Transitioning While Genderqueer (Despite the Standards of Care)

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trans*scribe illustration ©rosa middleton, 2013


In August of 2011, I managed to make an appointment with a counsellor.

I had been trying unsuccessfully for more than a year to see someone about receiving hormone therapy and this was the first step. It had been a difficult task — four years of trying to find a mental health professional that my insurance would cover and that would see me without me having to try to kill myself first. As I walked into the therapist’s office, I recalled a time the previous year, when I had called a local behavioral health center. I had been on the verge of doing something drastic and the woman’s voice came through the receiver in a calm juxtaposition to my desperation, “Oh, we only see patients who are recovering from an attempted suicide, not people who are feeling suicidal.” Despite being one of the darkest hours of my life, that memory became, as I entered the small office, a way to calm my nerves. I had already seen the most deplorable parts of the United States’ mental health care system, hadn’t I? My head started swimming with other questions. Had my information been right? Was this counsellor used to trans* patients? Would she be supportive or weirded out? Would this be a waste of time or the freeing experience I hoped it would be?

The lobby was small and well furnished. On a table near the door was the item I was looking for: “Matt, 12 o’clock, 6 pages,” read a yellow sticky note affixed to some papers on a clipboard. The name on the sticky didn’t have the same pang of regret, didn’t leave the bad taste in my mouth that it usually did. It felt more like a farewell to an old friend than an insult. For a moment I could understand the look I had seen in the eyes of those close to me when I have come out to them in the past, all the excuses of “quirkiness” they would make for me being washed away as understanding falls into place like the final piece of a puzzle. When someone comes out to you as trans*, I’m told, at least for a little while, it feels like losing a friend and it was at that moment that I felt I understood; seeing my old name was like being reminded of a fond memory of a friend you never got to say goodbye to.

I sat down on the sofa and waited, filling out the six pages of standard medical and legal histories and explanations to which the sticky note was affixed. I tried not to stare at the door across from me until, finally, it opened. I had come out to plenty of people over the years. I have been telling friends and family that I would prefer to be a girl with varying degrees of articulation and success since I was about four years old. I had not, however, come out to a perfect stranger. I hardly noticed the other patient leaving as the therapist looked toward me, smiling, and introduced herself, “I’m Linda.”

Linda asked me about my job first, probably noticing how nervous I was. While I was getting seated, she’d glanced through the papers I’d filled out, so she probably already had an idea of why I was there. I found myself brushing off the job question, answering quickly and in few details once I realized my true purpose in seeing her was no longer a secret. She could tell I was not interested in skirting around the issue, so she finally breached the subject, “What brings you here today?”

I considered several possible answers, as I had over and over in my internal practice sessions, and decided to stick with the plan. “I feel like I’m trapped in the wrong body, I’m transgender,” I said. I had weighed the options beforehand and I knew the risks of saying too much. Most people in the medical field operate on parameters set down in what at the time was known as the Harry Benjamin Standards of Care, which required a person to fit into a list of binary gender affirming criteria in order to receive hormone therapy. I was legitimately afraid of not being allowed to go on hormones because I felt more genderqueer than transsexual.

Over the next fifty minutes she asked me probing questions, surprising me with her openness at my responses and at her ability to get an idea of who I was without making it feel clinical. Yet, I always kept my gender nonconforming views to myself. The horror of not being able to transition was too much to risk, even though Linda was respectful and kind regarding the answers I did give. I told her the truth when it fit in with the accepted trans* narrative. I had known my body didn’t fit quite right since before I could speak. I had struggled with depression and in my relationships with other people because of my dysphoria. I even told her that I had grappled with the idea of transitioning for a long time, feeling like it would be a sign of defeat; that I would have lost a battle of wills against a misogynistic society which disallows feminine behavior in males. I divulged that, being a fairly spiritually-focused person, I also felt like I should be able to put myself into a state of mind where the dysphoria wouldn’t bother me, but that nothing I did seemed to help. When it came to where my personal experiences diverged from the accepted narrative, I left pieces out and downplayed events, making sure not to divulge too much information. I even steered the conversation myself near the end — something I rarely do — intentionally keeping away from subjects that I felt might warrant further investigation on her part. We talked about reactions of friends and family, difficulties presented due to the taboo nature of transsexuality, of the fear of rejection at work and the lack of legal rights for transgender people. We talked about clothes, appearances, passing, and the inevitability of being read.

Despite my fears and distrust for the system, I was surprised at how liberating the experience still was. I cried several times. Not the built-up, explosive cry I often had when talking or thinking about these things, but a half hour of eye-dampness. The freedom to let the tears sit there on my face without shame was exhilarating.

Though the Standards of Care have changed since my visit to Linda, the fear of people not fitting into the two (not-so-)neat categories of “male” and “female” hasn’t. It would have been nice to share my entire truth with her, but I feared my story would be seen as diverging from the typical trans* narrative too much. I had these fears for several reasons. First of all, there’s a pervasive portrayal of trans* women as, at worst, sexually exploitable and good for a laugh or, at best, depressed, misunderstood, and most importantly “trapped in the wrong body.” Despite what I told Linda, I don’t feel like I am trapped in the wrong body. To begin with, the only way I’m trapped is by society’s idea of gender’s intransience. If it were not for that social paradigm I could freely express my gender in any way I choose without the “trap.” For another thing, I am intersex, so the idea of being “trapped” with the wrong sex organs is a bit of a moot point in my case.

