Transgender Taxonomies: Alphabet Soup, Political Correctness, and the Conservative Transgender

One of those things that bothers me about the transgender community is the difficulty of figuring out what transgender-related words mean today, in the sense that they are constantly being redefined, re-invented, applied out of context, or having new contexts to which they are allowed to be applied.

Taxonomy defines identity? No, but…

The first question regarding this issue that one should ask is: why should I bother about what label is tagged to me?

This is, indeed, what I would call a typical Buddhist question — in what sense can a simple word define one’s identity? Is one’s identity limited to a certain amount of labels? But such labels vary with time and location — what does that say about one’s identity? In fact, when we speak of ‘identity’, we somehow think of something immutable about our personality, our traits, our behaviour. But the truth is that we are in a state of constant change: the way we thought about ourselves when we were teenagers hardly has anything to do with the way we think about ourselves today. So even that ‘identity’ is changing; it’s not fixed; it’s hardly ‘immutable’. Why, then, should we bother at all about defining our identity with a word (or a phrase) if it’s highly likely it will be changed in the near future — perhaps even tomorrow?

On the scientific side of the issue, this would also be a good question to pose. Knowledge about what actually constitutes ‘identity’ is also changing, as new researchers pose questions that nobody has thought about before, and try to give the appropriate answer. Different researchers, coming from different backgrounds, or asking questions in a slightly different way will come up with new answers. In fact, ‘constant change’ is what science is also about: we’re constantly coming up with new questions and new answers to old questions; we skeptically analyse the knowledge gathered by those who came before us, and try to see if we can reproduce their results and conclusions — or discover new knowledge to add to the vast amount of scientific publications that we have: since 1665, we have published 50 million academic papers, and every year we add at least 2.5 million new ones (and this amount is very likely also growing over time!).

What this means is that an idea, a concept that was brought up for the first time a few years ago will quickly be studied by hundreds, thousands, tens of thousands of people, many of which will question the same concept, and add new knowledge and information about it. This, inevitably, means that the concept changes. Most of the time, the change is merely incremental, but sometimes we have a few paradigm shifts. Let me give you a typical example, which I’m fond of quoting.

After the pioneering jobs of people like Dr. Alfred Kinsey, and more specifically, Dr. Harry Benjamin, we came to understand what we would today call the ‘classical’ models of transexuality vs. transvestism, and how the old notions (that there were only ‘sexual perverts’, namely, transvestites) subtly started to change. Dr. Benjamin is usually credited as having started to give credibility to the ‘theory’ that transexual people ought to go through transition (hormonal and surgical) in order to alleviate their suffering — after examining a child (at the request of Dr. Kinsey) in 1948 who, in spite of having been assigned male at birth, wanted to be a girl. Because children, at that time, were seen as non-sexual entities, clearly such a ‘wish’ expressed by a child must have a different origin. While it’s arguable if Dr. Benjamin was the ‘forefather of transexual studies’, he certainly was seen not only as one of the most prominent figures defining the whole scientific background behind transexuality and its only ‘cure’ (e.g. transition) to alleviate suffering, and, even today, what we know as the WPATH Standards of Care — a guide for doctors to help transgender people to go through transition — which have originally been proposed by him; but he also was known by his patients as being a caring, loving doctor who only had the interests of his patients in mind, and who helped them to transition (referring them for surgical procedures outside the US, since they were forbidden there), which, in the 1950s and well into the 1960s, would be rather the exception than the rule.

It’s thanks to Dr. Benjamin that psychiatrists and psychologists still look at the clinical issues as being mostly split among two major categories, transvestic fetishim and transexuality. I’m retaining their original, clinical names deliberately — since the whole aspect of ‘political correctness’ will also be dealt with later on this article — because they are still used today. For a good reason.

If you’re a transgender activist or an ally, take a deep breath. Transgender (and intersex) issues are a bit more complicated than other forms of social activism, and we have to turn the clock back half a century to understand that.

Nowadays we’re happy to bundle everything into the ‘alphabet soup’ — I mean the acronym LGBTIQ+ which is growing with more and more letters every year — and see it mostly as an issue of human rights — echoing the words of feminists who are not only defending women’s rights, but actually human rights. This is the same stance taken by political activists coming from the LGBTIQ+ communities (I’m abbreviating the ‘alphabet soup’ to LGBTIQ+ for now; feel free to imagine, in your head, all the other missing letters — taking only in account that I wish to be inclusive with that acronym and not leave anyone behind, but I cannot keep up with the growing pace at which new letters are added to the acronym): we’re not talking merely about the ‘rights’ of a specific group of individuals, but of human rights which apply to all individuals.

