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The facts and fiction of racial reassignment surgery.

Remember when Jon Hamm played one of Liz Lemon’s boyfriends on 30 Rock ? And after they’re broken up, she sees him again and he’s got hooks for hands . “Oh, freak accident,” he explains. “You know I work with Doctors Without Borders. Well, I was helicoptering into Zimbabwe, when I thought I saw somebody that I knew. So I waved from the helicopter, which, it turns out, is a big no-no. And the rotor took my right hand clean off. And it turns out the person I was waving to was not my old football coach.” He was confused, okay? “It looked just like a black version of him.”

Jess Row’s new novel, Your Face In Mine , is based on the same premise, but taken totally seriously: Kelly is walking down the street one day when he sees a man he thinks looks familiar. Except it can’t be the person he knew. It can’t be Martin, because Martin is white, and this guy is black. But then Kelly finds out Martin underwent racial reassignment surgery; he’s married to a black woman who has no idea that he ever used to be white, and he wants Kelly to write a story documenting this radical transformation. I talked to Row about the research behind and writing of his book and just how close we are to a world in which his science-fiction story is reality.

How did you begin writing this novel? Did you just start writing right away, or did you immerse yourself in research first?

I started writing it in a very strange way. I picked up a book in a used bookstore called Creating Beauty To Cure The Soul: Race and Psychology in the Shaping of Aesthetic Surgery , by Sander L. Gilman. It’s a history of plastic surgery, and it was especially focused on the history of the nose job, rhinoplasty, in Germany in the 19th century. I don’t know if Gilman used the phrase “racial reassignment surgery” in the book, but for some reason, it came into my mind. And I started thinking about it as a rough analogy for gender reassignment surgery. And especially the idea of someone thinking they were of a different race inside, and would have surgery to correct it. And as soon as I thought about that, I thought, I know people, personally, who would probably fall into that category. And my next thought was, I have to write a novel about this.

I relied on some combination of the kind of on the ground research that I did talking to surgeons and reading passing narratives, and there’s a terrific book, Sexual Metamorphosis: An Anthology of Transsexual Memoirs , that goes back to the earliest of what we know called transgender people, including Christine Jorgensen , who underwent the first man-to-woman sex change and was a huge celebrity in the U.S. That’s very much the person Martin wants to model himself after.

The analogy to gender, though, is a little problematic. Because race is complicated in a way that is so different from the way gender can be complicated, right? And there’s a historical identity you’re kind of adopting if you change races that is potentially a lot more layered and explosive than the history you take on through gender reassignment surgery.

Everything in a novel happens on the ground, on the strengths of the characters. So in the novel, the narrator discovers that his friend, who was white, had surgery that makes him appear as a normative African-American man. Martin is now kind of unsurprising, unquestionable, a person who wouldn’t raise red flags at all if you saw him on a normal day. He’s wearing those clothes, with that hairstyle, and so on. So what you get into is, you’re absolutely right, the analogy to gender reassignment surgery is a rough analogy, and almost problematic, which is intentional. And in both cases, you have this question of: what does it take to pass? What does it take to appear with the image that you want to project? And this is the business of plastic surgery, as I discovered in talking to plastic surgeons. A lot of it is about using certain standardized models of what people desire, and then coming up with physical surgical ways to achieve those models. So for the surgeons, it’s actually, it’s very factual. It’s very concrete. “You give me this picture, you say you want to look like this person. And I can either make it happen, or I can not make it happen.” That’s the way that I’m approaching it in the book: imagining it from the level of the person who wants to have the surgery done, what are the steps you would go about, what are the kind of models you would choose, and what’s actually conceivable? And what’s shocking is, you can achieve a lot of these results with the science and technology that we have today. It’s not as speculative as you might think.

What did you learn from your conversations with plastic surgeons that was most surprising to you?

“A plastic surgeon in Bangkok told me, ‘Racial reassignment surgery already exists.’”

I was really taken aback when I was in Bangkok and I told one surgeon what the book was about and he said, “That already exists, but we don’t use that word for it. Racial reassignment surgery already exists.” That was really shocking to me. And what he meant was, not the full-on surgical procedures I talk about in the book, most of which are made up, but the combination of actual, physical plastic surgery with hair alterations, skin-lightening creams, that are very common, especially in Asia but all around the world, that can effectively make a person able to pass from one ethnicity to the other. There are people who have, from an outsider’s perspective, turned themselves very much into Caucasian-looking people through some combination of these techniques. And in Thailand especially, it’s very widely accepted and embraced. There’s much more of an open culture there, when it comes to all kinds of bodily transformation. South Korea is the global hub of many kinds of plastic surgery, but especially the eyelid surgery , which is very hotly debated: is it having the effect of making Korean people conform to an Asian standard of beauty, or is it making them look more Caucasian? Plastic surgery has become so common and omnipresent there, it’s become such a major part of the popular culture. In a way that I think would never be accepted in the US, where I think there’s somewhat more of a complicated set of racial sensitivities about these things.

What made you decide to have the central character who undergoes this surgery be a white man who wanted to be black? It’s always a charged thing to think about, but especially with all the news coming out of Ferguson , it’s difficult to imagine the circumstances that lead this guy would make this choice.

It’s a great question. There’s a kind of literary conceptual answer to that question, and an autobiographical answer to that. The literary conceptual answer is that, I wanted to write a kind of reverse-passing novel. A traditional passing novel, like Passing or The Human Stain , those are novels about people passing from black to white in order to achieve a position of privilege and power and to escape the “stain” of blackness, or being of color. And I wanted to write about the reverse, because I wanted to illuminate the way in which white existence and white privilege, especially in contemporary America, carries with it such a high degree of self-consciousness and guilt, and also the fetishizing of others. There’s so much fetishizing and reverse-evaluation going on. On a personal level, when I was firs thinking about the novel, the first example that came to my mind were white teenagers I grew up with in Baltimore who I felt would choose to have the surgery to become black. It felt entirely naturally to me.

