Horrific Honorifics

“There seems to be a bit of an issue with your paperwork,” the hospital receptionist told Josie.

They sighed; this had become an unfortunately frequent occurrence since they had transitioned a few years ago. Was it so hard for a trans fem in the early 21st Century to walk into a hospital and get a malfunctioning gall bladder removed?

“It seems our records are mixed up. I have some of your data under Josie Kay, Female and some under Josie Kay, Male,” the receptionist continued.

It never ends, they thought. They had tried so hard to have that fixed.

“E139,” the automated voice had sung out through the waiting room. Josie grabbed their folder full of documents and marched up to the service window.

“What can I help you with?” said the woman behind the window with zero enthusiasm. She looked horrible, like the very life had been sucked out of her by years of dealing with the worst customers, and there was now nothing left but a deflated shell who was there to give the minimum and pick up her check.

“Hi,” said Josie, cramming a bunch of forms through the glass slot, “I’m here to apply to change the gender on my birth certificate.”

The woman sighed, “That’s not something we can do here.”

Josie was expecting such bullshit; this was not their first rodeo. They had been here months before, where another soulless drone had directed them to the Department of Records to get a signed application for invalidation of birth, where yet another gatekeeper sat behind a transparent plexiglass barrier and said they could not process such a request without documentation and birth certificates for at least six generations of ancestry. It had taken months of work, but Josie had gotten everything they wanted. Upon returning to the department with this stack of papers, they encountered wholly a different person behind the plexiglass, who told them that the first person had clearly been mistaken, and what they actually needed were birth, death and marriage certificates from thirteen generations of ancestry. After scouring every family file cabinet, raiding every coroner's office, and paying some very good forgers, they managed to scrape all of that together. Upon returning with this mountain of documentation, a third person told them that, actually, the Department of Records couldn’t help them at all. It was at this point that Josie had exploded in rage, ate most of their great-great-grandfather's birth certificate in a fit of mania while person three watched on and stormed out of the building. They then sat down and studied all the relevant legislation and policy they could find until they came up with the most legally defensible route to getting their birth certificate updated.

“You can, actually.” Josie told the women, “According to section 17b of the Births, Deaths and Records Act, persons who have undergone gender affirmation surgery may apply to update the gender marker on their birth certificate. So long as they have statutory declarations from at least three doctors, two psychologists, a biologist and a priest declaring that I have had a sufficient amount of surgery and there are reasonable grounds for me to be changing gender.”

Josie spared the woman how hard getting all of those had been. Initially, they had tried to get the surgeon who performed their orchidectomy to sign a statutory declaration. But after many strongly worded emails and voicemails, they eventually discovered that the surgeon had been embezzling money from the practice and had fled to a lovely Pacific island that was not big on extraditions. Without his declaration, it was challenging to convince other doctors to sign anything. The easiest declaration was surprisingly the priest, as there are plenty of corrupt priests out there who sign a form for the right price.

“I have supplied copies of all of those, as well as a completed copy of the B57 Change of Gender application form.”

The woman stared at the pile of documents before her. “I didn’t even know we had a B57 form.”

“I found a single copy of the form in the back of a cabinet in a basement in the government archives after days of searching.”

“Hmmm, okay,” said the woman, annoyed that they couldn’t reject all this out of hand, “Let me look you up in the system. Name and date of birth, please.”

“Josie Kay. June twenty-ninth, 1989”

They typed into the computer for a bit and had a furrowed brow, “I have a Joseph Kay in my records with that date of birth.” 

Josie ignored the casual deadnaming and sighed, “Yes, that’s my old name. But I filed change of name forms over a year ago to change that.”

“Well, it says here you’re Joseph.”

“They told me it had been approved.”

The person behind the counter could only shrug their shoulders.

“Well, I guess that is me.”

The woman behind the counter gave them a disappointed stare and sighed, “Very well. The standard processing fee is $150.”

