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18 Int'l Legal Prac. 113 (1993)
Advising Clients with Transgender Legal Issues in the 1990s

handle is hein.journals/ilp18 and id is 115 raw text is: OMBUDSMAN FORUM 113 marginal, frustrated, angry and defenceless Californians cost. There are only four American states which presently have ombudsman offices: Alaska, Iowa, Nebraska and Hawaii. Albeit, they have proven to work well, their services should be extended to include delegated au- thority from a federal ombudsman to also act as his deputies in the handling of citizen complaints against agencies of the federal government. Those states whose citizens do not presently enjoy access to a true ombuds- man could be motivated to provide it through appropri- ate congressional funding. As I said, there should not be any fear of creating another bureaucratic monster by implementing the ombudsman figure in the country. The crucial thing right now is for the politicians to take a minute off to look atwhat this new instrument of good government can do for the many different groups who compose the Amei- can people. The fruits of democratic change will not be reaped in the USA until the political participation of all its diverse constituents is adequately guaranteed. America has to face up to the facts. Youjust cannot get some people to vote. Experience shows, however, that you can get them to complain, providing of course, that there is easy access to do so and that the results are positive and made evident quickly. The ombudsman concept is not a panacea. It is certainly not an anti-riot measure. It will only workwhere government is receptive to independent criticism and willing to cooperate with the ombudsman to find the best ways to serve the people. The more effort the government puts into promoting the use of the ombudsman institution, the less conflicts there will be with the people and among the people. * Chairman, Ombudsman Forum, Committee 23, Section on Gen- eral Practice. MEICN AN TEA Advising Clients with Transgender Legal Issues in the 1990s M A Rothblatt International Conference on Transgender Law, Silver Spring Recent statistical surveys in countries from the United States to Poland, and from Holland to Singapore, have revealed an incidence of transsexualism that ranged from 1 in 10,000 persons to I in 50,000 persons.' The more general phenomena of rransgenderism has been reported as being perhaps ten times higher.2 Nearly all cases of transsexualism, and many of transgenderism, present several practical legal issues. Hence the general practitioner in the 1990s may well be presented with a legal case involving .transgenderism. Transgenderism is a human condition in which the mind's sexual identity (ie 'gender') is at variance with the prevailing anatomical sexual identity. A person whose anatomy is that of a male (or female), but who psychologically feels like a female (or male), is a transgenderist. When sex-type (anatomy) differs from gender-type (psychology) there is transgenderism. Transgenderism may he intermittent or continual, casual or obsessive. Transsexualism is generally considered to be the most continual, most obsessive form of transgenderism. A transsexual is a person who is obsessed with changing his or her anatomy to fit their mental sex-type picture of themself, that is, their gender. Surgery or pharmacology to convert one sex to the other is now fairly routine. Under doctor's prescriptions, tens of thousands ofpersons use male or female hormones to change aspects of their body toward a different sex. Pursuant to psychologists' recommendations, thousands INTERNATIONAL LEGAL PRACTITIONER December 1993 of persons have received 'sex reassignment surgery' to more completely change their anatomy toward that of the other sex. It seems clear that transgenderism and transsexualism are growing phenomena. Definition of sex When a child is born, the doctors make a legal decision to assign the child to the category of male or female. They make this decision based upon a physical examination of the genitals. For many years such decisions were thought to be infallible, including cases of hermaphroditism, where no objective assignment could be made. Following from the legal registration of the child as male or female, and the social conditioning into masculine or feminine gender roles, comes a rigid legal framework which is surprisingly resistant to change when it turns out that the doctor made an unavoidable error on day one. As noted above, doctors' transgenderism errors, meaning the individual innately adopts a gender role different from their anatomical sex, occur as frequently as one in every thousand to ten thousand births. The legal practitioner will usually be confronted with a transgendered legal problem when the child has grown past puberty, and probably is in adulthood. Among the

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