How Cis People Use “Trans Enough”
(This is the third post in the series about the concept of being “Trans Enough.” This post draws heavily on the previous post, so if you haven’t read that yet, please do!)
The idea that there is some standard of trans ness that makes any given individual authentically or truly trans is a powerful, seductive concept. This idea has been used by cisgender people for a very long time to control trans people—their access to medical and social services, their access to identity documents (like passport, ID cards, etc), and their access to all the many privileges that cis people enjoy, regardless of their gender. To be clear, not every cis person who engages with these structures has any personal investment in controlling trans people. This post is about effect, not about intent.
Anyway, in my previous post in the “trans enough” series, I discussed Harry Benjamin and his concept of the “true transsexual” as the foundation upon which the idea of “trans enough” was built. See, Benjamin’s book was the first English language volume that gave clear indications of how to medically treat those who wished to transition from male to female, and to a much lesser extent, those who wished to transition from female to male. Benjamin and the other doctors and surgeons who chose to treat trans people were used to following a specific formula—a patient presented to them for treatment, they performed diagnostics and provided medications or recommendations based on their findings. The doctors wanted a straightforward accounting of how to best provide care to trans people; these standards of care were and are typical in the profession, and provide doctors with legal and medical guidelines to follow to prevent malpractice suits. Benjamin’s book was the first step toward creating such a standard specifically for trans people.
There’s a large and important chunk of trans history that I could discuss here about the Erickson Educational Foundation (EEF) and the many millions of dollars that Reed Erickson, trans man, multi-millionaire, businessman, philanthropist, and spiritualist poured into trans medicine, research, and advocacy. You can find information on these topics here , and here. In the interest of staying on topic, however, I’m going to skip forward to the very end of the 1970’s, when the EEF money ran out, transphobic doctors at Johns Hopkins published fake news about the efficacy of their gender program, and very quickly, the gender clinics that had proliferated at universities across America shuttered one by one.
A small group of cisgender doctors decided that something had to be done to preserve access to healthcare for trans people. So they created the Harry Benjamin International Gender Dysphoria Association, and published a set of best practices (standards of care) for treating transgender people. Banding together to make sure trans people still had healthcare was a great move. But the standards themselves? Well.
Again, these standards focus on being “trans enough.” They focus on things that these researchers assumed were normal. They began with a series of principles that focused on how serious and irreversible the results of hormone therapy were, and how (mysteriously uncited) cases of regret existed and must be considered in the balance of deciding whether or not to provide care to individuals who sought it. These standards officially decried hormones or surgery “on demand,” and also declared that analyzing one’s reasons for requesting surgery or hormones required the expertise of a mental health professional. This was because hormone therapy and surgery were regarded as a treatment for a mental disorder. The standards then listed the criteria for trans-ness as recorded in the DSM-III, which required both a “persistent sense of discomfort and inappropriateness about one’s anatomic sex” and a “persistent wish to be rid of one’s own genitals and to live as a member of the other sex.” This was meant to be demonstrably present for 2+ years.
Tellingly, it was not enough that a trans person testified to this discomfort on their own. Instead the provider was required to independently verify their patient’s discomfort and distress. The standards go on, and there’s a lot to unpack there and a great deal to critique. But I would like to focus here on the way that these specific principles or rules relate to the problem of “trans enough.”
These standards created a system where a (presumably cisgender) doctor would judge a trans person’s gender based on their own medical knowledge, the knowledge of their colleagues, and the knowledges of their patient’s (presumably cisgender) family and friends. This approach failed to take into account the transgender person’s own experiences and the many multiplicities of trans identities and experiences. Because these doctors acted as gatekeepers, holding access to gender affirming technologies that were meted out according to cisgender ideas of gender identity and expression, any trans person that failed to conform to this very specific idea of “trans enough” was denied the life-saving help that they needed.
Further, by building the theory of trans identity on a foundation of suffering and pain (dysphoria) and medical intervention, being “trans enough” necessarily required being “miserable enough.” Those who couldn’t adequately perform misery, or those whom refused to, would be labelled as not needing treatment. Now, gentle reader, you may be wondering what trans identity would be based on if not dysphoria. After all, it is common to assume that trans people must experience dysphoria—if not, what would make them trans? However, I contend that requiring trans people to experience dysphoria as some sort of “proof” of their identity is just another aspect of the misguided notion of “trans enough.”
