Just in case you missed it, I’ve been doing a spot of guest writing for The Queerness, and I wanted to share two of these pieces with my blog readers
Just in case you missed it, I’ve been doing a spot of guest writing for The Queerness, and I wanted to share two of these pieces with my blog readers
I talked in a recent blog post about ditching the term “binary trans person”. I want to talk about another binary in this blog, the TS/TG (transsexual/transgender) binary. This is as a result of an admin of a trans group telling me I shouldn’t comment on a thread because it was for “transsexuals only” and “being TS means you identify with the traditional binary”, that non-binary people “absolutely cannot be transsexual”.
Obviously, I felt hurt and excluded by these remarks, and wanted to explore them. The subsequent conversation left me feeling unwelcome in the group as a non-binary person, and I left. It’s sad, but there are still many trans spaces that feel unwelcoming to non-binary people.
So here we have yet another binary, but also one created so that non-binary (NB) people can be excluded. We can be trans or transgender, but never transsexual, which smacks of the age-old issue of who gets to be “trans enough” and what it means not to be.
One underlying issue that creates this supposed divide is specific to trans women. A frequent complaint I hear from trans women is about happily-living-as-male crossdressers (CDs) throwing their weight around, as people with a bit of male privilege often do, without understanding the oppression and violence trans women suffer. Because many who might once have been called “crossdressers” have now adopted the term non-binary, this has perhaps created a narrow impression of what non-binary means. Some assume non-binary is synonymous with having less gender dysphoria, desiring less medical intervention, or not needing to socially transition. But none of these things is true.
I will fight forever for a diverse community to be held and protected under one umbrella. But we are not all the same. Non-binary covers a variety of people who don’t fit the prescribed and artificial binary that society currently inflicts on us. It does not mean we don’t transition, or don’t experience gender dysphoria, or have less gender dysphoria, or have less legitimately gendered or sexed bodies after transition.
So can transitioning non-binary people be transsexual? Some folks say that NB people cannot be transsexual because the historically older term was coined at a time when NB was not recognised and we had no civil rights. We are excluded because, well, we always have been.
But what’s the difference between a transitioning trans man or woman and a transitioning NB person? I have what some people call gender dysphoria, both physical and social. I changed my name, live in my identity, underwent medical treatment to change my physical sexual characteristics. Many NB peeps have lower surgery, and I’m not ruling it out. But some insist NB folk can never be transsexual. Our dysphoria is not like trans men or women’s dysphoria. Their gender identity carries some meaning and legitimacy that mine does not. Legally and socially that’s currently true, of course, but it still hurts when the trans community perpetuates this separation, particularly because they are people who have themselves faced a cis society that delegitimises their identities.
But what is dysphoria?
Not everyone likes the term gender dysphoria, because it’s associated with medical diagnosis. The opposite of euphoria, it means the clinically significant distress some trans people feel as a result of being trans. Some argue that in a perfect world, being trans should not cause distress, and a landmark Lancet study agrees that being trans is not, in and of itself, a cause of mental illness, but rather the treatment of trans people in society is.
Looking back at the conversation that sparked this blog, the implication was that having “lower dysphoria”, the desire to change your genitals, is what makes a person TS. But how do we know, when people desire to change their genitals, that it always means the same thing or feels the same way? Or if they don’t, might there also be multiple reasons for this?
Let’s look at how trans guys and AFAB non-binary people feel about their bodies. For a start, dysphoria is not just one thing but many strands of experience. You may feel that having a penis is part of being a man or male, and you will be incomplete/not a man without one. That it is impossible to be a man without a penis. This is an aspect of social dysphoria – a feeling created by the way society sees men and thinks about trans men. If you are surrounded by people who accept trans men fully, whether or not they have a penis, this type of dysphoria is less likely to cause you to need surgery. You may be disabled and fear how you will be treated during personal care, or fear personal care when you are older, if your genitals do not match the way you look. The experience of many trans men with their carers bears this fear out. Again, this would be resolved by feeling confident that carers will always treat you as a man no matter what is in your pants. This, too, is social dysphoria. You may fear being rejected by lovers or partners based on what your genitals look like. Again, that’s social dysphoria, and this may be lessened if you are in validating relationship.
Physical dysphoria is something different. Sometimes likened to “phantom limb syndrome” it’s the feeling that something should be there that isn’t. Or shouldn’t be there but is. This can happen with all kinds of body parts, a wiring glitch where the brain does not accurately map onto the body. So, there are people who, for instance, feel like certain body parts do not belong to them. Brains and bodies are weird and the way people experience their embodiment is diverse. So for instance, there are AFAB peeple who feel agender or woman-identified but have strong physical dysphoria, desiring male-typical anatomy.
