Following through on a July settlement, an Illinois judge approved a new decree yesterday allowing transgender people to obtain new birth certificates reflecting their identified gender without undergoing genital reconstruction surgery. This is important for the many trans people for whom the surgery is not medically prudent, particularly because it carries with it the consequence of sterility. According to the Chicago Phoenix, it does seem that the Illinois Department of Public Health will still require trans people to undergo at least some form of surgery, but the standard remains unclear:
The IDPH is now prohibited from denying applicants for new Illinois birth certificates who seek to change to change their gender marker solely because they have not had genital reconstruction surgery, but there is still a requirement for a different type of surgery to be performed. The specifics of the required procedures are left up to the individual’s physician, according to Melaney Arnold, Public Health Communications, Illinois Department of Public Health shortly after the agreement was reached in July.
This is a step forward for many transgender people who cannot afford the genital reconstruction therapy or do not feel the need to undergo such a procedure. However, the other procedures that may fit the state’s criteria may be just as invasive to some, including double mastectomy, hysterectomy, orchiectomy [removal of testicles], or facial feminization surgeries.
Ultimately, the decision will come down to the individual’s physician, according to IDPH.
This is more confusing than should be necessary. It makes sense for the state to entrust physicians to determine the best course of treatment that respects each trans person’s journey, but to still impose an unclear expectation of surgery is troubling. The entire purpose of the suit that led to this resolution was to challenge the expensive and invasive nature of surgery, and that burden hasn’t changed just because one form of surgery was ruled out. For some trans individuals, options such as hormone therapy and non-surgical cosmetic procedures may be sufficient to fulfill the needs of their transition, but the current parameters may create a situation where a physician has to lie that a surgery took place to affirm the patient’s successful gender transition. Such burdens respect neither transgender people nor the medical professionals entrusted with their care.