Also, though it is apparent (especially to Autostraddlers) that sexuality is not a product of gender, there is still a strong push for trans* women to date men and not other women. There is also an assumption that trans* women must be feminine and not masculine despite cis women being afforded the freedom to be “tomboys.” I have always been bisexual and didn’t see that changing with hormones (and it hasn’t). I also have mixed interests which involve things that are typically categorized as both masculine and feminine and had no intention of changing what I like based on my gender presentation.

Possibly the most important way that my goals do not align with those of the media’s representation of trans* women is in “passing.” I dislike passing as either “male” or “female” and sometimes feel that when I give into the pressures to do so I am being disingenuous to the fact that gender is a social construct and not so much a biological imperative as the world at large would like us to assume. This isn’t to say that I want people to use gendered pronouns for me however they see fit. If society is so firm in its gender binary system, then I expect to be called “she” when I am presenting as female. The fact that I prefer to be called by female pronouns rather than male is a matter of preference and I feel it should be respected.

So, if I don’t identify with the accepted trans* narrative, why, you ask, did I want to transition? Why should people who don’t fit into that narrative be able to transition at all? As I touched on before, if I have to choose a box that says “male” or a box that says “female,” I would prefer the one that says “female.” That box just feels more comfortable to me. Even for people like me who don’t really buy into the whole concept of boxes, one box can feel so uncomfortable that death begins to seem like a fairly nice alternative.

Furthermore, transition can be a social statement. If a trans* person isn’t passing, it is a testament to the fact that gender is merely a paradigm that people buy into. Likewise, when people find out your starting point is different than what they expected, it forces them to entertain the idea that gender isn’t as black and white as they’ve been told. As a corollary, both hormones themselves and the experience of being treated as part of the opposite group than you are used to have a way of broadening your own perspective. The hormones affect your thought processes and cause changes in the way your brain physically works. The subtleties of navigating social spaces as a female when you used to be perceived as male or vice versa create a powerful change in the way you see the world. To put it another way, the effects of transition can be, under the right circumstances, very enlightening.

Most importantly, just like with sexuality, people should be afforded the right to express gender in any way they see fit. Frankly, I, and others like me, just like being perceived as a female better than being perceived as a male (and like being perceived as something else entirely even more). It shouldn’t be up to anyone else what gender category an individual chooses to be categorized as.

What’s the point of all this? Instead of making rules for what experiences people can have, let’s all choose to embrace the differences in each other and respect the choices each of us make in our journeys through life.

Madeline is a writer of speculative fiction, non-fiction, and poetry. She writes short stories, flash fiction, and is currently working on several longer projects. She has also written for several periodicals and maintains a blog at which discusses gender, sexuality, disability, and other activism.

Special Note: Autostraddle’s “First Person” personal essays do not necessarily reflect the ideals of Autostraddle or its editors, nor do any First Person writers intend to speak on behalf of anyone other than themselves. First Person writers are simply speaking honestly from their own hearts.

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  1. This was a really great article. I empathize with your situation. I used to identify as a woman, trans and gay. So, my transition wasn’t too difficult, I “fit in” to the usual narrative, making care easy to get. Now, I feel like I’m less attached to those labels, and just identify as queer all around. I was so nervous about telling my therapist. She just told me that she wasn’t going to change my diagnosis, because I was clearly happy with the treatment I was getting. Sometimes people are surprising like that.

    • Thank you, it’s great that your therapist was so understanding. I think that, now that I know her better, my therapist would have supported me as well, but I wasn’t going to take that chance at the time.

  2. This is a fantastic article and it really resonated with me. I’ve thought a lot about the possibility of medically transitioning as a genderfluid person, to something which makes it easier to change my presentation on a regular basis “convincingly”, and every time this has been the sticking point; that the only way I’m likely to get any kind of go-ahead is to lie and I don’t feel I would be able to do so. I wish I lived somewhere with the informed consent model or something- but alas.

    I especially empathise with the mention of how if you had to pick a box, you’d pick this one. This is how I always explain it to people- I’m not either, but if I had to pick… but of course, we shouldn’t have to, should we?

    • Thanks for reading and for your kind feedback. I hope you find a way to actualise your self-image.

  3. I applaud this post, very well said! I especially liked the recognition of socially defined gender roles and pointing out that one’s sex, even if one chooses to transition, doesn’t automatically imply a certain gender expression or identity in terms of masculine or feminine. That one is required to fit into a gendered box in order to transition one’s sex is quite absurd, since they aren’t all that related. Someone in the therapy field should know better, but it sounds like they may just have narrow guidelines they’re required to follow. Also ridiculous, but our society is based on control.

    • Thanks for reading and for the feedback. I feel like therapists in general are probably as various as anyone else, so left up to them it could go either way. The problem lies with the established systems which govern who is “worthy” of transitioning based on a list of criteria.

      • FYI – the standards of care have changed a lot. Current criteria for readiness for HRT are:

        1) informed consent
        2) history of dysphoria

        And that’s literally all it should take. at least in print. No cookie-cutter story required. Finding providers who will apply the standards of care as written can be another matter, of course, and do not fu-cking get me started about insurance. I don’t identify as genderqueer so I’m in no position to say whether or not the new language is adequate, but the WPATH standards of care are at least roomier than they used to be.

        • Thanks for making that clear, I mentioned this in the original article, but it may have been cut for length. It’s very important, though!

        • At least in the US, we won’t see insurance cover much of anything until they are forced regardless of what WPATH looks like. I mean, I have really good insurance from the government in a pretty liberal state, but trans stuff is most definitely not covered so only a few things can be slipped underneath them (spironolactone has other purposes, seeing a gender therapist can be classified as treating depression to get coverage, etc.). Even if they ever do get forced to, they will probably find some way to have stricter standards than whatever WPATH’s are (whether WPATH’s standards are good or not is a debate for another day).

