Monday, January 19, 2015

Testosterone Does Not "Work Better" than Estrogen

Hang around with trans people and you're bound to hear it. Testosterone, it's said, is more powerful than estrogen. It makes for a faster and more robust gender transition, while estrogen works a more subtle form of magic.

According to this reasoning, "trans men 'pass' better than trans women" because we win at hormones.

This is a load of hooey.

As trans people, we are fundamentally opposed to classic biological essentialism. According to classic binary sex essentialism, a person born with XX chromosomes is ever and eternally female, and a person born with XY chromosomes immutably male.  (Biological essentialists tend never to consider nonbinary genotypes like XXY or intersex people generally, because they're all about the ideology of the sex binary.)

Those who gender transition must reject chromosomal sex essentialism.  We live by the tenet that it is gender identity that determines who we really are, not our chromosomes.

But a fair number of binary trans people actually cling to a variety of sex essentialism--specifically, a biological essentialism that centers hormones, not chromosomes or genitals.  Hormone-replacement therapy is the most common medical transition service we access, and we are raised in a culture that treats biological sex as "more real" than gender identities or gender expression.  So many find comfort in framing both their bodies and their psyches as rewrought in nature by testosterone or by estrogen and testosterone-blockers.  Obviously, HRT has visible effects. Our body hair grows more robust or more fine.  Voices drop or breasts bud.  Our faces are gently transformed by the loss or addition of subcutaneous fat and the bulking or shrinking of facial musculature, rounding the cheek of the estrogen-employing, and chiseling the jaw of a person using testosterone. When you've been living with gender dysphoria, these physical changes are very welcome.

I've met my share of people who overgeneralize from the celebrated physical changes of hormone therapy into hormonal essentialism, attributing every change they experience to sex hormones. "Testosterone has made me less interested in talking, talking, talking." "Estrogen has made me a lot better at matching colors."  But sex hormones don't make us more or less verbal, or improve or deaden our color vision.  Those are social effects, and they are culture-bound.

That doesn't make them any less "real," mind you.  Just like hormones, socialization is a powerful thing.  Living as a woman in our society means receiving constant cues about appearance that unconsciously shape behavior, just as living as a man in our society means receiving social deference that makes a person act more boldly.  And these things affect us even if, consciously, we challenge them.  Estrogen doesn't make a person a better parent, nor testosterone make a parent a less-engaged one.  But caring behavior is so intensely socially reinforced in people living as mothers, while those of us living as fathers receive so many messages that we're not expected to know how to braid our kids' hair and should prioritize work obligations over family ones, that we are inevitably shaped by these socializing messages without our realizing it.  We can resist those pressures of which we are conscious, and socializing forces are experienced differently when one's gender identity conflicts with one's perceived sex, but nonconscious socialization is a real and powerful and ongoing process. From the moment we begin a social transition, our behaviors and inclinations are impacted strongly by socialization, which changes our perceptions and our behavior.  (This is one of the things that transphobic radfem "gender crits" get all wrong.  They treat socialization as something that happens when you are young, and then stops, rather than something that is happening to all of us, every day of our lives.)

But taking a shot or a pill seems much more real and concrete to people in our society than does being (re)shaped by social cues.  And one way this manifests that I believe is particularly damaging is in the belief held by many people that "testosterone works better than estrogen."

Here's the thing about gender transitions: it's indeed true that most trans men transition more smoothly and swiftly than most trans women.  But this isn't because testosterone "works better" than estrogen.  It's because of how gender policing works in our society.  Our culture values masculinity and the male while it devalues femininity and the female.

Let's examine how this works through the lens of facial hair.  I've often heard people use as "proof" of the greater efficacy of testosterone the fact that taking T makes a person grow facial hair, while taking E doesn't make a beard go away.  But it would make just as much sense to say that estrogen is more potent an agent of transition, because it makes a person grow breasts, while taking T doesn't make breasts go away.

Let's consider facial hair and transition in greater depth.  Often before even starting hormone treatment, transfeminine individuals seek facial hair removal via electrolysis and/or laser treatments. And many experience ongoing anxiety because some hair may be left behind by these procedures, leaving a trans woman constantly worried that she may have some stubble, as the social consequences of being seen as a trans woman with a beard shadow are high. Those who transition using testosterone, on the other hand, have a much less anxiety-ridden experience in the facial hair arena. Sure, most trans men wait anxiously for their peach fuzz to materialize, and for some, peach fuzz is all they'll ever grow.  But every whisker is celebrated--and not just by us, but by society.

Think about it.  For a trans woman, a few whiskers are seen by a cissexist society as belying her gender identity, and the stubbly trans woman is a figure of mockery. Meanwhile, for a trans man, a few whiskers are all it takes to get a pass from the gender police.  If there were actual parity in treatment, the gender police would be imposing some sort of 50% standard on either side of their gender binary.  But instead, a trans woman must remove 100% of her facial hair to avoid harassment, while a trans man only needs to be able to grow 10% of a full beard to be treated as one of the brotherhood.

It's not testosterone that is working so well to benefit trans men.  It's patriarchy.

Our society trains people, especially cis males, in patriarchal binary-gender-policing from an early age.  Here's how we can imagine the "logic" of this system as operating: (1) immediately upon seeing a person, classify them as male or female.  (2)  If you can't immediately do that, this is a PROBLEM and must be addressed.  (3) When your initial glance leaves you in doubt, always treat the person as male.  Calling a man "she" is a terrible insult--and is dangerous, since a man whose masculinity has been insulted may feel compelled to prove his masculinity by doing violence to your person.  Calling a woman "he" is actually a sort of compliment, since it confers status.  And if a woman is insulted or has her feelings hurt, it's not likely that she's going to punch you in the face as a result, because that would make her look even less feminine.  Anyway, she should work harder to appear feminine and attractive to men.  (4) Now that the immediate snap judgment about whether to say "sir" or "miss" has been made (when in doubt, say "sir"), study the person to figure out what's wrong with them.  Not being instantaneously classifiable into an M or F box is an affront, but maybe it was the last thing the person wanted (it's some really short cishet guy who is sensitive about his height).  Maybe it was "negligence" (a straight cis woman who isn't doing her duty to be attractive).  Or maybe it was intentional (the individual is an "effeminate" gay man, a butch lesbian, a genderqueer "he/she" weirdo, a transsexual).  Intentionally breaking the binary rule of the gender police means that the offender should be punished with disdain, mockery, harassment, or even assault/sexual assault.  And the harshest punishment is to be directed at those who could have had male honor, but are traitors to the brotherhood--the "swishy faggots" and "trannies" and "shemales"--dishonorable freaks all.

So those are the rules of gender-policing engagement.  Now, combine them with what we discussed earlier--the high standards for inspecting the suspected transfeminine body combined with the low standards of inspecting the suspected transmasculine one. Interactively, they produce a situation in which gender policing affects those assigned male at birth much more strongly than those assigned female at birth. Of course, this is counterbalanced by the fact that people perceived as female or feminine (whatever their gender identity or physical status, really) win as a prize the joy of being catcalled and sexually harassed. But think about it.  This means that for a trans man, once you've crossed that scraggly chinpatch threshhold, chances are good you get to avoid both catcalling and gender-policing harassment. The path to male privilege is pretty short. For trans women, the path to freedom from constant misgendering is much longer, much more fraught with danger, and doesn't end with the prize of relative freedom.

I know that nobody is safe from male street violence, even those deferred to as masculine men, but there's a huge difference in the regularity of the onslaught.  And believe me, I understand that the safety experienced by trans men is conditional, and that if we are discovered to have breasts and/or a vagina, the best outcome is usually disgust, and the worst assault or reparative rape.  But most of the time, these body parts are not seen.  Transmasculine individuals just need to show up sporting that minimal evidence of beard stubble (or its inverse, the receding hairline), wearing moderately standard guy clothes, with chest bound or bundled under a sweatshirt, and the gender policing inspection stops. Not for us the unavoidable requirement that every body part be inspected for "questionable" hand size and foot size, adams apple or hairline.

So, please, let's stop spreading the lie that testosterone works better than estrogen, and that this explains trans mens' advantage over trans women.  Patriarchy and the male privilege it produces explain the transmasculine advantage.  And as long as we naturalize this transmasculine advantage, we do our transfeminine siblings a disservice. What we should be doing is fighting gender policing, not treating it as a fact of nature--and doing that fighting from a position that acknowledges it affects trans men less severely.

Wednesday, January 7, 2015

Trans Gender Body Mods: Who is "Obsessed"?

Many—though by no means all—trans people seek at least some body modifications (hormone replacement therapy, hair removal, surgery, etc.).  

In this post I want to talk about why we do this, and to critique the way seeking trans body mods is often framed.  The common medical framing presumes a cost-benefit analysis in which reduction of internal psychological distress is weighed against medical risks.  And the common layperson’s framing centers the problematic idea of us seeking to “pass.”