For some, physical dysphoria is unendurable and the need for surgery is intense. For others, it can be resolved through the use of prosthetics and surgery is unnecessary. For people like myself who are dissociative or out of touch with their bodies, it may be easy to ignore or we may even be unaware of physical dysphoria, as I describe here.
There is also a third kind of dysphoria some people call internal dysphoria – neither physical nor social, it is about how the person feels inside of themself, outside of a physical or social context. Again, this varies hugely from person to person.
Let’s not forget also that for AFAB trans people reproductive organs are more than just external genitals. Some people, like myself, feel far more physically dysphoric about our internal reproductive systems (owning a womb, having periods, hormone cycles, potential of pregnancy) than we feel about the size of our erections.
Because with or without intervention, AFAB people get erections! We have our very own erectile tissue. And when we take T, it generally grows (a bit, don’t get *too* excited). And for many of us, this growth is sufficient for our needs. Or we might be much more focused on chest reconstruction. Or just hysterectomy. And if we do decide we need more length, or want to stand to pee, there are a range of options from the very simple clitoral release, the more difficult metoidioplasty to the very complex surgery of phalloplasty. And of course, many disabled people and people without access to funded healthcare find lower surgery unavailable to them, however dysphoric they feel.
Am I defined by my gender or my sex?
I’ve written about how gender and sex are far more interconnected entities than we would like to believe. The reason transgender as a term has gained traction over transsexual is, I think, an acknowledgement of how much trans lives are affected by social gender (including birth assignment) rather than simply the shape of our genitals/size of our gametes. It’s the social consequence of our body shapes that affects us more than our bodies themselves. We are trapped in people’s perceptions of our bodies, as the saying goes.
The other reason the term transgender has gained traction is because more trans people now consider their gender to be something pre-existing a desire to transition – transition does not create us, it helps us be more comfortable. So I, for instance, feel I was trans as far back as I can remember – that my experience of gender, and the way I was treated, is not the same as the experiences of women who are my contemporaries. In other words, transition doesn’t make me trans, I just am.
But the term transsexual persists, usually meaning a trans person who alters their sexual characteristics medically. Let’s take it down to brass tacks – sexually, what am I now, with a male hormonal profile and secondary sexual characteristics, but XX chromosomes? If I can’t be described as transsexual, then how can that term carry any meaning at all?
I have so many questions about how this TG/TS distinction could possibly work in practice, and even more about why it is needed. Of course the reality is, it’s just some people preferring one term and some the other, and the terms thoroughly overlap each other.
Divide and conquer?
We know TERFs want the TS/TG distinction because they are trying to convince trans women that a special exception will be made for them if they have had all the available treatment, that they will be allowed civil rights and be partially treated as women as long as they hold the line against the rest of us gaining any rights. A classic divide and conquer tactic which alas seems to work all too well, playing into a widespread fear that non-binary rights are just going too far. But trans women already have civil rights, and these were never TERF’s to bestow. Whether or not they have surgery, they can have their gender recognised. The Equality Act 2010 defines “transsexual” as “proposing to undergo, is undergoing or has undergone a process (or part of a process) for the purpose of reassigning the person’s sex by changing physiological or other attributes of sex.” Transitioning non-binary people are understood to be covered by this wording.
So in law, I am transsexual. In my gender doctor’s notes, I am transsexual. It’s not my favourite word, and I tend to prefer my trans umbrella to be wider rather than narrower, but if TS is to endure as a term, can we at least make it mean something that isn’t NB erasing? Because saying my transition is so fundamentally different from a trans man or woman’s transition that it needs a separate word is unbelievably othering.
What is the underlying fantasy in all this? That there are clear lines dividing transsexual from transgender, non-binary from trans men and women, and that we can pin everyone down clearly, with no bodies straying over the lines? But many “crossdressers” are “true transsexuals” waiting for the right moment to take the plunge. Many NB people have more medical intervention than people who identify as trans men or women.
Ultimately (trust me on this) when you drill down into people’s experiences, the words they claim to describe themselves are often used in unique and idiosyncratic ways, and we are all still floundering around for the right universal language. So there are people who identify as non-binary transsexuals, some others who see the word transsexual as old hat, and some who think it signifies a binary, because it was coined by people who hadn’t imagined anything more than a binary.
Who gets to decide? That’s always an interesting question. Who are the gatekeepers of any community, the holders of the keys, who get to set the terms? Personally, I believe “transsexual” will remain with us as a term. Some people like it, some loathe it, but as long as it’s alive, and used by some people to self-identify, it’s valid, and we shouldn’t be denigrating its use. Is using it a valid way of creating spaces and discussions that explicitly exclude non-binary people? No, that would be really oppressive.
Do non-binary and other trans people need to reflect whether they have relative male privilege, or whether they are comfortable enough in their assigned sex they will never need to socially or medically transition, and so are exempt from particular aspects of trans experience? Sure. I know I’ve had moments of anger when someone happily living and working as a man has taken a place on a podium speaking as a trans woman.
