Miss Blanks On The Uphill Battle For Gender Affirmation Surgery In Australia
"When people uphold these structures that are oppressive to trans people, the onus and responsibility then needs to be on you to foot the bill for me to exist and survive."
On June 18, Brisbane rapper Miss Blanks posted a simple and powerful message across her social media: “I need help.”
“I don’t ask for help, I’ve been fiercely independent my entire life, I’ve always been the person to provide assistance to those around me — whether it’s friends, family, peers, community — it’s what I do,” Miss Blanks — Sian Van Der Muelen — wrote. “However, this support is life changing/saving and it’s necessary for survival, my overall quality of life, and for my trans existence within a cisgender world.
“It’s important that I make this happen and those around me and allies are committed to making this happen with me.”
Miss Blanks, who broke through the mainstream thanks to fiery singles like ‘Tommy’ and ‘Good Good D’, was asking for donations to help cover the costs of her gender affirmation surgery, which isn’t currently covered under Australia’s Medicare system.
Costs for surgery can run into the tens of thousands of dollars — depending on what procedures are undertaken — and for years Sian had put money away to make it happen. But last month, Sian decided to publicly ask for help — a decision which was not taken lightly.
“I felt such deep shame about asking for money, especially asking for money in light of the current conversations and that in my eyes and view, there’s so many other things that also require people’s money,” she told Music Junkee over the phone.
“And not just asking for money, asking for so much money as well, because in my eyes and in my experience, especially growing up, money was always linked to freedom. And it’s the capitalist view and consumer view but when you’re poor, that is your experience. Having money means you can eat, having money means you can sleep well at night with a roof over your head. So for me, I was like, “Yeah, it’s a lot of money.'”
“But after speaking to people, I realised a couple of things. One, shame has never existed within my culture, within our cultures, it came as a white concept that was adopted and burst out of colonialism. Two, people are capable and have the emotional bandwidth to care about multiple things at once. I can care about my mum whilst caring about this interview, whilst caring about my business; I care about multiple things at once. And people have the capacity to do that. To think that they can’t is more of your own bullshit to work through.”
From Brisbane To Beyond
Sian grew up in Logan in South East Queensland, with her younger brother. Raised by her white Dutch mother, she felt a particular loneliness and disconnect from her Samoan culture, as her father was absent early on.
“My upbringing was within white spaces around white people and a lot of my engagement was as the token brown kid,” she says. “People would question like, ‘Is this bitch adopted?'”
“[Mum] worked two, three jobs, and we were living pay packet to pay packet,” she continues. “Financial stability really meant freedom for us because it meant not having to worry about rent, not having to worry about bills or having to worry about food for the night.
“Being fa’afafine is prioritised in Samoan culture. Whereas in white spaces there’s a colonial lens of gender and it was very binary. It’s like you are cisgender male, or female, and everything else bit weird.”
“There was so much love, but also there were pressures — we had no option but to be mindful of race, gender, and class when it came to me and my experience, making sure there was space for how it influenced my family on these issues, and so on — especially when it came to my Samoan culture and fellow Samoan/Pacific Islander people. Whereas within white spaces and through a colonial lens, everything was binary.”
Fa’afafine, a Samoan concept that Sian explains translates to ‘in the way of the woman’, exists in stark contrast to the Western and colonial idea of trans identity — and it holds immense cultural importance.
“It’s the idea that not only as people we are connected to land and sea, we absorb and are the vessels of two-spirits — two-spirits but in a fluid form. It’s not masculine, it’s not feminine,” Sian says. “We didn’t have gendered language thousands of years ago in Samoa, and also many cultures across the world have their own ideations of trans people.
“Culturally, our people have existed for thousands of years, for as long as cis people have existed, but we just never used that kind of gendered language because we didn’t live in a gendered state. Gender is a colonial construct, it burst out of whiteness.”
Fa’afafine people are designated certain social roles, she says, and they’re treated with utmost respect: “You and I could be walking down the street, we’d have every single car pull over and be like, ‘Do you need a lift?; Or we would go into a restaurant and go and sit down we’d have every person come over to our table to pull out our seats.”
“I never identified really as a queer person, not because there’s internal self-hate, but because that label traditionally never aligned or appropriately described who I am.”
Being culturally fa’afafine and then confronting the white Australian idea of trans was highly uncomfortable, and for a long time Sian eschewed the Western label.