        • Yes and no. It’s true that the newer standards of care in the US should make this kind of deception unnecessary, but insurance companies have varied requirements, some more strict than others.

          I know that mine (a blue cross/blue shield variant specific to NY) requires a persistent binary identity in order to qualify for coverage. This is something I’ve been worrying about a lot recently, because I’m a terrible liar.

  4. Thanks for a very interesting and thought-provoking article. As a cis-gender lesbian woman I am a bit confused though. Are you saying that if only society allowed people to be gender queer, without imposing a clear gender, you wouldn’t feel the need to transition? This is something I often wonder about trans people. I have talked to some trans friends about it and had mixed responses. Some of them feel that they wouldn’t be disphoric if only they were allowed to express themselves without social constraints… Some other truly feel ‘trapped in their bodies’ regardless of how society makes them feel. Is transexuality just a reaction to society’s definition of gender, or is it a innate condition? I know it’s a big question and I don’t expect anyone to give a definite answer, it’s just something I’ve been thinking about.

    • Why can’t it be both? Dysphoria is a anxious state – I’ve found that people who have more difficulty passing are more interested in surgery than people who pass mostly. For me, I find a direct correlation between the level of my anxiety and my wish to surgically alter my body. I am from the Midwest; when I am there, it makes me incredibly dysphoric. When I am in other places, the anxiety goes away and I think of surgery/hormones as more of an…aesthetic choice? I am a FTM who identifies as a butch lesbian, which is hard for people to wrap their heads around, but its a reality. I think super macho men are disgusting, and as an FTM actively defying the masculine role, I often get slammed back into the ‘F’ category. Surgery would help others identify me as ‘m’, but then again, why should I have to perform for others? Fuck the heterosexual mainstream!! Down with the Patriarchy!!

    • I would say, and I am speaking only for myself, that *all* forms of gender expression/ gender identification, are conditioned and informed by social definitions of gender– both cis and trans. The fact that even the more liminal gender expressions are generally described in terms of their location on an axis with masculinity and femininity at its poles (eg “masculine of center”) reflects the social conditions– ie gender binarism, compulsory heterosexuality, etc– under which *all* gender is produced. Would I still identify as a woman, if the social organization of gender were different? Would I feel the need to transition? Would I express my womanhood in the same way? Maybe. I don’t know. The question, I suppose, is– would you? And why are these questions typically posed to some and not others?

      Ps. I hope I don’t sound overly aggressive or confrontational. I’m not directing these questions to you, per se, but more towards the entire discourse surrounding trans people and gender.

      Pps. I would also say that there are different forms of dysphoria faced by trans people. Again, only speaking for myself, I observe that there is both a bodily dysphoria, which is intermittent, and results from the discrepancy between my sexed body and gender identity. I imagine that as my transition progresses, this will decrease. But then there is the social dysphoria, the disorienting sense of shame and panic, that comes from realizing that dominant structures of power don’t consider me to be quite human. This is constant, and consistently alarming. I imagine that trans people share this with other dispossessed demographics. While I consider both to be the product of social structures, I don’t know if (all) trans people’s bodily dysphoria can ever be fully eliminated. But I think that trans people’s social dysphoria can and must be eliminated by political action.

      • HI Yuki, thanks for your answer, it made me think a lot and it clarified some of my doubts. I agree that gender is a result of social conditioning, and of course I woudn’t be the same ‘woman’ in a different society (or even just a different time. Being a lesbian I often wonder how my life would be had I been born a century ago). Maybe in a more fluid society I wouldn’t even define myself as a lesbian.

        The reason why I ask this question in relation to trans identity is because I do find these two aspects, i.e. physical and psychological disphoria, slightly confusing. Most of my trans friends want to ‘pass’ and I can understand social disphoria, as I have experienced similar feelings as a lesbian. My ftm friends say they don’t need a penis to be men, as they feel men already. Yet some of them like to pack as this makes them feel more male, which puzzles me a bit. The same goes for other parts of their bodies that they try to alter to match ‘how they feel inside’ but also to change how they are perceived from the outside.

        When you say “I think that trans people’s social dysphoria can and must be eliminated by political action”, do you mean that the need for surgery and the desire to ‘pass’ are also the result of society’s restrictive and oppressive view of gender?
        Can bodily disphoria, as you describe it, ever be completely detached from social disphoria? Can your body ever ‘feel’ wrong, I wonder, or is this the result of social conditioning?

        I know as a cis-gender person my understanding is limited and I apologise if I am being inappropriate. These issues interest me because I would like to gain a better understanding of transexual identities.

        • Thanks for responding to my comment. You aren’t being inappropriate; it’s totally ok!

          “When you say “I think that trans people’s social dysphoria can and must be eliminated by political action”, do you mean that the need for surgery and the desire to ‘pass’ are also the result of society’s restrictive and oppressive view of gender?”

          When I said that, I only meant that the oppression and violence trans people face– which contributes to our social dysphoria– will end when our political circumstances change, and trans people are no longer dispossessed of our humanity/ dignity/ etc. I definitely feel like the imperative for surgery, normative embodiment, and “passing”, are part of the “apparatus” that patriarchy uses to discipline and contain trans people– but I’m also wary of reducing all these to instruments of oppression, and of likening them all to one another. The necessity to “pass” is connected to both the fear of transphobic violence, and to shame at being visibly trans. But it isn’t exactly the same as the desire for surgery, for example, and I wouldn’t conflate the two. This leads us to…

          “Can bodily disphoria, as you describe it, ever be completely detached from social disphoria? Can your body ever ‘feel’ wrong, I wonder, or is this the result of social conditioning?”

