(CNN) — You might inwardly groan when you board your airplane and realize you're next to a screaming child, or find yourself squirming when the person next to you takes their shoes and socks off for the duration of the flight.
But how would you feel if you ended up sat next to a 70 pound, pot bellied pig?
Meet Hamlet the hog, owned by 31-year-old American Megan Peabody, who's based in the US Virgin Islands. Yes, pigs can fly -- because Hamlet's classified as an emotional support animal, Peabody can bring him into the cabin -- at least in the United States -- free of charge, to aid her in-air anxieties. "His presence is calming because it is familiar to me," Peabody tells CNN Travel. "It distracts me from my surroundings when they make me anxious."
Emotional support animals (ESAs) are an increasingly hot topic in the United States, as more and more passengers arrive at the airport with an animal in tow, arguing that a furry friend will alleviate their aviation anxieties.
The phenomenon's prompted vigorous discussion on what constitutes an ESA, whether the system's being manipulated by pet owners keen to skip travel fees, what the impact is on air crew and fellow passengers, and whether ESAs on the plane do a disservice to those who genuinely need service animals on board.
What is an emotional support animal?
Hamlet the emotional support pig checks out the airplane cockpit.
Courtesy Megan Peabody
Most of us are familiar with the concept of service animals -- they're usually dogs, cats or miniature horses that assist people with disabilities, or provide therapy and medical assistance to those with mental health issues.
Service animals are specially trained to perform tasks to help their owners, such as directing those who are visually impaired or detecting when an owner might be on the verge of a panic attack.
ESAs, meanwhile, don't need to be trained to do anything in particular. Usually, they just provide support and comfort simply through their presence.
For travelers with a fear of flying, or for those who suffer from anxiety, post traumatic stress disorder or other mental health ailments, the presence of a familiar animal can help alleviate panic.
Before a traveler can board an airplane with an ESA, they need to present a letter from a licensed mental health professional. The letter must indicate that the traveler has a mental health issue that renders an ESA necessary, but there's no need for the letter to spell out the details of the traveler's ailments.
The US Department of Transportation rules that emotional support animals can be brought on any US-based flight, although a degree of agency is given to the individual airline. For instance, an airline can request that passengers provide behavioral assessment records and health forms for their animal and can refuse boarding if they think the animal poses a threat to health and safety of others.
"This measure was put in place to balance safety concerns with the right of passengers with disabilities to access to air transportation," a spokesperson for the US Department of Transportation tells CNN Travel.
Five years later, there's still a lot of uncertainty about what they are and where they can and can't go.
The controversy around ESAs on airplanes stems from the fact flying with a pet is notoriously pricey and complicated. Some suggest that getting a pet registered as an ESA is a sneaky workaround for travelers trying to avoid extra costs and keep their pet in their line of sight.
It's also relatively easy to get hold of an ESA letter via online services. Travelers can buy a dog's harness embroidered with the words "Emotional Support" on Amazon for under $30.
Peabody condemns travelers who bring untrained pets on board airplanes under the guise of ESAs. But she also admits the thought of Hamlet traveling in the hold was one of the factors that lead her to register him as an ESA.
"I wouldn't say I have a fear of flying, because I do fly," says Peabody. "I have worries, and anxiety associated with flying, though. Hamlet is a distraction, and he is familiar. When people are uncomfortable, they seek familiarity because it provides comfort. Petting an animal lowers stress and anxiety, so it naturally makes me feel better to have him around when I'm flying."
When Hamlet was aged one, Peabody was moving from Boston to the US Virgin Islands.
“It creates a lot of skepticism, traveling with a pig. However, Hamlet has proven to be nothing but well behaved and obedient when flying.”
"I was very nervous," she says. "I was flying alone, and Hamlet would have to fly cargo, which made me more nervous. I talked to my doctor and found out I could have an emotional support animal. I took Hamlet to training at a training center for dogs, and the rest is history."
Peabody says Hamlet's renowned for his good behavior on board -- and she feels her reasons for bringing him on board are legitimate.
Still, these days, she usually leaves Hamlet at home.
What would she say to those who might say he's not a true ESA, as she can travel without him?
"I would understand," Peabody says. "It creates a lot of skepticism, traveling with a pig. However, Hamlet has proven to be nothing but well behaved and obedient when flying.
"I've seen many dogs and other ESAs. that were not properly trained. I try to understand that not everyone is in my shoes and can truly relate to my feelings."
Not everyone thinks animals such as Hamlet should be allowed on board the airplane.
