We’ve all lived through the necessary indignity of passing through airport security. Especially when the queue moves slowly, the process leaves you replaying familiar worries. Do I still have to take off my shoes? Should I pull out my laptop? Are my toiletries small enough to escape notice? When you pass through with a medical device, however, the list of questions is longer and the answers more frustratingly predictable. Yes, you’ll waste still more time as the agents scrutinize every aspect of your equipment. Yes, before the experience is done, one of them will touch your groin. Yes, you are being singled out for something that already makes you feel terrible—physically and emotionally—almost every day. If you’re lucky, you still make it to your gate in time.
In my case, the trouble starts with two medical devices that are always attached to my body to treat my diabetes: a wireless insulin pump, which I typically wear on my upper arm, and a constant glucose monitor that adheres to my stomach. Removing either would require me to apply a new module, which is both expensive and time-consuming. And though neither device is especially large, they announce themselves loudly on full-body scans: bright blots of light against the murky gray of my digitally rendered frame.
Each time they show up—and they always do—the next steps are the same. Officers pull me aside and pat me down. Somewhere along the way, they test my fingers for explosives. Inevitably, I’m all but compelled to explain my condition, telling the agents what I’m wearing and why, even as other travelers stream by.
Where devices like mine are designed to make my life easier, allowing me to live without fear of my disease, here they become objects of near-performative skepticism. For a few minutes, I become a sort of showpiece, a dramaturgical prop in the Transportation Security Administration’s ongoing work of security theater. In the moment, it’s hard not to feel that the TSA counts on such screening opportunities, if only because they allow the agents to show everyone else in line just how thorough they are.
Perhaps that’s unfair to officers who are, after all, simply doing an important job. While the agency does a great deal to accommodate those with medical conditions (individuals with disabilities don’t need to remove their shoes, for example), its information pages also clarify that any and all medical equipment may receive further screening. In other words, they’ll do their best to ensure you make it through safely, but they’re almost always going to look at you more closely than they would at another passenger.
This can be frustrating in the moment, but it’s not just those of us who repeatedly receive extra scrutiny who have concerns. The Electronic Privacy Information Center, which researches civil liberties and privacy issues, has argued that that the full-body scanning technology currently in use across the United States is unnecessarily invasive in ways that go beyond the basic imaging process. As the organization put it in a recent petition to the United States Court of Appeals for the District of Columbia Circuit, that’s partly because that system “heighten[s] the burden of disclosure for persons who rely on certain life-sustaining medical devices.”
In May, the court brushed off EPIC’s petition, writing that the issues “do not warrant a published opinion.” Jeramie Scott, director of EPIC’s Domestic Surveillance Project, told me that conclusion was frustrating. In particular, he told me, the court seems to have overlooked or otherwise discounted the pressures that the screening process can put on people with medical conditions to reveal information about their well-being.
Do TSA agents know how to sensitively move travelers like me through security? According to Supriya Raman, a manager in the TSA’s disability office, security screening officers undergo training that addresses both disabilities and medical conditions and devices associated with them. Raman’s office also circulates updates when it learns about new medical technologies as they make their way to the market, attempting to help the agency’s officers recognize devices that might pass through their checkpoints. In my own experience, at least, that training doesn’t seem to have stuck: Though my pump and monitor are both relatively common, few security officers recognize them.
TSA representatives also stress that passengers have the right to request a private screening. The agency even makes cards that travelers can hand to an officer, an approach that can, at least in theory, spare them the uncomfortable experience of declaring a medical condition aloud. But even that process requires that the traveler be publicly taken aside, which may amplify shame or other unpleasant feelings associated with a medical condition. And merely making the request still entails conveying potentially sensitive information to strangers about the private particulars of one’s health, something I, for one, am often loathe to do, even when the circumstances are stress-free.
For all that, these protocols do evince a real desire to ease the burden on travelers. The agency even advertises a passenger support helpline through which concerned travelers can prearrange to have a specialist meet them at a checkpoint, leading them through the process in a way that better accommodates individual needs. While this service is likely critical for many—especially those with mobility impairments—it still requires substantial effort on the traveler’s own part, effort that can only distract from the constant work of medical self-care. And as with other forms of enhanced screening, this process also still leaves the TSA dedicating considerable time and energy to the investigation of innocuous conditions.
TSA spokesman Mike England proposes that the situation is largely unavoidable, at least for now. “The technology we have can tell that something is there, but it can’t tell the difference between, say, a hip replacement or something dangerous,” he says. “We have no choice but to conduct further screening.”
As England and Raman told me, the TSA is working with “industry partners” to allay that situation. To that end, Raman said, the agency hopes to develop a process that would allow “a broader range of individuals to be screened without having to go through secondary screening.” What such a process might entail, and how it might work, remains unclear. It also seems entirely possible that a system capable of clearly distinguishing between medical devices and more threatening objects would raise new privacy concerns.
EPIC suggests that such innovations might not even be warranted. In its brief to the appeals court, the organization writes that a combination of metal detectors and already-available explosive trace detection devices could effectively assess threats without singling out travelers with medical conditions or disabilities. “All things being equal, TSA should have chosen the less privacy-invasive route. The bomb trace equipment is designed to detect the threat for which we have screening in the first place,” Scott told me.
Ultimately, England may be right about the inevitability of additional screenings targeting individuals with medical devices—an inevitability that speaks to the paradox that devices like mine present. When I first received my diagnosis, I did what I could with the options that were available, carrying around fragile insulin vials and sheaths of needles with me everywhere I went. Later, I upgraded to self-contained pens and eventually to the cybernetic attachments I now wear.
While each of those upgrades has made it a little easier to manage my disease, they also bring complications of their own, forcing me to reshape my days around their particulars. New technologies—medical and otherwise—never enhance our lives without transforming them. On occasion, I’ve had to rush home from the office because my pump failed and I didn’t have a replacement in my bag—something that never happened with the old needle method. In other circumstances, I’ve been woken in the middle of the night because my phone was shrieking about a mis-calibrated blood sugar reading. These devices keep me healthy, but they also do as much to manage me as I do to manage them.
It’s hard to grasp the burden of such experiences until you’ve lived with them. And though I spend a great deal of my time trying to forget it, passing through the already liminal space of a security checkpoint only serves to drive the experience home. Much as I appreciate the TSA’s efforts, I worry that its attempt to develop new screening methodologies will bring new irritations, redirecting our time with the agency in as yet unthought ways. For now, at least, I will have to continue resigning myself to the frustrations of enhanced screening every time I fly, as will others who live with chronic conditions.