The

Undeniable

Ruth

®

…and the Ruth shall set you free!

  • Misgendered for Medical Care

    ·

    Ruth Carter

    I use an LGBTQ-friendly doctor’s office. They even provide trans-specific medical care, including prescribing hormones for trans men and women. Their website says, “We strive to provide judgement-free, affirming care that allows our patients to live healthy, authentic lives.” If anyone understands how important it is to address patients appropriately, it’s my doctor’s office.

    But even the most gender-affirming medical practice can fall short of providing quality care to all its patients because they can’t overcome the fact that health insurance forces non-binary people to lie about their gender to maintain coverage.

    Photo by Terry Ross (Creative Commons)

    Here’s What Happened

    I recently made an appointment for some routine bloodwork. Shortly after I hung up the phone with the receptionist, I received an email that directed me to download an app to use to receive messages and results.

    “Sure, whatever,” I thought. I downloaded the app to my phone. When I logged in for the first time, I saw the disheartening information across the top:

    Ruth Carter, 43, Female

    I was instantly hit with a gut-punch of disappointment.

    I spent the rest of the day feeling frustrated and dejected, once again reminded that I live in a binary-centric society, that often doesn’t acknowledge that I exist.

    The System is Broken

    I assume the app is connected to my doctor’s office, which is connected to my health insurance, which says I’m female. (Grrr…) I would not be surprised if the developers who created the app have no idea that non-binary people are being discriminated against.

    Hang on. Let me go send them an email.

    We’ll see if I get a response.

    I get it. Most people are cisgender. Their genitals match their gender from birth. Even trans men and women are having an easier time updating all their records to accurately state their gender.

    Non-binary people make up only 2% of the U.S. population. Two percent doesn’t sound like a lot, but it equates to over 1.2 million people.

    Until the Social Security Administration adds the non-binary gender option, health insurance plans will continue to exclude us along with software, systems, and policies for designed to support the practice of medicine.  

    Even if there’s nothing that can be done to change my gender in the app from what’s on my health insurance, it would have been nice, when my doctor’s office sent me the email inviting me to download the app, if they included a note like:

    Hey, we know you’re non-binary. However, this app can only use the gender specified on your health insurance. We want to give you a heads up that that’s what you’re going to see every time you log on to the app, and we’re sorry.  

    My Lucy Jane – I love this pup.

    Going to the Appointment

    The night before my appointment, I was ready to walk in, be polite but short with everyone, stick my arm out, and try to get through it as fast as possible. Thankfully (for all of us), I mellowed a bit overnight and was in a better mood by morning.

    With my dog in tow (yes, Lucy Jane is an emotional support dog who goes where I go), I went to the appointment, and the staff was lovely as always – friendly and thorough, and they didn’t give me a hard time when I said I don’t get on scales.

    I mentioned how the app misgenders people like me, and the nurse agreed it was so frustrating, especially given the type of practice they have. That was the right answer. She did not make a single excuse or try to downplay the issue.  

    Maybe it’s Not So Bad

    After my appointment, I began to wonder if I over-reacted about the app misgendering me. I was especially happy because my blood pressure is 98/62 and my defective heart (born with a PFO) is still pumping perfectly.

    The next day, I received a message asking me to provide feedback on my appointment. I clicked on the link, and it took me to the app where I saw it again:

    Ruth Carter, 43, Female

    Ugh. I immediately felt like shit.

    When I filled out the survey, I told them that I’m less likely to refer people to my doctor’s office because I feel like shit every time I open the app and it misgenders me. As a non-binary person, it matters that I’m perceived and addressed as the person I am. (I’m sure that’s true for everyone.) Maybe it’s even more important for non-binary people since we’re regularly excluded and/or misgendered by so many people, systems, and institutions.

  • When Your Adult Child is Trans

    ·

    Ruth Carter

    Last year, two of my cis-hetero friends told me that their college-age child recently came out trans. I immediately shifted into protective Oggy Ruth* mode and wanted to protect all of them and make sure they had the resources they might need.  

    Photo by Ted Eytan (Creative Commons)

    Free Mom Hugs

    Free Mom Hugs was started by Sara Cunningham who is the mom of a gay son. Her advocacy started by offering to stand in as anyone mom if their biological mother refused to come to their child’s same-sex wedding.