Josie paid the fee and attempted to smile and say thanks. The expression of not caring didn’t leave the woman’s face, so Josie decided they should just leave.

The woman walked into the back room and looked down at the stack of papers in her hands. Not sure of what to do, and worried about doing the wrong thing, she decided to simply shred the application and documents, and pretend she had never gotten it

“It seems your doctor put in their part of your paperwork as female, and then you put in your part of the paperwork as male. So it created duplicate records.”

“Urgh,” Josie groaned. They had listed themselves as male, as that’s what Medicare listed them as. Their doctor had obviously tried to respect the fact that they presented feminine and listed them as female. Of course, they probably patted themselves on the back, congratulated themselves for being such a good ally, for not putting them down as male. But they didn’t for a fucking second actually think of asking what gender they preferred to be listed as. Half assed allyship was not really better than open bigotry. If their doctor had just been an open bigot, then at least the paperwork wouldn’t have been fucked up.

“I’m afraid we'll have to make a new patient file to fix this up.”

“Can’t you just merge the two?”

The receptionist laughed, “Oh, no. The patient record database doesn’t like it when I do that.”

“Name?”

“Josie Kay”

“What honorific do you want?”

“What?”

“What title? Mr, Miss?”

“Is Mx an option?”

“No.”

“Well, just leave it blank.”

“Sorry, I have to put something, won’t let me click next.”

Josie groaned, “Is there any non-binary option?”

“Hmmm,” the receptionist looked through the list, “Best I could do would be Dr, I suppose. Is that non-binary enough for you?”

“Sure, whatever.”

“Date of birth?”

Josie sighed. This was going to take all morning. How was the paperwork more painful than the surgery they were here to get? Maybe they should ask for some anaesthesia for all these forms. Even just a little hit of morphine would be helpful.

After a long, drawn-out process, they sorted everything and took a seat in the waiting area.

They sat and doomscrolled for a while, reading articles about transphobes railing against self-ID laws for gender, saying it will cause chaos if passed. As opposed to the bureaucratic chaos they had endured over the past few weeks. Josie held back the desire to hurl their phone across the room, lest they cause any other delays in this surgery.

A nurse entered the waiting room and asked loudly for, “Dr Kay?”

Josie laughed at being called a doctor, but it was slightly better than being called mister or misses, so they shrugged it off. They followed the nurse down a maze of hospital corridors until they arrived at a room. “You can get changed and wash up here,” she told them and departed before Josie could ask any questions. The room was stocked with surgical scrubs. Josie was expecting a hospital gown, but they had never been in many surgeries so they assumed every hospital must have their own procedures. They got dressed and started washing up as they had been instructed. Washing up seemed like a bit much, must be a holdover from the pandemic, Josie thought.

Another person in surgical scrubs burst through the door before Josie could finish washing up, “Dr Kay?”

“Yeah?” said Josie, unsure why they were so big on titles with patients here.

“You’re late!” the scrubbed man said and grabbed them by the arm, “We’re in theatre three!”

The man pulled them down another labyrinth of corridors. Josie wanted to protest that they should treat their patients better, and should be on a bed to be transported to surgery, but at least things were moving along faster than any other time they had been in hospital, so they decided not to complain.

They burst into an operating room full of nurses, anaesthesiologists and other medical professionals. Josie had expected all of them to be there. What they had not expected to be there was a patient lying on the operating table, already unconscious.

“Ummm, what are they doing here?” said Josie.

The medical staff all looked at them and then broke into laughter, “Oh, I see we’ve got a comedian!” said one of the doctors.

“Uh, no seriously, what is going on?”

Two of the doctors looked at each other, then back to Josie, “The patient has had a spontaneous coronary artery dissection. This man needs surgery before he bleeds out.”

“Uhh, I don’t think I'm supposed to be here,” said Josie.

“You are Doctor Kay, aren’t you?”

“Ah,” said Josie, “I think I’ve realised what’s going on. I put down my title as Dr on some forms earlier, and I think there’s been a mix-up. I’m a patient here to get my gall bladder removed.”