Courtesy Megan Peabody
There are a few different avenues travelers go down if they want to get a pet registered as an ESA. The idea might stem from a GP consulation, as in Peabody's case, or you can pay for a letter via an online service.
Los Angeles-based ghost writer Bob McCullough runs a website called RealESALetter.com
McCullough's keen to stress the legitimacy of his service -- all applicants, he tells CNN Travel, must fill out "an extensive online questionnaire detailing their their emotional-psychological-medical history."
This questionnaire is passed on to licensed professionals, he says.
"This is not a 'rubber stamp' process, as the therapists are bound by professional ethical guidelines and the State Licensure Board to verify the medical need for the issuance of legally-enforceable ESA documentation," says McCullough.
"A significant percentage of applicants do not qualify pursuant to our process; those who do are assured of the legitimacy of the documentation signed by our licensed therapists."
Does McCullough think it's sometimes difficult to confirm whether an animal is an ESA, or just a pet that the owner wants to transport without fees?
"That may be the case for other so-called 'ESA letters' provided by the plethora of websites claiming to be legitimate operations," says McCullough.
"For us at RealESAletter.com, it's not a problem because our process involves strict guidelines as to the type of animal owned by the applicant," he adds.
The majority of ESAs certified by RealESALetter.com are cats or dogs, says McCullough.
"Over the past year, we've rejected applications from people wanting to travel with alligators, peacocks, ocelots, cows, and snakes.
"I don't believe it's reasonable, for example, for airline personnel to be required to deal with farm animals, large reptiles, uncaged birds, or out-of-control animals of any kind," he adds.
While McCullough says his service rejects counterfeit applications, it's undoubtedly true that the line between pet masquerading as emotional support animal and actual emotional support animal is blurred.
"The department is aware of concerns that individuals may be fraudulently claiming that their pets are service animals," says a spokesperson for the US Department of Transportation.
They said the the USDT will issue new rules before the end of 2019 to safeguard passengers around the animals and to "reduce the likelihood that passengers wishing to travel with their pets on aircraft will be able to falsely claim that their pets are service animals."
Cassandra Boness, a doctoral candidate in clinical psychology at the University of Missouri, is one of several academics exploring the tricky issue of ESAs.
"We became aware that mental health professionals were being called upon to write ESA letters, which we saw as a role conflict and therefore decided to investigate further," she tells CNN Travel.
"We suggest that ESA evaluations be conducted with the same thoroughness as any other comprehensive disability assessment," says Boness.
The study outlines guidelines and a checklist for professionals to follow when undergoing an ESA check.
Many airlines have introduced new rules, following a number of high profile incidents involving emotional support animals.
In 2018, Delta introduced a one-ESA-per-passenger policy and instituted a ban on pit bulls, following a number of what the airline called "animal incidents and attacks" -- although in September of this year, the airline changed their eight-hour-minimum rule for ESAs and these animals can now fly on long haul flights operated by the airline.
United also stipulates only one ESA is allowed and says the animal is usually either a cat or dog --- and "any other animal species would need to comply with DOT regulations and will be evaluated for accommodation on a case-by-case basis."
Southwest Airlines, meanwhile, says it "does not accept unusual or exotic species of animals" and any ESA on a Southwest flight must be in a carrier that can be stowed under the seat in front of the customer, or on a leash.
Flight crew perspective
Dealing with ESAs is something flight crew have to be prepared for.
Courtesy Megan Peabody
So what's it like for the flight attendant who spots an ESA in aisle four?
"Myself, and many other flight attendants, are animal lovers," says Allie Malis, who's been an American Airlines flight attendant for the past five years. "But probably the first thing I think is, I hope this animal going to behave itself. I hope this isn't its first time flying, and I hope that the owner knows how to take control of this animal. And will be responsible for any -- all -- of its behaviors."
Malis, who heads up the government affairs division of APFA -- the Association of Professional Flight Attendants, a union that represents American Airlines flight crew -- says it's important airlines develop policies and regulation surrounding ESAs.
"We've seen a variety of domesticated -- and maybe even wild animals, beyond dogs and cats -- monkeys, chickens, kangaroo, miniature penguin -- and we've had some issues on board," she says.
Malis acknowledges and appreciates that some passengers really need assistance while traveling, whether via service animals or ESAs.
The issue with ESAs, she says, is that they can be "self identified and untrained."
ESAs are designed to help their owners, but they're not necessarily welcome travel companions for the other passengers in the cabin.