In my last post, I explained why I believe the language of “passing” is damaging.  I know that there are some trans people who get upset by such critiques, because they hear an attack on the language of passing as a dismissal of the pain of their gender dysphoria or the intensity of the transphobic violence and disrespect they face.  This post should make it clear that I want to do the very opposite of that.  I just want us to approach this discussion in a way that facilitates change.

Let me start with a personal example.  

A while back I participated in a study on chest binding. In filling out the questions, it became clear to me that the researchers framed chest binding in terms of a risk-benefit analysis.  They presented the benefit of reducing bodily dysphoria by binding the chest as balanced against physical risks associated with binding.  This is a framing that I find to be commonplace today in medical circles.  A trans person is presented as engaging in practices considered physically risky (binding or tucking, taking hormones that increase cardiovascular risks, undergoing surgeries that cause pain and always involve the danger of infection, a poor reaction to anesthesia, etc.). If these physical costs are seen as outweighed by the mental health benefit of reducing psychological dysphoria with the body, then the physical risks are justified. 

This is such a very American professional framework for transition: economic, rational, and individualistic. In its deployment by many cis laypeople, the same framework is given a rather sadistic moral cast.  Undergoing painful and dangerous body modifications is understood as the price trans people must pay if we want to be respected in our identified genders. (This is why, I believe, many cis people feel they have the right to ask us whether we’ve “had the surgery,” despite our protests that other people’s genitals are none of their business.  They feel that if they are being asked to respect our gender identities, they deserve to know if we have paid in coin of blood for that recognition.  The idea that we should not have to pay to have our genders respected any more than they do is apparently novel to them.)

Anyway, back to the study: the tension that I saw in the survey is one familiar to many people seeking medical transition services: paternalism.  It seemed to me that the researchers believed some binding practices (such as the use of duct tape or ace bandages or binding for extended periods of time) are too risky to be justified by any psychological benefit.  This will sound familiar to many trans people who have sought medical transition services.  Often we are turned away, as medical gatekeepers have declared hormones or surgery too risky for us.  My own spouse had had a doctor refuse to refill her prescription for estrogen because her total cholesterol level on one blood test was 201, 1 point into the “high” range.  It was blindingly obvious to my wife, to me, and to most any trans person that the risks involved in withdrawing transition services were much higher than the risk posed by a single cholesterol point of possible added cardiovascular risk.  But under medical paternalism, it is not the trans person zirself who decides if the benefits of medical transition outweigh the risks—it is the doctor.  This gives a doctor’s idiosyncratic beliefs about trans people a great deal of power. This is evident, for example, in how many genderqueer people seeking medical transition services have found they have to present themselves falsely as having a binary trans identity in order to access those services.  Presenting as genderqueer/agender/etc. is a disadvantage because doctors often impose their personal belief that nonbinary identities are weak, wishy-washy, impermanent, or insufficiently “real” to justify the risks of treatment.

After being rejected by paternalistic medical gatekeeping to transition services, some trans people just give up, resigned to lives of psychological misery.  Other, shall we say, more self-actualizing individuals simply turn to the grey and black markets, for example by buying hormones online.  Responding to this reality, the modest number of regional trans clinics mostly operate under the “harm reduction” philosophy, under which clients are advised of the risks involved in hormone replacement therapy, permitted to sign an informed consent form, and then allowed access to hormones.

I’m fully in favor of the harm reduction approach, which grants trans patients the human dignity of being allowed to make informed decisions for ourselves. But the framing of decisions about transition under harm reduction is just as individualistic as the paternalist model.  It’s about a contract being signed by a rational actor weighing physical risks against psychological benefit.

As no man, woman, person of any other gender, or person of no gender at all is an island, I find this pretty silly.  

We are not atomized individuals free-floating in space, making decisions about whether and how to modify our sexed bodies.  We are social creatures, with employers and coworkers, partners and offspring, schoolmates and neighbors.  And so many of the current risks and benefits of trans body modifications are social in nature, not medical.

Anyone who gender transitions does so because they wish social recognition of their gender identity.  If it is enough for us to know in our own minds what our true gender is, then being forever misgendered by others matters not at all, and transition is unnecessary.  Note that I am not equating gender transition generally with medical transition—many people transition socially without the use of hormones or surgery.  But whether we choose to and are able to access medical services, choose not to do so, or try but are unable to access them, the acts of coming out to others and of asking that others change the pronoun by which they address us are social in nature. 

And this brings up the thorny issue of being accepted in our identified genders.  For many binary gender transitioners, this is conflated with the idea of “passing,” or being perceived as a cis person of one’s identified gender.  (I’m very critical of the term “passing”—you can read my full critique here if you like.)  In my ideal world, gender identities would be accepted in the same way that, say, religious identities are: we just take someone’s word for it.  If someone tells you they are Catholic or Hindu, you say, “OK.”  If someone tells you they have converted to Judaism, you say, “Oh, OK,” and maybe you ask them about their experience, but you never say, “I refuse to acknowledge your Jewish identity because you don’t have a Jewish nose.  If you get a nose job maybe I’ll think about it, but since you didn’t grow up Jewish, I really don’t think you can know what it is to be a real Jew.” (By the way, I’m Jewish, and I am aware that there are some Jews who see Jews-by-choice as less authentically Jewish, though that is against both Torah and rabbinical advice.  But I’ve never in my life encountered a person, Jewish or otherwise, who has said “I won’t acknowledge you as a Jew unless you get plastic surgery to make your nose look Jewish.”)

Unfortunately, my ideal world where gender identities would be respected when announced, without regard to physical appearance, is far from the world we live in today.  

In the real world we have no choice but to negotiate, not only is transphobia, or hatred of trans people, rampant, but so is cissexism.  Cissexism is the belief that cis people’s gender identities are authentic, innate and unquestionable, while trans peoples’ identities are questionable performances.  One aspect of cissexism is the belief that one has the right to choose to respect a trans person’s gender identity or not—that one sits in judgment on our identities and presentations.  And central among the criteria that cissexist people use in deciding whether to respect or mock us is physical appearance, especially bodily configuration.  To be deemed “worthy” of the pronoun “she,” cissexism holds, one must have a body that looks like that of a cis woman.  To be granted the right to the pronoun “he” requires a body appearing cis male.  And to be acknowledged as genderqueer, a person is expected to be completely androgynous in physical form.

Now, the prize that cissexism dangles before us turns out often to be illusory.  Cissexism is deeply bound with enforcing the gender binary and essentialist notions of binary sex.  No matter what a person’s body looks like, it turns out, cissexist people generally treat all nonbinary genders as jokes, refusing to use nonbinary pronous or just “forgetting” all the time to try.  A trans man can bulk up, grow a beard, and get top and bottom surgery, but no matter—many cissexists will assert that he doesn’t have a “real” penis, and is thus a poor simulacrum of a man they will call “he” out of pity.  And transfeminine peole have it worst of all.  Transmisogynistic hatred focused on trans women is intense, presenting them as deceivers of straight cis men, potential rapists of cis women, and some unspecified but ominous threat to children.  Cissexist gender policing of trans women’s bodies is most extreme, inspecting necks for adam’s apples, staring at the size of hands, scrutinizing chests, and monitoring jawlines.  If they are visibly trans gender under this scrutiny—as so many trans women are—they are the subject of constant ire and harassment, mocked as “shemales” and “he-shes.”  Only the most model-perfect are granted the prize of being treated as women.  And even this prize turns out to be booby-trapped, because their very cis-conformity is reframed in romantic and sexual contexts as a sham, a trap, tormenting cis straight men by somehow making them gay.

So: cissexism is rampant in our society.  Its claim that it will grant us respect, if and only if our bodies “match” our identities, is largely a sham—and yet it is compelling to so many of us as trans people.  It keeps masses of trans people in the closet, convinced they can never transition because their bodies appear too stereotypically cis male or female.  We transition so that others will respect our gender identities, and if we are convinced no one ever will respect us because we don’t have the price of a nice suburban home to spend on plastic surgery, or that even if we spent a million dollars, it would never be enough, then many of us decide there’s no point in even trying.

For those of us who do come out, bod mods often become almost an obsession.  If you take a look at the mass of trans support sites, and you will find a million posts entitled “How well do I pass?—X months on HRT.”  Go to some genderqueer support groups, and you will find masses of people binding their chests, agonizing over whether they would look more androgynous if they took a little estrogen or testosterone, or commiserating over wanting some of the effects of HRT but not others.  The way this is framed by psychotherapists and doctors is as an individual preoccupation that is a keystone of the formal diagnosis of gender dysphoria.  It’s treated as an internal psychodrama of alienation from one’s flesh, the idea of feeling “born in the wrong body.”  And it’s certainly true that many trans people are driven to transition in part by a sense of unhappiness with their curves or lack thereof.  But this feeling does not emerge in a vacuum.  It is born from a life lived in the context of cissexism and its insistence on “passing” as cis gender as the gateway to respect for trans people. 

We’re the ones diagnosed with a mental illness, but it’s society that is sick.  Doctors say that we as individuals are weirdly obsessed with our sexed bodies, but it’s gender policing by a cissexist society that makes us rationally preoccupied with how our bodies appear. 

