Patterico's Pontifications

6/25/2014

No Surgery Required To Change Designated Sex On Birth Certificate

Filed under: General — Dana @ 12:06 pm



[guest post by Dana]

This month the American Medical Association opted to officially “modernize” its birth certificate policies and not require reassignment surgery in order to change an individual’s sex on their birth certificate. This is what modernization looks like:

The American Medical Association (AMA) adopted new policy supporting the elimination of any government requirement that an individual must have undergone surgery in order to change the sex indicated on a birth certificate.

Across the country, state laws governing changes to a person’s gender on a birth certificate is granted to applicants who change their sex by “surgical procedure” and provide a court order to that effect. Only a handful of states allow corrections to gender markers on birth certificates on the basis of “clinically appropriate treatment,” as opposed to surgery.

“Surgery shouldn’t be a requirement to align a person’s gender identity with their birth certificate,” said AMA President Ardis Dee Hoven, M.D. “State laws must acknowledge that the correct course of treatment for any given individual is a decision that rests with the patient and their physician.”

The AMA rejected “gender affirmation surgery” as the guiding requirement for changing birth certificates as inconsistent with current medical standards. The new AMA policy also supports that any change of sex determination on an individual’s birth certificate must not hinder access to medically appropriate preventive care. Medical options for transgender people include a medically appropriate combination of mental health care, social transition, hormone therapy, in addition to the option of sex reassignment surgery.

It is assumed that the decision was made, at least in part, to the advocacy and claims from the transgender community :

Transgender people say they need IDs to accurately reflect their gender when they apply for jobs, travel and seek certain government services among other things.

There is no consensus on this issue from State lawmakers:

Just last week, New York State said it will no longer require transgender people to require proof of surgery when they attempt to change the gender on their birth certificates. But earlier this year, New Jersey Gov. Chris Christie vetoed legislation that would have allowed those who had a clinical sex change to amend their gender on their birth certificate.

While historically, the AMA has been more progressive than lawmakers, this comes on the heels of the Medi-Care ban on sex reassignment surgeries being lifted, as well as President Obama recognizing Transgender Day Remembrance, and his recent comments made following a Department of Education action that designated an expanded view of protections under Title IX: [T]ransgender students can now “assert their rights.

Oh, and on a side note: last week the Obama administration quietly lifted its ban prohibiting health insurance carriers from covering transition-related care for transgender federal employees.

Of course, the debate will rage on as to whether a person’s gender can be changed by a piece of paper or even through sex reassignment surgery. Clearly though, the times they are a-changin’ have changed.

–Dana

62 Responses to “No Surgery Required To Change Designated Sex On Birth Certificate”

  1. Suicides-in-Waiting…

    Colonel Haiku (5f5b8b)

  2. “State laws must acknowledge that the correct course of treatment for any given individual is a decision that rests with the patient and their physician.”

    see this is why T’s need to go form their own groups and stop clinging to the L’s and G’s and B’s

    T’s have a disease.

    L’s and G’s and B’s don’t.

    It’s apples and oranges.

    happyfeet (8ce051)

  3. From the announcement at the link:

    “The AMA seeks to ensure that transgender patients always receive appropriate preventive care regardless of whether or not it matches with the gender on the birth certificate.”

    Ummm . . .
    Wouldn’t that mean if you got “it” chopped off and took drugs to look like a woman you should still be listed as “male” on your birth certificate so you could get screened for prostate cancer and such?
    And wouldn’t it also mean that you should have “something” to indicate you have surgically and chemically altered your appearance so doctors can know what drug side effects are more likely based on sex?
    Which means this whole thing does the precise opposite of helping to ensure proper treatment. (Aside from, you know, NOT surgically mutilating and chemically shaping a person with a mental illness in the first place and all that.)

    Sam (e8f1ad)

  4. We change the birth certificates of republicans all the time from hatched here to born here!

    vota (897b7b)

  5. Finally, I can declare myself as a lesbian in a man’s body that I am and have been forced to hid.

    Free at last. Thank God Free at last.