The major problem with this huge acronym is that the individuals covered by it have very different needs.

For instance, the issues purely associated with one’s sexuality (L, G & B) are mostly social issues — getting universal acceptance of the right to have a partner of whatever gender you feel romantically and/or sexually attracted to — and legal ones — having the right to marry or adopt children, no matter what gender each parent identifies with, and all the consequent legal rights (e.g. inheritance laws, or the right of partners to legally enter a country if just one of them gets a resident’s card, the right of taking care of children belonging to the couple, and so forth). There is a slight issue of public health as well: guaranteeing, for instance, good health care access to people regardless of their sexuality (i.e. no discrimination about treatments given to individuals engaged in same-sex partnerships in the case of STDs). And there is even a slight issue regarding mental health: due to homophobia/biphobia, individuals with a non-heterosexual orientation may suffer from trauma, depression, anxiety etc. due to the fact that they had to repress their true sexual orientation in fear of not being accepted.

So far, so good, but when we come to the letter ‘T’, things become much more complicated.

‘T’ stands today for transgender, but it used to stand for ‘transexual’, not so long ago — in the sense that transexuals were seen as people who suffered from having a body that was not aligned with the gender they identified with, and therefore required clinical help — from mental health specialists, to endocrinologists, and cosmetic surgeons — to be able to live successful lives. Because this also included fighting against backwards morality and giving transexual people the right to live in the gender role they identify with (which required changing many laws), the cause of transexuals was quickly picked up by activists who were already defending similar (but not equal!) issues regarding one’s sexuality.

In fact, there is some overlap in the activist fight. For instance, also not so recently ago, married transexuals who were allowed to transition would have to be forced to have a divorce, since same-sex marriage was not universally accepted; in some cases, this even required mandatory castration. By fighting for the right of same-sex marriage, LGB activists allowed T people to keep their marriages even after transition — so the fight for same-sex marriage was ‘common ground’ for the totality of the LGBT community.

By also separating ‘gender’ from ‘sex’, transexuals and intersex people were able to fight together for the right of deciding over their own bodies — namely, what kind of surgeries they would be allowed to get in order to align their bodies to their gender identities. And, working together with the LGB community, they were also able to forfeit the requirement (still in place in a few countries!) that post-op transexual and intersex individuals are forced to have heterosexual relationships (or none at all).

So it can be seen that there are a lot of points of convergence among all these communities, and it’s only logical to join forces together into a common agenda, especially one that promotes a very important buzzword in our times: diversity.

Nevertheless, the needs of each group (or even subgroup, as we will see later on) are quite different.

Consider the ‘classical’ MtF transexual case. Assigned male at birth, she wants to live her life as a woman, have a body that at least externally is female, and live a relationship and contract matrimony with a male partner, even adopt children. In this classical scenario, such a MtF transexual might even be a very strong supporter of binary gender (we’ll see why this is important later on as well) — she was just born with the wrong body for her gender and wishes to correct it.

Such a scenario had already been identified by Dr. Benjamin, and, in fact, it’s still one of the most common ones, followed closely by the reverse case, i.e. of the FtM transexual who wants to live as a male, get a male body as closely as possible, marry a woman, and have children together. Those cases are in fact the easiest to explain to the society at large, and especially to lawmakers, as well to doctors: after all, we live in a bi-gendered, heteronormative society, and someone wanting to change their bodies to fit into the ‘opposite’ gender is far more easily accepted than any other situation.

It’s also not surprising that this ‘classic’ scenario, being also the oldest one that has been recognised as such, and the one that has been more (and better!) studied, has far more chances of success to get some rights being recognised as the other, much more ‘confusing’ cases which we will analyse shortly. Indeed, in most LGBTIQ+ activist groups, it’s the ‘classic’ transexual who will be most vocal, and the one who will also be more represented, and, therefore, their needs will be quicklier established through appropriate laws. In a sense, because this is also the most common case, and the one that has better chances of success of being accepted and tolerated socially (even by a conservative, backwards-thinking society), it should come as no surprise that such cases were the first which were enshrined in law and transexuals were the first group to get their needs and rights recognised.

Incidentally, this is also why the medical profession still has the word transexual in their lexicon — it’s because it has a very specific meaning attached to a very specific scenario. More importantly, the followers of Dr. Benjamin have recognised that in transgender studies there are two completely different cases, both of which require medical intervention (in the sense of easing suffering). One, of course, is the ‘transexual’, and its associated condition, gender dysphoria, which can be treated only through transition. It is a medical case needing the collaboration of several specialities — general practice, mental health, endocrinology, cosmetic surgery — and they need to follow a specific protocol (the WPATH Standards of Care) to ensure that the patient gets the best treatment possible and can lead a normal, healthy life after transition. In this particular scenario, doctors, politicians, activists, and the community in general are all aligned towards the same goal, and work together with a common purpose.