          I would say that the two cannot be separated. When I differentiated between the “types” of dysphoria I’ve observed, I didn’t mean to imply that they are unrelated to each other. I would say that all manners of “inhabiting” the body, from security in one’s beauty/ status/ inviolability, to debilitating self-loathing/vulnerability/humility, are produced by socio-political conditions. I believe that our approach to our gender– whether this is security, curiosity, indifference, desire– is the same. I would say that to “feel wrong” (or, conversely, to “feel right”) in one’s body is the result of culture and power– but that, again, *any* sense of embodiment is also the result of social conditions, and trans people are no more an example of this than cis people.

          I hope my answers are ok! Again, these are only my own opinions/theories. Other trans people are likely to disagree. Thanks for being so respectful! :)

          • Thank you so much for taking the time to answer my questions, Yuki ;) Your answers are food for thought!

          • This was a wonderful exposition by Yuki of the genderqueer end of things. I hope you’ll permit me to offer the other “nature” end of the discursive field on this a bit?

            As a transsexual woman, my conditions did indeed fall pretty squarely and comfortably into the standard, traditional narrative. That does NOT mean I acquiesced to the gender role malarkey. I’m pretty androgynous on alot of my interests and content with that. Nor does it mean that I’m uncritical of the medical regime of gate keepers and their narrow view of gender.

            But it does mean that there are many, perhaps many millions, of transsexual women like me who DO feel a very deep and intrinsic bodily dysphoria. I was a pretty standard distribution girl who happened to have a body and a gender identity which did not jibe. BOTH estates caused pain, and I can tell you that the physical dysphoria was the absolute first and worst.

            In light of this experience, though I’m content to id as transgender, as an umbrella, I do worry that our (classically transsexual) experience is being erased in the trends within Queer discourse. Many other TS people have felt this, causing some tension under the umbrella.

            To wit, I do not believe in strong social constructivism in gender. Gender is far too polyphonous a beast, yes part social, but with many components actual empirical science is discovering are neurologically rooted in fetal development. Look up “BST region” for an interesting case of how the whole transgender/transsexual stew probably is backed by variously chimeric neural intersex conditions. That is to say, when transsexual women say, “I was born in the wrong body”, we bloody well mean it and *actual science is backing us up.*

            Personally, spiritually if you will, the social constructivist argument never spoke to me. When your body is deeply pathologically wrong in ways that transcend even body shock or body image problems, from the age of at least 2, these discourses hold little water. I simply was NOT programmed for the equipment the factory gave me.

            I know from my own life, in a thousand ways both empirical, experiential, and physical, that there most definitely are pre-social aspects to the person, and physical gender/sex discontinuity. This “nature” aspect is important and has given me and many others’ succor when our identities which we navigate in compromise with society are called into question.

            In light of this, I offer that the suggestion that sociopolitical remedies will somehow eliminate the need for SRS, etc, is not only insulting, but erasing of our lived experience. It conjures up the bad old days of Janice Raymond’s rampant transphobia, still alive in some circles.

            I’m fully prepared to accept the genderqueer experience on their own terms. I’m in FULL and UNEQUIVOCAL solidarity on this point, and deeply concerned that we need a robust LGBT/Queer political harmony. But I wish the MANY, MANY “classical model” transsexual people’s experience could be afforded more consideration in discourses which tend toward social determinism. Bodies are facts on the ground. Brains are bodies.

            So, no, I doubt very much that social justice for gender roles and identity will eliminate the physical need for transition. That sort of thinking smacks of Cartesian dualism to my mind. Minds and bodies are mutually generative. It’s mete and good to acknowledge that balance in interpretation of these issues! Coming to some accord in this muddy theory stuff may help further the political intersectional solidarity we desperately need in our communities.

            Anyway, something else to consider, if you would.

          • Brighid – that, so much. You’re much more articulate than I am! I’ve wondered why the difference between transsexual and transgender never comes up.

            ” I offer that the suggestion that sociopolitical remedies will somehow eliminate the need for SRS, etc, is not only insulting, but erasing of our lived experience.”

            Soooo much.

      • Without getting into an essay of my own, for me, yeah the body thing is the key. My body is wrong and needs to be corrected,the rest is just secondary details…

        • Yep. It really is that simple for some of us.

          I’m almost no different in interests or activities pre and post transition. But I’m darn sight happier in my flesh, I can tell you!

    • I think you’re trying to impose an artificial universal constant when there’s really no need to. It can be a combination of several things, or different for different people. Some people’s identities are probably innate. Some people’s probably aren’t, and for some people it may be more ambiguous than that. Gender is almost certainly affected by many factors, from the neurological structure of your brain to what you’re exposed to socially. It’s no wonder these questions never get a clear answer!

      My dysphoria comes entirely from how people perceive me; I am dysphoric about how I present. I have a friend who is a trans woman, however, who is much more concerned about how her body FEELS to her. We’re both dysphoric, but hers is something that requires surgery/HRT while mine is something which requires other methods in most cases. Mine is psychological while she’d describe hers as physical. It varies dramatically.

      • It always amazes me that commenters are ‘confused’ because trans people have different opinions and experiences. Or bisexuals. Or gay people. They are PEOPLE. Of course there are a range of opinions! Why are they expected to get together and come to some sort of consensus?