    /sarc (just in case)

    jakee308 (f1b953)

  6. Morons! (ding)

    askeptic (8ecc78)

  7. I guess I’m now free to file for government work as a minority/woman owned business, just because.

    askeptic (8ecc78)

  8. happyfeet- do you have trannyphobia?

    mg (31009b)

  9. i’m just grateful that all the big problems in the world got solved, so that we have the time & energy to devote to pressing issues such as this.

    redc1c4 (abd49e)

  10. i love trannies more than mere words can express but they’re just different than gay people is all Mr. mg

    decoupling trannies from gay people makes for more honest discussions

    happyfeet (8ce051)

  11. Just making sure the wheels didn’t come off, happyfeet.

    mg (31009b)

  12. Is it obsessive to prefer 8-spd trannies over 5-spd trannies?

    askeptic (8ecc78)

  13. The 5-spd must be for off road terrain…

    mg (31009b)

  14. As many men are familiar with this time honored phrase. This is just the tip.

    Time to invest in sex toy manufacturers. We’re all about the get f%^ked.

    DejectedHead (a094a6)

  15. Jakee308, I too am a lesbian, trapped in a male body, who has had to live with the shame of my otherness for over 50 years. Maybe we could start a support group?

    Mark Johnson (cf4f16)

  16. I’m also a butch lesbian in a mans body. If I self-ID as such, can I start using the women’s showers?

    Edoc118 (cddb25)

  17. Are we limited to M and F? Is the certificate asking for SEX or GENDER? In current usage “sex” means the physical apparatus, while “gender” has many many options of late. At least 6 even before you get to transvestites.

    Kevin M (b357ee)

  18. Can I change my birthdate on my birth certificate? My parents? Anything else?

    Can I change MY OWN NAME on my birth certificate?

    aunursa (82afe2)

  19. So this basically overrides any restrictions on gay marriage in those states, practically speaking, right? And can one change as many times as one can get a doctor to say it’s needed?

    Eidolon (aefa16)

  20. This will absolutely be used to get government contracts as a “woman-owned business,” no question. No women are even needed to apply now!

    Would any doctor get sued for malpractice if he prescribes this kind of “sex change” for money, for example so a business owner could qualify for contracts, or to get around gay marriage restrictions? Would anyone dare?

    Eidolon (aefa16)

  21. That’s what I wondered: what if a person officially changes it, but then decides they no longer like living as the new gender or no longer identify with it. Is it reversible? Is there an expiration date?

    Dana (fe2228)

  22. Feminists have been big on making sure no men whatsoever are allowed at women’s shelters. If a man is a “woman” according to this, can they legally keep him out? What about a girl’s school? How about a “man” trying to hold a position in the Catholic church, denied because of their biological sex — is that “sex discrimination” or “gender discrimination” or something? Can “he” sue?

    There must be a thousand weird and stupid repercussions of a stupid decision like this. If it’s on a person’s official documentation, then I’m not sure there’s any legal recourse as far as limiting anything to an actual sex, as opposed to whatever they think they are.

    And as many people have pointed out, there really doesn’t seem to be any reason why this doesn’t apply to race, since there’s no real principle at work here.

    Eidolon (aefa16)

  23. Greetings:

    Kind of like when, back in 1973 or so, the American Psychological (or maybe Psychiatric) Association voted to modernized homosexuality out of its diagnostic manual.

    11B40 (6abb5c)

  24. This finding can also be used to end Racial Discrimination. You can change your race to whatever ethnicity you want to identify as. Now 100% of the population can support affirmative action!

    DejectedHead (a094a6)

  25. I guess there’s sort of a principle; the principle, such as it is, is “you are what you think you are.” Which has no real limitations, such as race, height, weight, eye color, hair color, etc., as these are all just as concrete as one’s sex.

    Eidolon (aefa16)

  26. Is this a possible explanation for Obama’s reluctance to show a paper copy of his birth certificate ?

    Elephant Stone (6a6f37)

  27. 16- In CA, YES!

    askeptic (8ecc78)

  28. @ Eidolon,

    I guess there’s sort of a principle; the principle, such as it is, is “you are what you think you are.” Which has no real limitations, such as race, height, weight, eye color, hair color, etc., as these are all just as concrete as one’s sex.

