Part of a series
A pronoun is an important part of identity and a matter of health, says Melissa-Irene Jackson, transgender program manager at the Virginia League for Planned Parenthood. Here are a few guidelines.
- Never make assumptions about gender. You can't tell someone's gender by looks.
- Use the name a person requests that you use. Don't ask someone what a former name was.
- Don’t ask people if they’ve had surgery or are on hormones. This is a very personal topic.
- Avoid using gendered language such as “sir,” “ma’am,” “guys” and “ladies.”
- If in doubt about someone's pronouns, ask them.1
Gender Breakdown
Biological sex
Gender that is assigned to a person at birth based on physical traits that corresond to their chromosomes — XY for male and XX for female. Intersex refers to people with anatomy or genes that are a combination of XY and XX.
Identity
Gender identity is a person’s innermost sense of self. This is where the terms cisgender (or “cis” which means a person who identifies as the gender they were assigned at birth), transgender, nonbinary and agender often are used.
Expression
Personal presentation of our gender and how society, culture and families perceive, interact with and try to shape our gender. The terms masculine, feminine and androgynous often are applied.2
Trans Flag Celebrates 20 Years
BLUE represents male.
PINK represents female.
WHITE represents those who are in transition, intersex or are gender-neutral.
In January, newly elected U.S. Rep. Jennifer Waxman, (D-Va.), an aunt of a transgender teenager, placed the transgender pride flag outside her office, seemingly a first in the House of Representatives. The flag was designed in 1999 by Monica Helms. The Smithsonian Institution has Helms’ original flag.3
Equality Act
The Equality Act, proposed legislation that would prohibit discrimination on the basis of sexual orientation and gender identity with employment, housing, credit, public accommodations, education, federal financial assistance, and federal jury service, was introduced to Congress March 13. If passed, It would be the first national nondiscrimination law for LGBTQ Americans. In Virginia, anti-discrimination protection applies to state employee hiring.4
SOURCES: 1. The National Center for Transgender Equality; 2. genderspectrum.org; 3. The Washingtonian, The Washington Post and The Daily Beast; 4. The Advocate and The Movement Advance Project
Transgender Medicine
People who are transgender once had to leave Richmond for gender confirmation procedures, but several providers are now offering these services.
Dr. Neil Zemmel of Richmond Aesthetic Surgery says he began offering the service about four years ago. He’s seen more than 100 patients, and the number of people seeking his help has boomed in the last couple of years, to the point that he’s performing one or two procedures a week. “It was very gratifying to help these individuals on their journey,” he says.
There are top and bottom surgery procedures. Female-to-male bottom surgery is the most complex and can be a two- or three-step procedure, according to Dr. Nathan Guerrette, director and CEO of the Female Pelvic Medicine Institute in Richmond.
Costs vary. Most people had to pay out of pocket, since it wasn’t covered through insurance. But federal Medicare and Medicaid began covering costs in 2017, and other insurance carriers have followed. That was reflected in a survey by the American Society of Plastic Surgeons, who last year reported a 155 percent increase nationally in gender confirmation surgeries from 2016 to 2017.
Dr. Matthew G. Stanwix of Richmond-based Stanwix Plastic Surgery, who performs female-to-male top surgery, says he’s noted a boost in requests for procedures, though he no longer accepts insurance in his practice. He says his patients may pay up front for procedures and file with their insurance for reimbursement. It’s more than a cosmetic procedure, it’s a physical affirmation. “It’s just a pleasure to be part of the process,” Stanwix says.
Zemmel says that patients tell him that they felt they were put into the wrong body, and that surgery helps them feel whole. “It’s almost a sense of relief which washes over,” he says. “They’ve been waiting on the surgery their entire lives.”