        • I feel like there’s a large pressure from “outside” a community to come to consensus. This is done for a few reasons, but the most important reason is because what Audre Lorde said: “the master’s tools will never dismantle the master’s house.” Forcing a marginalised group to answer a set of questions unanimously, which cannot be answered unanimously (like what does it _mean_ to be gender nonconforming, non-heterosexual, black, disabled, etc.), forces said group into the mainstream’s paradigm (the master’s house) and hands them a toolbag of mainstream conceptualisations of gender, race, sexuality, etc (the master’s tools) and says, “here, once you’ve built something useful of your own we’ll think about including your room in our house.”

          In essence, the push for consensus from outside (which catches on, because the people on the inside _are_ interested in the answers, too) consumes a lot of time and energy in the marginalised group so that they can never really make much headway in the larger community, forcing us to focus on little problems instead of the big picture of demolishing the current paradigm and creating one inclusive one (ala “gay marriage” instead of equal rights for all). It’s a tactic that has unfortunately worked for years and years. The majority will continue to push for this sort of in-fighting until it stops working because their paradigm is being threatened which creates one of the largest fears imaginable, a huge change of perspective.

          • Awesome comments here. I love Autostraddle…

            Apropos, the tensions in are communties are indeed due to alot of outside pressure. Really, the whole TG/TS/GQ gender bunch is beset on all sides by people who absolutely hate us. So when we find a lever for political power or social affirmation, we yank. But the levers they offer us may not always mesh amongst us, given our divergent experiences.

            For example, many transgender folks are enthused by the push for “gender neutral” bathrooms. I and some other transsexual people shrug at this trend and even find it a bit of a side-step of full inclusion. (It feels like ghettoization to me.) This is not to say one is right or wrong, totally. But there are crossed purposes.

            So I think the cure for the “in-fighting” is mutual respect grounded on intersectionality and solidarity. Yeah, the consensus thing is counterproductive. Theories are interesting and sometimes fun, but they are a poor way to articulate the messiness of lived experience, because there is always some exception to any rule who will raise her/his hand.

            Real oppressions are obvious enough; the threats to us all are pretty big. Fight those with our precious energies and celebrate our differences as chances for discovery. Unfortunately, these differences are more often cause for jealous friction; more fool us…

          • Being forced to lie in order to be allowed to pee is not okay. That is the status quo for those of us who are not men or women, and remedying that is no side-step.

    • Thanks for reading and commenting! I’m glad that the post sparked so much thought and questioning for you. I see that others have already discussed this with you and their answers are probably much better than I could have come up with in such a short time.

      I feel I should add that this is really a question every person must really answer for themself. How much dysphoria is social and physical is a very personal thing and there are probably as many answers as people and the answer probably changes depending on the instance even within the same person. That is why I feel like having these lists of criteria to determine if someone is allowed to transition or not is ridiculous. Everyone’s experience and need is going to be different. Gender identity and transition is complicated and the government and indeed anyone other than each person should have no say in something so personal and important.

    • Well, I will say this. If society improved greatly on the gender and gender expectations front, trans* people’s dysphoria almost certainly wouldn’t get worse and would probably improve for most people. Going the next step and society accepting what people say their gender identity is would improve things more. But, even with all of these improvements, some dysphoria would remain for many trans* people. There is some coupling between physical and social dysphorias, but I would say that each has some underlying separate element. Fixing society would help handle the innate element of social dysphoria and help with the coupling, but wouldn’t do anything for the underlying element of physical dysphoria. Many would still want to and try to do what they could to fix/alleviate/whatever it. So, people would still do medical transitioning. With a society that was good on gender stuff, it would sure be a lot easier even on the physical dysphoria front because there would be less coupling and less obstacles to doing something about it.

    • For me personally, the desire to medically transition has a lot to do with my relationship with my own body.

      There is definitely some amount of social dysphoria that would be eased considerably if I didn’t have to be so worried about how people are reacting to my gender presentation. That doesn’t change the fact that there are things about my body that are wrong for me.

      I don’t feel “trapped in someone else’s body” because this body is mine, and there are a lot of things that are awesome about it. I feel more as though my body is trapped under the weight of breasts I never wanted, and I feel the same way about some of my other physical dysphoria triggers. Even if every person that I meet treated my identity with respect, and I never ever had to worry about whether I was going to get harassed in the bathroom or on the bus, I would still need to bind or get top surgery in order to not want to cry every time I glimpse myself in the mirror.

      Every person’s experience is different, but this is mine.

    • I just want to add to look at what you’re saying here, and why it’s viewed as threatening:

      “Is transexuality just a reaction to society’s definition of gender, or is it a innate condition?”

      Mmkay. Now let’s look at a similar question we’ve all probably heard all too often:

      “Is homosexuality just a reaction to society’s definition of sexuality, or is it a innate condition?”

      These can be asked with good intent, I’m not assuming bad will or anything; these can be just expressions of curiosity at the diversity of human experience. But they’re also potentially REALLY DANGEROUS, and also unfortunately often used as a bludgeon by people who absolutely do not have good faith but are trying to pretend they do (which is why, justifiably, this sort of question is going to be met with defensiveness, suspicion, and hostility most of the time).

      Because this is *also* the question asked by those who are not seeking to understand, but to undermine, to attack, to invalidate, and to eliminate.

      And so often this is used – by theorists like Bindel, for example – to claim that in a perfect world, there would be no trans people. Or, in a slightly reworded version of that coming from the same premises but with less concern for masking bigotry, that trans people’s VERY EXISTENCE – not just how we are treated, or taught to loathe and limit ourselves – is the symptom of a societal disease.