The surgery is so extreme, too. Just this idea that you are completely abandoning who you were and can never return to that identity, even if something happens to you that makes you think, “Oh, maybe I was better off before, maybe I was happier before.” I understand the idea of the surgery-as-fictional-thought-experiment, and I also understand the way people affect certain ways of speaking, dressing and behaving — it’s kind of like taking a vacation from who you are to a place you’d never live, but want to visit — but did you think, while writing, if this was something that people would do in real life?

I think the idea of surgery, of course, is that it’s not reversible. It’s permanent. Whether this is something that people would actually desire and if it would become a widespread pracitce if it were available, that’s difficult for me to speak to. But I think the desire to permanently change, to permanently escape your origin, and reassign yourself completely, that desire is everywhere in our culture. It’s everywhere in global culture. And as you say, sometimes it’s like a vacation of being something else. There are all kinds of instances where that desire led to a kind of permanent reversal or a permanent alteration. Just to choose one obvious example, a more traditional passing story, Anatole Broyard , who was Creole and from New Orleans, passed for white his entire adult life in a totally convincing way. And I’ve talked to people who read the novel and said they have a hard time believing this could ever happen and that someone would not wonder. But there are so many instances one could point to in the historical record of people who have altered their racial identity and lived their entire lives without being outed and exposed.

The novel takes place in 2012. I found one of the hardest leaps of faith to take, in order to go along with the story, was that Martin’s wife has no idea. She never Googled him? She’s never asked to see a baby picture? Isn’t it harder now than it has ever been to keep your past a secret?

Remember that he’s changed his last name, every element of his identity that he could change. He came back to the United States after the surgery as a passing black man, with a new passport and everything. And I tried to build in the plausibility in the novel to a certain degree, but yeah, of course, there’s a leap of faith. Just as someone who has been around a lot of different relationships, the degree of self-deception in some romantic relationships is amazingly high. In the case of Robin, Martin’s wife, I think there probably is some element of a blind spot for her: she very devoutly wants to believe in her family, and in her choices, as successful choices, and Martin’s self-presentation plays into that.

Going back to this idea of racial reassignment surgery as something people could really do, I assume you saw that New York Magazine piece about “ethnic plastic surgery.” What did you think of the story? Did it ring true to you, given the research you’d done for the novel?

“All forms of plastic surgery have to do with conforming to racialized assumptions about idealized body types.”

I thought that article was terrific in raising the questions. The one thing I would say about it is that it seemed to reflexively think racial plastic surgery is about people of color, and white plastic surgery doesn’t qualify as ethnic or racial. And I think that’s absurd: all forms of plastic surgery have to do with conforming to racialized assumptions about idealized body types. And plastic surgeons, if you talk to them, are very candid about that. The literature all goes back to Greco-Roman symmetry.

Why do you think people — not surgeons, but the general population — are so wary of describing plastic surgery in those terms? Are we just skittish about everything having to do with race, or is there something more going on there?

I think there’s a lot of, what can we call it? There’s an element of shame, there’s an element of sensitivity, or not wanting to think through the larger implications of what you’re doing, because plastic surgery is always presented as an individual choice, having to do with what you as an individual want. It’s personal perfectability. But as a social phenomenon, it has to do with people wanting to look more like certain archetypes of what they think is desireable. And in the case of rhinoplasty and the nose job — which is the most kind of obviously ethnic or racial reassignment -– and there are critics who have written about this much more, including Gillman, it has to do with the whole question of Jewish assimilation into American culture and, before that, European culture. And in that case, it has to do with fundamental questions about, what does it mean to be Jewish? And what elements of the culture should get preserved, or do get preserved, and what elements of the culture, what elements of the physical Jewish body are desirable or not desirable?

Can you tell me more about these friends you remember from Baltimore? You say they were white kids who wanted to be black. What do you think was driving that? Do you think they understand the implications of what they wanted? Was there just something teenage and, as you said earlier, fetishizing-another-cool-culture about it? Do you think they’d still feel that way today?

I’m not sure that there was any misunderstanding at all. This is something, since the book has come out, I’ve talked to a lot of people who have said “I felt the same way.” I was talking to a reporter, a white kid who grew up in Detroit, who said a white friend of his who went to an all-black elementary school believed that he was black until the third grade. I lived, in high school, in Baltimore, and had friends who went to schools in the city and the suburbs, but anyone who spent a lot of time in Baltimore, obviously a majority black city, and felt any sense of participation in the life of the culture, which is largely African-american culture, and a sense of participation in the world of hip hop, to say that it was a matter of coolness or that it was about some kind of fandom or some sense of an affinity for black culture, that’s not quite speaking to the issue, I think. There’s an element within white self-awareness, for some people, white subjectivity, that really tries to find an escape or an outlet into something else. I would say it’s a combination of guilt, of feeling a lack of any sense of what normative white identity means, and just a sense of affinity for things that are going on in your environment that seem the most important. There’s obviously an element of wanting to have a sense of union, of oneness, with the oppressed, to deny one’s role as the oppressor, to vanish into the oppressed. If you’ve witnessed that kind of subjectivity close up, and I would say I have experienced it myself.

“With Do The Right Thing came Public Enemy. After Public Enemy came N.W.A., Niggaz With Attitude… In the early Nineties, hip-hop was everywhere but invisible — still controversial, still not quite accepted even as music, still hardly on the radio, and therefore an indispensable part of a teenager’s education.” — Your Face In Mine Why does Martin choose Kelly, our narrator, as the person to entrust with this story? Did one of those characters come to you faster than the other?