    With that, I would like to hear from commenters who see very little or no correleation between moral and political stands. IOW, those who call themselves conservatives who don’t want the party to focus on issues of morality because they believe it is a losing card to play, how do you view the possibility of a somewhat limitless ability to “claim” one is anything they want to be? Does this impact you in any way as far as considering candidates who make moral issues part of their platforms?

    Dana (fe2228)

  29. How about college sports? If a person is officially a woman, wouldn’t they then be eligible for women’s sports teams? On what grounds would you be able to say they’re not woman enough? Could they sue the school if they’re not allowed on the team? Could other people sue the school if they are? What about the Olympics?

    Eidolon (aefa16)

  30. Didn’t we already see the Olympics scenario play out with the East German athletes??

    Dana (fe2228)

  31. @Dana

    I’m pretty sure the people were disqualified, and obviously the Olympics people can decide if you’re a man or a woman for their purposes. They’re not trying to answer questions about existential realities, they’re judging based on the obvious criterion, do you have a Y chromosome or not. But the thing is, the modern attitude is to boycott those who are non-progressive enough to not recognize your version of reality. For example, banning military recruiters from campus because of Don’t Ask Don’t Tell, because the military didn’t agree with the colleges about all of their views about gay people.

    So there are two issues with the Olympics. Point 1, while you know someone with a Y chromosome isn’t going to pass muster as a woman with the Olympics people, can the American Olympic team exclude them legally? Is it “sex discrimination” to discriminate based on whether a person is biologically a woman or not? And point 2, if American law sees them as a woman but the Olympics people won’t, shouldn’t we boycott the Olympics for its discriminatory policies, the way colleges did with the military recruiters?

    Eidolon (aefa16)

  32. R.I.P. actor Eli Wallach, age 98.

    Elephant Stone (6a6f37)

  33. I’m also a butch lesbian in a mans body. If I self-ID as such, can I start using the women’s showers?
    Edoc118 (cddb25) — 6/25/2014 @ 2:02 pm

    You can if you are a student in CA or MA.

    Pardon me, but this is ludicrous.
    However one wants to try to reconcile the issues that a transvestite person has, changing a birth certificate which represents an objective biological reality at birth is irrational. I don’t think a birth certificate should be changed even if a person has had sex reassignment surgery.

    MD in Philly (f9371b)

  34. I believe there was a situation a few years ago in the Olympics where a person who competed as a female, with apparent external female parts, actually was chromosome XY but had a congenital enzyme defect which resulted in not developing the male phenotype.

    Let me clarify, if necessary, my comment above. I was not calling transvestites ludicrous, nor any issues they face ludicrous. I was referring to the idea of changing birth certificates.

    If I think Warren Buffet was my father can I change my birth certificate?

    MD in Philly (f9371b)

  35. 23. Greetings:

    Kind of like when, back in 1973 or so, the American Psychological (or maybe Psychiatric) Association voted to modernized homosexuality out of its diagnostic manual.

    11B40 (6abb5c) — 6/25/2014 @ 3:10 pm

    I immediately thought of this, too.

    Kevin Williamson at NRO recently linked to an article about gender reassignment surgery by Psychiatrist Dr. Paul McHugh for he WSJ. Unfortunately it’s behind the paywall. But you’ll get the general idea from Williamson’s short piece.

    http://www.nationalreview.com/corner/380316/another-beastly-hatemonger-heard-kevin-d-williamson

    He also links to an essay Dr. McHugh wrote back in 1992, which is profound in what it reveals about psychiatry in general.

    http://www.lhup.edu/~dsimanek/mchugh.htm

    …But my other justification for corralling their enthusiasms
    is the sense that the intermingling of psychiatry with contemporary
    culture is excessive and injures both parties. During the thirty
    years of my professional experience, I have witnessed the power of
    cultural fashion to lead psychiatric thought and practice off in
    false, eve disastrous, directions. I have become familiar with how
    these fashions and their consequences caused psychiatry to lose its
    moorings. Roughly every ten years, from the mid-1960s on,
    psychiatric practice has condoned some bizarre misdirection,
    proving how all too often the discipline has been the captive of the culture.