      To be blunt, questions like this are not only used as weapons, but they’re also just not very good questions in the first place. EVERYTHING we perceive and experience is affected by our culture. Yes, clearly, our concepts of queerness and sex and gender are shaped and dramatically influenced by our culture. “Gender” is a manifestation of this culture, yes. But it’s this culture’s manifestation of something that has manifested – in many different ways – in every culture, around the globe, throughout history.

      So what would we be like in a different culture? Well, we can look at various cultures and compare and contrast. But what would it be WITHOUT any cultural influence? This question makes no sense. There is no such thing, it’s what we do. What would gender be like without oxygen?

      But you can’t eliminate us, or cure us. Being transgender is not, as Bindel or Butler would hope, merely a dysfunction of society, in which the person can find no way to reconcile themselves with their prescribed gender and so naively assumes they must be something else – that’s roughly how they tried to fit trans people into their theories, a condescending trick, and bearing little to no resemblance to our lived realities. But that is how most cis academics and queer theoreticians teach other cis people to think of us, and if that’s what you’re really after, you have your answer, a clear and simple no.

      • Thanks J – I am genuinely open about the topic and didn’t want to impose any view. I am not an academic or a theoretician as you can probably tell by my lack of sophisticated knowledge ;) and it’s definitely not my intention to say that trans people are the symptom of a social disease. Although I obviously don’t think being gay is a disease, I do think I am a lesbian in THIS society and I’m not scared to say that I might not be one in a different context. Simply because I am attracted to women and not men for how gender relations are conceptualised in this time and place. I am sure other lesbians would disagree with me, as it’s a very subjective experience. Maybe it’s the same for trans people, maybe not. Please, don’t feel offended by my genuine interest.

  5. i dont agree with this article. People are using so called disorders these days as a claim to do as they please or as an excuse for their actions which are purely based on relativism and therefore quite selfish.Always about me,what i want , what i feel, what i think, my rights. Is there then no objective truth to guide one’s life?What if everyone thought like this not even in terms of gender etc but otherwise…if there were no laws to direct what was wrong or right irrespective of how i feel then how would the society function?Look at the negative effects of those places that have allowed this relativism to swamp every aspect of their lives and it seems that we think learning from a mistake means that one has to make the same mistake and experience its harsh effects and then to opt for change well by then it would have already been too late. Wake up and think!! this is not a problem of gender it is a problem of misguided conceptions, judgments and a lack of a basic psychological and philosophical understanding of man (and let me just clear up that by saying man i refer to all)

    • I have to remind you that transitioning is about OUR bodies, OUR gender, OUR lives… so naturally we have that “me attitude” you describe.

    • Not only is the me attitude obviously important, but also objective truth is not the guiding light for all people. There’s entire faiths built on relativism. And even scenarios in which things seem clear and objectively immoral (i.e. killing someone), there are then subjective, situational keys that show that it might not be as immoral as previously thought (i.e. killing a chronic violent abuser/criminal).

      Also, with transition, much like other sexuality and gender rights issues: if it’s not hurting you, and you are not being forced into doing such a thing (like gay marriage: if you don’t like it, don’t get gay married).

    • Cool, let me know how I can contact you when I choose to identify myself publicly since it’s so selfish of me to exclude you from that process. Actually, it’s super inconsiderate of me to leave you out of so many of my choices! Want to come over and help me choose my clothing, since obviously that’s all about me me me and how I want to present myself to society at large.

    • Ah yes, we need the clear Objective light of gatekeeping to show us the way. Totally sensible, transcendent gender criteria that will make everyone happy like we’ve always had. The good ol’ ways. I don’t even know what a “proper philisophical and psychological understanding of man (surely using a gendered signifier for all of humanity can’t possibly pose any problems)” looks like.

      Allowing for more expressions and understandings of gender is not going to lead to some Bane-esque (gender) criminal anarchistic state. “So selfish” is also a terrible response because gender in our society is ALWAYS something selfish, because it’s always about the individual.

    • “Is there then no objective truth to guide one’s life?” – Nope, there’s not! Aren’t the possibilities great? No one has to be anything they don’t want to be!

      “What if everyone thought like this not even in terms of gender etc but otherwise…if there were no laws to direct what was wrong or right irrespective of how i feel then how would the society function?” – But we *are* talking about gender. And it doesn’t hurt anyone. So, in regards to gender, if everyone thought like this, life would be better!

      “Look at the negative effects of those places that have allowed this relativism to swamp every aspect of their lives and it seems that we think learning from a mistake means that one has to make the same mistake and experience its harsh effects and then to opt for change well by then it would have already been too late.” – Citation needed.

      “Wake up and think!!” I am! It’s awesome. You should try it! :)

  6. So good to hear some more genderqueer voices. Thank you Madeline & best of luck with your transition!

  7. Thanks for the GQ perspective Madeline. I’m especially interested to hear about MAAB (or Intersex) people being GQ because I feel as if so much of that identity is dominated by persons who were FAAB. The one part of the piece I had problems with is the blanket statement how “gender is a social construct.” From my perspective there are some parts of gender which are socially constructed (social gender roles and how expressed gender is interpreted) but there are other parts of gender (like gender identity or how we map to our bodies) which are quite biological. But that doesn’t mean they’re binary either. To me, the broad-brushed pronouncement of “gender is a social construct” is quite dismissive of a lot of trans identities.

    • I agree with this “gender is a social construct” statement being rather dismissive, and I’m glad that perspective is not always coming from a cis-priveledged person, and a critical analysis is not being undertaken simply to find proof to invalidate someone’s identity, but could also be used to protect it.