I’ve had conversations with various trans friends that start, “If you were living your life alone on a desert island. . . ,” as we have tried to disentangle personal wishes for body modification based on internal dysphoria from social forces pushing us toward them.  It’s an impossible exercise on many levels, because we’re never going to live such a life, and because social forces have shaped our feelings and understandings on an unconscious level.  Still, it’s interesting to me, because while some friends have said nothing would change for them, other people I’ve had such conversations with have said they’d want fewer body modifications.  Personally, if I were living on that proverbial desert island, or, slightly less implausibly, in some sort of trans gender utopian commune, what would change for me is my attitude toward top surgery.  I want it now, living in my Midwestern American context, but I wouldn’t in an ideal or asocial setting.

If nobody was around gender policing me, I could deal with having moobs.  I mean, I wouldn’t mind looking like Michelangelo’s David, but I'm a middle-aged guy with reasonable expectations and hardly obsessed with having a model body.  Early in my transition, I wore my binder every waking hour, but now, as soon as I get home from work, unless there’s company, I immediately take it off and relax.  Let’s face it: for most of us who wear them, binders are really uncomfortable.  But my attitude of relaxation and body acceptance has very little effect on my binding behavior outside the house—I bind tightly, whenever I’m stepping out my door, which often means for 12-18 hours a day.

Now, here’s where I return to that study I mentioned (remember the binder survey?).  According to the health information given with the survey, binding for more than 8 hours a day is medically risky.  As a rational individual, I should balance my dysphoric urge to bind against physical risks, and apparently I'm doing a poor job of it—I’m too obsessed with my body, making me put it at risk.

But I’m not obsessed with my body.  

I’m not binding for long days due to psychological reasons.  I don’t want top surgery because my body revolts me, or because my moobs feel like alien flesh somehow appended to my chest, or because I have a desire to live “stealth,” hiding my trans status.  I am responding to a social context in which the risks of my not binding or getting top surgery are huge.  I teach large lecture classes full of Midwestern undergraduates.  I sit in meetings with Midwestern administrators.  They all know I'm trans—I’m not in the closet—and there are rough patches, but mostly I get by pretty well by wearing jacket and tie, growing my beard, and binding my chest to pass muster with gender policing.  I recognize that in this I am privileged. But if I suddenly showed up with size D breasts bouncing around under my shirt, I have no doubts that it would trigger a cissexist freak-storm.  It’s one thing for your standard cissexist onlooker to see that I’m short and wide-hipped for a man, and have a somewhat odd-shaped chest.  I fall short of the masculine ideal, but it’s clear I’m making an effort.  Presenting as a man with a free-flying and quite substantial set of breasts, however, is a crime according to the gender police.

Unintentionally violating the cissexist law that gender identity and body must “match” gets you stigma, but overtly flouting this law is treated as a much more serious crime.  Now, the results are generally much worse for the transfeminine than they are for transmasculine people like me.  But there would be consequences—material consequences—for me, for example in the form of poor student evaluations and negative interactions with colleagues, and I am the sole economic support for a family of three.  Furthermore, the other members of my family have physical disabilities, meaning they must rely on me to do tasks like the shopping that would be made much more difficult and potentially dangerous if I appeared, not just as trans, but as “flaunting” a nonconforming body.

I know that there are people in the U.S. walking around in public with the combination of beard and big breasts and an androgynous body, if not in the Midwestern setting I live in.  Frankly, I’m in awe of their strength.  If I were single, maybe I would find out if I am strong enough to take the body I’m comfortable with in the privacy of my own home, and live with it in full view of a cissexist society.  Maybe I could dare to swim in a public pool, furry moobs exposed, or mow the lawn with my shirt off, like my cis male neighbors do, and dare the police to arrest me for bodily nonconformity.  Certainly I’d love to give the finger to our society’s gender policing, sexualization of body parts deemed female, and general body shaming.

But I am not just an individual with political goals and psychological impulses.  I am embedded in a society and in a family.  And I have duties to my spouse and child that mean that since I cannot afford top surgery, and my insurance excludes coverage of transition-related services, I have to bind my chest for more hours a day than is medically approved.

Any study or theory of trans experience that presents us as acting solely in response to internal psychological impulses deeply misrepresents our lived reality.  And a medical establishment that withholds hormones or surgery based on a cost-benefit analysis that only takes into account medical risks, and not the social stigma, unemployment, and violence that those of us transitioning in a cissexist society risk without those services, does trans people a great disservice.

At the same time, it’s very important to me to resist naturalizing and internalizing gender policing by evaluating myself using the language of “passing.”  Besides implying that my presenting myself as a man is deceptive, the language of “passing” puts trans people in an impossible position, where the “success” of our transitions are determined by something we cannot control: the way we are treated by others.  No matter what body mods we seek, or voice training we do, or how carefully we choose our clothing, other people can still mispronoun us, either consciously and cruelly, or based on their unconscious cissexist ideas about bodies without actively intending to be cruel.  We cannot control whether we “pass”—we can be passed as cis gender by others who honor our gender identities, or not passed as cis gender by those who do not, and control of that lies with them, not us.

So I want to emphasize that I am advocating for the great import of trans body modification and access to medical transition services largely because of our social context of constant gender policing.  Ideally, I believe, what requires change are not trans bodies, but society.  It’s cissexism that drives so much of our preoccupation with body mods.  What we must most fight for is the social acceptance of visibly trans bodies as being fully as valid and attractive and as deserving of respect as cis bodies.  In an ideal future, when all gender identities are fully supported and respected, I believe trans people will seek to change our bodies less than we do now.  But since we live neither in that ideal future, nor on desert islands, we must cope with the fact that social change is slow, and we have to live in the world as it is now, even as we fight to change it. 

Right now, trans people of all genders pursue body modifications for three reasons: (1) to reduce the social risks of stigma and mistreatment that are aimed at visibly trans bodies, (2) to get the social benefits of respect that are currently granted only to cis-appearing bodies, and (3) to reduce internal gender dysphoria.  The first of these, reducing mistreatment, I see as a necessary evil: something we rationally try to do to protect our safety, but much more effectively addressed by putting an end to transphobic discrimination and violence, making protective camouflage unnecessary.  The second of these, seeking to appear cis to get respect, I see as a dangerous illusion, because we cannot control whether people will grant us that respect, and because it perpetuates the idea that trans bodies like ours are inferior.  It’s only the third—seeking changes in our bodies that reduce our personal, internal gender dysphoria—that I believe would persist, in a world that moved beyond transphobia, transmisogyny and cissexism.

May that day soon arrive.

