If nothing else, I think we ought to come out of this conference with an answer to these two questions. I think most of us would agree that for lesbians - and everyone else - attaining a state of optimal good health involves physical, emotional, psychological and spiritual states of well being. We would probably all agree that healing involves the whole person. We might even agree that healing also requires the involvement of family, support systems, the community and the environment. Some would agree that our sexuality and our ability to freely embrace and express it have something to do with our health, and a few of us would also agree that our ability to fully embrace our gender identities and expression regardless of our biological sex might also have something to do with our health.

The problem is not with how we define health or even with how we define lesbian (we might, in fact, not agree on that definition) but in how we create health and maintain it. The problem is with the very conceptualization of lesbian health as a distinct and separate state. The fact is that lesbian health, like lesbian rights, does not exist, cannot exist. We are chasing a myth of our own invention.

Before I am asked to leave the stage, let me explain myself. I am, obviously, someone very lesbian, very butch and very happy with all that comes with those identities. If you ask, what is a butch lesbian, I would say who knows what butch is? For me, it's a way of walking and feeling and dressing and imagining and desiring. It is the notion, at age three, that you are the captain of the rocket ship, or the notion at six that you are the soldier, Adelita's savior. It is not male. It is not female. It is both and neither. How it looks changes because we change with age and new fashions, with more or less money. Faded jeans give way to Christian Dior, or Jones New York, to ClubRoom ties instead of Salvation Army hand-me-downs. Added weight makes the breasts heavier and you grudgingly concede to bras. Cold weather makes Calvin Klein boxer briefs far more interesting than silk boxers. But the essence of who I am does not change. Living in the shadows of a gendered world, in the nuances between male and female, this does not change. I am butch, as I am lesbian, as I am Puerto Rican. Dress me up or dress me down. It doesn't matter. I'm still the captain of the rocket ship. I'm still the person who relishes the public space and struggles with how to be open and unafraid in the private spaces of my life, and vice-versa. I am still the boy, excruciatingly afraid of vulnerability, who has learned to slay the "vulnerable" dragon in public but still steps back, forgetting how to breathe sometimes, from the private world of intimacy, from the danger of surrendering to trust. I spent twelve years of my life feeling humiliated and trapped in the skirts and dresses of Catholic school. I spent another twelve years of my life having no name for the "difference" I felt even from other lesbians. I have spent most of my adult life justifying the butch in me. Today, because of the risks you have taken and the work you do, there is no justifying to be done, not here. I thank you for inviting me into this space.

So, it isn't "identity" I have a problem with. We need identity. Identity is an essential organizing and service tool. It helps us identify each other, build community and organize for services and institutions - but it doesn't give us a leg up on equality, much less freedom or social justice. Identity is for fun and safety and a chance to dance in the light of the sun and be recognized by our own kind. It is not, however, a political goal. There can be no such thing as "Lesbian rights" Anymore than there can be "Latino rights" or "Irish rights." There can only be equal treatment and equal opportunity for all persons regardless of status under the law. There can also only be full and complete access to health care, including comprehensive reproductive health care, for all people regardless of race, class, sex, gender, sexual orientation, gender identity, nationality, religion or ability to pay.

Why, then, do we need a lesbian health conference or a lesbian health movement? We need them because we need to know each other, we need to know what lesbian- identified and lesbian-sensitive researchers are finding out about us and our health needs and risks, because we need to share what we know, because we need a base to organize from, because it isn't every day you get to sit in rooms full of beautiful lesbians and bi women and trans women and be mesmerized by the splendor of it all.

But all the lesbian researchers in the world, all the dyke docs on earth, all the femme and butch nurses in America, all the bi and trans health care people in the universe are not going to change the politics of health care in America.

It will not change the politics of health care in America because the people in charge of making decisions about health care policy in America don't give a damn about any women, much less lesbians. Consider the international agenda:

"President Bush cut off all $34 Million in funds for the United Nations Population Fund in all 142 countries in which it operates." In effect, President Bush has walloped international family planning efforts by banning the use of American aid to overseas organizations that simply provide any information about abortion …. regardless of whether or not US dollars are used in the provision of that information. In the Bush administration, the assumption is that the fundamental issue is abortions or sex. It is not. The central issue is that 500,000 women die each year in pregnancy or childbirth; that 100 million women and girls worldwide are "missing" because they are denied adequate food or medical care, or because they are …. killed at birth because they are female; that 60 percent of the children kept out of elementary schools are girls; that 130 million girls have undergone genital mutilation, that between one and two million girls and women are trafficked into prostitution annually."

If these statistics on the condition of women worldwide are too distant a concern for you, consider the homeland:

38.7 million Americans live without health insurance.
18.5 million of the total uninsured are women.
33% of single mothers were uninsured in 2000.
84% of homeless clients in families are women.
91.5% of uninsured children in America are children of color.

Uninsured women are 2.3 times more likely than insured women never to have a mammogram, 2.4 times more likely to never have a clinical breast exam, 2.7 times more likely to never have had a Pap test.