On top of reports of attacks, Malis spotlights incidents of emotional support animals defecating and urinating on board, or just aggravating fellow passengers' allergies.
Hamlet once sat next to a fellow traveller who was scared of pigs.
Courtesy Megan Peabody
Peabody acknowledges that bringing Hamlet on board isn't always pleasant for her fellow passengers, recounting how one time she was sat next to a passenger who was afraid of pigs.
She felt really bad. The airline separated the two travelers -- and gave the pig-phobic passenger a voucher.
"I try to empathize and understand that it isn't all about me and pet, and our needs. We are all traveling and we are all our own people, with our own histories. Our common ground is the price we paid for the ticket," says Peabody. "It would be as unfair for me to judge that persons fear as it would be for that person to judge mine."
Malis suggests there should be a "certain standard" for animals traveling on airplane, mentioning flight reports on ESA incidents that include phrases such as "badly bitten," "drew blood," "passenger had to restrain dog forcefully," "passenger bitten in his sleep" and "viciously barking dog."
If an ESA causes someone's allergy to flare up, the passenger with the allergy will be reaccommodated if possible.
"But in the end, it's not like there's a wall there that prevents the air from constantly being recirculated through the cabin," says Malis.
If the passenger has a really severe allergy, they'll likely have to get off the flight and onto the next available service.
It'll never be the passenger with the ESA who moves.
That's because "offense or annoyance to other passengers (e.g., a cultural or personal discomfort with being in proximity to certain kinds of animals) is not sufficient grounds to deny a service animal carriage in the cabin under the regulation," according to the US Department of Transportation.
Air crew want passengers to be comfortable and happy, but ultimately ensuring the airplane is safe and secure and avoiding inflight issues is of paramount importance.
It's alarming, not to mention costly, to have to do divert an airplane mid-flight. Still, there have been incidences when badly behaved ESAs have forced pilots to do just that.
The disabled passenger perspective
It's not just allergy-stricken travelers and exhausted flight crew who are growing frustrated at ESAs on airplanes -- passengers who need to travel with service animals are also feeling vexed by ESAs in the air.
One of the signatures on the letter is that of Lori Stevens, founder and executive director of Patriot PAWS Service Dogs, a group that provides trained service dogs for disabled veterans.
"Emotional support animals [...] are causing trouble for the legit service dogs," Stevens tells CNN Travel. "There's so many of them out there that don't have the appropriate training and they're causing trouble for the people with mobile disabilities or physical -- true physical -- disabilities."
Stevens clarifies that she believes some travelers have a true need for an ESA, but there needs to be stricter regulations.
"[My] dogs go through through years of training -- months and months of training -- and your emotional support animal doesn't have to necessarily have any training. I think there needs to be some minimum requirements set up."
Her comments are echoed by Jason Haag, CEO and founder of Leashes of Valor, a US-based non-profit that connects veterans with PTSD or a traumatic brain injury with a service dog. Haag also signed the letter to Chao.
"Emotional support animals are fantastic," says Haag. "I think dogs and cats and any type of animal can do a whole bunch of things emotionally and psychologically for a person."
The problem, he says, is when untrained ESAs are let loose in public spaces like airplanes.
"It can do a real disservice to other dogs that are in the area that have been specifically trained such as ours," Haag says.
Travelers with service animals have also expressed frustration at the general misconception of what constitutes a service animal, and what defines an emotional support animal.
In summer 2019, a service horse named Flirty made headlines when he boarded an American Airlines flight from Chicago to Nebraska.
Some media outlets referred to Flirty as an ESA, but the miniature horse is actually a trained service animal. Her owner, Abrea Hensley, suffers from PTSD, depression and anxiety. On Flirty's popular Instagram page, Hensley explains the horse is trained to alert her when she's on the verge of a panic attack or a dissociative episode.
Hensley declined commenting for this piece, telling CNN Travel she would "rather not contribute to the confusion of the general public by being part of an article that's mostly on ESAs."
Future of ESAs?
In the EU, emotional support animals aren't recognized -- on most European airlines, the only animals you can take in the cabin are assistance dogs.
Frequent flier Johnny "Jet" DiScala -- who recalls a time his son was nearly bitten by an ESA -- tells CNN one solution could be certain flights be set aside to accommodate animals.
Megan Peabody echoes this idea.
"It would be incredible if there were certain flights, or even an airline, designated for people traveling with animals," she says.
"It just seems there is a way around all the chaos that seems to be the norm now for ESAs. It's a lucrative idea for someone willing to give it a try, in my opinion."