    Each misdirection was the consequence of one of three common
    medical mistakes–oversimplification, misplaced emphasis, or pure
    invention. Psychiatry may be more vulnerable to such errors than
    other clinical endeavours, given its lack of checks and
    correctives, such as the autopsies and laboratory tests that
    protect other medical specialties. But for each error, cultural
    fashion provided the inclination and the impetus. When caught up
    by the social suppositions of their time, psychiatrists can do much harm.

    …The most conspicuous misdirection of psychiatric practice–
    the precipitate dismissal of patients with severe, chronic mental
    disorders such as schizophrenia from psychiatric hospitals–
    certainly required a vastly oversimplified view of mental illness.
    These actions were defended as efforts to bring “freedom” to these
    people, sounding a typical 1960s theme, as though it were not their
    illnesses but society that deprived them of freedom in the first place.

    What’s going on with he “transgendered” is a replay of what happened with gays back in the seventies. Politics and not medicine dictates what is and what isn’t a disease. The mania we have for declaring actual diseases to be alternative lifestyles dooms more than a few people to miserable lies, suicide attempts (many succeed), and substance abuse.

    Dr. McHugh compares gender identity disorder to anorexia; doctors would be guilty of malpractice if they did lyposuction on people who are dangerously thin to treat their delusions about being fat. Carving people up because they think they’re the wrong gender is even worse.

    Dr. McHugh notes that men who believe they’re women trapped in the wrong body actually have delusions about what it means to be a woman.

    …This interrelationship of cultural antinomianism and a
    psychiatric misplaced emphasis is seen at its grimmest in the
    practice known as sex-reassignment surgery. I happen to know about
    this because Johns Hopkins was one of the places in the United
    States where this practice was given its start. It was part of my
    intention, when I arrived in Baltimore in 1975, to help end it.

    …The patient claims it is a torture for him to live as a man,
    especially now that he has read in the newspapers about the
    possibility of switching surgically to womanhood. Upon examination
    it is not difficult to identify other mental and personality
    difficulties in him
    , but he is primarily disquieted because of his
    intrusive thoughts that his sex is not a settled issue in his life.

    …That you can get something done doesn’t always mean that you
    should do it. In sex reassignment cases, there are so many problems
    right at the start. The patient’s claim that this has been a
    lifelong problem is seldom checked with others who have known him
    since childhood. It seems so intrusive and untrusting to discuss
    the problem with others, even though they might provide a better
    gage of the seriousness of the problem, how it emerged, its
    fluctuations of intensity over time, and its connection with other
    experiences. When you discuss what the patient means by “feeling
    like a woman,” you often get a sex stereotype in return–something
    that woman physicians note immediately is a male caricature of
    women’s attitudes and interests.
    One of our patients, for example,
    said that, as a woman, he would be more “invested with being than with doing.”

    Of course, we started down his path long ago. It is no more delusional to say Bradley Manning is a woman because he decided to call himself Chelsea then it is to say Heather has two mommies. Both are equally impossible and nonsensical.

    Steve57 (334088)

  36. how do you view the possibility of a somewhat limitless ability to “claim” one is anything they want to be?

    This seems like reducio ad absurdum to me, so I decline. I am coming to believe the slippery-slope arguments were well founded.

    Kevin M (b357ee)

  37. This is the end of Title IX!!!!!!!!!

    DejectedHead (06f486)

  38. BTW, I do not understand “gender-reassignment” surgery as, technically, gender refers to behavior or self-identification. As I understand it, one has surgery to change sex, not gender.

    But then there are many things about this subject that continue to elude me…

    Kevin M (b357ee)

  39. If I think Warren Buffet was my father can I change my birth certificate?

    Yes. It will have no effect on paternity or inheritance, though; only on your name. And you will have to convince a chancery judge that you are not doing it for a fraudulent or illegal purpose.

    The AMA should stay out of things it knows nothing about, and that includes medicine in my opinion. Just stick to its job of keeping the number of doctors in the United States as small as possible. Birth certificates record a live birth, when and where. It’s a form of census. That’s a governmental matter, not a health issue.

    nk (dbc370)

  40. Oh, wait. “That’s a governmental matter, not a health issue.” I did say in the prior sentences that the AMA does government not medicine, didn’t I?

    nk (dbc370)

  41. The left mocks conservatives for believing in God, yet they believe that a person born with testicles, a penis, a prostate and a pronounced Adam’s Apple is a girl if he says he’s a girl.

