Similarly, we no longer consider facialsurgery for victims of extensive burns to be "cosmetic.

In this article, we argue that the ability to "pass" asthe member of one's target gender is required for trans-gender persons' well-being and ability to successfullyfunction in the current American society

have resulted in a greaternumber of people seeking gender-affirming surgeries

Therefore, FFS is notcosmetic or optional, but needs to be understood asmedically necessary for the treatment of gen-der dysphoria

Transgender people do notseek these procedures due to their personal preference,but rather to change sex characteristics as treatment fortheir gender dysphoria

These denials reflect a long history oflabeling medical care for transgender people as unneces-sary, unproven, and unworthy of payment by insurancepremiums.

treatment of gender dysphoria

Further, the approval or refusal of med-ical claims can reflect ideological or political agendas

Forexample, in the early 2000s insurance companies consid-ered bariatric surgery to be cosmetic and not medically

As a result,the definition of "medical necessity" is often found inindividual insurance contracts, where it is framed in abroad, multidimensional way, and is controlled by theinsurer, not the medical professional (Skinner 2013)

There is no federal definition of "medical necessity"and only one-third of states have a regulatory definitionof this concept

"Medical necessity" is a legal doctrine in the UnitedStates used as a means to control health care costs(Dolgin 2015). H

We draw upon queer, feminist, andtransgender theories of biomedicalization (Clarke et al.2010; Davis 2003) to interrogate the assumptions on whichDobov and Fraenkel's advocacy for FFS surgery rests

hat passing is a requisite for trans individuals' well-being and ability to "successfully function in Americansociety,

Modifications to the genitals are for intimate relation-ships, whereas Dubov and Fraenkel suggest that FFS isfor everyone else

demands spectatorship and not just readershi

sa`īd

Thatis the tone taken up in much of the article as it reifies distinctions betweenthe strange traditions of Upper Egyptians in the mostly rural, southern andcentral parts of the country, also known as al-Sa`īd, and its readers

bread” and “life

The author underscoresthat these people’s transfeminine embodiment is rootedin material realities and needs

Itiscertainlytruethatwithoutaconceptofgendertherecouldbe,quite simply, noconceptofhomo-orheterosexuality.

exuality”mightbetheveryoppositeofwhatwe originally referredtoas(chromosomal-based)sex:itcould occupy,instead, evenmorethan“gender”thepolarpositionoftherela-tional, thesocial/symbolic,theconstructed,thevariable,therepresenta-tional(seeFigure1)

Icanonlylovesomeoneofmyownsex.”Shouldn't“sex” be“gender”insuchasentence?

Com-paredtochromosomalsex,whichisseen(bythesedefinitions)astendingtobeimmutable,immanentintheindividual,

“male/female”functionsasaprimaryandperhapsmodelbinarismaffectingthestructureandmeaningofmany,manyotherbinarismswhoseapparentconnectiontochromosomal:sexwilloftenbeexiguousornonexistent

HomosapienswhohaveXXand thosewhohaveXY chromosomes.

Somefear thatqueer theoryseekstodissolvefamiliariden-titycategoriessuchasgayandlesbian,creatinganapoliticalmovementthatignorestherealmaterialconditionsofgaylife.Otherssuspectthatqueer theorywilloncemorerenderwomenandlesbiansinvisibleundertheguiseofagender-neutralpoli-tics

Any alliancesamong movementstoend oppressionare strategic and political, not natural.

Intheaftermathof thefamous Stonewallriots,whengaymenandlesbians fought back againstapolice raid onagay barinNewYork Cityinthesum-merof1969,

The extent towhich trans people can be targeted by conservative political actors and made intoa social threat has to do with the way in which trans people occupy a position ofgendered incoherence, which is to say, of lesser humanit

It is impossible toaccount for the rejection, marginalization, and aggression that trans people expe-rience without addressing the social, cultural, and political meanings of transsex-uality. This does not mean that all violence that trans people experience derivesfrom this condition, but rather that how social structures affect trans people isshaped by our embodiment of gender incongruence.

we simply need to accept that some minor frac-tion of the population (perhaps including ourselves) simply is ‘that way.’

I never went back to that doctorand instead got my testosterone injections illegally

nlanguage,on thecontrary, thereisonlythesound-image, andthelattercanbetranslatedinto a fixed visualimage.

Moreover,theindividualmustalwaysserveanapprentice-shipinordertolearnthefunctioningoflanguage;

Itisthesocialsideofspeech,outsidetheindividualwhocannevercreatenormodifyitbyhimself;itexistsonlybyvirtueofasortofcontract signedby themembersofacommunity.

Ratherthantheworld consistingofthingsthatneednames(theAdamicconception), eachlanguagebringsintobeing,bydescribing,aworldthatitthenknowsasexternal.

To reorient myself to listen to mybody, to acknowledge its existence, and to ask you to see it and learn fromit is to refuse the survival practices my relatives had to endure during theTermination Era of the twentieth century.

As a form of survival, I have been trained to pass,blend in, tuck away. If no one can see me or know me then I might surviveand not be found wrapped in a garbage bag by the river. T

It’s okayto admit when I just don’t know and whenI’m scared to dwell deep.

Relationships are never in balance—they are always uneven

For Simpson, the insistenceof sharing these stories become a teaching to remember how colonialismimpacted the actual land—that industrialization and other narratives ofprogress, innovation, and improvement have consequences to impact gen-erations to come.

cultural rhetorics is a“temporarily, hopeful intervention” designed to make space for anothergeneration of scholars to write and research in their language, on theirterms, and for and with and alongside the communities they value.

su; Patterson)

I want to share that I’ve been writing this article, in some variation,for a long time. Some of these stories were written from 2008 to 2012 whenI conducted two oral history projects with a group of Odawa women. A fewstories came from the B-sides of my dissertation—the scraps that I savedand tucked into my back pocket for later, always carrying them with melike a tobacco pouch. The rest of these stories have arisen as I’ve carriedand returned to the B-sides while completing other projects, living thattenure-track life, and having babies.

It is easy to writejoyfully about the practices that are easy and uncomplicated (are therepractices that are easy and uncomplicated?), but what about the practicesthat scare us, challenge us, leave us with few answers or unarticulatedmeanings?

These stories are snake stories and are used to theorize a rela-tional scholarly practice that draws from the decolonial option in culturaland Indigenous rhetorics.

Even if this is accepted as a description of the Pardoner's voice, it does not necessarily mean he is a eunuch (or a homosexual) any more than Nicholas in the Miller's Tale is one because he is described as being meek as a maiden (A 3202

Certainly the phrase "I trowe" qualifies what is to follow to some degree, as do the animal metaphors -- "a geldyng or a mare." We may assume a eunuch or a homosexual is meant, but the figurative language adds a measure of doubt; a geldyng is not a eunuchus ex nativitate, and a mare does not necessarily mean a male homosexual but may simply indicate that the Pardoner is effeminate in some way

testicular pseudohermaphrodite of the feminine type

The sexual interpretation of the Pardoner is quite new and first begins with Walter Clyde Curry's claim in 1919 to have discovered the Pardoner's "secret.

most Chaucerians seeking to reveal the "real" Pardoner have focused on the supposed irregularity of his sex life, and it is the assumption that the Pardoner's sexuality can be exactly Page 338 known that I wish to call into question here

but they are also overly subjective because they rest on little actual evidence in the text