The second case, which I have mentioned before, is the transvestic fetishist. Once the shackles of morality have been discarded, decades ago, there still remained a clinical case to take care of: while the vast majority of fetishist crossdressers have no issues about their crossdressing, some of them do, namely, anxiety (fear of getting discovered or exposed publicly, and consequently fearing the loss of a relationship or a job; shame because they were educated as children to consider crossdressing ‘wrong’; etc.) or compulsive-obsessive disorder or even depression (from a lack of opportunities to engage in sexual activity while crossdressed, for instance). Such issues fall neatly in the mental health realm of clinical sexology and are all treatable via therapy (and sometimes medication, if anxiety/depression are also present); note that in this case, unless the actual activity is somehow harmful to the person (which would be rare indeed!), the therapists will not try to ‘persuade’ a fetishist crossdresser to ‘give up’ their fetish — rather the contrary, they will teach how to enjoy it without feelings of fear, guilt, shame, etc., accomplished through learning to cope with such emotions and feelings that actually detract from the enjoyment of fetishist crossdressing, and accept it as a perfectly normal and healthy form of pleasure/sexual fantasy/whatever.

So clearly the approach towards transvestic fetishism is totally different from the one towards (clinical) transexuality. That’s why, for therapists, it is important to clearly separate those two conditions; that also means to be able to clearly identify between both in order to make the correct diagnosis and determine the appropriate course of treatment. You should think of this process precisely as the kind of thing that a doctor needs to do to figure out if you suffer from the common cold (rhinopharyngitis), influenza, a form of rhinitis (allergic or otherwise),  or something else that also affects the upper respiratory tract — all of which share many common symptoms but are treated differently. Laypersons tend to discard ‘transvestic fetishism’ as being ‘just a fetish’ and therefore unworthy of the attention of the doctor (unfortunately, many activists think precisely that way…), but from the perspective of a clinical sexologist, it can be a valid condition that requires diagnosis and has a treatment — assuming, of course, that the fetish in question does, indeed, produce discomfort, unease, or actual suffering. As said, this is not the case for the majority of fetishists.

Now, we’re not in the 1950s any more, so, even though these two ‘conditions’ are still recognised (and embodied in the DSM and other medical classifications/taxonomies), we have gone far beyond the simplicity of the ‘two-condition’ model.

First and perhaps foremost, around the 1980s, people like Blanchard (no matter how wrong his theories actually are) have ‘discovered’ that there are different ways of transexuality to express itself, which do not fit easily in this ‘classical’ model. While the so-called ‘classic’ transexual was relatively easy to diagnose when caught at a very early age — the reason why Benjamin took it seriously was because a young child was exhibiting signs of transexuality, and these could not been linked to ‘sexual’ issues, according to the prevalent opinion of those days — an increasing number of people showed pretty much the same symptoms as ‘classic’ transexuals, but they were exhibited in adult life, very often around middle-age or even beyond that. Figuring out what exactly these people were suffering from was, at the beginning, a bit difficult — especially because so many of them had tried hard to ‘fit in’ their assigned role at birth and had lived decades in that role. On top of that, they exhibited next to none of the physical (and most often not even the mental) traits of the gender they identified with. Weren’t they simply transvestic fetishists?

In the 1980s this simple diagnosis was starting to be questioned. Blanchard proposed a model of a ‘deviant sexuality’ — what he called ‘autogynephilia’ — where the sexual object of desire of certain men was drawn inwards towards one’s fantasy of having a female body. He based his conjectures on the fact that many similar cases had already been reported before, and usually discarded as ‘paraphilias’ by previous researchers, without taking the cases very seriously. Blanchard considered the hypothesis that such people would actually also benefit from transition, just like so-called ‘classic’ or ‘primary’ transexuals (or, as Blanchard himself so mistakenly put it, ‘homosexual transexuals’), but he considered (and still considers!) them a different kind of transexuals, one that has somehow a completely wrongly-wired sexuality. Ironically, in spite of all that, he suggested the same course of treatment as for ‘classic’ transexuals (which directly contradicts his own theories: if the same treatment produces the same results — in this case, a reduction of gender dysphoria — then it is the same condition, not a different one; treating it as a different condition is just prejudice, nothing more), in which he was a pioneer.

