Everything You Ever Wanted to Know about Trans (But Were Afraid to Ask)

by Brynn Tannehill

There are butch transgender women and femme transgender men. There are gender fluid, gender non-binary, and genderqueer transgender people as well. Asserting that transgender people reinforce stereotypical gender roles ignores all of these people, while conflating gender identity and expression.

In 2014, the Williams Institute at UCLA released a study which analyzed data on suicide attempts by transgender people. It found that bullying, homelessness, familial rejection, and even rejection by health care providers significantly increased the odds of a suicide attempt.100 It isn’t being transgender that’s killing us, though. It is the culture we live in, discriminating against us and instilling in us a deeply rooted self-hatred.

Another issue with the DSM-IV was that the criteria for diagnosing transgender youth did not require that a child experience dysphoria or have a cross-gender identity, merely that they exhibited stereotypically cross-gender behaviors. For example, a boy who plays with dolls, dresses up, prefers female friends, but does not identify as a girl could have been (and often was) diagnosed with gender identity disorder (juvenile).123 This created problems later on, as some therapists were claiming to “cure” children who were never transgender to begin with. This conflation of gender identity and gender expression also led to problematic results in research.124

What the actual hell

Being transgender (or having a transgender identity) isn’t in and of itself a mental disorder according to the DSM-5, but the distress caused by being transgender still is under the name of “gender dysphoria.”

The mental health community tried for decades to change people’s gender identities, the same way they tried to change sexual orientation. Drugs. Talk therapy. Physical abuse. Aversion behavioral modification.138 Electroshock therapy.139 Lobotomies. Chemical castration. Institutionalization. It doesn’t work.

The overwhelming consensus of the psychological community is that gender identity is formed by the age of 2 or 3.207 The consensus of the medical community is that sexual dimorphism of the brain occurs in utero as a result of exposure, or lack thereof, to androgens. In other words, gender identity and expression are often determined before a child is even born.208 It is only at 2 or 3 that they can express it.

This is an evolving area of neuroscience, and there is an emerging body of evidence of the effect of sex hormones on brain development. In utero, the reproductive organs develop and differentiate earlier than the brain does. When the brain later develops in ways that typically differentiate between male and female, it seems to be based on whether or not the androgens are present and received.209 Usually, because the gonads are already in place and producing minute amounts of hormones, this differentiation allows the brain development to match the typical pattern. When something (such as endocrine-disrupting chemicals) interferes with this process, you can get a mismatch between phenotypes.210

There is no proof that postnatal social environment has any crucial effect on gender identity or sexual orientation.

Nearly every parent of a transgender child I have met has told me that they reached a point of acceptance when they realized that they had a choice: either accept their child, or lose them altogether.

One of the most commonly used drugs to block puberty in transgender children is leuprolide, and has been used on children who aren’t transgender to prevent precocious (early onset) puberty.219 It has been approved for this purpose by the US Food and Drug Administration (FDA) since 1993.

Unlike puberty, however, leuprolide is reversible. If a youth on leuprolide decides not to transition, the drug is discontinued and puberty proceeds as normal.

One of the most prevalent attacks on transgender people is that they, as a population, suffer from high levels of suicidality. The anti-transgender argument nested in this is that transgender people are innately mentally unhealthy, and the best way to address this is to make them “not-transgender” by forcing them to spend their lives in the closet or to detransition. Usually this involves some implication of reparative therapy of some sort. However, when examining the actual factors associated with suicidality, it is not being transgender that is the cause. It is the society they live in which stigmatizes them that results in such high numbers.

Gender identity (the conviction of belonging to the male or female gender) [and] sexual orientation (hetero-, homo-, or bisexuality)…are programmed into our brain during early development. There is no proof that postnatal social environment has any crucial effect on gender identity or sexual orientation.288

The International Olympic Committee (IOC) settled the issue of transgender athletes in 2004, when it released the rules for them to compete.319 These were updated in 2016 by removing surgical requirements and bringing the period of HRT in line with existing National Collegiate Athletic Association (NCAA) rules. The current IOC rules boil down to four basic points: • They do not need to have had gender reassignment surgery. • They must have legal recognition of their assigned gender. • They must have been on HRT for at least one year. • Their (transgender women) testosterone levels must fall within the range of female norms.320

It is also important to know that any strength and endurance advantages a transgender woman arguably may have as a result of her prior testosterone levels dissipate after about one year of estrogen or testosterone-suppression therapy. According to medical experts on this issue, the assumption that a transgender woman competing on a women’s team would have a competitive advantage outside the range of performance and competitive advantage or disadvantage that already exists among female athletes is not supported by evidence.326

The conservative plan to effectively end the LGBTQ rights movement has snapped into clear focus based on these legal challenges. It is not a short-term plan, but it is one that will inevitably take place over the next five to ten years. The scary part is that the right-wing plan to tear down 40 years of civil rights progress using the court system is not just feasible, but also highly likely to succeed.

