System Failure, Part II

- by Stacey Prince

A few months ago in a blog article entitled System Failure I wrote about some of the challenges facing transgender individuals, including transphobia and lack of access to appropriate services.  I laid out how invalidation and discrimination experienced at the micro (family), meso (jobs, school) and macro levels (laws, lending institutions, insurance companies) contribute significantly to their emotional distress.  A very concrete example of this is the incredible inaccessibility of gender reassignment surgery, which is explicitly excluded by many health insurance companies, yet prohibitively expensive to pay for out of pocket.  Yet for many transgender clients, surgery and other gender confirming procedures are in my mind as medically necessary as is bypass surgery for an individual with severe heart disease, or insulin for a diabetic.  

What I really want to focus on here is what TJP can do about it.  What can we, as an organization espousing to integrate healing and liberation, contribute to the solution?  How can we make this better?  Do we work to reform existing systems ("sensitivity trainings" for hospitals and police officers, teaching clinical psychology graduate students and psychiatry residents how to work affirmatively with transgender clients, getting insurance to pay for SRS)?  Instead of reform, do we work toward transformation, and what would transformation look like in this case--for example, can we envision and work toward a world in which regardless of their assigned-at-birth gender, pre- or post-operative status, or anything else, individuals can self-determine their gender identity, that identity does not have to fit within our convenient male/female binary, and it can change over time?  In a world where that binary, and transphobia, do not exist, would gender reassignment surgery be readily available as a medically necessary procedure--or in some cases, would it not be necessary at all?  Do we go for advocacy (the slow, tedious process of systemic change, whereby perhaps laws governing surgery, bullying, and discrimination are altered) or activism (sit-ins and demonstrations outside of insurance companies who deny services)?  

I don't know the answers, but it is these questions that TJP, and particularly our leadership council, are deeply engaging with right now.  Although I am focusing on the challenges facing transgender individuals as an illustrative example, it is just one of the  issues at the intersection of healing and social justice that TJP is hoping to address.  Asked more generally, the question is how can we, as healers, really be a part of positive social change?  What does that look like?  Where do we start?  What goals can we set that we might reasonably expect to attain in our lifetimes, and what changes can we begin that might not fully bear fruit until several generations from now?  

Optimism is a political act. Those who benefit from the status quo are perfectly happy for us to think nothing is going to get any better. In fact, these days, cynicism is obedience. What's really radical is being willing to look right at the problems we face and still insist that we can solve them. A stubborn commitment to solving problems and a faith in our ability to do so doesn't need to be naïve.


--Alex Steffen