Blanchard made many mistakes, some deliberate (his own data does not sustain his hypothesis that there are two kinds of ‘transexuals’, but rather proves that those non-classic transexuals are, in fact, transexuals like the ‘classic’ ones, just having a different narrative – this allowed his clinic to ‘treat’ many more cases of ‘transexuals’, by including so-called ‘autogynephiliac transexuals’ as worthy candidates for medical interventions), some due to prejudice (namely, the difficulty at that time of accepting that transexual people could have any sexuality, for instance), some due to pragmatism (it’s far easier to go through a successful transition if one’s transexuality is diagnosed before puberty takes place; or if someone happens to be already androgynous when starting the hormonal treatments). In spite of the debunking of his theories, and even of some of his followers accepting some revisions of Blanchard’s original premises (namely that there might be a wider spectrum of transexuality, and not only two, distinct types), his theories, thanks to his own reputation in the field, have been widely disseminated and still have an influence in the minds of doctors. In other words, prepubescent children are way more likely to be accepted for transition than middle-age fathers with a solid career in a predominantly male job, for example. Similarly, androgynous males who are romantically and physically attracted to other males are much more likely to be referred to transition than ugly, very masculine-looking MtF transexuals in their middle-age, who are attracted to women and possibly married to one and having children. While this is clearly prejudice, it also reflects a certain pragmatism from the perspective of the doctors: even though both cases might have the same diagnosis, and possibly react similarly to transition, it’s much more likely that the first case will be perfectly accepted by society (mostly because they will be ‘invisible’, i.e. not noticeable externally as being trans), while the second case will have a very tough life during and after transition.

Thus, doctors do not only figure out a diagnosis. They also act as gatekeepers, in the sense that some subjective arguments — the ‘fitness for living as a person of the gender identified with’ — are also counted towards the final conclusions. And here we leave the field of purely clinical issues to enter the realm of subjective pragmatism and ethic/moral issues. Because doctors have acted for decades on behalf of newly born intersex children — chopping away at their genitals according to what was more desirable to the doctors — they also feel comfortable about taking the moral road when discussing transition options with an adult transexual. This, of course, is one of the many issues that activists have with doctors, as we will shortly see.

Now, around the 1980s, there was also a new ‘movement’ (if that can be described that way) under way. The Internet was still not widespread, but the crossdressing community kept in touch, as far as it was possible, through newsletters and magazines and similar ‘low-tech’ ways of information dissemination. And there was clearly a new pattern emerging, one that had not yet been described by medical research.

While a lot of magazines and even mail-order catalogues were clearly targeted to crossdressing fetishists, it now seemed that not all crossdressers were, strictly speaking, fetishists — a problem in classification that persists even today. Even though non-fetishist crossdressers existed for all time — there are documents and records from all epochs showing this, and perhaps one of the most notable examples was Casa Susanna in the 1950s — there was no clear dividing line between so-called ‘transvestites’ who were mostly crossdressing for sexual pleasure, and those who were mostly crossdressing for other purposes, without, however, wishing to transition (assuming that such an option was available for them!).

This lead (and still leads!) to a major source of confusion. Why should a perfectly normal, healthy husband and father, with a successful career and a bright outlook in life, feel the ‘urge’ to dress himself as a woman, unless it’s for sexual pleasure? Why would such heterosexual males wear women’s garments and adopt their behaviour and speech, even if temporarily, if they had absolutely no intention to attract a male partner? Such questions were not easily answered, and for generations, society in general but doctors and researchers in particular would throw all kinds of crossdressers in the same label — ‘transvestites’ — and just consider that some would be more shy in engaging into sexual activity than others, but they would essentially be part of the same group: it was a question of degree, not of kind.

But by the 1980s (at least!) it was clear that this was not the case. Also, groups of non-fetishist crossdressers started to become far more organised, creating their own communities, and forcefully distancing themselves from fetishist transvestites, by adopting strict rules of conduct for their events; they also started publishing lists of ‘acceptable behaviour’ for non-fetishist crossdressers, and what their goals and aims were; and they also started an attempt at creating a typical profile of the non-fetishist crossdresser.

They mostly identified as male, but with a so-called ‘inner female’ which needed to ‘come out’ and express itself. For many, while such an ‘expression’ was an unquenshable urge, it was not even sexual in nature (even though it might have been at least ‘erotic’); but the urge ‘had to be satisfied’. These crossdressers knew about transexuality, but they clearly thought that this label did not apply to themselves. After all, most of them did not really want to go through surgery to have a feminine body, nor did they want to live full-time as women. Most had family and children anyway; or even a job with a responsability that they couldn’t easily discard to ‘become’ a woman  (note that this was the actual language used, which would have not been politically correct today).

