What do doctors do, exactly? They cure physical illness, but with disability it is more complex- they help patients conform to an ideal as well as possible. Synaesthesia seems at best a distraction, but many synaesthetes like their peculiarity and seek no cure. Messiaen used it in his music, producing colours only he could see but sounds many enjoy. Mental illness is cultural with medical responses: what level of boisterousness is classed as manic? Plastic surgery is given for preference, even where there is no physical or mental need of it.
Trans women could fit three separate categories here. I am a woman, so my deformed, enlarged clitoris is reduced, to look like any other woman’s. I am mentally ill, with the chronic delusion that I am female, so unusually the doctors help me conform to my delusion in the hope it will make me function better. Or I am well, but want to alter my body so should have plastic surgery if I want it.
I say the sickness is in society and not in me. I am effeminate and unmasculine, and this is a bad thing- or at least I hear enough messages that it is bad, for me to be distressed at how feminine I am. You might think society is more accepting than that, but a friend recently expressed to me his distress at being thought unmanly. He thought the solution was to become more manly, rather than to find people who would accept him as he is- like the two of us who heard him, at that moment. Perhaps he will change, and see the solution as self-acceptance; and perhaps he will veer between these two paths, uncomfortable on both.
Whether I am a man or not, I am more comfortable dressed feminine calling myself Clare. If others were completely happy with feminine men, I would not need to, and perhaps never would have. I might have retained my gonads. This fashion blog, where I got the pictures, thinks that is OK now. I notice evidence otherwise.
We don’t fit in, so get sent to Doctors, who have to do something. How to alleviate distress? “Therapy” to make me more Manly does not exist, though some treatments might get me suppressing my nature, to my harm. I don’t think I am mentally ill, but within the normal range of feminine to masculine. Are there ways to thicken my skin, get me able to tolerate messages I should be more masculine, that I am wrong in some way? What we have in Britain is a path where those who persist in expressing ourselves female are allowed to have hormones and plastic surgery to help us better approximate a female appearance; or deal with the issues in our own way, without the treatments. In Iran, where homosexuality is seen as wicked but transition permitted, some people who would function as gay men here get gender reassignment.
I needed to accept my femininity. Without the cultural judgment that such femininity is womanly, a psychiatrist might have seen that self-acceptance was the way to alleviate my distress, without the need for transition.
But transition is the path the doctors prescribe. They like to do what all the other doctors do. That is the Hunter v Hanley test of medical negligence- did s/he do something different?