http://youtu.be/lpKaP6-1Bus

“Two Spirits” is a documentary that uses the tragic story of the 2001 murder of a nádleehí teen, Fred Martinez, to explore the Navajo beliefs concerning gender. In contrast to the rigid binary gender roles perpetuated in Western culture, the Navajo tradition defines 4 gender roles: male, female, male with a feminine essence, and female with a masculine essence. TPT (Twin Cities Public Television) will be airing Lydia Nibley’s documentary, “Two Spirits” on the following dates and times:

• Sunday, 6/19/11, 10:30pm (channels 2, 440, 802)
• Monday, 6/20/11, 4:30am (channels 2, 440, 802)
• Saturday, 6/25/11, 10:00pm (channel 13)
• Sunday, 6/26/11, 4:00am (channel 13)

The Navajos are not alone in their recognition of a gender spectrum. Indeed many cultures throughout the world have made place for those of us who do not so neatly fit into one-size-fits-all gender roles. Click here or on the map below to explore them.

When a baby is born the first question people usually ask is, “Is it a boy or a girl?” Yet many babies are not so easily classified. Some babies have genitals that have both male and female features. Others may appear to be girls only to discover as teenagers that the reason that they are not menstruating is because the have testicles instead of ovaries. Similarly apparent boys may have ovaries and there are others who have a mixture of both.

Some people’s brains do not match their bodies; there are numerous accounts of children and adults who feel this way. Although the American Psychiatric Association (APA) labels these people with the diagnosis of Gender Identity Disorder (GID), it is the only “mental disorder” that is treated medically (with hormones and surgery) instead of with psychiatric medications. And evidence continues to mount that the brains of these individuals are both structurally and functionally similar to the brains of the gender they claim to be. In Westernized countries we label these people “transsexual” or “transgender”. Other cultures make room for a third sex and use other labels: “Hijra” (India), “Fa’afafine” (Polynesia), “Kathoeys” (Thailand) and “Two-Spirit” (Native American Tribes) are well-known examples.

In the distant past rigid gender roles may have been useful to delineate the expectations and responsibilities of individuals and to maintain order within their collective communities. On the other hand these gendered roles also created power differentials that have been used to disempower, subjugate and abuse women for millenia.

The roles of women in American society have undergone radical changes. During WWII, a shortage of male factory workers gave women an opportunity to leave the home and made Rosie the Riveter a cultural icon. When the men returned from war women were encouraged to return to the home by the promotion of the idealized homemaker exemplified by June Cleaver of the TV show “Leave It to Beaver”. While many women did return home many did not. Given that women continue to make less money than men for similar work and that they remain outnumbered in leadership roles today it is clear that inequality of the sexes is alive and well in modern society.

But what about all the individuals who do not neatly fit into these cultural boxes? A video interview with Norrie of Sidney, Australia by abc NEWS shows that Norrie is one such person who defies definitions and prefers the box “sex not specified”. The interview subtly suggests that if gender is really a continuum then perhaps we should reconsider the purpose that gender identification serves and consider its worth in context of the inequality that it propagates.

The much anticipated 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the renown American Psychiatric Association (APA) continues its misguided tradition of pathologizing gender variance. And they have newly expanded the patient base by including intersex individuals who reject their sex of rearing. Mounting evidence continues to demonstrate that gender is hardwired into our brains at a very early age. Indeed most children know their gender identity by age three and adamantly attest to it; no amount of social pressure, environmental factors or psychiatric persuasion can alter this. For individuals whose bodies do not match their gender identities, the only “cure” (normal variation is not disordered and thus does not necessitate cure) is gender reassignment either by physical presentation alone or aided by hormones and/or surgical modification.

According to the APA, “For a mental or psychiatric condition to be considered a psychiatric disorder, it must either regularly cause subjective distress, or regularly be associated with some generalized impairment in social effectiveness or functioning.” Thus in 1973 the APA concluded that “Clearly homosexuality, per se, does not meet the requirements for a psychiatric disorder since, as noted above, many homosexuals are quite satisfied with their sexual orientation and demonstrate no generalized impairment in social effectiveness or functioning.” It is baffling to me how these same conclusions do not apply to gender variance. Both the homosexual and the gender variant are capable of living full rich lives; only they who deny their inner truth and they who are socially tormented for revealing it are so impaired.

And why include the intersexed? After being surgically modified as infants and subsequently forced into living within the socially imposed system of binary gender roles these individuals are somehow disordered for rejecting this suppression? Apparently the medical community who altered them and inaccurately chose their sex of rearing cannot be at fault. What a travesty it is that the medical community continues to rubber stamp society’s aversion to gender minorities by pronouncing them disordered and thus justifying their mistreatment.

Good news for individuals paying for gender reassignment surgery — it’s tax deductible! So while many still have to pay out of pocket for these procedures, at least the Feds won’t be adding to the costs.

Scott Moore and his husband, Thomas, have decided to follow in the footsteps of Thomas Beatie and Ruben Coronado by going public about Scott’s very much wanted pregnancy and impending delivery in order to raise awareness.

While pregnancy among trans men actually occurs with some frequency it has only recently been brought to public attention. And unfortunately the medical community is often just as startled, befuddled and prejudiced as everyone else.

In the article linked above Scott speaks to the difficulty he had obtaining appropriate prenatal care: “We didn’t want everyone to be shocked when a man turns up to give birth. We found it very difficult to get a doctor and midwife at first. It was hard when people didn’t want to treat me… No pregnant person should be denied healthcare just because they are a man.”

Now granted, a portion of the hesitation Scott encountered in finding a provider was likely related to the lack of established treatment guidelines for pregnant trans men, the inherently increased risks to both father and fetus and the medical-legal liability to be assumed by the would-be provider. Even the standards of care published by the renown World Professional Association for Transgender Health (WPATH) are silent on this issue. But the fact remains that few providers make the effort to educate themselves regarding the medical needs of individuals with atypical gender experience and there has yet to be published even one case report in the Medline (Ovid) primary literature database regarding trans men and pregnancy. Clearly medical providers have a long way to go in meeting the needs of this neglected population.

So what should a trans man considering pregnancy do? First of all, do your research early on and find a provider before you get pregnant. Second, testosterone should be discontinued at least 6 weeks prior to pregnancy in order to prevent its deleterious effects on a potentially female fetus. Elevated levels of androgens like testosterone can masculinize external female genitalia as well as brains with potential social, sexual and gender identity consequences. In the event that an inadvertent pregnancy occurs, testosterone should be discontinued immediately if termination is not desired.