But we need to remember if we were to exclude those with assumed “male privilege” we might also exclude the most vulnerable of trans women and NB people. I know many trans people who are unable to access trans medical treatment because of other, pre-existing physical or mental health conditions. If you’re homeless, access to healthcare, to clothes, to shaving equipment and all the other means to present in your gender may be inaccessible, not to mention how unsafe it can be to present as trans or gender non-conforming while homeless. Other trans people are awaiting the result of asylum applications before embarking on transition because they would not be safe in their country of origin. Some are not safe to transition for economic reasons (they would lose their income, home, or other security), others are waiting for elderly parents to die, for whom they are sole carers, or for children to grow up. Or perhaps they are children themselves, with unsupportive parents. Still others are in abusive family situations where it would not be safe to come out. Some of us had to work through complex mental health issues before coming to terms with our gender.
Non-binary people have the additional hurdles of trying to live within genders not legally or socially recognised, which restricts our choices and means there is no clear transition pathway for us. Many non-binary people have publicly transitioned and are living in their gender as much as they are able yet their identity is perpetually erased and defaulted back to their birth assignment, and this is certainly not a privilege. So “living as” is not the same as “identifies as” is not the same as “perceived to be”.
Not forgetting that NHS waits are 2 years now, and everyone deals with that wait differently.
There is a variety of privilege, and a range of experience within this community. But is there a TS/TG binary? A TS/CD binary? Is there a clear dividing line between non-binary and trans man or woman? The hell there is. Life is just not that simple. We all exist on a continuum. We are who we are, all our self-identities are valid, but gross generalisations need not apply.
We, as humans, keep creating false binaries, and I’m so tired.
Oh, how humans love a dichotomy, an either/or, when messy nature is so often more both/and. Why do our brains do that? I suspect it’s a programming glitch.
The most ridiculous and artificial dichotomy is binary/non-binary. Honestly, if I could wish on a magic unicorn for anything at all, it would be for a much better word for what I am. Non-binary really does not work as a term, but we seem to be stuck with it.
Let’s spell this out. Binary means 0 or 1. It means 2 mutually exclusive and incompatible options. It means there can only be male or female, that these two things exclude each other, and no other options exist.
Non-binary means there is more than 0 or 1. It is an analogue, a continuum, much like the Kinsey scale (only way more complex). Let’s just borrow from Kinsey for a sec, and say “Man” scores 0, “Woman” scores 6, and everything in between is non-binary. Technically, that’s everything from 0.000001 through to 5.999999, but of course for practical purposes “Man” extends all the way to at least 2.5 and maybe more, and it all gets a bit fuzzy and complicated in the middle because English doesn’t have very good words for this sort of thing.
Anyway, it’s completely not like that at all, it’s way more complicated, but I hope you see the point – man and woman still exist completely and safely, perhaps even more expansively than if forced to hover over one precise point. They exist, just not as a binary.
This means if “non-binary” exists, there is no binary and “non-binary” becomes too vague a term because it includes everyone, including people who are just men, and just women – cis, trans, intersex, male, female, enby. I will use “enby” from here to differentiate from “non-binary”, meaningless as that term is in the absence of an authentic binary. I use “enby” for people who cannot live within the artificial legal/social binary that is imposed on us. And enby people need everyone else to understand this legal/social binary is not fixed or objectively real, and can be reshaped or dismantled without hurting anyone, to allow for the reality of our existence, and to give us the civil rights everyone else has.
It should not be controversial to say neither sex nor gender are binary. Intersex people exist, enby people exist. To invoke or enforce a binary is to erase us. There has to be another way of doing things. But for those more comfortable in this artificial binary, it may be hard to see that.
The trouble is, enby people require an adjustment of how things are done, a change in social understanding away from the idea that there are only men and women and that’s that. At this point sometimes people get cross and say I want to erase men and women. Trans men and women, despite the social, legal and linguistic changes that have made their lives easier, still sometimes resist the idea that we should change from a binary system into something else – a ternary system, or a fully open, self-determining system, for instance.
Sometimes it’s about the fear we may be pushing too far and that the push-back will hurt trans people who are comfortable with things as they now are. Be patient and wait your turn, the bus will come back for you, they say to us, just as gay people said to trans people 40 years ago as they disappeared over the horizon without a backward glance. Of course, some of us would say that if we stood together for rights for all we would be stronger, not weaker, and that the dilution of civil rights caused by glossing over some people’s needs only serves to reinforce prejudice and limit everyone’s options. Plus, what makes one person’s rights more of a priority than another’s, exactly?