    Now there are Free Mom Hugs chapters throughout the U.S. Their members often attend pride events wearing “Free Mom Hugs” and “Free Dad Hugs” t-shirts, giving hugs to whoever wants them. It appears to be a great organization for parents who want to be involved and show support for the LGBTQ community.

    Photo by Hayley Tschetter (Creative Commons)

    Trans Education from Jammidodger

    Jamie Raines is a bisexual trans man in the UK. He also has a Ph.D. in psychology and dissertation on something related to transgender people.

    Jamie has a YouTube channel, Jammidodger, where he talks about and responds to a wide range of topics related to LGBTQ issues. He’s also been quite open his experiences taking testosterone as well as having top and bottom surgeries. Jamie also does videos where he responds to transphobic statements made by well-known people.

    One thing I appreciate about his channel is when he responds to transphobic statements, he cites studies that support what he’s saying, so he’s not just telling his opinion, but providing evidence.

    Where to Buy Clothes

    One issue I had to deal with when embracing my non-binary gender is figuring out what size I wear in men’s clothing. I also wanted to try different looks, and I didn’t want to buy a bunch of stuff online, knowing I’d have to send most of it back because most menswear doesn’t fit an estrogen-generated body.

    The place I first felt welcome to try on whatever I wanted was Buffalo Exchange. The staff is open to all types of people, and they don’t care what you want to try on. The only downside of Buffalo Exchange is they have dressing rooms labeled for men and women. I’ve also had good experiences trying on men’s pants at Lululemon and Eddie Bauer.

    If you’re lucky, you live in or near a city that has a clothing store that specifically caters to trans people, like Margie’s Closet in Cleveland, Ohio. 

    Where to Get a Haircut

    Not everyone feels comfortable getting their hair cut if they want a style that doesn’t conform to the gender they were assigned at birth. Thankfully, there’s the website Strands for Trans. It helps people find trans-friendly salons and barber shops.

    Photo by Ted Eytan (Creative Commons)

    How to Legally Change Your Name and Gender

    I’ve worked with several parents who needed guidance while helping their adult trans child legally change their name and gender. The process is not rocket science, but it can seem overwhelming at times with the various forms. It’s also easy to get confused about the order in which you have to update everything.

    Legally changing your name requires a court hearing. Check the county court where the child lives for information and the forms needed to change their name.

    Thankfully it’s much easier to change your gender on your passport. It’s just a matter of applying for a new passport and select their correct gender – no additional proof needed. If they’re a trans man or trans woman, they can just as easily update their social security record.

    Once they have their new passport, they can likely get their corrected driver’s license. If they want to correct their birth certificate too, contact the Office of Vital Records where they were born and them what documents they’ll need.

    Where to Ask for Help

    While there are plenty of resources for trans people and their families, they can also look to Reddit for help from strangers on the internet. There are subreddits for trans people, trans men, trans women, nonbinary people, and LGBTQ people. There’s even a subreddit to ask transgender people questions.

    If your trans kiddo has a question about sex or relationships, they may want to check out advice columnist Dan Savage and the Savage Love podcast. If he hasn’t addressed your kid’s concern to date, they can call or email him with their question.

    Dan and his partner also started the It Gets Better Project, which is an incredible place where LGBTQ people share their stories and messages of hope. Speaking of it gets better, if your kid is ever having a “baby trans” moment where they feel small, scared, or discriminated against, here’s a song that might help: It Gets Better by Rebecca Drysdale.

    How to Protect Yourself

    I would be doing a disservice if I didn’t mention this, and I’m really sorry this is how it currently is in the U.S., but violence against trans people is disturbingly high, especially trans women of color. There have also been mass shootings at gay night clubs, including at Pulse in Orlando in 2016 and Club Q in Colorado Springs in 2022.

    Your kid may want to take some preventative measures like taking a self-defense class or carrying something for self-defense like pepper spray or the Go Guarded ring. I own the Go Guarded ring, and I’ve considered getting a bulletproof undershirt, but that thing costs hundreds of dollars.

    Photo by Quinn Dombrowski (Creative Commons)

    * There is no gender-neutral term for aunt/uncle, so I created my own title: oggy. It rhymes with “doggy” and “foggy.”

  • Non-Binary Americans Can’t Get Health Insurance

    ·

    Ruth Carter

    Did you know that there are no health insurance options for non-binary people in the U.S.? Whenever you apply for health insurance, the application asks for your gender/sex, and every application only has male/female options.