The two characters were sort of born together. And Kelly, in some ways, is the less interesting of the two — how could he not be? He’s the subjective center of the book, he’s the emotional core. His story is the story we know we believe. So I had to come up with a scenario that sounded — again, as we were saying, you want this element of plausibility and then a leap of faith as well. So Kelly works in public radio, he has contacts in the media. And Martin, who doesn’t really have any savvy in that world at all, thinks, “I know this person who is connected to media types, he must be able to do this thing for me.” So it’s this question of two people coming together at the right time. Martin is sort of desperate enough and also, in some ways, manipulative enough, and enough of a game player, that he sees in Kelly somebody who probably has the skills that he needs, but more importantly, someone that he can manipulate. And then there’s just the history they have together, which makes Martin feel that Kelly is going to be in it for the long haul.

As a journalist, this was the part that made me want to say, out loud to the book, “There is no way some guy at a low-level NPR affiliate has the ‘media contacts’ to get a huge feature story in The New Yorker .” Of all the implausible things, that could be the most implausible of them all!

You’re not the only person to say that. It’s one of the things about civilians, outside of the media world. They can be hoodwinked into thinking things that don’t make sense.

How have readers reacted to your premise so far? The whole idea of racial reassignment surgery, are people game to go with this narrative, or are they disturbed by it?

Many people do find the idea very unnerving. And Kelly himself finds it very unnerving. At one point, late in the book, when he’s entered the stage of doing the procedure himself, he says there’s something like autoerotic — it’s sort of like incest, almost. There’s something uncanny and almost, very deeply disturbing and transgressive about it, about being able to refigure and remold oneself in this way. But as you say, and Martin’s feeling about this, is other elements of American black culture are global lingua franca –- graffiti, hip hop, hip hop dance, style, fashion –- those things have enormous cache all around the world, and if you travel around the world you see that everywhere you go. So Martin’s response to that is, what about blackness itself? How can we turn blackness itself into a commodity, a brand? He sees it from a global perspective.

What parts of the book were hardest for you to write? Were you unnerved by the surgery as you were writing about it?

The sections that I was just describing, where Kelly is contemplating the surgery himself, were probably the creepiest parts to write. Because I’d spent so much time with him as a character, it was like imagining going through it myself. Also in Chapter 7, the early section where Kelly is doing this kind of confession of his own life as an American, and his own troubled conscience about black people, that was tricky to write because it’s the most autobiographical section of the book. That had a lot of elements of my own desire for confession, and I wanted to complicate the idea of confession. So that was painful.

Do readers of different races have different reactions to the book? Are some more receptive than others?

It’s really been mixed. And I definitely would never predict anyone’s response from their background. That’s really been my experience with the book. As with any book, people bring their experience and their story to it, and sometimes people bring the pain and anger that they have in their lives, and the response to the book is inflected with the pain and anger of their own experience, and look, that’s totally fine. The book is full of different voices, it’s full of dialogue. It’s about dialogue, and dialogue is not supposed to be ‘yay! everyone is happy!’ Dialogue is supposed to be an exchange, and sometimes exchanges are painful and cutting and can reveal things you didn’t anticipate.

This interview has been edited for brevity and clarity.

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Uncomfortable in His Own Skin

By Dwight Garner

• Aug. 14, 2014
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The title of Jess Row’s first novel, “Your Face in Mine,” sounds like (but isn’t) a selection from the Great American Songbook, something composed by Rodgers and Hart and sung by Johnny Hartman or Billie Holiday or Chet Baker.

Like such songs, it has timeless themes: identity, desire, class, grief, lust downshifting into more Sunday kinds of love. Its tone is familiar, too, though rarely detected in recent fiction by novelists under 40 in America. This book is adult in its weight and complexity, and formidable in its thoughtfulness.

I mention these qualities because “Your Face in Mine” has the kind of capital-P premise that borders on the techno-sensational. What if doctors were able to push plastic surgery further, as they surely will? What if it were possible to change not merely your sex but your race?

Would this lead to, as a character in this novel argues, the worst “reverse-eugenics experiment since Tuskegee ” and “some kind of bioethical genocide”? Or would such surgery add to the aggregate happiness of the world, allowing humans to be who they most want to be? To quote a joke about the French, as the author does, “It may work in practice, but will it work in theory?”

Mr. Row is the author of two short-story collections, “The Train to Lo Wu” (2005) and “Nobody Ever Gets Lost” (2011). This novel more than fulfills the promise of those books. It puts him on another level as an artist.

In “Your Face in Mine,” he doesn’t shy away from the hard intellectual and moral questions his story raises, or from grainy philosophical dialogue, but he submerges these things in a narrative that burns with a steady flame. You turn the pages without being aware you are turning them.

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FACT SHEET: Biden- ⁠ Harris Administration Advances Equality and Visibility for Transgender Americans

Today, the Biden-Harris Administration recognizes Transgender Day of Visibility, an annual celebration of the resilience, achievements, and joy of transgender people in the United States and around the world. Every American deserves the freedom to be themselves. But far too many transgender Americans still face systemic barriers, discrimination, and acts of violence. Today, the Administration once again condemns the proliferation of dangerous anti-transgender legislative attacks that have been introduced and passed in state legislatures around the country. The evidence is clear that these types of bills stigmatize and worsen the well-being and mental health of transgender kids, and they put loving and supportive families across the country at risk of discrimination and harassment. As the President has said, these bills are government overreach at its worst, they are un-American, and they must stop. Transgender people are some of the bravest people in our nation. But nobody should have to be brave just to be themselves. Today, the Biden Administration announced new actions to support the mental health of transgender children, remove barriers that transgender people face accessing critical government services, and improve the visibility of transgender people in our nation’s data.

Reinforcing federal protections for transgender kids. The Justice Department announced today that it has issued a letter to all state attorneys general reminding them of federal constitutional and statutory provisions that protect transgender youth against discrimination, including when those youth seek gender-affirming care. Advancing dignity, respect, and self-determination for transgender people by improving the traveler experience. For far too long, transgender, non-binary, and gender non-conforming Americans have faced significant barriers to travelling safely and many have not had their gender identity respected as they travel within the United States and around the world. To create a safer and more dignified travel experience, the Biden Administration is announcing the following changes.