    Peter (1d4db1)

  42. If I say that President Obama is no longer my president, will that make it so ?!

    Elephant Stone (6a6f37)

  43. Rather than sex or gender, why not just put body part lists on driver licenses? Henceforth, the license will list your possession of the following body parts: penis, vagina, or breasts.

    Denver Todd (891fa0)

  44. I am so wearied and dismayed by this admin. Not since the movie Salo have I been so scandalized. It is also looking like the ending will be the same where the obscene perps “ride off into the sunset”. Another fall of Babylon – Someone start the Deus Ex already.

    felipe (960c75)

  45. My comment was for the Grassley thread. WTH happened?

    felipe (960c75)

  46. nk (dbc370) — 6/25/2014 @ 5:40 pm

    Well, in that case, I’m not sharing my inheritance, that I’m not going to get, with you, so there!

    MD in Philly (f9371b)

  47. The AMA gave up any pretense of concern for physicians years ago. They play the tune requested by the person paying the bill.

    Just remember, Christine Jorgenson died of prostate cancer. It’s not nice to fool Mother Nature.

    Mike K (cd7278)

  48. It has gotten very silly, gender is physiological, not psychological

    narciso (3fec35)

  49. There is an episode of South Park (season 9, ep 1 “Mrs. Garrison’s Fancy New Vagina”)that describes this madness.

    felipe (960c75)

  50. Kevin M (b357ee) — 6/25/2014 @ 5:34 pm:

    I am coming to believe the slippery-slope arguments were well founded.

    The cultural Marxists made it clear how much lying they were ready to do to incrementally wreak the destruction on society they knew would be necessary. No slippery-slope arguments involved, if you listened to them and read their books. You can’t fundamentally transform a society without destroying quite a few things first.

    http://www.nationalreview.com/corner/381148/state-dept-lgbt-speaker-we-dont-want-gay-marriage-we-want-no-marriage-ian-tuttle

    Fighting for gay marriage generally involves lying about what we’re going to do with marriage when we get there, because we lie that the institution of marriage is not going to change, and that is a lie. The institution of marriage is going to change, and it should change, and again, I don’t think it should exist.

    Like marriage, the bourgeois family, and objective standards of truth and justice.Marxism and reality don’t mix.

    Steve57 (334088)

  51. It has gotten very silly, gender is physiological, not psychological

    Actually, gender is neither physiological nor psychological, but grammatical. I was taught that only words have gender, people have sex.

    Really, this whole PC notion that “sex” and “gender” are separate traits, and one can’t even call it “normal” for a person’s sex and gender be the same, one must call it “cisgendered”, is ridiculous, and I refuse to go along with it. As far as I’m concerned, if someone’s got male genitalia he is a man, and if she’s got female genitalia she’s a woman, and I don’t care how they feel, or claim to feel. Everyone agrees that people who think they’re Napoleon are not, so why should we pretend that people who think they’re the opposite sex are?

    If someone has actually had surgery, that’s different. I accept that sex can be changed, even if the surgery isn’t yet good enough to make someone a fully functioning member of the opposite sex; I expect that eventually it will be good enough for that, but in the meantime a sterile man or woman is still a man or woman.

    Milhouse (b95258)

  52. Then again, I don’t inquire of my transsexual friends whether they’ve had surgery, let alone ask to see them naked. I assume that people are what they present themselves as, because they almost always are, and it doesn’t pay to worry about the tiny number who pretend to be what they are not. So most of the time this won’t come up or be a problem. Still, if I know someone is physically of one sex and is claiming to be of the other, I will not go along with the pretense, though I won’t be needlessly rude about it.

    Milhouse (b95258)

  53. Basically, I do not accept the entire concept that we can change what things are simply by calling them something else. Things are what they are, as a matter of objective reality, and words can’t change reality. This may seem obvious to us here, but there’s a whole branch of the left that claims the opposite, and that’s in part what all this “transgender” and “cisgender” nonsense is about. They’re not just trying to undermine the distinction between the sexes, they’re trying to undermine our sense of reality itself.