“It all felt too clinical to me,” she says. “And it didn’t include my cultural experience or perspective, or it didn’t see me and read me through a cultural lens as a queer person. And even then the term queer to me I’ve never really, and you’ll notice I never identified really as a queer person, not because there’s internal self-hate, but because that label traditionally never aligned or appropriately described who I am and my experience or didn’t include my people and I, and my cultural experience.”
She would rather identify as fa’afafine in Australia, but she uses the term trans because it’s “palatable” with the Western world. “I wouldn’t use ‘transgender’ if I went back home to Samoa, you know what I mean?” She laughs.
“We hold such maternal strength and guidance for community, for culture, for people,” she continues. “That’s why I feel like, based on who I am as a person, my moral code, my instincts, passion, and staunchness, is all influenced by my cultural identity as a fa’a’fafine. It’s rooted in my actions, in my voice, my movement and navigation through space, my music, my sheer presence, and the way in which I hold those around me and uplift my community/communities. My cultural identity is interwoven to who I am, the very fabric of my DNA, and that will always remain present.”
An Unrelenting, Uphill Battle
According to Australia’s National LGBTI Health Alliance, trans people over the age of 18 are 11 times more likely to attempt suicide than cisgender people, and 18 times more likely to contemplate ending their lives. The statistics for self-harm are just as shocking — 53 percent of trans people 18 and over have self-harmed, and are nearly 10 times more likely to be diagnosed with depression in their lifetime. In trans youth, these stats worsen: almost 80 percent had self-harmed, while 48 percent had attempted suicide, a 2017 study found. Additionally, trans women of colour are 10 times more likely to report being assaulted by a stranger — and twice as likely to report having been sexually assaulted ten or more times.
Academic studies over the last few years have pointed to the benefits of gender affirmation surgery on the mental health of participants: “The likelihood of being treated for a mood or anxiety disorder was reduced by eight percent for each year since the last gender-affirming surgery,” a 2019 Swedish study noted.
Sian points out that it’s important to note that not all trans people decide to undergo surgery; trans identity isn’t inextricably linked to the physical, and there are many ways someone will feel affirmed in their gender. For those that do decide to have surgery, it’s a tough, uphill battle — one that shouldn’t be insultingly deemed ‘cosmetic’. To Sian, and for many trans Australians, this surgery is nothing short of life saving.
“We live in a heteronormative society that applies so much pressure to trans people and the ways in which we exist, if I am forced to exist in your world, then you need to foot the bill, not me,” Sian says. “When people uphold these structures that are oppressive to trans people, the onus and responsibility then needs to be on you to foot the bill for me to exist and survive and be safe and feel safe within your spaces.”
The roadblocks for trans people are placed at almost every step — from the numerous hoops people have to jump through to change their legal name and gender marker on state-issued identification, to undergoing psych evaluations for surgery, to sitting on waiting lists for months and months, to severe lack of trans-specific medical specialists and resources in Australia. All of this, coupled with the fees that Sian says can run to triple the cost of procedures in other countries, means that trans people are often placed in precarious situations to save up the money.
“If I am forced to exist in your world, then you need to foot the bill, not me.”
“The onus should be on our healthcare system and the government to pay, making these surgeries free, for trans individuals, rather than trans people putting themselves at risk by seeking dangerous methods and means — compromising on safety by exploring cheaper or black-market alternatives, being forced into sex work which can be high risk for trans people, the list goes on. Transitioning is hard enough on trans people already, surgery and the journey for surgery just adds to things. It’s a whole mental, physical, emotional, spiritual shift when you get surgery.”
It’s nearing the end of our conversation, which runs for nearly 40 minutes. Sian is warm, thoughtful, engaging, quick to laughter; and while it’s clear that this is a vulnerable conversation, it’s one she is determined to have publicly. Not only for herself, but for all trans people.
“If you are in a position to have these conversations, that’s privilege in itself,” she says after a pause. “I’m very mindful of my privileges, pertaining to the social capital and influence I hold, being equipped with the language and education around these issues and my experience, which is why it’s important for me to speak up and use my voice and platform, and encourage growth and change within people and the system.”
Contribute to Miss Blanks’ GoFundMe here.
Jules LeFevre is the editor of Music Junkee. She is on Twitter.