A few might actually suffer from the ‘urge to crossdress’ to the point of actually becoming non-functional in their daily lives, and therefore seeked out professional therapists to deal with their ‘urges’. But the vast majority had no such issue, they kept their urges well under control, and saw these mostly as a form of escapism, a fantasy, or little more than a hobby, albeit a very strange and unusual one.

Because they sort of ‘transitated’ between the male and the female gender, and back again, they coined for themselves the term transgender. It’s no coincidence that this word is similar to ‘transexual’, but there is a distinct difference: transexuals do not change gender, they always identify with the same gender; instead, they transform their bodies (and that includes their sexual characteristics) in order to appear physically to be of the gender they identify with. Whereas the 1980s transgender people would keep their bodies (and their sexual characteristics) but change genders, or, more precisely, temporarily adopt a different gender role than the one assigned at birth – and go back again.

Some of those ‘transgender’ people were what we would call today gender non-conforming; most, however, shared some characteristics with transexual people – like them, they believed in binary gender, they felt they belonged to one gender but sometimes had to express themselves as the opposite gender, and, regarding their identity, they would still label themselves as mostly male but with a female side. Some might even go as far as admitting to be bi-gender, i.e. Having both a male and a female gender identity, and switching between both at will. Today, such people would be called gender oscillating, or fluctuating, or sometimes bi-gender and even two-spirit, depending a bit on context. Again, in general, the characteristic of ‘being two genders

What about smoking? Is it also a criterion for exclusion??

at the same time’ and switching between them at will (without surgery or hormone treatments) would not include any form of clinical suffering. As such, this particular group rarely, if ever, gets mentioned in the transgender literature (even though ironically they coined the name!), since they neither appear at a doctor’s office for an appointment regarding their situation and are much less willing to answer surveys, interviews, etc.

Transexual, however, was a word that quickly acquired a negative connotation. I have not read about all the reasons why that happened, but I can imagine a few: in the 1990s, Blanchard was actively promoting his own theories, and using the words ‘homosexual transexual’ and ‘autogynephiliac transexual’ to designate his alleged two different kinds of transexuality. The community was not happy about the strict meaning given by medical science to transexuality, namely that, to be considered transexual, and therefore eligible for surgery and HRT, you had to:

  • Assume that there are only two genders (you were just assigned the wrong one at birth)
  • Be physically and romantically attracted to people of the opposite gender (coming first out as homosexual was not a requirement, but it showed goodwill)
  • Willing to lead a ‘normal life’ as a member of the gender identified with (at that time, the porn industry was full of so-called she-males, and some doctors, based on their own moral prejudices, would refuse to grant surgery to them, not believing them to be ‘true transexuals’ but somehow sexual deviants seeking uncommon kinds of surgery…)
  • Unmarried at the time of transition (but marrying afterwards with the ‘correct’ partner acording to heteronormative sexuality was strongly encouraged); if married, willing to get a divorce before transition completes)
  • Willing to undergo sterilisation
  • Be good looking enough as the gender one identified with so that ‘passing’ would not become an issue
  • In general, conforming in thoughts, attitudes, temperament, behaviour etc. to stereotypical members of the gender identified with
  • Willing to undergo all surgeries (i.e. top/bottom) and continue the hormone therapy all their lives (meaning that detransitioning was not an option)

This was often seen as excessive by the community, especially those that did not conform to all the above stereotypes; for example, lesbian trans women would simply lie about their sexual preferences in order not to be excluded from transition. In fact, lying to the doctors became so extremely widespread that many communities, having members that had ‘passed’ all questioning, would eagerly share the ‘right’ answers with the rest of the community, so that people had a better chance at getting a favourable recommendation for transition. With the advent of the Internet, such lists of ‘right’ answers became even more popular and widespread.

On the other hand, activists started to question the whole role of doctors to impose morality and gender stereotypes upon those that were deemed to be ‘true transexuals’ by them. Because there was clearly a huge part of the community that did not conform to the ideas that doctors had about transexuals, doctors started to be seen as the conservative gatekeepers who defended a society of two genders only, and only admitting sex reassignment surgery to those who would match the ideal stereotype of a person of the gender they identified with – while leaving all the others stuck with their gender dysphoria, classified as ‘transvestites’ or ‘deluded fetishist crossdressers’, or labelled as suffering from paraphilias (‘why do you wish to keep your penis if you’re going to live full-time as a woman, and you have already said that you prefer to have sexual relationships with men anyway?’)

The right for doctors to define who is a ‘true transexual’ (and thus allowed to transition) and who was not (and thus condemned to a life of suffering from gender dysphoria) remained polemic ever since, and has only very recently been settled by the handful of countries allowing an administrative change of name and gender without the need of ‘consent’ from anyone (surgeries are another story).