• The Department of State is announcing that beginning on April 11, 2022, all U.S. citizens will be able select an “X” as their gender marker on their U.S. passport application. This is a major step in delivering on the President’s commitment to expand access to accurate identification documents for transgender and non-binary Americans. Information on how to apply will be available at travel.state.gov/gender .
• Implementing enhanced screening technology. The Transportation Security Administration (TSA) will soon begin updating its Advanced Imaging Technology (AIT) body scanners with new technology that will increase security and efficiency by reducing false alarm rates and pat-downs for the traveling public. By replacing the current, gender-based system with this more accurate technology, TSA will improve the customer experience of transgender travelers who have previously been required to undergo additional screening due to alarms in sensitive areas.  This new technology will help to improve the experience of travelers, particularly those who are transgender and non-binary travelers. TSA will begin deploying this new technology in airports throughout the country later this year.
• Expanding airline partnerships to enhance the overall travel experience.  TSA is working closely with air carriers across the nation to promote the use and acceptance of the “X” gender marker to ensure more efficient and accurate passenger processing. As of March 31st, two major domestic air carriers already offer a third gender marker option in their travel-reservation systems, with a third air carrier planning to offer this option in the Fall of 2022.
• Streamlining identity validation. TSA has updated its Standard Operating Procedures to remove gender considerations when validating a traveler’s identification at airport security checkpoints. This ensures that TSOs can accurately and efficiently validate each traveler’s identity while avoiding unnecessary delays.
• Updating TSA PreCheck and CBP Trusted Traveler Programs enrollment to include “X” gender markers. The Department of Homeland Security is beginning the process of adding “X” gender markers options in Trusted Traveler programs and the TSA PreCheck program to enhance access for transgender, non-binary, and gender non-conforming travelers to these programs.

Providing resources for transgender kids and their families. Transgender children are put at higher risk of attempted suicide or mental health challenges when they face bullying, rejection, or denial of health care. The Biden Administration is releasing several new resources to help transgender children and their parents thrive:

• Providing mental health resources for transgender youth.  In recent months, multiple states have removed critical information about mental health resources for LGBTQI+ youth from official state websites. Transgender youth often face significant barriers in accessing supportive resources, and are at greater risk of attempted suicide. In response, the Department of Health and Human Services released a new website that offers resources for transgender and LGBTQI+ youth, their parents, and providers. These resources include best practices for affirming an LGBTQI+ child, and information about suicide prevention services.
• Expanding trainings to support transgender and nonbinary students in schools. The Office of Safe and Supportive Schools in the Department of Education will offer new training for schools with experts and school leaders who will discuss the challenges faced by many transgender and nonbinary students and strategies and actions for providing support.
• Confirming the positive impact of gender affirming care on youth mental health. The Substance Abuse and Mental Health Services Administration (SAMHSA) has posted LGBTQI+ Youth – Like All Americans, They Deserve Evidence-Based Care , in which Miriam Delphin-Rittmon, Ph.D., HHS Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA, shares how to engage LGBTQI+ youth, the evidence behind the positive effects of gender affirming care, and available resources for LGBTQI+ youth, their families, providers, community organizations, and government agencies.
• Confirming that gender-affirming care is trauma-informed care. The National Child Traumatic Stress Network (NCTSN), which is administered by the Substance Abuse and Mental Health Services Administration, is releasing new information for providers confirming that providing gender-affirming care is neither child maltreatment nor malpractice.
• Providing resources on the importance of gender affirming care for children and adolescents. The Office of the Assistant Secretary for Health has developed a resource to inform parents and guardians, educators, and other persons supporting children and adolescents with information on what is gender-affirming care and why it is important to transgender, nonbinary, and other gender expansive young people’s well-being.

Improving access to federal services and benefits for transgender Americans.  With support and coordination from the U.S. Digital Service, federal agencies are removing barriers to access government services by improving the customer experience of transgender, non-binary, and gender non-conforming Americans:

• Accessing retirement savings. The Social Security Administration is announcing that it is removing the requirement that transgender people show proof of identity such as doctor’s notes in order to update their gender information in their social security record by the fall of 2022. This will significantly improve transgender individuals’ experience in accessing their retirement benefits, obtaining health care, and applying for jobs.
• Filing an employment discrimination complaint . The U.S. Equal Employment Opportunity Commission (EEOC) is announcing that it will promote greater equity and inclusion for members of the transgender community by giving individuals the option to select an “X” gender marker during the voluntary self-identification questions that are part of the intake process for filing a charge of discrimination.
• Applying for federal student aid. The Department of Education plans to propose next month that the 2023-24 FAFSA (Free Application for Federal Student Aid) will include an opportunity for applicants to indicate their gender identity as well as their race/ethnicity when applying for federal financial aid. The questions, which will be posted for public comment, will be in a survey that accompanies the application. This privacy-protected information would help to inform the Department about possible barriers students, including transgender and nonbinary students, face in the financial aid process.
• Visiting the White House.  The White House Office of Management and Administration is announcing that it is beginning the process of implementing updates that will improve the White House campus entry process for transgender, gender non-conforming, and non-binary visitors by adding an “X” gender marker option to the White House Worker and Visitor Entry System (WAVES) system. This change will ensure that transgender, non-binary, and gender nonconforming people can visit the People’s House in a manner that respects and affirms their gender identity.

Advancing inclusion and visibility in federal data. In too many critical federal surveys and data systems, transgender, non-binary, and gender non-conforming people are not fully reflected. To improve visibility for transgender Americans, agencies are announcing new actions to expand the collection and use of sexual orientation and gender identity (SOGI) data.

