Silke Steidinger’s “Exploration of gender dysphoria”

Silke Steidinger, psychotherapist, musician, and researcher on minority religious movements, “explores being human” and produced her film, “Trans-Actions: An Exploration of Gender Dysphoria” for her MA degree. She is gender nonconforming, AFAB, but apparently not trans as the person who introduced me to it claimed. That person is an anti-trans campaigner, yet she called it “a very good film” and I find it interesting.

In 2018, Steidinger produced a ninety minute film, and now only a thirty minute cut is available. She interviewed trans people, anti-trans campaigners, and medical professionals. They were,

  • Christopher Inglefield, a plastic surgeon who performs trans surgeries and cis man;
  • E-j Scott, curator of the museum of transology and trans man;
  • Susie Orbach, psychoanalyst and cis woman;
  • Emily-jo Miller, performer and trans woman;
  • psychotherapist Robert Withers, later disgraced, cis man;
  • Peter Tatchell, human rights campaigner, cis gay man;
  • Susan Matthews, contributor to a discredited anti-trans book and cis woman, who unfortunately spreads the myth of desistance;
  • Peter Fonagy, psychologist and cis man, and
  • James Caspian, cis man anti-trans campaigner who seeks to do worthless, unethical “research” and conspiracy-theorises about why the ethics committee prevented it.

Caspian introduces himself, then only appears once in the film, saying he is taking his former university to court. Judicial review was refused, so he went to the European Court of Human Rights in February 2021. Their target is to deal with cases within three years. (When I refer to “the film” hereafter, I mean the shorter version, as I have not seen the longer version).

Then Steidinger assembled their comments to show different ways of seeing trans. Her questions are rarely included. Sometimes she writes an afterthought on the film. She has a twitter but does not tweet. Her eponymous website is no longer available. As a psychotherapist, she offers help with gender and gender dysphoria, among many other issues, by offering a secure attachment with professional boundaries.

Why would an anti-trans campaigner and a trans woman both think a film about trans interesting or worthwhile? Perhaps she saw the ninety minute version, and perhaps it gives a very different impression. Or, on a superficial viewing both could pick out the bits they agreed with, and dismiss the rest, not knowing how someone coming new to the film might see it.

The film starts with Scott, the trans man, who says the NHS has a gender crisis, then goes on to Withers, who says trans people have psychological issues they can’t recognise. Scott is shown saying he knows no detransitioners and the panic is unfounded, then Withers tells the story of his trans patient. After nine years expressing female, the patient reverted. Being post-operative, he needed a testosterone prescription and cannot live fully as a man. He was vilified by the trans community, says Withers, and unfortunately that is likely. He would be angry about being treated, we would be frightened his case would be used to prevent our treatment. Therapist and client both thought he had been sold a surgical solution to a psychological problem, and Withers’ refusal to consider alternative explanations later led him to being sanctioned by the discipline tribunal- but few people coming new to the “debate” will know that.

Very well. There are detransitioners. For the anti-trans campaigner, that is all that needs to be said. Transition has damaged them. For me, given that retransitioners talk of the transphobia that led them to detransition, it is all more complicated than that.

The surgeon, Inglefield, repeatedly says that surgery- the removal of breasts and penises, changing the facial appearance- is the only cure, but then is shown saying “Even five years ago, individuals would have been pushed into surgery because they were told the only way to manage GD is surgery.” So he is shown apparently contradicting himself. So is Peter Tatchell: he is shown saying with gender dysphoria there is too much focus on anatomy and not enough on psychology, and then shown saying he has always opposed the designation of trans people as having a mental health issue.

Matthews is an academic in English Literature who nevertheless expresses forceful opinions that trans children aren’t really trans. In the film, she appears once, saying she was concerned about the psychology of gender clinic clinicians, “blasé to the harm” they did their patient. At this point, the hater would be cheering.

Orbach gets a lot of screen time. She says the idea that medical treatment should be for a medical disorder throws up challenges to gender treatment. She does not think you should need a psychiatric diagnosis in order to get treatment. But as a psychotherapist, she would investigate people’s search for meaning, the complexities of their situation, their ability to be certain and at the same time tolerate internal differences.

Then she says (I think) that gender dysphoric children are forced into treatment because of pressure in the culture stopping them accepting their bodies, rather than a problem with the body itself. Well, I would like to change society too, and get rid of gender stereotypes, but until we do we need physical therapy.

Fonagy is chief executive of the Anna Freud national centre for children and families, where he taught Steidinger. He says that the distinction between physical and mental is unhelpful. I am not a Cartesian dualist either. He says trans people should have an opportunity to explore, psychologically, their problem with their experience of their body, without being stigmatised as mentally ill. The stigma reduces their willingness to explore their feelings. He feels if this were done, it might produce a resolution of gender identity issues “above other approaches that are more radical”. He can only mean surgery. So, if we understand, we will cease to want to transition, or at least to transition physically.

In the middle of this, Miller is shown saying easing gender dysphoria by psychological treatment is not a viable alternative. It would only end up seeking to deter people from transition. So cisnormative people, uncomfortable with trans people, are seeking a solution which they find comfortable.

Near the end, a caption asks, “What is gender dysphoria?” Miller says, “I dunno it’s hard to describe”. She is 23, transitioned since 17, and still “hyper aware of facets that seem overly masculine”. It’s how she is perceived, but also it is in her body.

Fonagy then says we need to be more sensitive to how gender can manifest in an individual.

Steidinger hardly appears until the last segment. She strings together her interviewees’ answers. But with Scott, we hear her voice. She asks him if he has thoughts about the causes of transgender, and he finds this stigmatising, like old questions about causes of homosexuality. We seek causes for things we find unpleasant or unacceptable.

Steidinger still thinks it is an important question. Things run smoothly for cis people, for trans people there is disruption, she says. Well, that is because society others us. Scott says it is possible that there are problems with current understandings of gender, even understandings which include trans people, but that is a different question.

Steidinger says, “I identify as lesbian”. An afterthought appears written on the screen- “Well, gay really”. “And also as gender nonconforming. I wanted to be a boy until I was twelve or something” and in writing it says, “Maybe to this day at times….”

“I ask what being gay was about,” she says. Ah, there it is. It is a film made by someone forced to question herself because she has minority sexual desires, and possibly a minority gender identity. So she produces a film where authority figures speculate on causes and psychological cures for gender dysphoria separate from being trans.

I know nothing of the ninety minute cut. I too speculate about causes, and underlying psychological issues, and get more and more certain that I am deeply feminine. Transition was the only way I could permit myself to be who I am. For me to feel safe presenting male but expressing my femininity would need a different life for me, a different upbringing, and almost certainly a different world.

I hope Steidinger has not suffered abuse for her film, but probably she has. Anti-trans campaigners could probably watch the short version and go away satisfied that surgery is wrong, and possibly that post-operative trans people are damaged, pitiable, and probably dangerous. And I see a filmmaker whose gender does not fit our society, who is questioning, and who just wants a psychological solution, as I still do. Oh, I want not to be in conflict.

And the film shows various cis people claiming that gender dysphoria is a psychological problem needing psychological solutions, and two trans people insisting it isn’t. So it is the perfect introduction to the “debate”. Which do you believe?

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