“So you’re not a cardiac surgeon?”

“No.”

There was an awkward silence, only permeated by the periodic beep of the heart monitor attached to the patient.

“Why did you put yourself down as a doctor?!” A masked surgeon yelled, breaking the silence.

“I was just trying not to be gendered!”

“Do you really think your gender matters when this man’s life is at stake?”

Josie looked over at the person on the operating table. “Did you ask them how they identify?”

“What?”

“I’m just worried that you might be accidentally misgendering the patient by assuming they are male.”

“Is that your biggest concern right now?”

“I mean, we can be concerned about their imminent death and their gender identity. If I were about to die, I’d prefer people got my pronouns right.”

“He was brought in after his heart exploded! There wasn’t time to ask him his pronouns!”

The heart monitor suddenly turned into a loud, long single tone. Everyone in the room glared at Josie. 

“Uhh, do any of you know where my gall bladder surgery is happening?”

“We’re here reporting live from the first day of what some people are calling the trial of the century,” the gorgeous court reporter monologued into the camera in front of the courthouse. “Josie Kay is defending charges of the murder of Murray Montag as well as impersonating a Doctor. It’s gathered so much attention across the nation that everyone has forgotten all about that whole mushroom murder trial.”

The camera panned to follow as the reporter dramatically walked across the forecourt.

“Some pro trans activists are claiming that this whole incident could have been prevented by better management by the hospital and record-keeping that respects gender diversity. Anti trans activists responded by yelling a lot, making a series of incomprehensible arguments, and using a continuous stream of slurs against trans people. Some of them are here today protesting the proceedings.”

The reporter walked over to a small group of women holding signs such as “Men ≠ Women” and “Self ID = Murder”.

“What exactly are you here to protest?” she asked before tilting her microphone over to the group.

“We just want justice for the victims,” one woman replied.

“You mean the deceased patient and their family?”

“No! The women who are insulted by this man, thinking they can impersonate a woman!”

“I believe they are accused of impersonating a doctor, not a woman.”

“We told you this is what would happen if we allowed people to self-ID!” Interjected another woman, grabbing the microphone, “First, they’ll take women's spaces! Then doctors' spaces! Soon there’ll be no room left for the rest of us!”

“Well, there you have it,” said the reporter as she walked away from the protesters to give her final thoughts, “Trans people, will they destroy society? People with no qualifications and a large amount of bias think so, and we can’t be bothered asking anyone else. In fact, our editorial policy prohibits us from talking to anyone on the pro trans side. For channel 17 news, I’m Amy Toole. Back to you in the studio.”

The judge’s gavel banged several times, and the courtroom hushed. 

“Miss Kay, how do you plead?” The judge boomed.

“Mx,” replied Josie.

“Sorry?”

“My title is Mx, not Miss.”

“Oh, well, that’s not important right now. If you could just enter your plea.”

“Oh, so we’re supposed to refer to you as ‘Your Honour’ but you don’t care how I prefer to be referred to?”

“Didn’t you learn anything from how you got here? Just enter your plea and sit down.”

“Urgh, fine. Not guilty,” they said, and reluctantly sat down, much to their lawyer's relief. Their lawyer had been assigned to them through Legal Aid. Josie wasn't super happy with them. They didn’t seem to listen when Josie lectured them about the implications for trans rights in this case, and seemed to mostly be focused on playing games on their phone.

One by one, the prosecution called their witnesses. First was one of the psychologists Josie had asked to confirm their gender for their application to update their birth certificate.

“Yes, I gave them a reference for the purposes of changing their gender. I did think they were a disturbed person with strange habits, and I now regret not informing the police of my suspicions.”

“We never even had a session!” Josie stood up and yelled at the psych.

“Miss Kay, please sit down,” said The Judge, “If you interject like that again, you will be held in contempt.”

Josie sat down, holding back the urge to correct their title once more.