How do all these millions of women and lost lives have meaning within the context of the larger "Lesbian & Gay" movement's focus on identity as a marketing tool and a mainstream strategy for achieving "equality"? It does not. It has no meaning for all these women because the strategy of achieving "equality '' by mainstreaming or normalizing ourselves ignores the necessity for alliance with others left out of the mainstream, with those whose status as poor people, as people of color or as immigrants leaves them with emergency rooms as their only source of health care - if they can get there.

Why is it in our interest to have our equal share in the privileges of the patriarchy? What is the cost of assimilation into the normal? Who is it we should be equal to? I have been asking these questions a long time. Sometimes I think I am clear about the answer. Sometimes I am not. Let me try again. I had a very smart intern at the Center last semester whom I asked to write an essay on same gender marriage. In it, she rejects the argument that marriage might mean equality - but certainly not liberation - for all the reasons that most radical lesbian feminists would reject it: it is a weapon of sexism, it controls women, it is intended to establish and uphold property and inheritance rights, it is not simply an act of love. She also, however, makes an interesting observation that same gender marriage is part of the drift toward assimilation in our not-so-queer-anymore movement and that assimilation, by definition, is meant not to respect difference but to contain it.

Containment. This is what the right wing tilt of the country-and of the "Gay Movement"- has gotten us: containment.

The 90's were supposed to be "Gay." They weren't. Instead of the supposed rush to equality we were to have experienced, we got "Don't Ask, Don't Tell," an infantile shame and secrecy response to our demand that we have the right to openly serve in the military. We demanded the right to equality in marriage. We got the Defense of Marriage Act (DOMA) at the Federal Level and 38 baby DOMAS at the state level. Sobered by the loss of the Executive Branch to a very centrist Bill Clinton, the Right moved to set their ship right back on course. "Houston, we have a problem. The fucking queers want to get married. We need containment. A pre-emptive strike is necessary. Launch the Defense of Marriage Act. And while we're at it, let's take Bill Clinton down as a pervert."

We wanted equality. We got an invitation to assimilate, to refute the shame assigned to our sexuality and gender deviations by embracing normalcy. And many of us accepted the invitation, at the expense of the dignity that comes with living without apologies for who we are. We accepted it at the expense of a broader political agenda for sexual and gender liberation, at the expense of the demands for social and economic justice - including universal health care - that progressive women, most of them women of color, have put before us for well over half a century.

Justice and Freedom? Social and Economic Justice? Worry about welfare or homelessness or the spiraling cost of education or the millions who can't afford health care? Oh no, not us, say the "normal" gays. Horrors, not us. Those are left buzzwords, things those colored people and poor folk talk about. Not us. Oh, God, no, not us. No. The normal gays just want to hoist the rainbow, buy the brownstone, get the babies, get the Gucci bag, go on RSVP or Olivia Cruises, and travel the world.

Well I, too, would love to travel the world. But is there really nothing more to aspire to than containment in pretty apartments after I'm done traveling the world? And what happens if I can't afford the apartment, much less the world tours? What happened to reaching for the stars? What happened to the notion that we all have the right to live freely and without fear? What happened to being-really being-all of who I am? What happened to universal health care? It got sucked into the mainstreaming strategies of the Gay Right. It got left on the floor of equality. It got contained. In that contained mainstream, I assure you there is no room for gender transgression. There is no room for difference. In that contained mainstream, health is reserved for those who can afford it.

This is not new in America. It is called class privilege and racial privilege and we queers keep doing the same damn thing. How is lesbian health conceivable for a woman who may or may not call herself a lesbian in Nigeria or Puerto Rico or Nicaragua, or for the young butch in the Bronx who is never, ever going to let anyone come anywhere near her vagina until ovarian cancer claims her life? Do those women not matter? What is the matter with us?

WHAT IS TO BE DONE?

We must - finally - put an end to identity politics as the central strategy of our political work, Yes, we need places of safety and places to heal. But what are we healing ourselves for? So we can leave the world in the same mess we found it? It is reductive. We reduce our struggle to that which can be understood within the construct of our identities rather than placing our identities as lesbian, bisexual or trans people within the context of the lager struggles for sexual and gender rights and for social and economic justice.

We must put an end to all the posturing around being "inclusive" that really only means we put a black or brown or Trans face on the program but never really change the agenda. We must treat each other with respect for our social, racial, ethnic, physical and political differences. We must continue to acknowledge the many painful ways we have internalized sexist, racist and homophobic messages in order to move beyond the limitations of how we have been conditioned. It does no good to say we're not racist or we're not up to our eyeballs in class inequities. We are so. And the quicker we acknowledge the truth of our own complicity in the formulation of a movement and health agenda that disowns the most vulnerable among us, the sooner we can get on with the work of building a movement that is anti-racist, the sooner we can create a health care agenda that can have meaning for all women who love and desire other women.

We must formulate and act upon a vision for our movement beyond equality. Equality is a floor, not the sky. I expect equality. I want and I demand justice.