I do want to undo the idea that men and women are “opposites” or clear and distinct categories that neither overlap nor have an alternative, but I cannot deny the existence of men and women, nor do I want to. I like men and women, trans or cis. I like that people are different from each other, and the last thing I desire is for us all to live in some grey unisex fog. And I can’t deny that the majority of people sit comfortably with the idea of being (more or less) one or the other. I see no need for this to change.
I just want enby identities to be as legally and socially valid. To have complete parity. I want my civil rights please.
And this is where as a community we sometimes come unstuck, because trans men and women seem to often want the “binary” to exist, and to be held sacrosanct and separate, and for “enby” to be a category outside of this. And that simply is not possible. At best, we have a ternary. I suspect though, we actually have something multi-dimensional. What we can’t have is a binary.
You can see how our own language dooms us enbies, and in a way we have only ourselves to blame. We actually coined, or at least gave rise to the terms “binary trans man/woman” where once trans man/woman was sufficient (as it should be). We constantly talk about being “outside the binary” “beyond the binary” as if the binary exists but we are somewhere else entirely, when we have always been right here, in the detail of ordinary, everyday human existence. This horrible othering banishes us into number three of only two imagined options. An impossible conundrum, created by the way legal and social sex was conceptualised in the 18th Century and just hasn’t moved on much since. Before then, everything was much more flexible. And it could be again.
I think, unfortunately, we might be stuck with the word “non-binary” for want of a better term. Like “lesbian” and “bisexual” its meaning has shifted from what the term means literally, and it has become a fait accompli as the accepted term for our community. A way of talking about people whose existence cannot be described by the word “man” or “woman” alone.
But the newcomer term “binary trans person” has no such use or purpose. Neither does it have enough heritage or traction to warrant preserving. There is no compelling argument to justify its use other than a vague and muddled sort of “tit for tat”. It was coined to differentiate from non-binary, but it is redundant – the terms man and woman already exist, and are entirely sufficient. What the term “binary trans person” does is achieve an over-emphasis, a reinforcement of the legal binary and the legitimacy of those identities over others. It also exaggerates the distance between enby people and trans men and women. It feels othering to many of us.
And it’s often accompanied with a criticism of any perceived attack on “the binary”. The binary must be preserved, we are told, and trans men and women’s identities are somehow under threat if the binary is not preserved. But as enby people cannot exist within a legal (or social) binary, we are at a standoff. The preservation of the binary does violence to us.
Much like the artificial pitting of trans and cis women’s rights against each other, our rights are seen as somehow in conflict. For us to be legally recognised, the binary cannot help but be broken – that sounds violent, but what breaks is not people’s identities but a dividing wall built where people need to live. To use an analogy, East and West Berlin still exist and have their own styles and cultures even now the wall has come down, it’s just that now travelling and mixing and living in the centre become far easier.
Eventually, we’re going to gave to stop talking about “binary trans people” and simply talk about “trans men and women” or else we are going to keep reinforcing the idea that a binary exists. Which, if I exist, and intersex people exist, it doesn’t. Trans men are real, trans women are real, but the gender “binary” is a lie.
Here are things you can say instead of “binary trans person” – someone more aligned with, or comfortable with, the binary. A non-enby trans person. A trans man. A trans woman. There are plenty of language uses that validate trans men and women without reinforcing an artificial binary that does enby people genuine violence.
Part of accepting the need to reflect on language use is accepting the privilege trans people hold if they have legal and civil rights that enbies don’t. And when I talk about us not having civil rights, I am explicitly talking about those of us who require a change in law in order to have a correct gender marker on our passport, marriage or birth certificate. Those of us who use pronouns other than he or she and titles other than Mr/Ms. This doesn’t apply to all enbies, and there are some people who might be described as enby, like Eddie Izzard or Grayson Perry, who live in relative privilege compared to most of the trans community. We are by no means a homogeneous group.
My existence does not threaten other people’s, but of course, the usual reaction to any emerging civil rights campaign is to try and suppress it by claiming it poses some sort of threat. I am asking, from the bottom of my heart, for trans men and women to stop talking about themselves as “binary” and to stop reinforcing or clinging onto the idea of a gender and sex binary that does not need to exist. Please allow me to exist alongside you and just as real and valid and equal. Embrace the ternary.
CN: discusses top surgery and associated body parts in some detail (with post-surgery photo), also trigger warning for references of child sexual abuse, trigger warning for anyone with emetophobia
Today was the big reveal, my post-op appointment 10 days after chest reconstruction surgery with Mr Kneeshaw at Castle Hill Hospital, near Hull. This has been such an emotional ride, and I feel the need to share some of the highs and lows. When I made the choice to have surgery, it felt more like a necessary evil than something I longed for, so I was completely unprepared for the joy I would feel when it finally happened.
I was never one of those people that hated their breasts. I was happy with one aspect of them for many years – being an inconsequential AA cup size meant nobody had ever ogled them, catcalled me because of them or even really noticed them. Then I got fat, and they grew (a little), and for a while I enjoyed the fleeting sensation of being womanly.