Friday, January 2, 2015

Some Advice to Allies Following the Suicide of Leelah Alcorn

Having listened to a bunch of conversations about Leelah Alcorn's suicide, I wanted to provide some advice to cis gender allies who would like to help advocate for children and adults who wish to gender transition.
Leelah Alcorn committed suicide because, rather than respecting her gender identity, her family rejected it, isolated her from friends and the internet, and sent her to "Christian therapists" who told her a trans identity is a sickness she must cure by faith and prayer. Her despair was built of familial rejection, societal transphobia, the pain of not being allowed to live in her identified gender, and a lost hope that she would be able to transition before puberty and her body's masculinization.
It's this last item that I want to talk about with you. Like other trans-identified children, Leelah wanted to have access to puberty-blocking drugs. (Yes, they are considered safe--doctors regularly prescribe them to children who don't identify as trans, but are experiencing "precocious puberty" at a young age. And yes, all they do is postpone puberty, which will resume if they stop taking the drugs. The fear often cited by those unsupportive of allowing children to live in identified genders other than that they were assigned at birth--that it's just a phase which they may grow out of--shouldn't justify denying trans children access to puberty-delaying medications, because if a child actually did decide not to transition, they could just stop taking the meds and their puberty would resume.) By using hormone-blocking meds, a trans child can avoid experiencing their body changing in ways that undermine their sense of self--something most trans people alive today have experienced, and can tell you is very painful.
I have heard some very well-intentioned allies arguing for trans children's access to transition services--supportive therapy and hormone-blockers--in the aftermath of Leelah Alcorn's suicide. I appreciate that advocacy a great deal. But there is an aspect of some of what I've heard that I've found very problematic, that I want to raise with you here, and that has to do with discussions of "passing."
First of all, the term itself is one I find highly problematic, as I have addressed before on this blog. In short, we usually use the word "passing" to refer to a person hiding their true identity. I am not "passing" as a man. I am not "really" a woman who is performing a successful deception on the public. I *am* a man. By reiterating the term "passing," well-intentioned cis allies re-entrench cissexism--the belief that cis people's gender identities are authentic and unquestionable, while trans people's gender identities are a performance open to question, and in some way fundamentally deceptive.
It is true that most people who identify as trans men or trans women would like to have bodies that conform to our society's ideals of what men's and women's bodies look like. Those ideals are currently based on cis bodies. Binary-identified trans people typically wish to have bodies similar to cis people's for one or both of two reasons. The first is internal--the thing we call dysphoria. People who identify as women, whether cis or trans, often feel uncomfortable with having substantial amounts of facial hair, for example, or with having only one breast, and would feel the same if they were living alone on the proverbial desert island. They want their bodies to conform to some basic female norms--again, currently defined around idealized cis female bodies. Thus, a trans girl who starts to grow a beard at puberty is very likely to experience psychological discomfort with that. That's bodily gender dysphoria.  And just as when a cis woman has a mastectomy, we view surgical recreation of the missing breast as a medically-justified reconstruction rather than cosmetic, we should view removing breast tissue from a trans man's body as medically-justified, not cosmetic.  It's a way to treat internal gender dysphoria.
But another reason most binary-identified trans people today wish to have bodies similar to those of cis women and men is social: the huge impact on our lives of transphobic gender policing. Visibly trans women in particular are subjected to huge amounts of social stigma, street harassment, job discrimination, bathroom panic, and sexualized violence. This social mistreatment of trans women is transmisogyny, and it is intensified in interaction with race/ethnicity, and with other characteristics such as disability. But even those of us with the privileges of being white and male suffer disrespect and sexualized violence when we are visibly trans gender. Wanting to avoid disrespect, discrimination and violence is rational, and we're told the way to do this is to gain access to hormones and surgery and voice training and other services so that our trans status will become invisible. We're told that we must "pass" as cis people to avoid transphobia.
Now, it is true that Leelah Alcorn wanted access to testosterone blockers so that her body wouldn't masculinize at puberty, and as an adult trans woman, she could have a body that would look like that of a cis woman. Probably, she wanted that both due to internal gender dysphoria, and to avoid social gender-policing shaming and violence. As an ally, it's fine and right that you should want to voice support for Leelah and for trans kids everywhere, and to explain why access to puberty-postponing medication is important.
But please, please, don't do it by saying something like this: "A trans person needs to pass in order to be successful. If they don't pass, their lives will be horrible. So they need all sorts of medical treatments starting before puberty."
Please bear in mind several things. First of all, the vast majority of the trans people you'll encounter today have had no access to puberty-postponing drugs. So most trans men you'll meet developed breasts and hips, and most trans women you'll meet had their voices change, their shoulders broaden, their facial hair start to grow. If you say "unless you start transition before puberty, your life will be pathetic," you're consigning all of us to a dustbin of gender tragedy.
Secondly, bear in mind that violence and mockery are not "caused" by being visibly trans gender. They are caused by transphobia. The end goal of reducing the appalling rate at which trans people attempt suicide will be met when we embrace visibly trans people of all genders. Normalizing the idea that only those who live in a binary gender and appear cis gender by valorizing "passing" is counterproductive.
I am certainly not asking allies to stop acknowledging the extreme stigma aimed at visibly trans people, especially visibly trans women of other marginalized statuses, such as trans women of color. What I'm asking is that you frame that stigma and violence as problems rather than as facts of nature. Don't naturalize the idea that trans people must "pass" to be "successful." Instead, acknowledge the force of gender-policing violence in our society, but frame it as a problem we as a society must fight. Our goal should be to live in a society in which trans bodies are not seen as deviant, ugly, lesser, or in need of massive medical revisions. A visibly trans body should be embraced as no less valid than a cis person's body.
Yes, it's good to advocate for trans children's right to be treated with love, respect, and medical transitional support. But I would frame this in terms of reducing internal gender dysphoria, not in terms of some requirement that trans people get tens or hundreds of thousands of dollars of medical interventions if we are to be respected.
I appreciate the advocacy of all of our allies. And as my allies, I hope you will work to dismantle the ideology of "passing" rather than entrenching it in your advocacy for our access to transition services.

Thursday, November 20, 2014

A Hope for the Transgender Day of Remembrance

On this Transgender Day of Remembrance, let's remember honestly and with open eyes. Here in the USA, the names and faces of those murdered each year reveal that we are not just talking about the evil of transphobia. We are seeing a terrible and terribly clear example of intersectionality, of intersecting biases--transphobia, misogyny, racism, classism, ableism, etc.

The people who are being remembered today do not look like me. Their deaths are deeply relevant to me because they are my siblings, but as I am not a trans woman of color living on the economic margins of society it is important that I acknowledge my privileges, including the vastly lower chance that I will be murdered in an outburst of (always intersectional) transphobia. I do not wish to appropriate others' experiences to paint myself as a martyr by proxy.

People who are cis gender, or male, or white, or middle-class, or living without disabilities should mourn our fallen trans siblings. But if we do so without focusing on our duty to the living, our memorials mean little. Treating murdered trans women of color as pitiful martyrs at ceremonies where living, breathing trans women of color feel unwelcome, or nervously tolerated, or denied agency to be lead partners in directing the event, or are in fact totally absent because "nobody knows any". . . that illustrates the extent to which the participants are part of the problem.

Because the problem is not just "out there" in the cis, straight community. The problem of transmisogyny, especially as it intersects with racism, classism, ableism and other biases, is alive and well in LGBTQ+ communities. It's easy to revile the evil of those who murder the most marginalized among us. It's much harder to own our own privileges and take responsibility for our participation in perpetuating marginalization. All of us--every single one--has some sort of privilege. It's easy for us to focus on the ways in which we are ourselves marginalized, but it's when we examine and own our privileges, and take action based upon that, that the truly transformative things happen.

I hope that this TDOR, we all reflect, not just on the lives of the fallen, but on what we personally can do to reduce the marginalization of the living.

Sunday, October 19, 2014

Who Belongs in Women's Spaces, Again? Women's College Edition

This weekend, the NY Times cover story was on trans men at women's colleges.  I found the article very frustrating, first of all due to the title, "When Women Become Men at Wellesley."  Dear NY Times: trans men are coming out at college, which is different from cis women "becoming" trans men.  Your title is as off-base as one reading, "When Straight Women Turn Into Lesbians at Wellesley."

The subtitle of the article is "Can women's colleges survive the transgender movement?" The answer to this hyperbolic question is obviously yes.  The reporting in the article itself is much less inflammatory, so let's just re-title it in our heads to match the actual content--something like "Women's Colleges Struggle with the Place of Trans Students"--and consider that content.

I understand why trans men wind up in women's colleges. If you're a young person who is assigned female at birth, and you are struggling a lot with gender issues, a women's college might seem a good place to go.  One student in the article, Jesse, says "he chose to attend Wellesley because being female never felt right to him.  'I figured if I was any kind of woman, I'd find it there.'" It's actually quite common for people struggling with trans identities to enter institutions highly centered around the sex they were assigned at birth--for example, many trans women report joining the military or entering highly masculine fields such as firefighting to see if those institutions can reconcile them to living in the gender expected for someone of their birth-assigned sex.  Of course, the result, for many, is to realize they do not identify with that gender at all.  And so it's right and good that students who realize they are trans come out.

But once a trans man or masculine-of-center genderqueer person comes out at a women's college, they have to face the fact that they are a man or masculine-of-center person in a woman's space.  Personally, what I would do at that point is start making arrangements to transfer to another college, because I support the existence of women's colleges in a patriarchal society, and the whole point of them is that they are for women--and I am not a woman.  That said, I don't believe that transmasculine students should be required to uproot themselves and transfer out.  Leaving a college can be emotionally difficult and have financial repercussions, and a transitioning student has a lot on their plate to deal with. I believe that an ethic of care demands a struggling transmasculine student be permitted to stay, and be treated with respect as a man or genderqueer person.

But there is a big difference between accommodating struggling transmasculine students and having trans guys make women's colleges all about them.  And that's exactly what I'd call it when trans men keep insisting that when these colleges call themselves "women's colleges" without adding "plus some transmasculine people" they are doing evil.  That's exactly what I'd call it when trans guys demand that students should stop calling their classmates "sisters" and start calling them "siblings."  I absolutely agree that it undermines one's identity as a man to be referred to as a sister, and I'd hate it too--which is exactly why I would not stay at a women's college.  To stay, and then insist that your needs as a man outweigh the needs of everyone else who chose to go to a women's college . . . that's hubris.

I've certainly met my share of trans men with hubris.  When someone transitions from female to male, they face hurdles in the form of cissexism and negotiating legal and often medical challenges--but they also gain male privilege.  All trans people are aware of the challenges they are facing.  But many trans men seem little aware of the male privilege they are gaining.  That's normal, in the sense that most people are unaware of most of their privileges--but it's ironic when you encounter it in someone who talks about patriarchy and cis privilege, as I have.  Just like a cis man, a trans guy can be oblivious to his own privilege, taking over conversations about sexism in a circle of cis women, or transmansplaining cissexism to a trans woman.  You see, when someone who is being respected in his male identity talks, whether he is cis or trans, people listen more attentively than they do when a woman talks.  That's basic patriarchy, and I've certainly experienced the difference in how my statements are taken more seriously as a result of transitioning to male status.  If you're expecting it and looking for it, as a man, you can see it some of the time and catch yourself.  (I'm sure it happens often without my recognizing it.)  But I've met my share of trans men who conflate their new male privilege and the greater deference they are granted with their gaining confidence and coming into their own as they transition.  They presume people pay such attention to what they say now because they have fascinating things to contribute.  And at a women's college, where young men are a novelty, this effect of attention centering on a man is exacerbated.  (Some of the ways this manifests in the article are pretty creepy, in terms of cis women proving they can be "tranny-chasers" too, but trans men like Jesse report loving having become popular and having people "clamoring" to date them.)