    When I corrected my birth certificate to state that I’m “non-binary,” I called my health insurance provider to update my account. They said they could not do the update because their insurance plans are specifically and only for males and females.

    Photo by Ivan Radic (Creative Commons)

    Health Insurance Broker Claims They Could Help

    In the summer of 2022, I received an email from the State Bar of Arizona with information about its health insurance exchange. I snarkily responded that I cannot get health insurance because I’m non-binary. The rep for the program sent me a response that said they were “confident” that they could find me a health insurance plan because federal law prohibits discrimination based on gender.

    My thoughts were dripping with sarcasm. I thought they were coming from a good place, but I didn’t think they knew what they were talking about.

    Wait – The Rep Found Me Non-binary Health Insurance?

    A few months later, when open enrollment started, the rep from the health insurance exchange sent me an email saying they’d found me some options for health insurance.

    Really?! I figured, if they even bothered writing me back, that they would saying they couldn’t find any options for non-binary people.

    Intrigued, I clicked on the link to the options they found. My curiosity quickly shifted to anger when I saw that the rep classified me as “female.”

    What the fuck, dude! (I thought it. I didn’t say it.)

    I sent them an annoyed, but respectful, response that I explicitly told them months ago that I’m non-binary, not female. (This is the issue I’ve been dealing with for years.)

    The rep responded that every health insurance option requires the applicant to declare themselves as “male” or “female.” I messaged them back with something like, “Welcome to my non-binary life.” I refuse to declare a gender that’s a lie.

    Photo by Thomas Backa (Creative Commons)

    Obnoxious Emails from HealthCare.gov

    Open enrollment also meant the beginning of a slew of emails from HealthCare.gov about researching and applying for health insurance under the Affordable Care Act. Every time one of these messages arrived, I became more and more prickly.

    I finally replied to one of these emails with “I can’t get health insurance because I’m non-binary.” Less than a minute later, a response arrived:

    “The email is not monitored.”

    Damn it!  

    Photo by Timo Kohlenberg (Creative Commons)

    I Called the Government

    When HealthCare.gov did not provide an option to email the government for help, I picked up the phone and called them. I clicked through their menu of options to get to a human, a polite man with a southern accent.

    I explained to him that I’m non-binary and there are no health insurance options for people like me on their site. His response: “Let me put you on hold and ask my manager.”

    When he came back on the line, the rep said a trans person can claim their new gender, male or female, when applying for health insurance. I told him again that I’m non-binary, not male or female, and that’s what’s on my birth certificate, driver’s license, and passport.

    “Birth certificate?”

    “Correct.”

    “Let me put you on hold and ask my manager again.”

    When he got back on the line, he was apologetic, but said that every health insurance plan requires you to state that you’re male or female.

    I knew this would be the answer. The point of making the call was to spread awareness about this issue, and I was curious to see how long it would take them to realize that non-binary people can’t get health insurance without lying about who they are. Before hanging up, I asked the rep to please let his manager know that this is a problem impacting all non-binary Americans.

    I also set my email up to automatically send all future emails from HealthCare.gov to spam.

    Why I Keep My Current Health Insurance

    I need health insurance to cover my medications and to be there if something catastrophic happens. If I didn’t, I’d approach an organization like Lambda Legal or the ACLU about teaming up, giving up my incorrect health insurance plan, paying the penalty on my federal taxes, and suing the government and/or health insurance providers for gender discrimination for not providing a health insurance option for non-binary people.

    Photo by Joe Abbruscato

    Hope on the Horizon

    The Social Security Administration is expected to add the X gender option sometime in 2023. Hopefully, this is the last year we have to identify as something we’re not in order to get health insurance. (Trans men and women were recently given the ability to update their social security records without needing a doctor’s letter.)

    I think social security is the last piece of the puzzle. Once someone has “non-binary” on every document across the board, I don’t think health insurance providers can get away with not having non-binary health insurance options or an option that doesn’t require the applicant to disclose their gender.

    Perhaps a non-gendered option will have a questionnaire that will ask about what body parts we have as well as what types of medical treatment or procedures we’ve had to date.  That seems fair and reasonable to design coverage based on your current health care needs. If you don’t have a prostate, you don’t need coverage that includes prostate cancer. Likewise, if you can’t get pregnant, you don’t need coverage for prenatal care or delivery.

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