This also lead to serious discrimination according to wealth – rich transexuals could always travel abroad and find a less ethical doctors in a less ‘controlled’ county and get whatever surgeries they needed: it was just a question of being able to afford the right price. From Casablanca in Morocco to Thailand, rich people always were ‘above the law’ in what concerns deciding for themselves what to do with their bodies – and often regretted their decision and detransitioned, but, again, they could afford to do so.

While poor transexuals had no choices but to submit to the rules set by prejudiced doctors.

Things started to change from the 1980s onwards when the social sciences began to become interested in studying transexuality as well. Sociology and anthropology had quite different approaches – and therefore also came to different conclusions – towards their research about the phenomenon. I have obviously not read everything, not even the most important textbooks in the field, but nevertheless I saw that things started to become different in the approaches and attitudes towards transgender people. While the community continued to argue for their own right to self-label themselves, the social sciences started to evaluate these labels and contextualise them, and compare them to what was the norm with the medical sciences. And there were clear differences, the most important of which being diversity, and the notion of gender as a purely social construct. In other words, scholars started for the first time to question a ‘black-or-white’ world, where people were either born as what we call today cisgender (but possibly transvestites) or ‘true transexuals’ – there clearly were quite a lot of people who defied either classification, some of them suffering from ‘not fitting’ the appropriate label in order to get some treatment and relief.

So, to answer this (long) chapter’s question… labels are important for doctors, in the sense that they make a diagnosis and, based on that diagnosis, they recommend a person for treatment (or not). In the case of gender dysphoria, being labelled as a ‘true transexual’ was the only chance of having any hope of getting a friendly ear from a doctor; everything else was pushed into the realm of paraphilias and simply forgotten by doctors. It’s thanks to activists, but also to social scientists, that doctors started to realise that transgenderity was much more complex – and diverse – than they thought.

Labels change, confusion begins

We come now to the start of a complex process when the community (and later the scientific community and the lawmakers) started to change all taxonomies. But to make things more complicated, they reused existing labels and categories and gave them new meanings.

‘Transvestite’ and ‘transexual’ were the first to be abandoned. While they are still in use by doctors today (and possibly lawmakers) – and have specific meanings, diagnosis, and treatment options – they have mostly been abandoned by everybody else. Instead, the word crossdresser, to designate ‘someone who wears clothes predominantely associated with a gender different from the one assigned at birth’, started to be used as a replacement for ‘transvestite’.

This complicated matters for many reasons. First and foremost, crossdressing is an action, crossdresser is a person who crossdressers. Such a label does not mean anything else. A Kabuki player (all of which are male) playing a female character in Japan is technically ‘crossdressing’, because that’s what the word means; but a Kabuki player is not a transvestite! Crossdressing (and female impersonation in general) is an art form taken very seriously by Kabuki players and requiring years of training (usually starting before puberty); calling them ‘trannies’ would be extremely rude!

However, by employing the word ‘crossdressing’ to designate mostly an action, we lose the previous meaning, which was applied to MtF crossdressers who wore female clothing either for sexual/erotic pleasure or for ‘expressing their inner female self’ (which usually, but not always, isn’t linked to sexual activity). This confusion still persists to this day: in most contexts, when talking about ‘crossdressing’, most people — including those of the LGBTIQ+ community! — immediately think about crossdressing as a fetish and not simply as an ‘action’. More specifically, transexuals do not ‘crossdress’, strictly speaking: they dress in the clothes of the gender they identify with, no matter what their physical body actually looks like. This naturally even creates more confusion, this time outside the LGBTIQ+ community: most heteronormative cisgender people will think that someone wearing clothes of a gender that is not aligned with their physical body is ‘a crossdresser’ and therefore a fetishist, or, worse, someone having a paraphilia (this is also one of the many reasons that a few transexuals quote for not ‘crossdressing’ in public before formal transition).

This was the main reason why the word ‘transgender’ was introduced in the mid-1980s: to create a new term, not previously used by any community (nor by scholars, academics, or activists), to specifically designate those who go ‘between genders’ in some form, a behaviour that they were compelled to do with a certain amount of regularity, and which was separate from eventual sensual/erotic/sexual pleasure, or arousal, or adrenaline rushes induced by the actual act of assuming a different gender role from the one assigned at birth. This word was powerful in the sense that it was sufficiently specific to separate those people from transexuals and transvestites — the two classifications still used by psychiatrists and psychologists today — as well from drag queens (or kings) and crossdressers (mostly fetishists), which were taxonomies used by the community as well.