      I think that the above comment about relativism becomes so much more poignant when confronted with these issues, as it becomes increasingly clear that there is no “right answer” and neither science or sociology can box it into our dichotomous paradigm.

    • Well, I think there’s room for ‘gender is a social construct’ to accomodate a lot/most trans identities/bodies/people/perspectives, it’s just that once you start trying to unravel what’s socially constructed, well….all of it sort of is. You are born with a squishy, squirty, spongy body, yea, but we always have to interpret those squishy, squirty, spongy body parts and functions, place them into categories, and assign them meaning. I just think that the theory, such that it is, is just a soundbyte now is the major problem, and one often used to invalidate trans experiences because cis experiences are invisible. My gender is no less fake than pretty much anyone else’s. That FAAB person who proudly says she’s a woman, wearing makeup and a skirt but chastising trans woman for ‘participating in false gender categories’ is articulating the language of femininity in the same way to other people as I am.

      • Ashley, the fact is we (I’m using the scientific/social science “we”) don’t really know much about what you’re born with vs. what is categorically a social construct. We might have ideas or suspicions about it, but to make blanket statements isn’t helpful (any more than expecting everyone define themselves in relationship to a binary is either). The reality is, we’re not disconnected from society so it’s easy to suggest that how we define it must be a social construct… when in fact there could very well be sections of gender concepts and perceptions which you’re born with. All I know is I’m not going to feel good having Gender 101 theory used to explain (away) my life, perceptions and experiences. Nor am I going to get in a gender theory pissing contest (especially with all these anti-relativists floating around this thread), just know that your explanation of it doesn’t make me feel all warm and fuzzy whether it’s coming from the mouth of person who’s a GQ person, or a cis person.

        • In the interest of avoiding the pissing contest I won’t really expand on what I said, and I hope that’s okay. All I will say is that I most certianly don’t think you should feel good when gender 101 is used to explain away your life, perceptions, and experiences. It’s used to explain my life away as well, I think they’re poor arguments and I hate them too. That section in the bottom is where I was trying to explain the context in which I’ve encountered such arguments and the hypocritical feeling I have towards them. I agree with you for the most part, but I guess I didn’t communicate that very well. I’m sorry you didn’t feel warm and fuzzy at my explanation, that’s on me, I messed up. Apologies.

    • I was intending it to be conceptualised in the way that Ashley describes, but she has put it in much better words than I could have. I apologise, I definitely did not intend to dismiss anyone else’s experience or understanding in any way. I think the variety of gender and it’s expression is what makes it beautiful.

  8. Yay! Thank you for sharing this story, I think it illustrates some important points re: trans* narratives.

  9. This was a much needed article on the trials of transitioning while not being binary.

    I’ve worried about how much I should trust others about how I am not exactly binary female (I’m somewhere between female and agender/genderless), especially anyone who might be able to get in my way or otherwise throw roadblocks in my transition. With others, I worry that they will then think “oh, so you are really just a feminine man” which is really far off (absolutely no part of my gender identity is male and I am actually slightly masculine, but that is a story for another day) and painful. I’ve told many so far without problem, but I am rather lucky (sooner or later, it is going to run out) and it is 2013 which helps. Still, I worry about it. With the vast majority of people, I just tell them the closest binary approximation to my gender, which is female. At least binary female isn’t painful – not the best fit, but at least somewhat comfortable. Now, as far as body stuff, binary female is what I want. Its just my gender identity isn’t 100% female.

    • That’s about exactly my experience with gender, too. Interesting to find someone who feels the same! Thanks for reading/commenting :)

      • I’ve known more than a few others in similar positions including the similar somewhere between male and agender/genderless. I think it is probably pretty common (already know enough people to make a team for certain sports and I don’t know that many trans* people).

    • This is my experience too :) (I tend to fluctuate between extremes in which it’s very clear to me that I’m binary female and nothing else, or very clear to me that I’m genderqueer and nothing else, or some squishier mix. but offline, augh, I almost never come out re: genderqueerness, also out of fear that people would then not take EITHER seriously and default back to ‘really just a confused man’ which would be so much worse, for me)

  10. Thank you for this article Madeline. It was really interesting and informative. Also it got me thinking. I am currently training to be a therapist (one more year ’til graduation!) and I worry quite a bit about how to communicate to new and potential clients that I am open and supportive of their truth whether or not it lines up with societal norms. It was very helpful to hear your perspective as I continue to struggle with this quandary. Thank you again so much for posting.

  11. Not sure what I think about the idea that one needs someone else’s permission to transition.

  12. my problem as a cis-gender person is that I am exposed to dominant narratives of what being trans* is about… and most of the times, the image I get (in the media mainly) is that of a boy or a girl who grows up feeling s/he should be the opposite gender, because s/he wants to play with the ‘wrong’ toys or dress in the ‘wrong’ way, etc. Even talking to some trans* people I know didn’t really help me get a more comprehensive view, as the people I know tend to conform to this narrative. That’s why I think most cis-gender people end up thinking “oh well, if that person was allowed to be who s/he is and play with whatever toys s/he wants, s/he wouldn’t feel the need to transition”. I know it’s silly and I’m grateful for your comments because you made me aware of how limited my view was. Obviously disphoria is very difficult to understand for someone who’s never experienced it. On the other hand, as a lesbian, I know very well how social expectations can make you feel ‘trapped’. That is why I find it genuinely hard to understand what it means to be in the wrong body and experience it physically. But I do not intend to undermine the experience of those who do. I just think it’s extremely helpful to talk about these issues so thank you for this!

