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Outraged Over Sweden’s Forced Sterilization of Trans People? It Happens Here, Too.


Every state except for Iowa requires proof that a person has undergone “sexual reassignment surgery” in order to change the gender on a person’s birth certificate. Sixteen states require the same surgery to change the gender marker on identification documents such as driver’s licenses.

A push for reform by liberal Swedish leaders is drawing worldwide attention to a decades-long disgrace: A requirement that transgender people be sterilized before changing the gender marker on official forms of identification.

Human Rights Watch condemned the practice earlier this month, and an article in Mother Jones last week drew attention stateside. But while the Mother Jones article referred to the U.S.’s fairly backwards practices, the American media has largely ignored that the same sterilization requirements exist, albeit in a different form, across this country.

Every state except for Iowa explicitly requires a surgeon’s letter proving that a person has undergone “sexual reassignment surgery” in order to change the gender on a person’s birth certificate. Sixteen states require the same surgery to change the gender marker on official identification documents, such as driver’s licenses.

The rationale is different, but the result is the same: Most transgender Americans who want every government document to match their gender will be required to have a surgery that renders them sterile. 

“Sexual reassignment surgery” is the term most commonly used in state restrictions. As the ACLU has noted, it is a vague term:

What the law means by “surgical treatment” is unclear. In many cases, a letter from a doctor documenting that one has completed all the recommended medical treatment for “altering one’s body and appearance” or “a gender transition” is enough.

However, these kinds of ambiguous notes by doctors are used to circumvent the reality that many authorities—including those in Louisiana and in Kansas, who explicitly reject mastectomies and breast augmentation as sufficient—want transgender Americans to have undergone genital surgery.

Genital surgery for transgender men and women is quite different, but both procedures are monumentally expensive and render patients infertile, though transgender men can have their eggs frozen, if they’re willing to pay several thousands of dollars more.

To make matters worse, there are three states that never allow an alteration to the sex on a birth certificate. Trans people born in Ohio, Idaho, or Tennessee may change the sex marker on their license in more amenable states, but can never have a birth certificate that aligns with their experienced gender.

Thanks to new Obama administration guidelines, transgender Americans can change the sex on their passports without undergoing surgery. Passports can then be used as an identifying document when applying for a new license, circumventing some state restrictions. Still, trans Americans are often stuck with official documents with mismatched gender and sex markers.

In the end, America isn’t better than Sweden on transgender rights—we’re just less effective at enforcing the same horrific policies. 

Shay O'Reilly is a reporter with Campus Progress. Follow him on Twitter @shaygabriel.

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