Astounded. Alarmed. That’s how I’m feeling right now — as a doctor, as a researcher, and as a queer person — while our government threatens to erase the existence and experiences of transgender and gender expansive people.
Today, Trump's transgender military ban becomes reality: openly transgender people cannot join the military — and many who are already within its ranks can face discharge if they receive a gender dysphoria diagnosis while serving. According to guidelines from The Pentagon, trans service members will be required to serve according to “the standards associated with their biological sex” and cannot “serve in their preferred gender.”
This is not a fringe issue. This is a deliberate move to define personhood in a very particular way — a straight, white, male cisgender-dominated, Republican, wealthy, colonial way. But news flash: Sex is not binary. Gender is not binary. And sex and gender don’t always match. In short, some men have vaginas. Some women have penises. And some people have both.
Today I worked on three projects: one about challenges to abortion and contraception for trans masculine and gender expansive people, one about family-building and fertility preservation for transgender people, and another about contraception and abortion for sexual minority women, especially lesbian and bisexual women. What all of these projects have in common is that they arise from the understanding that health care is worse when we don’t acknowledge all of who people are, and the totality of their experiences.
That includes acknowledging the existence of more than two genders and recognizing that people’s gender can be potentially different from their sex assigned at birth. When our laws define sex as either male or female, and gender as either woman or man, real people receive worse care, avoid care, or are harmed in the process of getting health care. Legislating the fallacy of binary sex won’t make things better for anyone.
In fact, there is tons of evidence that shows denying the existence of transgender people and their health care needs and resiliencies leads to worse health care. On the other hand, when we call people by their affirmed names, use their self-identified pronouns, and provide services needed to transgender people, health outcomes improve. Challenges to fully participate in civic life will also become easier—whether it’s getting a job, obtaining a driver’s license, having health insurance, or going to school. Our country and military benefits by more diversity, not less.
Denying the reality of who people are including that someone’s gender and sex assigned at birth are different, makes life unsafe. It exposes people to violence and vitriol. When this country is unsafe for anyone — specifically immigrants, people of color, and transgender people (and especially folks who live in all of these domains at the same time) — it is unsafe for us all. We are all hurt by narrowed definitions of humanity that only seek to limit the possibilities of life. We are all diminished when some among us are rendered invisible, cloaking the true diversity of nature and humanity.
We must all fight now because our lives depend on it. Even if you are not LGBTQ or trans specifically, we must stand strong and be heard. Now.
This fight must be waged beyond the ballot box. Speak out. Write op-eds. Talk to friends and families. Tell people about the lives of trans folks and how this ban flies in the face of science and what is supported in medicine. Do what you can in your jobs and in your free time. Support trans-run programs, projects, and businesses with time, money, and visibility. Hold people accountable to being trans-inclusive and supportive. Teach your kids not to assume gender or ascribe gendered activities to people. And while you’re at it, teach yourself to do the same: it can be tough to unlearn that life is more than either/or, but it’s not hard to understand if you simply respect, listen, and love people as who they are.
For the nearly 1.5 million trans people in the U.S., I will keep fighting every day to make sure your lives are recognized, respected, and that we make medicine and health care a better place for you all and all of us in the process. I hope you’ll join me.
Dr. Juno Obedin-Maliver is an Assistant Professor of Obstetrics and Gynecology at Stanford University School of Medicine. Along with Dr. Mitchell Lunn, Dr. Obedin-Maliver is the Co-Director of The PRIDE Study, the first large-scale, long-term national health study of people who identify in the United States. Learn more about The PRIDE Study at pridestudy.org.