• The White House announced that the President’s proposed Fiscal Year 23 budget includes $10 million in funding for additional critical research on how to best add questions about sexual orientation and gender identity to the Census Bureau’s American Community Survey, one of our nation’s largest and most important surveys of American households. This data collection will help the federal government better serve the LGBTQI+ community by providing valuable information on their jobs, educational attainment, home ownership, and more.
• The Department of Health and Human Services has released the findings of the federal government’s first-ever user research testing conducted with transgender Americans on how they want to see themselves reflected on Federal IDs. This groundbreaking user research by the Collaborating Center for Question Design and Evaluation Research (CCQDER) at the National Center for Health Statistics (NCHS) directly informed the State Department’s adopted definition of the “X” gender marker.
• The Department of Health and Human Services  has released a comprehensive new consensus study on Measuring Sex, Gender Identity, and Sexual Orientation. This work, commissioned by the National Institutes of Health and carried out by the National Academies of Sciences, Engineering, and Medicine, will inform additional data collections and future research in how to best serve LGBTQI+ Americans.

These announcements build on the Biden-Harris Administration’s historic work to advance equality for transgender Americans since taking office, including: Combatting legislative attacks on transgender kids at the state level.

• Condemning anti-transgender bills. The President has consistently made clear that legislative attacks against transgender youth are un-American, and are bullying disguised as legislation. In his March, 2022 State of the Union Address, the President said, “The onslaught of state laws targeting transgender Americans and their families is wrong. As I said last year, especially to our younger transgender Americans, I will always have your back as your President, so you can be yourself and reach your God-given potential.” The White House has also hosted listening sessions with transgender youth and advocates in states across the country that are impacted by anti-transgender legislative attacks.
• Reaffirming that transgender children have the right to access gender-affirming health care. In March, following state actions that aim to target parents and doctors who provide gender-affirming care to transgender children with child abuse investigations, the Department of Health and Human Services took multiple actions to support transgender children in receiving the care they need and promised to use every tool available to protect LGTBQI+ children and support their families.
• Department of Justice statements of interest and amicus briefs. The Department of Justice’s Civil Rights Division has filed Statements of Interest and amicus briefs in several matters to protect the constitutional rights of transgender individuals, including in Brandt v. Rutledge , a lawsuit challenging legislation restricting access to gender-affirming care for transgender youth; B.P.J. v. West Virginia State Board of Education , a lawsuit challenging legislation restricting participation of transgender students in school sports; Corbitt v. Taylor , a lawsuit challenging legislation restricting the ability to change gender markers on state driver’s licenses; and Adams v. School Board of St. John’s County , which involves the right of a transgender boy to use the boys’ restroom at his school.

Advancing civil rights protections for transgender Americans

• Fighting for passage of the Equality Act.  President Biden  continues to call  on the Senate to pass the Equality Act, legislation which will provide long overdue federal civil rights protections to transgender and LGBTQI+ Americans and their families. As the White House has  said , passing the Equality Act is key to addressing the epidemic levels of violence and discrimination that transgender people face. The Administration’s first Statement of Administration Policy was in support of the Equality Act, and the White House has convened national leaders to discuss the importance of the legislation.
• Signing one of the most comprehensive Executive Orders on LGBTQI+ rights in history.  Within hours of taking office, President Biden signed an  Executive Order  which established that it is the official policy of the Biden-Harris Administration to prevent and combat discrimination against LGBTQI+ individuals, and to fully enforce civil rights laws to prevent discrimination on the basis of gender identity or sexual orientation. This Executive Order is one of the most consequential policies for LGBTQI+ Americans ever signed by a U.S. President. As a result of that Order, the Departments of Health and Human Services , Housing and Urban Development , Education , Consumer Financial Protection Bureau , and Justice have announced that they are expanding non-discrimination protections for transgender people in health care, housing, education, credit and lending services, and community safety programs.

Supporting transgender service members and veterans

• Reversing the discriminatory ban on transgender servicemembers.  In his first week in office, President Biden  signed  an Executive Order reversing the ban on openly transgender servicemembers serving in the Armed Forces, enabling all qualified Americans to serve their country in uniform. President Biden believes that an inclusive military strengthens our national security As a result of his Executive Order, the Department of Defense issued new  policies  which prohibit discrimination against transgender servicemembers, provide a path for transgender servicemembers to access gender-affirming medical care, and require that all transgender servicemembers are treated with dignity and respect.
• Supporting transgender veterans. To ensure that transgender veterans are treated with dignity and respect, the Department of Veterans Affairs (VA) launched an  agency-wide review  of its policies and practices to ensure that transgender veterans and employees do not face discrimination on the basis of gender identity or expression. In June, VA also announced that it is beginning the regulatory process to remove restrictions that prevent transgender veterans from accessing the gender-affirming care they need and deserve.

