Some people are trans. How much of that is innate, and how much cultural? I say effeminate men might find transition attractive. Others say that people with the sexual orientation of autogynephilia transition- in that case I am bisexual between an autogynephilic orientation and a gynephile orientation, as I am attracted to women other than myself. The real world is more complex than theories can portray.
Others say the phenomenon is Trans, where female souls/brains/psyches in male bodies are only happy once transitioned, and children as young as three can experience bodily dysphoria, loathing their penises. This is the “trans ideology” so hated by the TERFs. If I am really a woman, of course I should be allowed in women’s space. I say I am sort-of culturally a woman, an anomaly, so should be tolerated in women’s space, because the majority of women so tolerate me, and because I am harmless and we are mostly harmless.
Or I could say that I am Different, so for the comfort of the Normal people I have to be shoved into a box, and when I could not tolerate the Man box the Transwoman box was the other one available. The goal of Diversity is that no-one should be shoved into a box.
Possibly what you want to do governs what you think about it. I wanted to transition, so I thought I was transsexual. And what your identity is affects what you do. I thought true transsexuals had sex reassignment surgery, so I had sex reassignment surgery. So there are different names for it, validating it- gender confirmation surgery is the latest I heard. Neovagina, says the surgeon, making it sound good. “Fxxk hole”, says the radical feminist, communicating her contempt.
This post about identity is written by someone who opposes transition. People approach medical services saying they are trans, and seeking medical reassignment. Their identity is that of a trans person. They believe they are a trans person, and that that means hormones and surgery. Lisa Marchiano wishes to treat gender dysphoria as a symptom, and explore with her patient what that symptom means. Gender dysphoria causes distress. The identity model says the person is trans, and the way to alleviate the distress is medical transition. Marchiano is against transition: it is a “drastic, permanent medical intervention”, leading to “permanent, life-long sterility 100% of the time”. One never reads in such articles that transition makes some people happier and higher-functioning, but it does. I would be happier if the writers admitted the value of transition for the patient in some cases.
She values self-identity. We tell ourselves stories about ourselves. I identify as Quaker, Scots, English, cultured. These things matter to me. The therapist accepting them empowers me. The therapist only challenges them if they lead to maladaptive behaviour. Yet how can I know myself? I identified the Real Me as female, but now identify it as feminine. I am a pansy. My self-identification often is changed by the words I use. I seek more accurate words. She says gender dysphoria does not mean necessarily that I am trans, but that the therapist needs to explore the meaning of the symptom and be open to what emerges. That she questions self-identity as trans does not mean she treats the symptom as unimportant or illusory.
She breaks down gender dysphoria into separate symptoms, including alienation from ones body. I hated the slimness of my arms, because it seemed weak and unmanly. Now I love my arms and hands, which I find beautiful. Finding a way to accept me as me, rather than accept aspects of my body because they fit “woman” and I identify as “trans woman”- accepting what is, and finding the good in it- would have been better than transitioning, if only I could have pulled it off. Teenage girls are alienated from their bodies by porn culture, and she says they decide transition is the answer due to a social contagion: it is the answer they find, and they latch onto it, then seek out evidence to confirm it, which they find in many sites providing mutual reassurance. (As do the radical feminists who decide we are monstrous then seek evidence and reassurance to confirm that.) I was homophobic and femmephobic- a man should not be feminine, I thought. It was not internalised transphobia, but femmephobia. How much better to relieve my self-loathing than to force me into the trans-woman box which I thought fitted my feminine self!
She says there are often other mental health conditions. One doctor said I had narcissistic personality traits, another denied it, and those traits might cause or be caused by the dysphoria, but finding a way of alleviating them might make the dysphoria less serious.
I see no evidence that she accepts transition as an appropriate course for anyone. She attacks “transgender ideology” as incoherent. She says there is no basis for a “gender identity” (her scare-quotes) that supersedes “objective biological sex”. This makes her assessment of research on outcomes suspect, though I doubt you would find an objective meta-analysis, untainted by any desire to affirm or deny transition as a treatment. Her reference to “a late-transitioning MtT autogynephile” links to Anne Lawrence. That is hostile. Here she writes that trans people exist, and should be protected; but she would rather manage gender dysphoria without transition. I feel her position has hardened further since. But I agree that we should explore the anima and animus, male and female, within ourselves.
I love her desire to explore deeply the sources of distress and seek varied possible solutions. That is not the NHS model, which favours quick fixes, even bodges. We would see the person in front of us in all of their miraculous complexity, and not just as a “gender identity,” she says. If only!