Personally, were I a woman at a women's college, I'd be upset at trans men telling me not to presume my dorm or class was a women's space.  My accepting of transmasculine students would not contradict the fact that they are sojourners who chose to enter a rare territory designed for women.  I guess I'm just fascinated, given the uproar that many cis feminists made when trans women tried to participate in women's events like the Michigan Womyn's Music Festival, specifically so that they could be with other women, that when trans men plant their flag and actually say "stop calling this a women's space," the opposition is so minimal.

Which brings me to the topic of transfeminine students in this article--a brief bit near the end of the piece.  I find it very disappointing that an article about women's colleges should give trans women such little attention, while devoting masses of space to transmasculine people.  Look: fundamentally, trans women belong at women's colleges, and trans men don't.  But there's little to report, given that no trans woman has ever attended Wellesley, as far as anyone knows.  (If one did, she did it utterly in the closet, and at great personal risk.  Such things have happened before, however--Anita Hemmings, a woman of African descent, passed as white and graduated from Vassar in 1897, though she was outed in the last weeks of her exemplary college career and kicked out, lucky to have a diploma mailed to her afterwards.)

What really disturbs me is that much of what the article conveys on the topic of trans women entering Wellesley is the opinion of some trans guy.  He says that trans men and genderqueer people who were assigned female at birth belong at Wellesley--but that trans women should have to face barriers to admission, and be treated with suspicion.  No trans woman should be admitted, he declares, unless she can prove she's started medical transition or has changed her name legally (steps very difficult for someone of a typical age to be applying to college to have taken, requiring parental support for the transition and financial resources).  Why this disparity? To keep Wellesley a safe space for women, of course! If she hasn't had medical and/or legal interventions, a trans woman might not really be a woman, he claims. Taking the difficult steps of coming out and applying to Wellesley as a woman aren't enough proof of her commitment! Maybe her identity is fluid and she'll identify as a man again . . .  But hey, aren't genderfluidity and lack of interest in medical interventions treated as fine in transmasculine people?  Yes, says the trans dude. "Trans men are a different case; we were raised female, we know what it's like to be treated as females and we have been discriminated against as females.  We get what life has been like for women."

This argument is appalling on so many levels. First, it is exactly the reasoning used by "gender crits" and Trans-Exclusionary Radical Feminists to "prove" that gender transition is an impossibility: that gender socialization is rigidly binary, inescapably tied to birth-assigned sex, and sex assigned at birth is thus immutable. The thing is, the TERFs are at least logically consistent in saying that this means not only that trans women are "really" eternally men, but trans men "really" eternally women.  It's transphobic logic--yet it's being voiced here by a trans gender person.  How is this possible?  Enter transmisogyny: the trans Wellesley student applies it only against trans women, while ignoring the implications of the argument for trans men like himself.

Underlying the ability of this trans man to assert a transmisogynistic logic while refusing to see how it applies to trans men is that hubris again.  Look, he basically says, a trans woman on campus might make cis women feel uncomfortable in what's supposed to be a women's safe space!  But apparently it never occurs to this student that a cis woman seeing him in her dorm at night might feel unsafe.  He presumes (a) that women can always tell if a given man is cis or trans at a glance,  (b) that everybody agrees trans men are always "safe" in a way cis men are not, and (c) that if a woman did feel unsafe seeing him in her dorm, her reaction would simply be wrong, as he is Mr. Perfect Nonthreatening Male of Female Experience, and can tell her what she should feel.

For a trans man to believe that trans women pose a threat to female safe space, while transmasculine people should be allowed free access to women's spaces--that demonstrates a combination of patriarchal egotism, lack of awareness of one's own male privilege, and transmisogyny that I deplore.

I do believe that trans men in women's colleges should be treated with respect, but I look forward to the day when a report on trans students in women's colleges will center transfeminine people and decenter transmasculine ones.

Thursday, October 9, 2014

That Awkward Moment

I wanted to do a quick post about this thing that happens a lot, which is probably quite clear to you if you are a white trans woman, or spend much time with one.  I've illustrated it courtesy Bitstrips (click to see a larger version).  It's a window into the ways that intersectionality and the consumptive chaining of varieties of marginalization work, even when the only people you have interacting are white women.

The scenario goes like this: young white cis women meet a white trans woman.  Because her trans status is in some way visible to them, they do not treat her as they would other women they encounter.  Instead, they treat her as a drag queen--as if she were some hyper-gay man performing femininity for their entertainment.  Their framework for acting flamboyantly gay is some sort of urban femme minstrelsy, so they greet her through an awkward performance of tropes of fierce black femininity.  And for good measure, they treat her body as sexualized public property, perhaps by slapping her on the rump.

It's horribly cringeworthy.  It's cissexism piled on transmisogyny topped with misogynoir. But the young white cis women involved think they're being supportive and progressive, and an attempt to call them on any of the many problematic layers of their greeting results in defensiveness and hurt feelings.


Sunday, September 14, 2014

Are Trans Communities Losing Intersex Allies in the TERF Wars?

Recently I spent several days in a public internet group for "gender critical" people, after a few intersex friends voiced some positive things about this line of thinking.  As an intersex individual who gender transitioned from the sex he was assigned at birth, I was puzzled and concerned by this development.  I'd read in trans writing that "gender critical" feminists were actively transphobic--yet here were some intersex advocates excited by what they were saying.  So I wanted to go have a look for myself.  Were "gender critical" feminists in fact good allies for the intersex community?  What would it mean for trans communities if this were so?

Intersex People Critique the Insistence that Sex is a Binary

Simply on the face of it, from an intersex perspective the phrase "gender critical" sounds appealing.  Advocates for the intersex community are extremely critical of the way sex and gender are understood and enforced in contemporary Western socieities.  We live with a social ideology of binary sex which conflicts with the biological reality that sex is a spectrum, and many people are born with bodies that lie between the male and female ideals described in textbooks.  The textbooks say "men have XY chromosomes and women have XX," but there are XX men and XY women, and people with many other sex genotypes (XXY, Xo, and XX/XY mosaics to name just some).  Textbooks proclaim "men have a penis and scrotum, while women have a clitoris, labia and vagina," but many people are born with an intermediate phalloclitoris and labioscrotum.  Children are born with a phallus and a uterus, with vulvas but internal testes, with intermediate ovotestes, with external testes but no penis, and with other variant genital configurations.  

Sex is a spectrum of variations, in humans and the rest of the animal kingdom.  But societies cut that spectrum up into socially-recognized sexes, just as they slice the color spectrum up into named colors. Cultures in different global locations and different historical periods have sliced the sex spectrum up in contrasting ways, just as they've named differing numbers of colors when looking at the rainbow.  While other social sex systems recognize three, four, or five sexes, contemporary Western societies generally only recognize two: male and female.  And people are deeply invested in the ideology that there are just two sexes--it's been embedded in religion ("Male and female created He them");  it's graven into our birth certificates and a thousand other forms of ID listing "M" or "F"; it shapes our built environment with bathrooms and locker rooms and the like divided by binary gender; and it underlies our understanding of sexuality, family, and intimacy.  So when, inevitably, intersex children are born, it's treated as a crisis.

It's hard, growing up intersex in a society that enforces a sex binary, medically, socially and legally.  We are subjected as children to surgeries meant to "normalize" our bodies, with lifelong ramifications that can be quite negative (loss of genital sensation, loss of fertility, loss of a source of natural sex hormones, and sometimes assignment to a sex with which we do not grow up to identify).  Often we are not told the truths about our own intersex status.  Our bodies are treated as shameful, and we are taught to keep our variations secret, closeted.  We may find it hard to form relationships, being told both that our "conditions" will drive people away and must be hidden, but also that if we do not disclose them to sexual partners we are deceitful. If our variance isn't discovered until adulthood, we may find ourselves losing relationships, reputations, even careers, and forced to have hormonal and surgical medical interventions (as a condition, for example, of participating in sports).

Intersex advocates want this to change.  We want the natural sex spectrum to be acknowledged, and our bodies accepted.  We want to put an end to genital surgeries forced on unconsenting children.  We want our gender identities to be respected without our having to alter our bodies medically unless we so desire.  We want to remove gender markers from birth certificates, since that requirement is used as an excuse by doctors to force rushed sex assignment decisions on parents of intersex children.  We want children to be told the truths about their bodies matter-of-factly, for doctors to stop treating us like fascinating "cases" to poke and prod, and for society to stop treating us as freaks.  We want intersex children to grow up with self-respect, and with the autonomy to express their own gender identities and make their own decisions about what medical interventions, if any, will be made into their bodies.

Intersex people are very critical of the binary sex and gender ideologies of our society, and how they are implemented institutionally.  Therefore, a group that says they critique gender from a feminist perspective certainly sounds like it would make a reasonable ally.

