I listen to a lot of podcasts on my way to classes, some of the most frequent being political. I’ve heard from several 2020 candidates, the ones held up as being the most progressive to be electable under our banal electoral system, that the only thing that shouldn’t be covered by Medicare for All is “cosmetic stuff”, like getting a nose job. They usually pass this bit off as a joke, but it got me concerned.

I’m a trans woman. At least, that’s the most accurate way to describe myself in the language we have. I’ve accepted that I need GRS (genital reconstructive surgery, it goes by many names) to truly accept my body. I want a vagina. I want to be flat down there, and have the option of vaginal sex (although I’m a lesbian) or clitoral orgasms. But whether a trans person gets operated on, if you’re not their doctor, is none of your fucking business.

This shit is expensive. The number most often thrown around for vaginoplasty is about US$20,000, and that varies depending on the specifics of the operation and post-op care. It’s like buying a car, yo. My theoretical pussy is gonna be awesome.

But I have only 1 path to get it: go to work and slave away at the same corporations that I believe will be responsible for the end of our society. Because they have good benefits! I would take PTO to fly to SF or Montreal or Bangkok or wherever the few surgeons of the world that do it are based then. And then spend a month there recovering. Then spend the next few months recovering on the job to pay back the debt I now have to them. ALL BECAUSE OF THE CIRCUMSTANCES OF MY BIRTH. Because of something that I was denied by the stars above. And, worst case, by the same politicians that are the best bet before we come to our senses and adopt socialism.

The point I’m getting to is, will MFA cover the needs of all Americans?. Of me, as a trans person that needs to regularly navigate healthcare to be the best version of myself? Of diabetic people that are captive to buying insulin for life from 3 pharma firms raising prices over 1000%?

I ask you: is my surgery “cosmetic”?

We need to do socialized medicine, free at point of service. Which is the ONLY real solution to this problem, free of neoliberal baggage like “how are we gonna pay for it”. You know as well as I that healthcare, the science of keeping people alive and healthy, should never be about anything other than just that.

Look at the UK’s NHS. I’ve met a lot of trans friends across the pond over Reddit and Discord, and they consistently complain of the NHS’ ridiculous wait times for trans care clinics, or anything that’s unusual or specialized. Meanwhile, the rich Brits with supplementary private plans, similar to the Medicare supplement plans paraded on daytime cable news, get appointments in weeks rather than months or years.

I’m sure economists and wonks older than me will have some explanation for that involving supply/demand curves or market structures. But I just see it as another bullshit situation that no one asked for. How did we get to this, as a world? How did we decide that this was the best system we could possibly make?

I think everyone should do what makes them happy. This isn’t possible under capitalism, unless what makes you happy is working a call center taking verbal abuse for $12/hr at age 26 because you dropped out of college but still have $65k of student loans and will be on the street within days of missing a paycheck and haven’t seen a doctor in 5 years and dream of being born a cute girl but don’t have time to even entertain the idea because another call’s coming in and they just got their cable bill and can’t afford it because they’re in the same situation as you.

Where was I? Right, I was working on another essay. Gotta get that college degree to get scouted by Microsoft to build the next Hololens for the DoD so they can go blow up another country and remake them in our image of capitalism.

I’m tired.


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