I was always at odds with my gender, wanting to be a woman or at least feeling I ought to work at being a woman, and finding it impossible to achieve in a way that felt authentic. This despite enormous effort on my part to feminise my voice, my clothes, my behaviour, my walk. So for a while, having (still fairly inconsequential) boobs felt like an accomplishment, but soon enough, they began to feel like an anachronism, a lie.
But even after starting to take testosterone, it took me a long while to consider having my chest surgically reconstructed. At first, I bound them with commercial chest binders, but these caused me pain, (curse my fibromyalgia), and were difficult for me to get into and out of. I could at this point wax lyrical about how little we talk about the health risks of chest binding. Eventually I passed my binders on (please consider sending your cast-offs to Morf) and I made my own binder, a much looser garment created from an old bra, with a flat panel sewn in at the front in place of the cups.
After the surgery, I had a ritual burning ceremony for this by now exceedingly manky piece of kit. It made me wonder about the (somewhat apocryphal) bra burners of the 1960s, and whether any of them were actually suffering from dysphoria.
Would I have felt more comfortable with my breasts if they had not been constantly associated with social gender labels like “ladies”, “she” and “ma’am”? Would I have felt my gender dysphoria more keenly had I not suffered from such extreme dissociation for much of my life that it’s hard for me to connect to my body at all? It’s impossible to say, because what we go through makes us who we are. But I had a lot to untangle to get here.
How abuse stopped me hearing my dysphoria
I have spent a lot of time lately diligently reflecting on the journey my breasts and I have taken together.
At times, I was grateful to my breasts, because when they grew, the abuse I suffered throughout my childhood stopped. I don’t want to get into the head of my abuser, but he left my two sisters alone, and treated me in many ways like a boy, so I have little sense that the abuse I suffered was specific to my birth anatomy rather than my gender presentation.
It’s hard to mention abuse in conjunction with being trans, but here’s the reality – AFAB or AMAB regardless, around 50% of us are sexually abused as children, a figure that’s much higher than for cis women. A potential reason for this is because as non-conforming children we are less valued, looked after, believed, and socially supported. Easier to isolate and prey upon.
Because of the negative way society thinks about trans people, it’s easy to internalise “did abuse make me trans?” and ignore the reality, that abuse can interfere with the clarity with which we understand our trans selves.
If anything, abuse blocked the intensity of feeling I had towards my body, and pushed me towards thinking of myself as a woman, which was far from a natural inclination. I also thought of myself as a woman because society equates sexual abuse with femaleness and erases the high levels of abuse in minority populations such as trans, queer, racially oppressed and disabled.
When I went through recovery, there were no books for sexual abuse survivors who weren’t women. It was as if being a woman was the only kind of oppression in existence. This forced me to think about my gender in a particular way that was ultimately unhelpful. I was urged to learn to “love my body” by an old-fashioned and puritanical feminist rhetoric that disallowed the possibility of making your body more comfortable to live in. I worked through the abuse, but in the process got tangled into some very simplistic messages about gender, that delayed me fully acknowledging my transness.
I realise now, I freed my body from the abuse I experienced as a child, but handed it over to the control of a particularly toxic kind of feminism (other, wonderful, intersectional feminisms are available). Suddenly my body was owned by, and politicised by, a clumsy kind of second wave feminism. And amidst all the other liberations, surgery has also cut me free of that trap.
Getting my body back
In the last year, as testosterone slowly made me happier with some parts of myself, I allowed myself to connect to my breasts and was shocked to discover the strength of feeling I had about them. I had thought the intense body dysphoria of other trans guys was altogether alien to me. Instead, I discovered it had been carefully and thoroughly suppressed. And as I let go, it was like discovering some hidden programme running in the background that’s hogging all your processing power – dysphoria is a truly disabling mental state, and when you unearth it, the relief and overwhelm is indescribable.
As surgery neared, I began to feel my fear of the anaesthetic’s impact on my fibromyalgia (and thanks to fibro pals especially womandrogyne, I took this warning card with me for the anaesthetist, which seems to have helped a whole lot). But there was another, growing feeling – excitement. Unambiguous, uncomplicated pleasure at the thought that I own my body and can shape it to be more comfortable for me to live in. My guilt, perpetuated by the mini-TERF that lives in my head, began to slip away. Perhaps, after all, a procedure that would allow me to connect to my body more and love and take care of myself and be happy is not so drastic. Not a mutilation, but an alteration, a sending to the menders of something that simply didn’t fit right no matter how hard I wriggled around in it.