To be clear, I haven’t always felt this way. I’ll talk more about my personal journey with “trans enough” in a future post. But for now I will just say that what changed my mind about all of this was actually reading some of the accounts of people who we would now consider trans, but who lived before such categories existed. Some such accounts have been published in Magnus Hirschfeld’s book, “The Transvestites,” referenced in my previous post. Reading these accounts was very eye-opening for me, personally, because while some of them described something that I might call “gender dysphoria” in modern parlance, they also described something else…something I can only think of as the opposite of gender dysphoria. For linguistic ease, I’ve been calling it gender euphoria, although the connotation of “euphoria” feels like an ill-fit at times. However, the point is that folks would describe intense feelings of happiness, relief, safety, and joy when they wore gender-affirming clothing and/or were around others who affirmed their gender. Had early sexologists actually listened to trans people, engaged with their true stories and reflections, and not assumed that they were mentally unbalanced etc, dysphoria would be considered to be a part of the transgender experience that presented differently for different people, and that wasn’t necessarily present in every case.
To recap, then, cis people have used “trans enough” ideology and logics to control trans people’s access to hormones and surgery, to constrain the possibilities of trans identity and embodiment, and to create inaccurate or incomplete criteria for trans identities. And now that the cisgender narrative of what “trans” means has had a bit of time to percolate in society, we have started to see the next iteration of this dangerous idea. Mainly, this has resulted in a number of ideologies where the real trans people are fine and should be allowed to transition in peace, but the fake trans people must be exposed and kept from accessing resources. What constitutes “real” and “fake” in this approach is, at best, unclear, and is typically predicated on stopping a specific person or group of persons from transitioning.
One good example of this is the recent cis-gender panic over “rapid onset gender dysphoria” (ROGD)—a spurious, bad-faith “hypothesis” based on poorly constructed, politically motivated studies that have failed to stand up to even the barest scrutiny. Essentially, this theory holds that some young people suffer from a social contagion that makes them suddenly develop gender dysphoria. Because they are not “really” trans, instead of affirmation treatment, they need corrective treatment. While some people who tout ROGD are openly hostile toward trans lives, many will say that they fully support people who are “really” or “actually” trans, but just not people suffering from ROGD who need help from a mental health professional.
There are many issues with this “hypothesis,” which have been explored extensively by Julia Serano and Florence Ashley. Because they have done such thorough and high quality analyses, I am going to keep my comments brief and focused on the “trans enough” aspects of this issue.
The thing is, drawing a bright (arbitrary) line between people who are “actually” trans and those who aren’t rests on the idea that trans identity is something that can be so straightforwardly defined and rigidly held. This logic suggests that anyone who comes into their trans identity after early childhood is a poor sap who has been duped by the “trendy” nature of trans identity. When parents who are feeling lost and unsure about how to react to a trans child coming out see this literature, they are in danger of accepting it as true or proven fact. Practitioners who use this paradigm as a guide for treatment may subject their patients to conversion therapy, which is a traumatic form of psychological torture that the American Psychiatric Association has condemned for well over a decade.
To be clear, people come to their trans identities in many ways. Some folks realize when they are very young that their assigned gender is wrong, others realize much later. Some children may realize that their assigned gender is wrong, but keep it to themselves for any number of reasons. Some folks don’t have the words to describe their feelings, or locate them on some other bodily dissatisfaction or area. It can take years to fully come to terms with one’s identity, and longer to feel into the right steps to take with regard to transition. People might realize they are trans at any age. People might come out or take steps to transition at ay age. To be clear, there is no age where one is too old or too young to realize they are, or announce that they are trans.
There may be other relevant situations as well. For example, some folks identify as trans for a time, and then later, identify differently. This is fine and normal! Sometimes it takes a bit of time and exploration for one to find their sea legs in this wide world. It doesn’t mean that anyone was “wrong” or that anything should have been done differently. But because transgender identities have been so intensely coded by cisgender people as mental illnesses, anything related to them tends to be seen as suspect or actively harmful. In reality, allowing people of all ages to freely and openly explore their relationship to gender and to their own bodies helps us to move toward a more just and inclusive world.
Unfortunately, the impact of this idea of “trans enough” is far-reaching and deeply negative. In fact, it has infiltrated the minds of trans people as well, resulting in community gatekeeping, in-fighting, and perhaps worst of all, many trans people neglecting their needs due to what I would call a transgender-specific imposter syndrome. In my next post, I will discuss some of the impacts of the “trans enough” idea on trans people—on both ourselves and our communities.