The ‘transgender’ word was very successful. Suddenly, people in the community understood that what we now call the ‘transgender spectrum’ included far more people than the doctors thought — but also way more than even the LGBTIQ+ community included. In particular, it allowed to include under that term those who had not begun transition but might eventually do so — and drop the ‘pre-op/post-op transexual’ distinctions, which was so often an issue of discrimination even inside the community, designating those who hadn’t made their bottom surgery a being ‘lesser’ transexuals in some way.

This had important implications. The ‘transgender’ word was more neutral, more political correct, simply because it was ‘new’, more inclusive, and people didn’t have a prejudice against it. The small, very specific community of crossdressers which used the term to describe themselves were mostly politically inactive – in the sense that they were not visible at the activist arena – and surrounded by a certain degree of secretism (most of them did not want to be seen publicly, after all); also, they wrote well about their own situation and condition, they were reasonably good at explaining transgender issues (namely, the difference between fetishists, transexuals, and ‘those in between’) and of organising themselves into support groups in order to help others. As a consequence, they had a rather positive attitude towards their own small community, and this carried over to the word they had chosen to represent themselves, transgender. But they had a wonderful advantage over other communities: in spite of their relatively strict guidelines (which differentiated their subcommunity from others) they were actually very inclusive and open-minded about who joined their groups – so far as one was willing to follow a few rules and guidelines, what they were ‘inside’ or whatever their reasons were for having a non-conforming gender presentation, one would be always quite welcome in the group. Thus, in effect, they let others co-opt the word describing their own community – which eventually changed meaning and became something entirely different (even if related).

So, what is a transgender person?

This is now 2017, and if you just type the word ‘transgender’ on YouTube, Instagram, Facebook, or wherever you prefer (even on adult sites!), you will get a gazillion hits. Never as before people are transitioning all the time and being very open about it. Some transgender YouTubers, stars in their own constellation of admirers, direct complete documentaries on their own transition; they not only answer to the uncountable questions about all possible issues regarding transition, but they even hold sessions of live streaming, where they answer directly, with sincerity, what they have been through, what self-discoveries they made, and what experiences they went through, positive and negative. It is therefore not in the least surprising that transgender people of all ages and all over the world get nowadays access not only to a wealth of information, but, much better than that, they get in touch with real, living transgender people, who are more than willing to answer every question they might have. This is by far the best option today for someone who is uncertain about their own gender to find all relevant information, well before they join a support group or talk to a doctor – things that require an extreme amount of courage to do, but it’s so much easier when one knows that one is merely walking in the heels of others who did precisely the same. And the sheer amount of transgender people willing to share their experiences is simply staggering!

Most of them are (comparatively) young, many of which still in their teens; most are millennials and therefore much more accessible to the younger generations and having a different mentality from the older ones; and most also share a characteristic in common: they are all beautiful.

Leaving that last (subjective) comment besides, we can see that most of these people have a very consolidated, uniform message, which they are quite good at transmitting to others. In essence, they describe themselves as ‘transgender’ and go to explain that this is a word that replaced the old ‘transexual’ classification; signs of ‘being transgender’ pretty much follow the descriptions given by Dr. Benjamin for the ‘classic transexual’, but with a little more leeway: in other words, you can be transgender but not do any surgeries (and still change your name and gender on your documentation); and your sexual orientation doesn’t matter. The rest of the narrative, however, is pretty much the same, and I’m sure that those people are not even aware of those similarities…

Perhaps one interesting aspect of contemporary transgenderity is the abandonment of the concept of gender dysphoria. In other words, transgender people tell to others that they did, indeed, go through depression and anxiety because other people did not allow them to transition (either the parents, their family, the social pressure, whatever). This is consistent with a contemporary thought about the self: we’re becoming much more individualistic and selfish, and all the blame is pushed to external causes, most commonly other people.

The actual words in the narrative are not totally relevant. What is relevant, however, is the exclusivist description of transgenderity. Like the ‘classic transexuals’ before them, contemporary self-styled transgender people associate ‘transgenderity’ with two things: having a different gender identity than the one assigned at birth, and going through a process of formal transition to live their lives according to the gender they identify with.

We have to tread carefully when examining these narratives. Yes, there is an element of open-mindedness which was not present in the 1990s – the issue of surgery being optional, for instance, is totally accepted; and all kinds of sexuality are also tolerated. However, those that self-style themselves ‘transgender’ do not see that word as describing a much vaster community. Instead, they consider that community to be of non-conforming gender (identity), which they believe to be something entirely different. And as the years pass, I confess that I have seen this happening more and more: the word ‘transgender’ is, once again, used to describe a very exclusive community, one which defines very clear rules about who is part of the ‘transgender community’ and who is not. They see ‘transgender’ as the 21st century label that replaces ‘transexual’, with a few added details (but very slight ones), and not as a vast community (in the sense that I use the word!) which includes pretty much everyone who is non-gender conforming in any way, including gender identity non-conformity as well as gender presentation non-conformity.

