Federal trans-formation

By DAVID S. BERNSTEIN  |  August 15, 2010

The Justice Department has rolled out programs for enforcement and training of the hate-crimes act, an Obama priority passed last year, and the first piece of federal legislation to ever provide protection specifically for transgender people.

This April, Obama virtually eradicated the problem of hospitals denying visitation, or health-care-proxy rights to gay and transgender partners, when he ordered HHS to make those rights a requirement for all hospitals participating in Medicare or Medicaid. According to LGBT advocates, it was the first mention of gender identity, ever, in a presidential memorandum.

"I don't want to diminish the importance of Don't Ask Don't Tell, or ENDA," says Keisling, "but hospital-visitation policy is a much more important thing for the people trying to see their sick partner."

And this June, Secretary of State Hillary Clinton approved new guidelines for changing the "gender marker" on a passport — reassignment surgery is no longer required to obtain a passport with one's new gender identification.

Transgender advocates like Sanchez point to that change as perhaps the biggest stride forward in years — and one they hope will now be copied by the Social Security office and others.

Lots to fix
In many of these cases, the old policies were not necessarily planted with malevolent intent by past administrations. For instance, the problem with the passport policy stems from an honest attempt, more than 30 years ago, to make it easier for transgender people to change their gender marker. Basing that on surgical alteration was, Keisling says, "an attempt to recognize the best medical understanding at the time."

The updated policy acknowledges the old policy's unfair exclusion of those who, for medical or cost reasons, cannot have reassignment surgery, as well as those who simply choose not to. Instead, it requires only that one has gone through clinical treatment for gender transition.

The failure of past administrations to make these kinds of changes probably has more to do with inertia and lack of understanding than anything else — although, it certainly has not helped having George W. Bush's people in charge for eight years. This was, after all, a presidency that denied that federal employees were protected from being fired for being gay, despite clear guidelines to that effect.

"Some things the Bush administration did" — like clamping down on allowing passport changes, and disallowing grants for research into transgender health — "were mean-spirited and political," Keisling says. "Others were because we were just not on their radar."

They're clearly on the radar now — thanks in large part to GLBT employees scattered all through the administration, as well as in Congress.

Massachusetts's openly gay congressman, Barney Frank, is one of those increasingly powerful advocates — and he has Sanchez making sure he understands the transgender sides of the issues. Sanchez describes being called into Frank's office, where the congressman was meeting with then–White House counsel Greg Craig, to explain the issue of changing gender markers on official documents.

"In terms of policy-making, [Sanchez] is a party to all of the conversations," says Nangeroni. "It's very helpful to have a person there on the inside."

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