Next, they brought in an expert witness. A statistician hired by the prosecution to twist the numbers in their favour.

“As you can see from this graph, the hospital has only ever admitted one non-binary patient. And this directly correlates with the first murder ever perpetrated on the grounds.”

“Aren’t you going to object to this?” Josie whispered to their lawyer.

“I would,” he said, looking up from his phone for a moment, “but it’s hard to object to such advanced mathematical concepts when I’m not a mathematician.”

After that, they called the receptionist.

“You are the receptionist who processed their admission into the hospital?” asked the prosecution lawyer.

“That is correct, yes.”

“According to the statement Josie Kay gave to the police after the alleged murder, you are the one responsible for listing Mx Kay as Dr Kay.”

“Well, I put that down on the form. But only because they insisted. I thought it was weird at the time, but they told me it was the only way for me to respect their gender. I now see it was part of their sick plan to commit transgender murders.”

“Surely you're going to object this time?” Josie said to their lawyer.

“Sorry, I was close to my high score on Candy Crush. What happened?”

Lastly, the prosecution called the third ghoul from the Department of Records.

“I calmly told them where the proper place to lodge their application was, and they snapped. They yelled at me, then ate a birth certificate in front of me. It was very disturbing.”

“Should I be objecting to this, too?” The lawyer asked Josie.

“No, that actually happened.”

The lawyer could only sigh.

Eventually, the cavalcade of people who hate Josie for no good reason ended, much to Josie’s relief.

“The court hasn’t received any witness list from the defence. Do you intend to call any witnesses?” The judge asked Josie’s lawyer.

“No, your honour,” he replied. 

“We’re not going to call any witnesses?” Josie asked, slightly dismayed.

“Well, I tried to get your parents in as character witnesses, but they told me they thought prison could actually be good for you.”

The court broke for a recess while the judge deliberated on their verdict.

“So, what are my chances?” Josie asked their lawyer.

He gave them a very grave look, “I hope you’re a fan of bread and water.”

The court quickly resumed. Apparently, the judge didn’t need to think about the verdict much. 

“In the case of Kay vs. The Commonwealth, on the charge of first-degree murder, I find the defendant guilty. Due to your total lack of remorse or respect for the rule of law, I’m sentencing you to life without parole.”

“I didn’t even touch them!” Josie yelled out in rage.

“Please don’t disrupt me during my sentencing,” said the judge, “If you interrupt this court again-”

“What are you going to do? Give me another life sentence?”

“Security, please remove them from the court.”

Josie was cuffed and dragged out of the courtroom.

“Hey, easy!” they said as a police officer shoved them into a backroom. 

They were dragged into a small holding area with some other recent convictions. A processing clerk sat at a desk near the door.

“ID, please,” the clerk asked. 

Josie pulled out their passport and handed it over. Ever since this whole thing had started, they felt they should carry around a piece of ID with their gender listed on it.

“Hmmm, I have a conviction recorded here under Josie Kay, Female. But your passport has you listed as male.”

“Oh, okay,” said Josie, not really having any empathy for their captors.

“Hmmmm,” the clerk typed on their computer, “The system isn’t letting me process you.”

“What does that mean?” asked Josie, bracing for the worst.

“Look, I don’t want to deal with the IT people to get this fixed. You’re free to go.”

“What?”

The clerk walked around their desk and undid Josie’s handcuffs. “Just leave before you cause any more issues for me, okay?” 

“Uhhh, sure,” Josie said as they rubbed their wrists, got up and quickly walked off before the clerk changed his mind. 

Josie stood outside the court, somehow a free person. At least the chaos goes both ways, they thought. The family of the person who died in surgery walked out of the courthouse and glowered at them. Josie could only mouth “sorry” to them as they walked off.

There was a sudden pain radiating from within their abdomen. They realised they had never gotten their gall bladder removed. 

“Fuck,” said Josie, and they started walking towards the emergency room.