The double incision procedure that I had is relatively simple. Two curved incisions, removal of tissue, nipple re-sizing and re-placing. You’re usually left with scars and loss of nipple sensation with this procedure. It’s an overnight stay. Under Dr Kneeshaw, you come home from the hospital with two drains concealed in fabric bags that the hospital lends you. I was given two very flowery bags, and a kind nurse offered to swap them for something more “manly”. Of course, I declined, but with gratitude for her sensitivity. For bigger folks the procedure’s technically trickier, sometimes revisions are needed.
I see a lot of overjoyed faces beaming through anaesthetic haze when my friends go through this. I wasn’t expecting to be one of them. But there I was, post-anaesthetic, lying in bed with a huge grin on my face. Even the projectile vomiting a couple of hours later didn’t completely wipe the smile away.
Pure joy. I thought it was perhaps some drug-induced high, but it hasn’t left me. A weight off my chest, indeed.
Transition hasn’t been easy for me. However much my story overlaps with that of trans men, it doesn’t quite compare and that has left me out on a non-binary limb. I don’t get the same civil rights as my partner. I’ve experienced job discrimination, and astonishingly bad behaviour from some members of the lesbian and gay communities. Testosterone has taken its sweet time to make changes and I’ve felt in limbo. I fell into a pretty bad pit of depression and got well and truly stuck there. And I was afraid that surgery and too much time to myself during recovery would only make things worse.
I simply had not anticipated the possibility of being happy about my new chest. But here it is, in all its rawness, freshly revealed; and it does make me feel incredibly happy – so happy that I’m sharing a picture of a bit of my body, not something I am used to doing.
It is curious the way I can connect to my body now in a way I never could, and this gives me hope for being able to care for myself better in the future, and potentially make health gains because of this. I feel not the slightest regret. Surgery was the necessary price of my wellbeing, and I’m confident that what I give back to the world can be greater now I no longer struggle under the burden of dysphoria.
I am unbelievably grateful to the NHS. It took time for me to realise I could not do without this op, that it was as necessary as any other procedure available in our increasingly beleaguered healthcare system. The nurses and doctors at Castle Hill are amazing. Mr Kneeshaw* is one of the kindest and most down to earth surgeons I’ve ever met; his results are good, and he’s not huffy about doing revisions if needed.
This procedure is life-changing and potentially life-saving, and I am simply overjoyed and full of gratitude.
PS – after the post-op, Robin and I treated ourselves to vegan rocky road brownies from Blondes in Cottingham – life really couldn’t get any better than this!*
*nobody is paying me for these endorsements
There’s a lot said about the co-occurrence of transness and autism, but I am struggling to find an article that does not slip into unhelpful speculation about how autism might “cause” transness. The latest article I read is good for the most part, but still falls in to speculation about cause along with other tropes and inaccuracies, particularly about non-binary people, that I found unhelpful.
I wanted to write a little about my own personal journey to embracing the simple fact that a lot of people are both trans and autistic, including me.
Human variances often co-occur
Let’s start by laying out a simple fact. We know, from research, that there are a whole bunch of divergent traits that cluster together in the population – non-heterosexuality, left-handedness, genius, synaesthesia, certain tissue disorders such as EDS, gender variance, certain physical appearances, dyslexia, adhd, sensitivity, autism, etc.
So, “different” people tend to be different in lots of ways. Break some of the above “things” down a bit more, and we see that they are in fact clusters of other traits that come together, like Seurat’s dots, to make a certain kind of picture – and that actually, when you start looking at these individual traits, you discover that no two geniuses, and no two autistic people, have quite the same formula of traits, even though the overall effects can have something in common. Genius isn’t a “thing” and neither is autism, nor transness – these are all many threads of experience woven together to create overall effects that are broadly similar but often diverge in the detail.
Which differences do we see as “pathological”?
How we respond to these traits is interesting in itself. A hundred years ago, left-handedness was seen as unacceptable. In my (left-handed) grandmother’s time, children were forced to write with their right hand. In my (also left-handed) mother’s time, left-handedness was still disapproved of, but reluctantly allowed. Now, I hope, prejudice against left-handed people has all but vanished, though the vestiges of it remain in language in words like sinister.
Suppose the stigma was still around today, in our society that loves to pin things down with “hard answers”. Would the co-occurrence of left-handedness and autism start people down a track of “maybe autistic people just don’t feel able to conform the way neurotypicals do, and that’s why they write with their left hands”. Would the inevitable bullying that any person who is different gets, and the resultant anxiety and stress, lead people to see left-handedness as a symptom of mental health problems or abuse, rather than understanding stigma and bullying due to being different as the cause of any mental health problems or abusive treatment?
Society decides which traits are a “problem” and which are an asset. Nobody is going to diagnose somebody with “genius disorder” and raise funding for a cure. Thus Alan Turing was celebrated for his genius, treated (relatively) neutrally for his left-handedness, isolated for his (probable) autism, and driven to suicide as a result of horrific criminal and medical interventions for being gay.
Nature or nurture?