Responding to the crisis of anti-transgender violence and advancing safety

• Establishing a White House-led interagency working group on anti-transgender violence. To address the crisis of anti-transgender stigma and violence, during Pride Month in 2021 the White House established the first Interagency Working Group on Safety, Opportunity, and Inclusion for Transgender and Gender Diverse Individuals. The Working Group is co-led by the White House Domestic Policy Council and Gender Policy Council. To inform the priorities of the Working Group, throughout the fall of 2021 the White House convened 15 historic listening sessions with transgender and gender diverse people, advocates, and civil rights leaders from across the country and around the world, including a White House roundtable with transgender women of color .
• Releasing a White House report uplifting the voices of transgender people on gender-based violence and discrimination. On Transgender Day of Remembrance, the White House released a  report  sharing the perspectives from White House listening sessions, uplifting the voices and advocacy of transgender people throughout the country, and highlighting over 45 key, early actions the Biden-Harris Administration is taking to address the root causes of anti-transgender violence, discrimination, and denial of economic opportunity.
• Department of Justice civil rights enforcement actions. On September 14, 2021, the Department of Justice announced that it was launching a statewide civil investigation into Georgia’s prisons, which includes a focus on sexual abuse of transgender prisoners by other prisoners and staff. The Department of Justice’s Civil Rights Division and U.S. Attorney’s Office for the District of Puerto Rico also obtained a federal indictment charging three men with hate crimes for assaulting a transgender woman because of her gender identity.
• Ensuring non-discrimination protections in community safety programs. The Department of Justice issued a Memorandum from the Assistant Attorney General for Civil Rights regarding the application of Bostock v. Clayton County to the nondiscrimination provisions of the Safe Streets Act, the Juvenile Justice and Delinquency Prevention Act, the Victims of Crime Act, and the Violence Against Women Act to strengthen non-discrimination protections for transgender and LGBTQI+ individuals in key community safety programs.
• Strengthening protections for transgender individuals who are incarcerated. In January 2022 the Bureau of Prisons revised its manual on serving transgender offenders , improving access to gender-affirming care and access to facility placements that align with an inmate’s gender identity.
• Honoring those lost to violence.  The White House and the Second Gentleman of the United States hosted a first of its kind vigil in the Diplomatic Room of the White House to honor the lives of transgender and gender diverse people killed in 2021, and the countless transgender and gender diverse people who face brutal violence, harassment, and discrimination in the United States and around the world. The President also released a statement honoring the transgender people who lost their lives to violence.
• Advancing safety and justice for transgender and Two-Spirit Indigenous people. LGBTQI+ Native Americans and people who identify as transgender or “Two-Spirit” are often the targets of violent crimes. On November 15, 2021, President Biden signed an Executive Order on Improving Public Safety and Criminal Justice for Native Americans and Addressing the Crisis of Missing or Murdered Indigenous People. The Executive Order directs federal agencies to work hand in hand with Tribal Nations and Tribal partners to build safe and healthy Tribal communities to address the crisis of Missing and Murdered Indigenous People, including LGBTQI+ and “Two-Spirit” Native Americans.

Advancing health equity and expanding access to gender-affirming health care to support transgender patients

• Protecting transgender patients from health care discrimination. The Department of Health and Human Services (HHS) announced that it would interpret and enforce section 1557 of the Affordable Care Act’s prohibition on discrimination on the basis of sex in certain health programs to prohibit discrimination on the basis of gender identity and sexual orientation.
• Advancing gender-affirming care as an essential health benefit.  In 2021, the Centers for Medicare and Medicaid Services (CMS) approved the first ever application from a state to add additional gender-affirming care benefits to a state’s essential health benefit benchmark plan.
• Advancing health equity research on gender-affirming care.  The National Institutes of Health (NIH) announced that it will increase funding for research on gender-affirming procedures to further develop the evidence base for improved standards of care. Research priorities include a more thorough investigation and characterization of the short- and long-term outcomes on physical and mental health associated with gender-affirming care.
• Ending the HIV crisis among transgender and gender diverse communities.  In December, 2021, in recognition of World AIDS Day, the White House Office of National AIDS Policy released a revised National HIV/AIDS Strategy which now identifies transgender and gender diverse communities as a priority population in the federal government’s strategy to end the HIV epidemic.
• Advancing access to gender-affirming care through Ryan White HIV/AIDS Program. The Health Resources and Services Administration announced that it has released a letter encouraging Ryan White HIV/AIDS Program service providers to provide access to gender affirming care and treatment services to transgender and gender diverse individuals with HIV. The letter reaffirms the importance of providing culturally-affirming health care and social services as a key component to improving the lives of transgender people with HIV.
• Ensuring transgender patients can access birth control. In 2021 HHS issued a final rule to strengthen the Title X family planning program, fulfilling the Biden-Harris Administration’s commitment to restore access to equitable, affordable, client-centered, quality family planning services. The rule requires family planning projects to provide inclusive care to LGBTQI+ persons. Additionally, the rule prohibits discrimination against any client based on sex, sexual orientation, gender identity, sex characteristics, or marital status.

Supporting transgender students and their families

• Ensuring educational environments are free from sex discrimination and protecting LGBTQI+ students from sexual harassment.  President Biden signed an  Executive Order  recommitting the Federal Government to guarantee educational environments free from sex discrimination, including discrimination on the basis of sexual orientation or gender identity. The Executive Order charged the Department of Education with reviewing the significant rates at which students who identify as LGBTQ+ are subject to sexual harassment, including sexual violence. The Department of Education has announced that it intends to propose amendments to its Title IX regulations this year.
• Protecting the rights of transgender and gender diverse students. The Department of Education has affirmed that federal civil rights laws protect all students, including transgender and other LGBTQI+ students, from discrimination. The Department published a notice in the Federal Register announcing that it interprets Title IX’s statutory prohibition on sex discrimination as encompassing discrimination based on sexual orientation and gender identity.
• Department of Justice memorandum on Title IX. The Department of Justice issued a memorandum regarding the application of Bostock to Title IX.
• Speaking directly to transgender students. The Department of Justice, Department of Education, and Department of Health and Human Services issued a joint back to school message for transgender youth.
• Outreach and education to transgender and gender diverse students and their families. The Department of Education has published fact sheets and other resources showing the federal government’s support for transgender students, highlighting the ways schools can support students, reminding schools of their duty to investigate and address harassment based on sexual orientation or gender identity, and informing students how they can assert their rights and file complaints.
• Advancing research to address the harms of so-called conversion therapy.  The Substance Abuse and Mental Health Services Administration (SAMHSA) announced that it will update its 2015 publication  Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth  to reflect the latest research and state of the field. 

Promoting fair housing and ending homelessness for transgender Americans

• Advancing fair housing protections on the basis of gender identity. In February 2021 the Department of Housing and Urban Development (HUD) announced that it would administer and enforce the Fair Housing Act to prohibit discrimination on the basis of gender identity and sexual orientation.
• Ensuring safety and access to services for transgender people experiencing homelessness. In April, HUD withdrew the previous administration’s proposed “Shelter Rule,” which would have allowed for federally funded discrimination against transgender people who seek shelter housing. By withdrawing the previous administration’s proposed rule, the agency has restored protections for transgender people to access shelter in line with their gender identity. HUD has also released new tools for recipients to ensure compliance with these requirements in shelters and other facility settings.

