTANTLY told my feelings were wrong, to the point I not only doubted my own feelings, I don’t even know what they are, and never asserted I felt like a boy inside. Because I was wrong, I obviously was a girl.
And still I was forced to pull inward and fake it. I even faked it for myself. It is so much easier to become what others want for you, when the pull is so strong to conform. The real test is when we assert who we are to others. Not in an aggressive way, but in a meaningful way.
Head Rebel-Rouser in her blog Ten Blogs for Gender Rebels and Allies listed some of the better blogs on gender. There is one in particular that touches me; it is by a mom whose four year old son told her one day he was a girl. She responded “Today you are who you are” a Dr. Seuss quote. Now with love and support she shares her thoughts on watching her daughter navigate this world. It is filled with love and compassion.
So today, I love my maleness. I LOVE the picture of me in a TUX in 9-grade (it was the ‘in’ fashion wise). I am working to love all parts of me, but the little boy has a special place in my heart, and every day I wake I think “Today, I am who I am.”