HB2 would likely have allowed discrimination against anyone who violated any sort of gender stereotypes, and didn’t happen to be carrying their birth certificate on them. The bill made it perfectly legal to tell non-transgender women and men (cisgender women and cisgender men) that they cannot use the bathroom if they do not meet some arbitrary standard for femininity or masculinity. Butch lesbian?555 Take a hike. Have polycystic ovarian syndrome or acromegaly?556 557 No loo for you. Teen boy who wears his hair long? Go use the women’s facilities and hope your friends do not ever find out. Wearing sweat pants and a hoodie instead of a house dress?558 To the men’s room you go. It is not hard to see how this bill had potential for abuse.

Transgender people make a great political dog whistle for conservatives. They are a tiny minority that the public has had a hard time empathizing with. It’s harder to empathize with people whose experiences you don’t understand. That lack of understanding allows conservatives to fill in the gaps with their own explanations of the transgender experience. It is relatively easy to demonize a group of people you don’t know or understand, and social conservatives have done so with gusto in recent years.

Socially conservative commentators like Williamson approach transgender people from a perspective of “this is what I think based on nothing in particular other than my own personal disgust” rather than “this is what the bulk of research shows and what the consensus of the medical community believes.”

Conservative commentators cherry-pick the fact that gender dysphoria is in the DSM-5 to claim that all transgender people are, by definition, mentally ill. They fail to note that the American Psychiatric Association (APA) does not list being transgender as a disorder, that the condition of gender dysphoria is only diagnosable if there is “clinically significant distress,” and that the main reason why the diagnosis was included is because medical professionals need diagnostic codes for providing treatment. Indeed, the APA specifically states that “gender nonconformity is not in itself a mental disorder.”578

Fundamentally this is just a continuation of the all-but-lost cultural war on gays, lesbians, and bisexuals. Twenty-five years ago, social conservatives were making the same accusations that LGB people are psychologically damaged sexual predators who recruit children. These same conservatives oppose societal acceptance of LGB people as much as they did 25 years ago but it has become a political and legal liability to express it openly. Targeting transgender people does not (yet) carry the same political penalties.

Trans people are more likely to be the victims of violence in gender-segregated spaces including public restrooms and there has never been any evidence to indicate that transgender people or mythical “people claiming to be transgender” enter these spaces to engage in illegal or improper behaviors.689 Significant numbers of transgender people report being denied access to facilities, or being physically or sexually assaulted in them. Almost 60 percent of transgender people in a national survey report having avoided going to the bathroom at least once in the last year for fear of harassment or assault.690 Regardless, if a transgender person ever did engage in improper actions in a bathroom, there are already laws to prohibit such conduct; thus these laws do nothing but stigmatize transgender people.

While many individual Republicans are not hostile to LGBT people, it does not prevent them from voting for candidates who are incredibly hostile towards LGBT people, to the point of being off the deep end.

PRRI also found in a follow-up study that 34 percent of Millennials who left their religion did so because of their religion’s anti-gay teachings or treatment of LGBT people.959

The latest research shows that socially transitioned youth who live in supportive families have mental health outcomes equal to their cisgender (non-transgender) peers.990 A Danish study on the use of puberty-blocking medication on transgender youth showed that the test group had mental health outcomes equal to their peers, no medical complications, and that none of the cohort expressed regrets.991 A separate US study released in 2015 had the same results.992

Eighty-seven percent of Americans know someone who is lesbian or gay, but only 16 percent know a transgender person.1129 Thus media portrayals of transgender people are likely to have a disproportionate effect on how cisgender people perceive a transgender person when they meet them.

Satire can be incredibly socially progressive when the audience is somehow wiser than the characters in the skit. They have to know why something is a dumb idea, or wrong, or enforcing a misguided stereotype in order for the satire to be effective. Whether it’s Saturday Night Live, Mel Brooks’ movies like Blazing Saddles, or In Living Color, great comedy and satire clearly illustrate biases and perceptions in a way that highlights their stupidity and shows how much damage that stupidity causes. Most people, though, know very little about GCS, and even less about trans masculine people. Instead of breaking down stereotypes, the video reinforces them. It takes existing confirmation bias and tells the audience, “Yeah, run with it.” Great satire doesn’t come at the expense of a group that’s already the butt of jokes and stigmatized to the point of poverty.

Until a transgender person matters to you in a personal way, most people will treat transgender issues as “Not my circus, not my monkeys.”

In the 1970s, a strain of Second Wave Feminism hostile to transgender people emerged. Academic Janice Raymond’s book The Transsexual Empire is an example of this line of thinking.1201 Much like religious conservatives, some of these feminists reject the idea that gender identity is separate from sex. Other anti-transgender feminists argue that sex is biology and that gender (and by extension gender identity) is purely a social construct. Both religious conservatives and anti-transgender feminists reject the concept of an innate gender identity that is independent of sex and social conditioning.