Advancing economic opportunity and protections for transgender workers

• Ensuring nondiscrimination protections for transgender and gender diverse workers. In November 2021, the Department of Labor’s Office of Federal Contract Compliance Programs proposed to rescind the agency’s 2020 rule “Implementing Legal Requirements Regarding the Equal Opportunity Clause’s Religious Exemption,” an important step toward protecting workers from discrimination while safeguarding principles of religious freedom.
• Ensuring equal access to the workforce development system. The Department of Labor is enforcing discrimination prohibitions in workforce development programs funded by the Workforce Innovation and Opportunity Act, protecting workers from discrimination based on their gender identity or transgender status.

Advancing gender equity and transgender equality at home and around the world

• Advancing transgender equality in U.S. foreign policy and foreign assistance. In line with the Presidential Memorandum on Advancing the Human Rights of LGBTQI+ Persons Around the World , the United States is making significant investments to uphold dignity, equality and respect for transgender persons globally.  For example, USAID supports the Global Barometer for Transgender Rights and the LGBT Global Acceptance Index which track progress and setbacks to protecting transgender lives around the world.  The Department of Health and Human Services through the United States President’s Emergency Plan for AIDS Relief supports inclusive health care services for transgender individuals, enabling health clinics to provide care to the transgender community. And through the Department of State’s Global Equality Fund , local transgender rights organizations receive support to document human rights violations and provide critical legal assistance to community members.  
• Establishing the White House Gender Policy Council to Advance Gender Equity and Equality.  President Biden signed an  Executive Order  establishing the White House Gender Policy Council to advance gender equity and equality across the whole of the government, including by addressing barriers faced by LGBTQ+ people, in particular transgender women and girls, across our country.  

Supporting transgender leaders and public servants

• Making the Federal government a model employer for transgender public servants. President Biden signed an  Executive Order  which takes historic new steps to ensure the Federal government is a model employer for all employees – including transgender, gender non-conforming, and non-binary employees. The Executive Order charges agencies with building inclusive cultures for transgender employees by: expanding the availability of gender-neutral facilities in Federal buildings; ensuring that employee services support transgender employees who wish to legally, medically or socially transition; advancing the use of non-binary gender markers and pronouns in Federal employment processes; and expanding access to gender-affirming care and inclusive health benefits.
• Appointing historic transgender leaders. The Biden-Harris Administration includes barrier-breaking LGBTQI+ leaders, including Assistant Secretary for Health Dr. Rachel Levine, who is the first openly transgender person ever confirmed by the U.S. Senate. In October, she was also named a four-star admiral in the U.S. Public Health Service Commissioned Corps, becoming the first openly transgender person to hold that rank in any of the country’s uniformed services. Over 14 percent of Biden-Harris Administration appointees identify as LGBTQI+.

Advancing visibility for transgender Americans

• Issuing the First White House Proclamation for Transgender Day of Visibility.  On March 31, 2021 President Biden became the first U.S. President to issue a  proclamation  commemorating Transgender Day of Visibility.  
• Hosting a White House Virtual Convening on Transgender Equality.  In June, White House Press Secretary Jen Psaki hosted a first-of-its-kind  national conversation  on equality for transgender, gender non-conforming, and non-binary Americans.
• Releasing a toolkit on equality and inclusion for transgender Americans.  The White House released a new  toolkit  with best practices for advancing inclusion, opportunity, and safety for transgender Americans.
• Establishing a National Pulse Memorial. On June 25, 2021, President Biden signed H.R. 49 into law to designate the National Pulse Memorial. As the President acknowledged in his statement on the fifth anniversary of the Pulse nightclub shooting, we must acknowledge gun violence’s particular impact on LGBTQ+ communities across our nation, and we must drive out hate and inequities that contribute to the epidemic of violence and murder against transgender women – especially transgender women of color. As the President has said, Pulse Nightclub is hallowed ground.

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Book Reviews

False equivalencies mar this bold 'face'.

Amal El-Mohtar

Your Face in Mine

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Trans men and women face many problems — not least among them is the small but pernicious group of people, usually found on Tumblr, who use the rhetoric of trans experience to claim that they too are trapped in the wrong body: an able body (I have the soul of a person in a wheelchair!) or a white body (I'm black inside!). Treating gender, race and ability as identical and equivalent categories, they blithely declare that they are "trans-abled" or "trans-ethnic," so they too understand oppression. The appropriate response is usually an eye roll.

To see Jess Row raise the subject of "Race Reassignment Surgery" with seriousness, and to see him use it as a fulcrum from which to examine, at exhaustive length, white liberal guilt, demands rather a different response. Never before have I read a book that marshaled such a wealth of research and intellectual inquiry to so grating a purpose: portraying the white need to appropriate black culture as an equivalent to the danger and difficulty of living with gender dysphoria.

Kelly Thorndike, our first-person narrator, is grieving, trying to make sense of his life after losing his wife and daughter in a car accident. He's working in public radio in Baltimore when he meets Martin Lipkin, a friend from high school — except his formerly white Jewish friend is now black, and named Martin Wilkinson. Martin wants to recruit Kelly to tell his story: that he was always African-American, that he was a black man born in a white body, and that Race Reassignment Surgery has enabled him to live the life he was always meant to live. Told in essays, cassette transcripts, academic papers and business proposals, Martin's story unfolds alongside Kelly's scrutiny and self-reflection, as he thinks about the loss of his Chinese wife, Wendy, their daughter Meimei, and his own desire for acceptance and belonging in China.