    Milhouse (b95258)

  54. 54. …there’s a whole branch of the left that claims the opposite, and that’s in part what all this “transgender” and “cisgender” nonsense is about…they’re trying to undermine our sense of reality itself.

    Milhouse (b95258) — 6/25/2014 @ 10:41 pm

    Exactly. On a wide range of issues. “White privilege” works the same way, to pick another example out of the cultural Marxist playbook. White people, especially white men, can’t see it due to their inherent racism. If whites deny the existence of “white privilege,” because outside of the fevered imagination of the left there is no evidence it exists, that just proves their racism. The only way whites can begin to make up for their past racism (and other ingrained habits of oppression) is to defer to the morally superior left and accept their version of reality instead of trying to perceive it on their own.

    And if tomorrow reality is different from what the morally superior left said it was last week you must obediently accept the new version of reality without question.

    Indeed, expecting the oppressed races and genders to provide evidence of anything to their oppressors is proof we still live in oppressive, racist, sexist, heteronormative, colonialist, imperialistic, and militaristic society that remains in desperate need of being fundamentally transformed.

    See “rape culture” and the college feminist view of the need to provide evidence of a crime or indeed to observe the niceties of due process for further examples of the concept. Asking for evidence is to “rape” the “victim” again. Facts, the very idea of objective reality, and impartial standards of justice are racist and sexist.

    All you need to know is “Rapists don’t have rights!”

    Not to prejudge the accused as guilty before the student/faculty kangaroo court even convenes is to promote “rape culture.”

    Steve57 (334088)

  55. “Henceforth, the license will list your possession of the following body parts: penis, vagina, or breasts.”

    If you have all three (well I guess technically four) can you sue yourself for sexual harassment?

    Mark Johnson (21f0b0)

  56. Mutilating your genitalia can no more change what you are then grafting a tail on to your ass will make you a cat. These people are insane.

    JNorth (ed90e3)

  57. Mutilating your genitalia can no more change what you are then grafting a tail on to your ass will make you a cat. These people are insane.

    What makes someone male or female, if not their genitals?

    Milhouse (b95258)

  58. What I am concerned about is the psychological problems associated with this… What if a straight person, who is sure that they like only the opposite sex has fallen in love with a supposed “member” of the opposite sex whom which was originally born “not the sex they are today”? For example, a man falls in love with a “woman” who was actually born a “male” and finds out that the person wasn’t born that way to begin with…. What rights would the man (the non-transgendered) have? What about the lies, deception, psychological disorders that could arise from this scenario? Would the transgendered “female/woman” have the right to not disclose this information because of the fact that “she” is legally deemed a “female/woman” and it collaborates with all legal documents (including the darn birth certificate)? Come on! I have many drag queen, Gay and Lesbian friends. They are all proud of that…. If you are transgendered, well, be proud of that too!! I just think it is going a little too far because there are so many dishonest things that can come of it. Why not just change the words MALE or FEMALE to TRANSGENDERED… that’s actually the TRUTH!!! Who needs to know that I am a FEMALE or MALE?? Nobody, but I still have to have the in formation there! In this case I would be just a human being that was born a (fill in the blank) but believed I was a (fill in the blank), decided to get some good plastic surgery to change me physically to look and feel like a (fill in the blank). This doesn’t change the fact that I was born physically the way I was.

    j. gaston (859ab0)

  59. Don’t judge a Trans person until you have lived in their body. How would you like to be trapped in some one else’s body and nobody will believe you or help you. All doors are slammed in your face and you must comform to societys views of what is normal. Transgender is not a choice but rather a disease and it needs to start being recognized as such. It is like alcoholism,cancer or any other unwanted disease. Some have no cure but the road for a T is long,,depressing and lonely often with no way out but suicide. I find it apalling that the way you must live your life depends on the you were born in to and not the sex you should be. Why is this world so consumed with sex? Does it really matter? I say no judge a person for who they are not what sex they are!!!!!!! Shouldn’t the world be worrying about bigger problems other than discriminating against someone due to the sex they are or want to be?

    Parent of a T (e20cda)

  60. Transgender is not a choice but rather a disease and it needs to start being recognized as such.

    this.

    happyfeet (8ce051)

  61. Some people hate science.

    JD (61a2fb)


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