October 4, 2013

Joy Jacobson is the CHMP’s poet-in-residence. Follow her on Twitter: @joyjaco.

Coy Mathis, photo courtesy of GLAAD
Coy Mathis, photo courtesy of GLAAD

For many good reasons that have to do with identity and personal integrity, the public restroom has taken center stage in our gender debates. For instance, in an article I wrote called “Helping Transgender Children and Teens,” on the role nurses play in the lives of gender-nonconforming kids for the October issue of the American Journal of Nursing, I discuss the case of Coy Mathis. A gender-nonconforming girl whose parents filed a complaint with the Colorado Civil Rights Division, Coy as a six-year-old had been barred from using the girl’s room in her school. The civil rights ruling in June stated that the school had denied Coy “equal treatment based upon harassment.”

And over the summer California became the first state to pass legislation that will let students in its public schools use facilities such as locker rooms and restrooms and participate in sports according to their gender identity rather than their sex. Assembly Bill 1266 will go into effect in January, but already there has been a significant backlash against it. Opponents are citing concerns over the “privacy rights” of students and are trying to get the signatures required to bring the issue to a referendum on the state ballot in November. But the privacy concern sounds bogus to me. Many of those organizing the opposition to AB1266 were also involved in the passage of Proposition 8, a well-funded campaign that for a short while banned same-sex marriage in California.

Why should we care what bathroom a child uses? The question is a matter of life, health, and well-being for many gender-nonconforming young people. Last week’s Newsweek cover story by E. J. Graff puts it in brilliantly plain terms. Graff writes about what’s at stake for children whose families, schools, and clinicians try to force them to conform to a gender they don’t identify with:

Gender identity (your internal sense of whether you’re a girl or a boy) and gender expression (how you walk, move, and talk) emerge and are relatively fixed by age 5, researchers now say; by age 11 or 12, if a child is still insisting on a trans identity, that’s almost certainly going to persist. Trying to undo that is as brutal as trying to undo later sexual orientation (which our nation has now rejected), and it results in increased risks of drug and alcohol abuse, depression, suicide attempts, and so on.

Graff takes stock of the gains realized by the LGBT-rights movement in a relatively short period—marriage equality will be realized in all states in a few years, she predicts—and goes on to say that while much remains to be done to end discrimination, there’s a big question we’ve yet to explore as a society: what constitutes gender, “the way our culture, our politics, and our legal system treats femininity, masculinity, and everything in between”?

Our schools are an appropriate place to begin this conversation. The National Association of School Nurses has issued a position statement on “sexual minority students” (those contending with issues of sexual orientation or gender identity and expression), and Beverly Bradley, the statement’s lead author, told me that school nurses can work to ensure these students’ health and safety, but not all of them will do so. “There’s no way to enforce it. But the standards are a terribly important place to start,” she said.

I’d like to hear from nurses: where do you stand on this issue? What role do you think school nurses should have in political matters affecting young people, like the fight over AB1266 in California?