Intersex People and "Gender Critical" Politics

The intersex friends of mine who mentioned being drawn to "gender critical feminism" were particularly attracted by the fact that these feminists were critical of the term "cis gender."  Intersex people are often uncomfortable with the application of the terms "cis" and "trans" to intersex experience.  The terms apply very poorly because they presume that physical sex is binary (even if allowing that gender identities may be nonbinary).  For example, if a person is born genitally intermediate, is surgically assigned female in infancy, and grows up to identify as a woman, is she "trans gender" because she was surgically altered to become female, or "cis gender" because she identifies with the sex she was assigned at birth?  Either term winds up misrepresenting something about her experience.  (I've suggested the alternative term "ipso gender" for intersex people who identify with the binary gender they were assigned at birth, because I think it vital that we have a term for people who identify with their birth-assigned sex, rather than leaving them unmarked as "normal." The problem as I see it is not the term "cis gender," but the fact that the cis/trans binary erases intersex experience, and at least one additional term must be added to address this problem.)  In any case, gender critical feminists reject the term cis gender, and this has appeal for intersex people frustrated with binary cis/trans terminology applying so poorly to them.

Another reason some intersex friends of mine may have been drawn to gender critical writing is that In recent months, there have been a series of "mainstream" articles and online posts in which these positions have been sympathetically expressed.  For example, one article mentioned by an intersex friend critiqued the term "cis privilege" by caricaturing it as meaning "having a female body is a privilege."  Clearly this is false: because of patriarchy, female bodies are sexualized, framed as weak, and subjected to surveillance.  Lots of nonintersex cis women dislike getting periods or feeling constantly at risk of an unwanted pregnancy.  Having a female body is not a privilege--but it is also not how trans advocates define cis privilege at all.  Trans people actually define cis privilege as "the benefits one derives from being seen as a 'real' and 'natural' member of one's identified sex" (lack of public scrutiny of one's primary and secondary sex characteristics, being able to use a public bathroom with relative ease, having ID that matches one's identity, etc.).  Nor do trans people deny, as the linked article claims, that cis people also suffer from gender policing.  Someone who identifies as a woman yet who is very butch in her gender expression can suffer from bathroom panic, and a male-identified person who is quite feminine may well face a great deal of street harassment.  That is why trans advocates regularly fight for laws banning discrimination on the basis of gender identity or gender expression.  But if you read the article mentioned by my intersex friend and took it at face value, as they apparently did--why, the arguments of trans women sound regressive and ludicrous and enforcing of binary gender stereotypes.  Trans women are telling other women their privilege is to enjoy being pretty and silent and submissive and having lots of babies, says the author!  If that were true, transfeminists really would be revealed to be patriarchal oppressors in disguise.  Only. . . it's not true.  It's a false characterization on par with saying that "feminists are man-haters."

Another factor attracting intersex people to "gender critical" arguments is that they put the idea of accepting the natural body front and center.  Instead of rejecting one's body as defective, embrace it!  This exhortation has enormous appeal to intersex advocates whose central concern is stopping the imposition of "normalizing" genital surgery on intersex infants.  If only parents, upon the birth of a child with intermediate genitalia, would look on them, not with dismay, but with the same tender appreciation that parents feel when seeing tiny little sex-typical penises and vulvas on their newborns!  If only female-assigned intersex tweens weren't told they would have to have a vagina constructed soon, because otherwise they would never be able to have sexual relationships.  If only so many American children born today and given an "M" on their birth certificates weren't given genital surgery for hypospadias, sometimes just because the urethra opens low on the penile head instead of the tip.  Shouldn't the person possessing genitals be the one to decide if the risk of loss of sensation in their genitalia is worth the presumed benefit of those genitals looking somewhat more like the idealized binary?

Now, as a practical matter, it turns out that intersex advocates and gender critical feminists have very different end positions on medical interventions into the sexed body.  Intersex advocates believe that no intervention should be forced--but also that once an intersex person is old enough to give full informed consent, that hormonal, surgical, or others interventions should be performed if that's what the individual truly wants.  Any many, many intersex people do choose interventions of their own free will.  Sure, an intersex person who has vaginal agenesis may have no desire whatsoever to have her pelvis dissected and a neovagina constructed from a section of cheek or intestines or labia.  There are so many ways to enjoy sexual relations other than vaginal penetration.  But many do want a vagina, to support female identities if they so identify, or because of the great social value placed on penetrative vaginal sex, or in the case of those with a substantial uterus and with ovaries, because they could become pregnant through sexual intercourse.  Intersex people often seek hormone replacement therapy to masculinize or feminize their bodies, or surgeries to move their urethras to allow neater or standing urination, or any of a wide number of other interventions.  And intersex advocates support all of these choices.  We just wish them to be free choices, not forced by doctors or parents or social shaming.

Gender-critical feminists, on the other hand, turn out to hold a very different position: that all interventions into the sexed body are mutilations, not just those imposed without consent.  Just as it is a mutilation to surgically alter the innocent bodies of intersex babies, they say, it is a pointless self-mutilation for an adult to choose to have their sexed body medically altered, because sex cannot be changed.  Chromosomes can't be altered.  A vaginoplasty cannot produce a real vagina, nor a phalloplasty a real penis, they say, and all interventions into the sexed body are motivated by patriarchy and thus counter to the interests of women.  The only healthy and feminist response to unhappiness with one's body presented is to learn to accept it as it is.  For intersex people, this just replaces the rigid regime of forcing medical interventions with a rigid regime of withholding them.  Switching one constraint on intersex people for another isn't the motivation for this gender critical position--I don't know if they are even aware that intersex people desire some medical interventions.  The main purpose of their argument that one must accept the natural body is to tell trans people that they must give up on the "delusion" that one can be born with a penis but really be a woman, or born with a vagina but really be a man, or born a human being and really be a member of some alternative sex.

Gender-critical feminists, it turns out, have one central obsession, and that is with rejecting trans people, or more accurately, with rejecting trans women.  In other words, they are TERFs.

Gender Crits, Radfems and TERFs, Oh My

Most trans folks are familiar with the label "TERF," standing for trans-exclusionary radical feminist.  This is the term used in most writing by trans people to refer to feminists who oppose the acceptance of trans women in feminist organizations, women-only "safe spaces," and female facilities, and who fight against regulations, laws or policies that would protect trans people from discrimination.  The designation "trans-exlusionary radical feminist" was created by other radical feminists who are not transphobic, and who were upset that the name "radfem" was becoming associated in the public mind with bigotry against trans people.

Few people actively call themselves TERFs--transphobic feminists generally portray the name "TERF" as a slur. I used to have the impression that most called themselves radfems, and were older second-wave feminists, who came of age in the era of lesbian separatism and who thought of themselves as "womyn-born-womyn."  I thought of them as people whose transphobic framing of feminist politics was frozen in their youths, destined to fade into irrelevancy as the rest of the world moved on.  But instead there's been an upswing in their movement, probably as backlash to the fact that trans people have become more visible and, while still lagging far behind the rights being secured based on sexual orientation, some protections for people based on gender identity and expression have been won. 

Now, the group in which I sojourned called itself a gender-critical discussion group.  It had rules prohibiting personal attacks and requiring respectful listening, which sounded heartening.  Nothing in its mission statement said anything about excluding people, it was open to all, and on its face, there was not a thing about it that seemed bigoted.  I could certainly understand why a random intersex person coming across the group would be curious.  I myself hoped that the "gender crits" would be different from transphobic radfems, and that their criticisms would be helpful to intersex people.   But that's not what happened, and a couple of days spent reading and attempting to have conversations left me feeling depressed and sullied.  The gender crits turned out to be TERFs by another name: feminist transphobes.  There were a few positive moments, but they were vastly outweighed by slogging through a lot of LOLing about how stupid a person must be to think they can call themselves female when they were born with a penis.

What I think it is important for trans advocates to point out to intersex people is that trans-exclusionary radical feminists believe that sex is a natural binary, innate and immutable: men have penises, women have vaginas and uteri.  The TERFs note that gender is a relationship of power, and frame this in an embodied way through binary sex: men seek to control women's uteri, reproductive capacities, and thus lives.  The ultimate expression of patriarchy in this framework is the use of the penis to rape.  As a result, "gender critical feminists" make the strong claim that anyone who denies that sex is a binary and that genitals determine gender is ignoring the terrorizing of "natal" women by rapists. ("Natal" is their alternative to "cis" to refer to a person who was born with the sex organs expected for someone of their gender.)  This gender-critical feminist claim puts intersex people in a very bad place, positioned as supporters of rape if we argue that sex is not a natural binary.  

