Pick and choose

New York City's department of health is expected to approve two controversial policies this month: One will prohibit New York City's 20,000 restaurants from serving food full of trans fats. The other will allow the city's residents to change the sex on their birth certificates if they believe they are transgender.

If both policies pass, New Yorkers won't be able to choose fatty fries from a menu, but they will be able legally to choose their gender without having a sex-change operation.

Supporters and opponents of the birth certificate plan agree it could set a precedent for similar changes in cities around the country. But opponents warn that the policy will hurt those who disagree with it, as well as the people it purports to help.

New York's health department already issues new birth certificates at the request of residents who undergo sex-change procedures. Nearly every state in the country has similar policies allowing transsexuals who undergo specified medical procedures to amend their birth certificates. Only Tennessee, Ohio, and Idaho do not allow such changes.

New York's latest proposal cuts out the requirement for medical procedures and allows transgender residents to define their sex based on personal feelings.

Michael Silverman of the Transgender Legal Defense and Education Fund, which advocates the change, argued in a New York Daily News editorial: "The measure of a person's gender isn't surgery, but rather how that person lives and feels on a daily basis."

The new policy will require applicants to legally change their names, prove that they have lived as a member of the opposite sex for at least two years, and provide affidavits from mental health professionals confirming they are transgender.

Silverman rejects the notion that gender is an objective fact, and told WORLD: "The question is: Should the birth certificate be a document that reflects what was then or what is now?" The department of health supports the latter, and Silverman hopes New York's proposal will "set an example for other cities."

Mat Staver, an attorney with Liberty Counsel, is afraid that the new policy might do just that. Staver called the proposal "a total rejection of objective truth and reality. . . . You can't change your gender like you can change your clothes."

But Staver notes that dozens of states and municipalities have expanded their nondiscrimination laws in recent years to include "gender identity." At least 17 states offer some nondiscrimination protection for transsexuals, and nearly 100 cities have additional protections.

Staver says those protections could lead to more policies like the one in New York, and that New York's actions could "embolden other agencies separate and apart from courts to make these kinds of changes."

These kinds of changes are already leading to thorny issues for bystanders. For example, some cities are grappling with whether a man dressed as a woman should be allowed to use the women's restroom. San Francisco already allows it. New York's Metropolitan Transit Authority decided earlier this year that transsexuals may use whichever restroom corresponds to their outward appearance. A handful of corporations like IBM, American Airlines, and Apple allow the practice as well.

Silverman hopes more cities and companies will adopt similar accommodations. He acknowledges that the restroom policies may raise privacy and safety concerns for people who are not transsexual, but says people can learn to adjust: "We are asking people to open heavy doors in their minds."

Paul McHugh says those are doors that people, including transsexuals, shouldn't open. McHugh, a psychiatrist at Johns Hopkins University, helped persuade his university hospital to stop performing sex-change procedures 30 years ago. McHugh says transsexuals need help, not affirmation. "We don't do liposuction on an anorexic," he told WORLD. "That would be to indulge their problem."

Alan Chambers of Exodus International, a Christian ministry that helps people leave homosexual and transgender lifestyles, agrees that the policy is "dangerous . . . especially for the people confused enough to believe they were born in the wrong bodies."

Chambers, a former homosexual, recalls the anguish of feeling, "I should have been born a girl." He says society shouldn't "put a stamp of approval on gender fluidity. . . . The most loving response is to tell people the truth and show them grace."