    • Yeah! Haha, it’s funny how little my experience matched that, really. My parents are pretty staunch feminists (unfortunately, second-wavers) and did make some effort to try to raise me without pressuring me in terms of gender roles. Wasn’t enough ;P

  13. This has helped me a lot.
    I’ve really been considering transitioning, but what what’s stopped me (besides being unemployed) is that I’m not even sure what I want. Everywhere I look, people are so sure. But that feeling of dysphoria has been there my whole life.

    • I totally understand that. Just remember that it’s a different journey for everyone and don’t take the sureness of others as a way to make yourself feel bad. There’s a very real pressure that you must “need” to transition to do it. People use fear of “irreversible changes” as a weapon to keep people from it. But don’t let the terminology scare you. There are risks and benefits from transition (just like anything else), so weigh your options, way the risks, figure out what’s good for you and go with it. And above all, don’t let other people’s ideologies, black and white thinking, or anything else keep you from doing what’s best for you. The one ideal that is true about transition is that it should be for _you_.

      • That made me smile. Thank you!
        I’m currently looking for a therapist, since I’m finally taking this seriously. The one thing I find infuriatingly difficult is reconciling the difference between my physical body and the perception of gender. I’ve read about it, thought about it…and yet, I can’t get it through my head.
        It’s really great to see that I’m not alone.

        • I hope this is alright to say, and if I’m way off the mark, forgive me… but, in my experience that reconciliation is going to go on for some time if not forever, because gender perceptions change from person to person AND over time within a person, so it’s a really complicated thing. Add in that your gender identity may shift over time as well and it can be very disorienting and frustrating. The good news is, it gets easier the more experience you have with it. In my experience, it got easier once I started hormones because I am now able to present as something that is perceived as male or female depending on my mood and see how those perceptions change reactions of other people to me. Hopefully that helps. If you want we can talk elsewhere about this stuff or if you’re not comfortable with that, that is fine also :)

          • I will definitely consider your offer. It’d be nice to talk to someone else, especially someone with experience, but I need to clear my headspace first. I keep doubting…well, everything. But thank you. Thank you so much.

  14. This has helped me a little. I’m female-assigned genderfluid, and I want to partially transition with T and hormone balancers, and I didn’t actually know that therapists (I’m in a different country, but the attitude will probably be the same) might actually ask stupid questions to make sure you’re binary. Hoping I don’t have to lie and say I’m FtM…dunno how I’d get low-dose hormones if I did!

    • I’m not sure the specifics of the country you live in, but at least in the United States there are low dose testosterone choices which are over-the-counter, meaning you wouldn’t need to go through any doctors/therapists. There are some complicated reasons for this, but it’s basically misogyny. In general (at least in the US) it is far easier to get T.

  15. This was an excellent piece. I relate to it very strongly, but from the opposite perspective – genderqueer FAAB who wants to present as male if one of two options has to be chosen. I’ve been considering transitioning for years, but it’ll be at least a few more before I’m in a position to do anything about it. At any rate, thank you for writing the article!

  16. Thanks for sharing your experience! I put off addressing my gender issues for years because I didn’t fit the “trapped in the wrong body” narrative. Thankfully I have found healthcare providers who know that the gatekeeper model is rubbish. And I have found voices like Kate Bornstein, S. Bear Bergman, Rae Spoon, Ivan E. Coyote, and you that make me realize that my experience is much more common than the dominant narrative!

    Hurray for genderqueers and down with binaries, kyriarchy & cissexism!

  17. This article was on point! I personally have been struggling with similar issues, but it makes me more confident about making the move to take hormones as a genderqueer in the future. I hold strong to my gender non-conforming views, so I’ve been going back an forth with the idea of actually making the move to take hormones. It would make me feel uneasy blatantly lying to myself to beat the system… It’s unfortunate that we have to abide by such guidelines. My main interest in taking hormones would to be able to express more masculine characteristics, but I honestly don’t care to pass as either gender, because I see myself in the middle, if not outside of the given spectrum we have been so conditioned and confined. I hope that there will be some needed changes to the way the system goes about “diagnosing” because each and every individuals condition is different.Thank you!

  18. I’m sorry if this barely seems relevant– but the author mentioned being intersex, and I was wondering if anyone knew how to approach testing for being intersex? I’m a young enough adult that to be honest I’ve only ever scheduled two doctor’s appointments of my own before, haha… so it seems overwhelming about what kind of doctor do I talk to about this? What kinds of tests have to be done? How much does it usually cost (in the US)?
    I feel overwhelmed, but I have a strong suspicion that I am intersex and it would mean a lot to me to get answers once and for all.

  19. Hi i am genderqueer and asperger.

    It really hard to me to have a MTF hormonal treatment, because doctors have a narrow mind.

    Really, it no fair and i am desesperate.

  20. I found myself agreeing with the vast majority of ideas presented here by Madeline. Being a Trans-woman myself I’ve encountered many of the same situations in my own transition the last three years. I also have been confronted often with the concept that I must have become a Woman simply to snare a Man for whatever demonic reasons Cis-people imagine. Men have no appeal to me at all, all my life men have berated and marginalized my very existence. I was allowed only provisional status as a “Man” so I could do the mundane & tedious tasks Real Men are loathe to do. I had more job experience than the two Men I worked with, but I got paid $13. an hour while they got over $20. an hour. They thought they were extremely open-minded allowing me to exist at all ! No way in Hell would I ever consider being SEXUALLY attracted to such Neanderthals.

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