Owen Conley had to cancel the appointment.
Conley, a UNC junior sociology major who identifies as a transgender man, was seeking a double mastectomy — or top surgery — to affirm his gender identity.
Last month, Conley received news that his mother’s insurance coverage through N.C. State healthcare won’t cover the surgery.
Conley began his transition — presenting himself socially and physically as a man and taking testosterone — two years ago. He said that top surgery is his next step toward affirming his identity.
“The joys I found in transitioning, at least at first, were daily, simple and rooted in the warm physicality of a new freedom," Conley said in an email. "I turned, and he turned. I smiled, and he smiled. I expanded, and so did he.”
Conley recently created a GoFundMe page to help cover his future medical bills. Despite this, he said he feels uncomfortable putting his personal life on public display, especially since he hasn't yet come out to his grandmother.
But accessing affordable, supportive health care, he said, has been a challenge. He has rescheduled the surgery twice due to insurance confusion and financial stress.
Because of N.C. State Health Plan's policy, the $9,000 estimated cost of the surgery, and potentially all future trans-related health care, will fall on Conley. He said he has saved his own money, but it will not be enough without crowdsourcing.
He also said it has been difficult to find trans-positive health care providers and surgeons.
“This is just one example of how transgender people are left out of the discourse,” Ezra Wright, a member of UNC’s Sexuality and Gender Alliance said.
There is minimal representation and few doctors that perform gender affirmation surgery, they said.
Anne Stephens, a clinical medicine physician at Campus Health, said she understands that LGBTQ+ healthcare should not have a singular approach.
There is a range of ways individuals may choose to transition and express their gender, she said. Changes may be social factors like name and clothing style, or more medical-based changes with male or female hormone medication. The medical side of student transitions is what she and her colleagues aim to help with.
Conley said that pursuing gender confirmation surgery is the right choice for him. However, medical transitions mark a small piece of the deeper LGBTQ+ identity.
“The idea that as a transgender person you need to be transitioning is not true,” Wright said. “It has nothing to do with validity.”
They said that the story of gender does not end with surgery — that surgery is not the core of the transgender experience.
“It’s like gender,” Wright said. “Transitioning is treated as binary — it’s not.”
The transgender and LGBTQ+ experience, Conley said, is somewhat shaped by cultural exceptions and the media. He said that it is extremely important that support for the transgender community be genuine.
“There are a lot of people at this University that I have found to be my best supporters,” he said. “But I’m not sure that this University as a whole is cognizant of the struggles that trans people face."
Conley said that there is a prevalence of token queer people or token people of color in the media and University public relations.
“In terms of University treatment of trans individuals,” he said, “a motto that they should go by is 'representation, not exploitation.'”
He said acknowledging the successes, not just the dangers and violence, in the LGBTQ+ community is a necessary shift in mindset. He said the resilience of the transgender community is shown through the presence of transgender people in academia, healthcare, the arts and other industries.
“Why should someone have to die in order for people to care?” he said. “The ultimate act of resistance is still being alive.”
Conley said he is still discovering his own identity and his advocacy work.
“I don't want my narrative to be pigeonholed into being a single-story narrative," he said. “There is not a ‘before’ or an ‘after’ to my transition, as I am learning.”
Conley is often afraid that his identity defines him and his body.
“Sometimes when I look in the mirror, I still see a stranger," he said. "I will always be living in a state of transition."
Conley’s view of top surgery is not cosmetic.
“It's one step closer to becoming someone I recognize to be myself,” he said. “And quite honestly, it will be a life-saving procedure like any other surgery someone may have.”
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