I’m guessing most people, looking at the list above, will have some traits they prefer to think of as more “biological” and some which they would prefer to think of as less so, but we are all, as Cordelia Fine says, the result of a ““sheer exhilarating tangle of a continuous interaction among genes, brain and environment.”
What matters, is that trans people are more likely to be autistic, and autistic people are more likely to be trans. Not why this happens, unless you want to see human variation as disease, and look to cure it. This non-affirmative, pathology approach is what leads to tragedy, as in the case of trans and autistic Kayden Clarke. If both/all aspects of Kayden’s identity had been affirmed and accepted, he might still be here.
Besides, what dullness and lack of creativity would ensue if some humans did not exist outside the boxes the world expects, and thus teach people to expand their horizons and frontiers? If we try to iron out differences society sees as problematic, what other treasures might be erased in the process?
As somebody who instinctively picked up a lot of male socialisation, but fumbled with female socialisation, I reject the idea that my gender identity is caused by my autism in a “you are poor at reading social cues, therefore you didn’t learn how to be a girl” way. If I was so bad at picking up cues, how did I take to male-socialised behaviours like a duck to water?
Then there’s “your thinking is rigid – you’ve decided because you liked boy things you must be a boy”. I hear this a lot – that the autistic mind is deluded, unable to cope with nuance. But my autistic mind is just a fountain of nuance – I am open to so many possibilities, so sensitive to detail that yes, I can get overwhelmed and lost, and it has taken me a half a lifetime and a lot of therapy to find my own edges amid a sea of information and cultural story about gender.
That I must be socially labelled and legally categorised according to the shape of my genitals is a rigidity I cannot live with. To me, it’s an idea that becomes increasingly bizarre and arbitrary the more times I think about it. If my autism helps me more easily defy these arbitrary rules, why then it is an asset.
Conformity vs divergence
I think in our increasingly individualistic society, it’s important to understand that human beings have evolved to cooperate with one another, and that this is generally a positive thing about humans. But I like to think of human difference as an important balance to our tendency to conform. Cooperation can put a person on the moon, but people are also too good at going along with things that are not in the best interests of anyone – this is how we can end up voting for fascists, or arbitrarily colour coding our children.
We need to both go along with each other, but also put our feet down and say no. It’s a delicate balance between our immense capacity to work together for the greater good and our equally immense capacity to form a mindless mob that can be led into all kinds of nastiness.
People who smell colours, kick the ball with a different foot, experience gender differently, and focus in on all kinds of human experience in a drastically different way to the norm, are able to offer up different possibilities, remind us our experience is not monolithic, introduce the element of uncertainty that we require to balance progress that can take us to the moon but also over cliffs.
Combating the shame
The process of coming to terms with being both autistic and trans has led me to at times fall into a pit of shame. “Why can’t I just be like everyone else, why do I have to make it awkward for people?” is a constant theme, as I find myself presenting a challenge for everyone I meet that makes our interactions at times not fun for anyone. I feel shame that I can’t perform woman, or small talk, or gratitude for being allowed to exist, but instead speak my mind, tell people how I really feel, and who I really am.
In the worst moments, I consider it would be better for everyone if I did not exist – the road would be smoother. But the road to where? Where is the human race going, that it cannot take people like me with it? Where is the LG community heading, that it hasn’t got room on the bus for people who don’t conform to an assimilationist idea of monogamous, neurotypical, gender conforming respectability?
I feel like an inconvenience, but maybe I am the grit that forms the pearl. Maybe I am the grey cloud that waters the dry earth. Maybe people like me are meant to be here and have our value and our place.
Maybe we could be celebrated, instead of being constantly, relentlessly pushed aside.
Another article published in Beyond the Binary:
Transgender children have been in the news spotlight recently, with unhelpful and misleading “debate” and sensationalised headlines. The impact this will have had on trans children and their families is considerable.
As a therapist who has mainly worked with children and young people, and a trans trainer for schools and colleges, all children’s welfare is very important to me. Because of their isolation and marginalisation, trans kids are particularly vulnerable to bullying, abuse, and poor mental health outcomes. We need to discuss trans kids, and the discussion needs to be well-informed. Read more
I remember when my partner had come out to me as trans, but before he (or I) had come out to anyone else, I began to share more educational information about trans people on my personal Facebook feed. I had already been running the Facebook page “Lesbians and Feminists Against Transphobia” (now, alas, deceased because I was unable to manage the traffic from the 10,000 people who liked the page). I started to migrate some of the content to my own timeline, in the hopes that people would be somewhat prepared for the forthcoming announcement.
At that point, we were at the “I’m transgender, now what?” stage. Because what we are is not what we do. Robin knew he was a trans man, but the thought of transition is daunting, and there are so many options. Name changes and pronoun changes were some of the possibilities. Medically, one option was just to have chest surgery, one was to take hormones and have chest surgery. We weren’t really going any lower than that just yet. For me, there didn’t seem to be any options for “non-binary transition” (little I knew) so coming out (or not) was really the only option I was considering.