Your Face in Mine is, to be charitable, an uncomfortable book; I entirely believe that it's meant to be discomfiting. I don't fault it for being unsettling, nor for setting out to unsettle. I fault it for being boring and pointless; I fault it for demonstrating knowledge of serious issues only to lampshade the awfulness of its premise; I fault it for effectively depicting Kelly's grief only to deploy it in ways that feel manipulative and disingenuous. I fault Row, essentially, for writing with skill and intelligence a book that amounts to little more than legitimizing the clueless in their desire to appropriate experiences to which their immense privilege affords them no access. Also egregious is the fact that a book built on transgender rhetoric can't be bothered to tell the difference between a trans woman and a trans man: "A ladyboy, of course," Kelly thinks about one character. "A trans man. I've forgotten all the words." Yes, yes he has.

Row's decision to not use quotation marks to separate internal monologues from dialogues makes for thematic sense but practical distraction. He seems to strive for self-awareness, but turns instead to a performance of self-flagellation over how hard it is to be white: At one point, Kelly muses that he's never been attracted to black women because he fears enacting a master/slave dynamic.

It's true that eventually Kelly encounters individuals of different ethnic backgrounds who've changed their appearance: Julie-nah is originally Korean but has been surgically altered to look like a white woman "from Nantucket"; Tariko is a Japanese Rasta who has been altered to look black because he wants to be accepted in Jamaica. But these transformations are narrative outliers; they're thought experiments masquerading as characters, with particularly disturbing implications given some late, weak plot twists.

Over and over, what this book says — through Kelly, through Kelly's conversations with people of color, through Martin's ambitions — is "white people are the worst; the only way to escape my guilt over being white is to change my race."

Which is, in a nutshell, the final form of white entitlement: The white need for absolution is absolute. The white need to not feel othered in any circumstance anywhere in the world is so important that a history of blackface, the reality of respectability politics, of riots, of young black men being murdered by vigilantes and police, of disenfranchisement, class warfare, exist only as talking points in a conversation about why white people should always get what they want because they suffer too.

If it were apparent at any point in the book that Row was highlighting this attitude as a problem instead of propping it up as legitimate and intellectually interesting, I might feel more kindly disposed toward it. As it is I'm left feeling disgusted and — I can't stress this enough — bored. This could have been a good book about Baltimore, or about China, or about Thailand, or about people from those places; instead it's about how hard it is for white people to have it easy.

Amal El-Mohtar is the author of The Honey Month and the editor of Goblin Fruit , an online poetry magazine.

• The Inventory

Imagining a future where racial reassignment surgery is the norm

Jess Row’s haunting new novel, Your Face In Mine, is an invitation to the future, an era bound only by the limits of imagination, money, and technology. It’s a time when you can edit anything about yourself—your location, occupation, your status and even your race—if you are a part of the right network.

In the future Row casts, some of us have grown accustomed to the sights and sounds of diversity and the ideal that law and culture treat every person equally. While others are experiencing “racial dysphoria,” or significant discontent with the  racial identities we’ve been assigned at birth  or the stereotypical roles associated with those racial identities. Row’s novel argues that racial dysphoria stems from the failure of racial assimilation in our techno-driven world. It’s a sign that racism persists even as race no longer seems to matter. The future Row casts is eerily reminiscent of what many cultural critics call our “post-racial” present, a time in which real racism persists without any real racists to blame.

Let’s take the real-life case of African American journalist Jamie Nesbitt Golden as a point of departure for understanding how technology allows for and complicates expressions of racism and racial identities. In April 2014 Nesbitt Golden penned an article for XO Jane explaining why she, a black woman, passes (or presents herself) online as “a white bearded hipster guy on Twitter.” Nesbitt Golden argues that she is trolled less and respected more for her opinions when she attaches a white male avatar to her profile. She writes:

The number of snarky, condescending tweets dropped of considerably… I had suddenly become reasonable and level-headed. My racial identity no longer clouded my ability to speak thoughtfully, and in good faith. It was like I was a new person. Once I went back to Black [and female], it was back to business as usual.

Nesbitt Golden’s experience reminds us that in a culture whose values and opportunities are reserved largely for the bodies of “white bearded hipster guys,” it is often necessary to take on the characteristics of such bodies to become more valuable and visible. Golden knows that assimilation doesn’t work. That’s why appropriation takes assimilation’s place as her strategy for being seen and heard.

In the novel, Kelly (a white man who will become Chinese) starts out believing that Martin (a white Jewish man turned black) is only trying to assimilate to racial categories based in white supremacy (because all racial categories are based in white supremacy). He eventually realizes that Martin’s transformation actually represents the profound failures of such an assimilationist project.

As I argued in Clearly Invisible: Racial Passing and the Color of Cultural Identity , the very fact that some feel that they cannot even inhabit white male racial identities suggests that even the most privileged among us can find racial norms unacceptable and constraining. What’s more, Martin and Kelly teach us that when assimilation fails appropriation—through the dramatic step of “racial reassignment” surgery in their cases—takes its place. The fact that this elective procedure is available to the likes of the white, wealthy protagonists also begs the question of whether race—equal parts biology, sociology and, now, consumer choice—can ever be transcended.

Row doesn’t seem to think so.

He hints at the idea that there will never be enough white people who will racially reassign themselves as there will be people of color who choose to reassign themselves as white. Racial reassignment to whiteness is the most difficult and costly procedure because it requires removing so much from the “patient.” Row’s reference here is two-sided: On one hand racial reassignment to whiteness invokes ideas about the global market for skin lightening treatments, which is projected to reach $19.8 billion by 2018. On the other hand, Row is also suggesting that racial reassignment to whiteness also involves removing the parts of a person’s spiritual and cultural core that (s)he finds too difficult to confront, a process so costly that money is no measure.

In the end, Row’s unique take on race, racism and identification presents us with an opportunity to think more about some dilemmas of identification and representation in the future. And, Row’s approach suggests that what is concealed—potential consequences characters face as they accrue status and benefits in through racial reassignment—is as interesting as what is revealed. If Row is right, then there is only one way to end racism and it can begin right now. Ending racism starts when people embrace all parts of their histories instead of denying or running away from them. Only then can everyone else begin to acknowledge and dismantle racism and promote an egalitarian society that provides safe spaces to be whatever we all are.

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