Showing that TERF Positions are Not Good for the Intersex Community

Intersex advocates are interested in criticizing binary sex ideology--that's what makes the term "gender critical" sound appealing.  But that's not what these transphobic feminists mean by it at all.  As they use it, the phrase "gender critical" denotes being critical of (or more bluntly, rejecting) the concept of gender identity--most especially the fundamental precept of trans gender advocacy, which is that when gender identity and legal sex conflict, this provides pragmatic and ethical justification for a change of legal sex.  But intersex people don't reject the concept of gender identity at all.  Most intersex people in the contemporary West have a clear gender identity, often as women or men, or sometimes as genderqueer or as as identifying with the term intersex as a third gender category, and want their gender identities to be respected.  Intersex advocates believe it is of paramount importance to center a child's gender identity in any decisions made about altering an intersex child's body, and have been famously fighting the legal case for M.C., a child who identifies as a boy, but whose doctors assigned him female based on their treatment protocols.  The "gender critical" feminists' core belief--that gender identity is a myth or delusion that society should ignore rather than validate--would undermine M.C.'s case.  Transgender people need to point this out to retain intersex individuals as allies--and make trans support for children like M.C. clear by supporting the rights of children and adults to refuse imposed medical transition procedures, not just to request desired ones.

Another thing that may initially draw intersex people to TERFs is that they actively deny that they are transphobic, presenting themselves as reasonable women who are victims of slander.  They often say they have compassion for "men under the delusion that they are women," which they present as equivalent to believing one is really a horse or a space alien.  They only wish, they say, to help trans people improve their mental health and come to accept their bodies.  Accepting one's body means accepting that one cannot call oneself a woman while having a penis.  But participating in discussions with gender crits, it quickly becomes apparent that they are indeed transphobic--and apparently obsessed with penises.  They talk about them constantly, and presume that all trans women have them (because they say even a trans women who has genital reconstructive surgery now simply possesses an "inverted penis").  And penises are always presented as dangerous--"natal girls" might see them in locker rooms and be traumatized, trans-protective laws would mean no woman could ever be sure the person in the next stall didn't have a penis, and thus pose a threat to her.  This obsession with other people's genitals and validation of the idea that people should be upset by those with the "wrong ones" runs completely counter to the interests of intersex people.  It's the very same binary sex essentialism and acceptance of gender policing that the medical profession uses to justify intersex genital reconstructive surgery.  It is the logic used by doctors when they amputate or "reduce" the intermediate phalloclitorises of children they've assigned female: unless they do so, the child's body will inspire shock and repulsion.  In painting trans women's bodies as deceptive, dangerous and disgusting, transphobic feminists paint those born sex variant with the same brush.

TERFs are not just binary sex essentialists, however, dividing the world into oppressors and oppressed through reference to binary genitals.  They also have a theory of gender socialization.  Their vision of gender socialization is bleak: boys are socialized to dominate, control, and rape women; girls are socialized to submit to this and embrace their oppressors and call this "femininity."  Clearly this is bad, and feminism is a movement of "natal" women that teaches women to recognize and resist this programming.  Men, however, are presented as inevitably and eternally shaped by their socialization into patriarchy, as it advantages them.  Trans women are asserted to be men, and while they may claim they do not enjoy being treated as men, this is said just to illustrate their blindness to their own privilege.  Trans women are inevitably socialized to try to control "natal" women, as evidenced by their belief they should be able to force "natal" women into "supporting their gender delusion" and treating them as sisters.  Again, this rejection of gender identity conflicts with the interests of intersex people.  It also paints a simplistic and binary picture of gender socialization, a process which is in fact quite variable and complex, shaped by one's gender identity and one's many social locations.  Moreover, it is important to acknowledge the intersectional nature of marginalization and privilege, and speak not just of patriarchy but of kyriarchy, taking into account race, age, sexual orientation, (dis)ability, and other dimensions along which power is distributed.  And one of these dimensions for nonintersex people is the axis of cis privilege and trans marginalization.  Trans women--particularly those who are poor, of color, and/or have a disability--suffer huge levels of social stigma, violence, employment discrimination, etc.  

Women who are neither intersex nor trans gender need to acknowledge that while they are marginalized as women, they are privileged as cis people.  But if trans communities want intersex people to be their allies in getting others to acknowledge this, then they have to take some steps as well.  The first step for trans organizers is to recognize and affirm that intersex people don't have cis privilege in the same way nonintersex people do.  An intersex ipso gender person shares some privileges with a nonintersex cis person--having thier birth certificate and other ID matching their identified sex, for example.  But an ipso gender intersex person is marginalized in other ways like a nonintersex trans person, such as by having the veracity of their gender identity called into question by others due to what is deemed a mismatch with some of their sex characteristics.  Furthermore, I hope that nonintersex trans people will acknowledge that they enjoy privileges which intersex people lack, especially that of not facing one or many unconsented-to medical interventions into their bodies, perhaps destroying the very sexed aspects of their bodies with which they matured to identify.

A final core factor in "gender critical" ideology is that while it grows frothy in its fears about trans women, it is weirdly quiet on the topic of other trans people.  Trans men are presented by TERFs as just sad: women who don't understand that it's ok to be a butch woman or a lesbian, victims of Stockholm syndrome identifying with their oppressor.  There's some anger about butch women "abandoning" the women's community to chase fantasies of joining the oppressor camp, but the  basic attitude is that "women who are deluded into thinking they are men" should be pitied and exhorted to return to the fold.  Genderqueer people are presented as quite silly, confusing the admirable androgyny to which we all should aspire with a mythic new gender identity.  They're presented as dupes of the "genderist trend," obsessed with something that doesn't exist.  In this, gender-crits are little different from society as a whole: much more transmisogynist than generically transphobic, paying much less attention to trans men and people with nonbinary gender identities than to the big bugaboo, trans women.  

There's a parallel thing that happens with respect to intersex people.  Intersex people who identify as women get fetishized and scrutinized, and may in fact be misperceived as (nonintersex) trans women.  On the other hand, those raised as men are mostly invisible to society--in fact, many people believe the old saw that "all intersex people are assigned female at birth."  In fact, at least 1 in 125 children assigned male at birth is diagnosed as having hypospadiacal DSD (disorder or difference of sex development).  But doctors carefully avoid the term "intersex" in describing most of them--calling them just "boys with hypospadias"--and very, very few men with hypospadias come forth to claim their intersex status.  Fragile masculinity in our society discourages men from doing anything that makes them appear less than fully masculine in society's eyes.  As a result, most, though not all, of the interesx individuals assigned male at birth who come out to claim their intersex status are those who have nothing to lose thereby, as they identify as women or with a nonbinary gender.

And those intersex children assigned male at birth who mature to identify as female face huge levels of scrutiny.  Sadly, this is one of the things that my attract intersex people to "gender critical" rhetoric.  That's because transphobic feminists claim that trans women are using the intersex community to try to force others to treat them with pity.  They claim that it's not intersex people, but trans women who are always going on about intersex issues in public discourse on sex and gender.  And they claim that most people presenting themselves as intersex are really trans women pretenting to intersex status.  Unfortunately, when they hear this, a lot of intersex people nod their heads angrily.

I really have to say, as an intersex person, that TERFs did not make up the issue of trans gender intersex wannabes being a problem.  I have spent many years in support groups and networks for intersex people, and they are often inundated by people either speculating that they are intersex, or flat-out asserting it, wanting to know how to access gender transition services.  Now, there are a number of perfectly understandable reasons why people may believe they may be intersex, although this is not the case.  There's so little information given to people about intersexuality in the course of education about biology and sex.  And the idea that physical sex traits determine gender identity is widely held.  So, if a person does not identify with the sex they were assigned at birth, they are likely to be prompted to wonder if their reproductive organs or genes have caused them to trans-idenify.  And there's so little understanding even of what sex-typical genitals are "supposed" to look like or do that people can misinterpret quite typical characteristics as strange.  A person with a typical phallus may see a line on the underside and think it must be proof of childhood surgery, when all people have a perineal raphe, which extends up the underside of the typical penis.  You'd be surprised how many people have asked me if the fact that their clitoris gets erect when they are aroused is proof that they are intersex.  Similarly, a lot of people seem to be unaware that it's totally typical for women to find some darker hairs on their upper lips, or some whiskers spouting on their chins.

I see no problem with people who are questioning or exploring their gender identities to have questions about how typical or atypical they are in their bodily sex characteristics--though it can be frustrating to try to run an online intersex support board and have people posing questions like these overrunning them.  But what is really damaging to the intersex community is when nonintersex people wishing to gender transition decide they are intersex, while knowing nothing about actual intersex bodies--and then run around telling eveyone they meet strange stories about what being intersex means.  I've encountered dozens of such people, and some of the stories they tell are frankly bizarre.  Often these stories involve being born with two sets of genitals and reproductive organs, one male-typical and one female-typical, and one of these sets somehow being removed.  (One person said his mother forced him to take birth control pills as a child, which caused him to absorb his penis into his abdomen, leaving just a set of female genitals behind.  Another told me his uncle had hated his atypical genitals, so had ripped off his testicles and cut a hole for him to menstruate through, and now he just looked like a normal girl.  A third told me she had a penis and scrotum in front, but a clitoris and uterus attached to her rectum, and regularly menstruated rectally.  And several have told me that they were born with a uterus that doctors removed when they impregnated themselves.)  These are not plausible stories because intersex people are born, not with two sets of sex organs, but with one intermediate or mixed set.  And a person cannot impregnate themself, even in the extraordinarily rare situation where a person has both an ovary and a testis and a small vagina and uterus and a small phallus, because a sex hormone balance that allows producing viable sperm will not support a menstrual cycle, and one that will support a menstrual cycle will not support spermatogenesis.  