We need to get deadly serious about wresting political control of our government and the cultural, media, educational and health and human services institutions controlled by government from the right wing. This means getting our hands dirty with the work of electoral politics. We cannot attain social and economic justice without political involvement in the make up of our government. It cannot be done. Cultural accommodations are nice, but a thousand "Will and Grace" sit-coms won't buy us freedom. If you want your state or your city council to protect the rights of transgender people, if you want social and economic justice, if you want access to health care for all - get used to talking with your elected officials, get used to walking precincts, get used to organizing rallies, get used to politics.

We need to remind ourselves and some of our colleagues - you know who they are - to quit whining. There's no crying in baseball and there's no whining in social justice work. I know of no work that is more fundamentally about social justice than the work of creating access to health. This is not just about you. It is not just about me. This is about the people we say we love, about making the world safer for them, about creating health for them, about creating justice for them. If it's not about these things for you, then get out. Go golfing, go fly a kite, go live on the beach. Leave us be. "Me" is not what social justice movements are built on. Social justice is built on an unwavering commitment to make the world a better place for all people who suffer violence and poverty, for all people who suffer the indignity of having to hide their body, their desire and their souls in exchange for a job or a room or a meal.

We have to learn to state the problem and offer a solution. We need to help each other understand both the problem and our vision for a solution. Endless dissertations on the oppressor are a bore. I want to know where you and I need to go, together. I want to know how we will get there. I need to know that I have room to fail and room to grow.

We need to keep our eyes on the prize. The economic and ideological underpinnings of enforced heterosexism and sexism or any other form of oppression are formidable foes and far too complex for the scope of this discussion. It is important to remember, however, that bigots are each other's natural allies, and that poverty - or the fear of it - has the power to seduce us all into conformity. In Castro graffiti, 'faggot" appears right next to "nigger" and "kike." Race betrayal or any perceived treat to the sanctimony of light skinned privilege engenders no less rage than gender betrayal. "Queer lover" and "fag hag" are cut from the same mold that gave us "nigger lover," a mold forged by fear of change and a loss of privilege.

Unfortunately, our sacrifices to conformity rarely guarantee us the privilege or protection we were promised. Those of us with a vision of tomorrow that goes beyond tolerance to a genuine celebration of humanity's diversity have innumerable fronts to fight on. Homophobia is one of them. But there are many, many others. I believe that the goals of our movement must include economic justice and greater social freedom because too many in our communities and among our allies are poor, too many of us are disabled, and too many of us are dying of AIDS without access to the drugs that can save our lives. Too many among us are still terrified of being out because we haven't the privilege of living without a paycheck; or because we will be denied housing, or we will die of the stress and pollution and hopelessness that women living in Southern rural toxic dump sites must endure day in and day out. These are not just people "out there" somewhere. These people are also us.

Until individuals are free to choose their roles and be bound only by the limits of their own imagination, until sexual and gender rights are recognized by the political leadership of this country as among the inalienable rights of all free people, until freedom from fear and freedom from hunger and freedom from want are realities in this country and not just thundering rhetoric from cynical white men, until universal health care is the right of all people living in the United States, until comprehensive reproductive health care and reproductive technologies are available, on demand, to all women - we have a lot of work to do. It is work that demands we be bigger than our queerness. We have to be bigger than wherever we came from. Whether the world likes it or not, the romance of Mother, Father, Dick, Jane, and Spot is doomed to extinction and dangerous in a world that can no longer meet the expectations conjured by history. And, whether we like it or not, creating the health of our communities will require more than the sound of our own voices, more than polite conversations in the corridors of Congress, more than the romance of lesbian warriors.

It's a very, very long road that we are on. Long after there is an Employment Non Discrimination Act with gender identity and expression included, there will remain the unmet needs of those among us who can't afford the mainstream. There will be queer children and trans children afraid of coming out. There will be women all over the world, lesbians among them, with no way to survive beyond that which their bodies can offer others. There will be people of all ages, races and genders living on the streets. There will be gender radicals and people who don't fit no matter what we call them who will need the safety of the spaces you create. Personhood and the health of our communities won't come with civil rights laws, more of us in the health professions, or better research. It will come with social and economic justice. It will come when we have the political wisdom and moral strength to think beyond the confines of our own identities and the limits of our individual needs. It will come when the fate of those women in Africa and millions in our own country matters enough to us to remove from office the insolent liars and misogynists who consider those women - and us - expendable in their quest to consolidate right wing power in America.

It will come when we understand that we really are all cut from a single fabric even if the threads, resplendent in their distinct hues, are each and every one, different from the other. In the best tradition of Star Trek, I say engage. Engage in the political work necessary to change a very, very sick and inequitable health system; engage in the alliance work necessary to create health for all women, to make health care a right, not a privilege. Remember above all, to keep your faith of the heart and know the strength of your soul. It will take us to our dreams.

©Carmen Vazquez
Healing Works Conference
Washington, DC
September 27, 2002