San Francisco Examiner, by Dr. Dawn Harbatkin, June 20, 2017
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Thousands of Californians see their gender misrepresented on state-issued identification cards every day. A bill overwhelmingly passed by the state Senate can start righting this wrong.
If passed by the Assembly, Senate Bill 179, the Gender Recognition Act, would establish a third, nonbinary gender option and simplify the process for Californians to change their gender identification without the hardship and indignity of a physician’s certification.
While most people define themselves as male or female, in fact, there are additional gender identifications beyond these “binary” categories. Think about nonbinary identity in terms of the fluid shades of purple between red and blue. Where one stands in this nuanced spectrum reflects an internal sense of self that may or may not align with the sex assigned at birth. Some people choose to name their gender outside the binary female and male categories; others simply prefer to be considered “nonbinary.”
If enacted, SB 179 would allow people to use a gender marker that better describes who they are. Having to choose between male and female when you don’t identify with either does not merely invalidate your identity, but renders the gender marker inaccurate and useless for identification purposes. Further, being recognized as who you are, not having to pretend to be someone you aren’t, can be transformative.
The bill would also eliminate the requirement to secure a doctor’s certificate stating that a person has undergone “clinically appropriate treatment” before courts can grant gender-change requests on documents. The current model is burdensome for everyone. Those affected frequently travel long distances to find an experienced doctor and incur additional health care costs just to have their true identity reflected in legal documents. Physicians and judges are often unsure what these certifications need to state. Even for our doctors at Lyon-Martin Health Services, who know the process, this is an onerous requirement.
As a physician specializing in LGBTQ care, I know for a fact that it makes no sense to require transgender people to, in essence, obtain a prescription for something that is actually self-determined.
If the bill dies, the status quo of restricting gender identity to the outdated male and female options persists, rendering a significant number of Californians invisible, maintaining barriers to legally validate identity and burdening our health care system with pointless costs. At an estimated one-time price tag of $500,000, the bill will make gender change as accessible as name changes and require that driver’s licenses, state IDs and birth certificates have a third, nonbinary gender option.
The Gender Recognition Act is a big step forward — one we must take unafraid. The uphill road to gender inclusiveness is uncharted, but every step frees more people from exclusion. If enacted, SB 179 will help educate law enforcement, health professionals and society at large on this remarkable societal transformation. It could spark an extraordinary cultural change whose impact will reverberate well beyond California.
Dr. Dawn Harbatkin is the medical director of Lyon-Martin Health Services, a San Francisco clinic serving LGBTQ patients.