In my own experience, trans people of all genders present as intersex wannabes and tell strange stories about their bodies, trying to gain support from others to secure binary gender transition services or to validate their genderqueer identity.  A particular focus on trans women as intersex wannabes probably just reflects transmisogyny on the part of TERFs and, sadly, some intersex people.  Hopefully this phenomenon will fade away as transition services become easier to access, but today it's still a big problem for the intersex community, because these wannabes spread disinformation, sometimes setting themselves up as "intersex authorities" to people around them.  Some of this disinformation can be actively dangerous, and none of it helps demythologize intersex reality in the general populace.  Unfortunately, the substantial frustration in the intersex community about trans gender wannabes plays a large part in making transphobic feminist rhetoric sound attractive to intersex people. If the trans community wants intersex people to ally with it, it is very important that trans people educate themselves on what intersexuality actually means, and call out other trans people they hear telling impossible stories of having had two sets of genitals in childhood, or having impregnated themselves.

It's not just a problem that some trans people tell bizarre stories of impossible intersex bodies.  Trans people are going to continue to alienate intersex people if they continue to assert the more abstract claim that the entire trans community has the right to call itself intersex, because trans people have an intersex brain, or the brain of one binary sex in the body of the other.  This claim deeply alienates intersex people for two reasons.  First, the impulse to appropriate the term intersex is based on the presumption that it is better to be deemed an intersex person than a trans person.  This indicates a profound ignorance of all the the pain and marginalization intersex people face--in other words, it illustrates nonintersex privilege.  And secondly, the people who make this "intersex brain" case generally go on to assert that they deserve free gender transition services, because intersex people get those services for free as children, as society understands in their case that this is medically necessary.  This claim presents the central problem against which intersex advocates struggle--forced genital surgery performed on unconsenting children--as both necessary and good.   Arguments in favor of forced sex assignment surgery on intersex infants (or adult intersex athletes, or any other group of intersex people) are so maddening to intersex advocates that they can drive people into the arms of TERFs.

Steps Trans People Can Take to Support Intersex People and Keep Them as Allies

1.  First and foremost, since TERFs believe that the "natural" sexed body should be accepted rather than medically altered, many commenters in the "gender critical" discussion group I visited were opposed to performing genital surgery on intersex infants, seeing it as a mutilation.  This aligns with the central focus of intersex advocacy: stopping the imposition of genital surgery onto unconsenting intersex infants.  Trans advocates tend to describe hormone therapy or genital reconstructive surgery only in positive terms.  When someone presents a surgery as mutilating, trans advocates may immediately attack them as transphobic.  This is very alienating to intersex people, and it is time for a more sophisticated approach.  What trans people need to do is shift from arguing that hormonal treatment and genital surgery are lifesaving wonders that are never misapplied, to talking about a fight only for positive interventions into bodily sex, and never for negative ones.  What distinguishes good from bad medical interventions into the sexed body are autonomy and full informed consent.  Centering full informed consent will allow trans people both to counter transphobes and support intersex allies.  When a transphobic critic claims that "confused girls are amputating their breasts," for example, the reply can be, "Chest reconstructive surgery is supported by the American Medical Association as a treatment for gender dysphoria.  Those trans gender individuals who receive it are not confused, but have undergone careful counseling and have given their full informed consent.  As trans people, we believe very strongly that interventions into the sexed body should only be performed with the full informed consent of the individual involved.  For example, we oppose genital surgery when it is imposed on intersex infants, who cannot agree or disagree to it."

2.  In addition to becoming more vocal critics of intersex infant genital surgery, trans people can show that "gender critical" feminists make bad bedfellows for the intersex community by focusing attention on TERF insistence that sex is a binary.  In the discussion group I visited, the fact that people are born sexually intermediate was somehow said not to undermine the "natural" sex binary because intersexuality was presented as a disorder, and, I was informed, "you can't take a disorder and call it a sex."  Group members believed intersex infants must be permanently assigned to a binary sex.  They dismissed the alternatives advocated by intersex people (removing sex-markers from birth certificates generally, or making a provisional sex marker listed at birth easily amendable to "M," "F," or a nonbinary alternative, once an individual matures to be able to express their identity and give full informed consent).  Removing binary sex markers from IDs, or at least expanding the gender options and making them easy for an individual to change, are also goals of the trans community. Trans advocacy about gender markers on identity documents is widespread, but rarely if ever addresses the central intersex concern about such markers: that requiring a permanent gender marker on the birth certificate leads to hasty binary sex assignments for intersex children.  Making this issue a regular part of all trans advocacy about gender markers, and offering to work in partnership with intersex groups on it, would be a good way to strengthen trans/intersex community ties.

3.  While it was agreed in discussion in the gender crit group I visited that doctors shouldn't perform cosmetic genital surgery on intersex babies, I was told that they should examine the infants and assign them to the correct binary sex based on capacity to reproduce in the "very rare" situations in which that would be possible without surgery, and otherwise on genes.  This was an odd rule, not comporting with the treatment protocols imposed by doctors, and would lead to results that the discussants seemed unaware would counter their own precepts.  For example, people with complete androgen insensitivity syndrome (CAIS), born with typical vulvae and developing female secondary sex characteristics at puberty if unaltered by gonadectomy, would be understood as permanently and naturally male, being infertile and having XY chromosomes.  Yet CAIS is often not diagnosed until late childhood or puberty, so either CAIS teens would be forced into gender transitions--a process the "gender crits" frame as impossible--or the TERFs would have to accept XY women.  Trans advocates can point out that TERFs propose schemes for assigning intersex children to a permanent binary sex that are even more problematic than those applied by doctors today.  Demonstrating that the trans community has considered the outcomes of different sex-assignment schemes, and understand why both the standard medical protocol and the TERF alternative are harmful to intersex children, will prove that trans folks are doing the real work of being allies to intersex people.

 4.  Since the central point of "gender critical" feminism is that gender identity is a sort of delusion or myth, the idea that families and society should allow a child to mature to assert their own gender identity (male, female, or something else) is basically incomprehensible to transphobic feminists.   This is an important issue to focus on for trans advocates seeking to cement allyship with intersex groups.  Intersex advocates urge, in addition to leaving intersex children's bodies intact, assigning them a provisional binary gender marker to deal with institutional forms and spaces requiring one, but following the child's lead, and supporting them in whatever gender identity they grow to have.  This is a model trans advocates can certainly support, while TERFs view it as "genderist" lunacy, and that's an excellent fact to point to in showing who the real allies of intersex people are.

5.  We've discussed how transphobic feminists try to draw intersex people to them by framing trans people as appropriating intersex issues.  Trans advocates can turn this claim on its head by showing that "gender critical feminists" are appropriating intersex issues to try to advance their transphobic goals.  The main situation in which intersex concerns were treated as relevant in the group I joined was in the context of discussions of trans-identified children.  (A particularly overwrought conversation in the group discussed an article which bore the blaring title "Toddler Aged 3 Assessed for Sex Change at London Clinic," which actually just reported that a 3-year-old was assessed for gender identity issues, not that the child was offered any sort of hormonal or surgical treatment.)  A claim made in the discussions of trans-identified children was that for parents to "indulge" this "fantasy" by bringing them to a clinic to be diagnosed, changing the pronoun they used to refer to the child, and/or having the gender marker on their ID changed was analogous to forcing genital surgery on intersex children, and thus a human rights violation that should be banned.  I don't see an analogy at all, but rather an inversion: forced genital surgery performed on infants violates their autonomy, while validating a child in their gender identity supports the child's autonomy.  I see TERFs appropriating intersex concerns about unconsented-to genital surgery to bash at children who assert a trans identity.  And pointing this out is another way to convince intersex people that the trans community is their true ally, and transphobes poor allies indeed.

So: I followed a recent suggestion that "gender critical" politics might be useful to intersex people, and spent several days reading posts and participating in a group for "gender critical" partisans.  What I found was something that left an awful taste in my mouth: a lot of transmisogyny, a denial of the lived reality of trans people of all genders, and an insistence on an immutable sex binarism that frames intersex people as disordered.  I was told that most people who say they are intersex are trans pretenders, using a tiny minority to advance their nefarious goal of insisting that gender identity should be respected and genitals treated as nobody's business other than the person bearing them and their intimate partners.  And I found the intersex community's concerns being co-opted to vilify parents who support their children in identifying with a gender other than that on their birth certificates.

Intersex people may be drawn to the intriguing moniker "gender critical," but I believe the trans advocates can and must demonstrate that these trans-exclusionary feminists make very poor allies for the intersex community.  Trans people should commit to becoming better and more active allies for intersex folks in the future, and ensure that what seems a natural alliance between trans and intersex communities does not founder, but flourishes.