They say when you go through something big you find out who your friends are. This is true, but you also find out which of your friends are bigots.
This was the point at which we discovered that a (thankfully not close) friend of ours was on her way to becoming a prolific and formidable anti-trans campaigner.
I would post something positive about trans people, this friend would come back with a response about how transitioning makes people suicidal. I posted an article about trans men, she launched into a discussion of the dangers of phalloplasty. She was the ultimate concern troll.
So hung up on how what’s in everyone’s pants should determine the ultimate and unbreakable social order, our friend had assumed trans man = phalloplasty. Which is ludicrous. There are so many different surgical and non-surgical options for trans men because what’s in people’s pants should not socially define them. And nobody should have to go through major surgery in order to gain social acceptance and safety.
But her graphic, alarmist response, also made me terrified of phalloplasty in a way that really was unhelpful, because the reality is some people have lower dysphoria, a sense that there is something missing that they cannot reconcile. And dramatic as surgery is, it makes some people feel whole and okay with themselves in a way that benefits how they are able to be in the world. Which is obviously a win/win, because people who are happy with themselves and their bodies generally make for better citizens, friends, partners, workers, lovers.
Admittedly it’s hard for trans people to be happy with themselves, given what a shitty world this is to trans people (hence the suicide stats), but all the evidence suggests being trans in itself isn’t the problem – but rather barriers to acceptance, support, and being able to transition as we need to. Negativity and barriers just make a hard life harder.
Let’s not pretend we live in a perfect world, and that medicalising trans identities is ideal. It isn’t. The media still very much use language that speaks of a process of transforming a person from woman into man, or vice versa, and our community still talks about someone being “pre-op” or of surgery being something that assigns or affirms gender, as if we need the surgery to make us real.
This is awful, and it has to stop.
At the same time, in a world that places so much social emphasis on what is in a person’s pants, it is impossible to ask trans people to feel okay with what’s down there, even if their dysphoria is not fundamentally physical rather than social. I think this varies from person to person and some trans people admittedly feel a profound, instinctive sense of something missing from their bodies long before it can possibly be the result of socialisation.
Some trans people will cope with their bodies configured as they are, and some will not. This does not make us more or less transgender, it just means we are not experiencing lower dysphoria to the extent that having surgery will be beneficial to us.
I was going to talk about how hard phalloplasty in particular is to go through, having just nursed my partner through the first stage. It is exhausting, terrifying, psychologically demanding, and I promise you the gaslighting comments from the anti-trans brigade make things a thousand times worse.
But I don’t need to tell any trans person how big a deal this is. We all know. The idea that well-meaning (concern trolling) cis people need to explain to us the demands of this surgery is infantilising and outrageous. No trans person gets to the point where they are signed off for major abdominal surgery that will leave them with visible scarring without knowing what they are about to undertake. Many trans men go for the slightly more straightforward metoidioplasty, or have no surgery at all, content with the growth they gained from taking testosterone, or just content with how their body is configured.
Most trans guys will follow others in groups or on YouTube and typically for men, no gory detail goes undescribed, including the times things go wrong. And they do. Phalloplasty still has only a 97% success rate and that is a scary thought, that you might go through all of this surgery and end up with nothing but scars. All this is heavy enough to deal with without ignorant creeps making you doubt yourself that it can ever be worth it.
Maybe the societal issue of not talking about men’s health plays a part in how we react to phallo. We know about the gory details but we probably don’t speak enough about what trans men and their supporters go through with this surgery. The months off work, the worry about it failing, the overwhelming stress, the involved care required for a skin graft and several wound sites, the two or three equally complicated follow-up surgeries. Maybe it’s still seen as some sort of “optional extra” and so the pain and magnitude of it is somehow disregarded. But for those who undergo it, I don’t think it really is “optional” but rather integral to their wellbeing.
Maybe I didn’t fully understand that until I saw Robin going through it. How alongside the pain there was something else – a sense of confidence and completion. Of rightness.
And just to be clear, this has nothing to do with sex, or dominance, or any other notions we may have about dick-swinging men. It’s more about walking in the world, about being able to use male toilets more comfortably, about what may happen when he is old and needing personal care. And simply about his relationship with his own body.
It can be worth it. It’s not an easy decision, but the reality is, like any self-awareness, dysphoria once acknowledged can’t just be wished away. Demi-boys like me spend a lot of time hoping that the little niggles of lower dysphoria we swat away will never manifest into something big enough to make surgery feel necessary. Nobody wants to need major surgery. But living with a trans man, I see it very clearly – how dysphoria has been taking up too much of his mind, his life. his energy. How this surgery has set him free from that and will allow him to live.