Perhaps in my own enthusiasm about the open-mindedness of the so-called transgender community I also misread a lot of definitions that I happened to read about. Indeed, it was only after many (online) discussions with several hundreds of self-styled transgender people that a new picture of the community started to emerge. Those who defend the rights of transgender people believe that transgenderity is strictly limited to a specific classification (which allows little margin of flexibility) which does not admit the inclusion of a lot of people in their category. In particular, transgender activists are fond of explaining that transgenderity only applies to gender identity, and not to gender presentation, which they assume to be ‘part’ of gender identity — which it’s not. This confused me for a long time until I understood their point of view: those who cross the gender spectrum regarding their presentation include the ‘dreadful’ drag queens/kings as well as the (fetishist?) ‘crossdressers’, two groups which the activists do not see as worthy of their attention — in fact, they would rather prefer to have them wiped out of existence, since they are seen as a source of prejudice against their activism. The more tolerant activists (I have met personally a small handful of them) might accept their existence, but they are clueless about what ‘rights’ they ought to fight for them.

I’ve talked about this issue on one of my previous essays. Legislation, in most Western countries, includes ‘freedom of expression’, which is not necessarily limited to speech (or the written word, of course), but also the way one presents socially — in other words, nobody can tell us what to wear in public. Well, to a limit: like freedom of speech is restricted, for instance not allowing hate speech, label, defamation, and so forth, freedom of expression is also restricted: you cannot run around naked except in designated places; and technically you should not present yourself in swimwear or beachwear when working as a teacher or something like that. So, there are a few rules here and there to limit one’s freedom of expression, but they tend to be very few and very restricted to certain contexts — in fact, there are more rules for private spaces (where the owners set the rules, e.g. demanding gentlemen to wear a tie and ladies to be in proper evening dress to attend a fancy restaurant) than for the public one. More specifically, in the Western world, there are no rules to prevent ‘crossdressing’, in the sense of choosing to present oneselves as a person attired with clothing usually worn by a different gender (no matter what the intent). Each country might limit this more or less, and of course I have only experience with my own country and its separation of the various kinds of places as ‘public’, ‘private’, or ‘private with public access’, where freedom of expression is just guaranteed on the first kind — but that includes a lot of spaces: it’s not just the outdoors or the streets, but all public buildings, including schools, universities, museums, all kinds of buildings bought by the local municipality (for instance, some theatres and opera houses), and of course all places where you can contact civil servants. Theoretically you would also have full freedom of expression inside a courtroom, although the judge might have a word to say on that, if they believe that your attire shows contempt or disrespect to the court, and demand you wear something different (I would have to check that, so don’t quote me on that!).

In fact, even if your intent is not ‘pure’, you would still allowed to dress as you wish; for example, you’re allowed to dress pretty much as you want to deliberately provoke others (say, to push them to accept a certain lifestyle, ideology, or even religion). Again, I’m speaking for my country; the question of wearing burqas, which is slowly being forbidden all across Europe, one country at the time, might also be posed in my own country as well (although we aren’t victims of radical Islam terrorists — there is really nothing around here that might ‘provoke’ them in some way, and we’re insignificant enough for the world not to care much if they blow away a few buildings — and we are, at least culturally, in part ‘descendants’ of the Caliphate, even though I’m also aware it was the ‘wrong’ Caliphate, it split up during the Middle Ages, oh well, it’s all so incredibly confusing, but anyway… our most holy place of Christian worship, attracting pilgrims all over the world, and possibly on the top 5 holiest places for Catholicism, is named… after the daughter of the Prophet. The irony! 🙂 ). That means that one day certain attires might be also ‘forbidden’ in my own country, although currently this is not the case. You can even go around dressed as Hitler if you wish, and with a group of followers in full SS uniform sporting swastikas all over their attire, so long as you do not engage in any activity that might be considered hate speech, racism, or whatever sort of prejudice and discrimination — and no, we do not have crazy guys walking around impersonating Hitler just because they’re allowed to do that, but my point is that crossdressing is very mild compared to all the extreme cases that are allowed around here, and which, in fact, nobody actually does that.

In any case, the problem here for activists is that ‘crossdressers’ (and remember that they have drag queens/kings and fetishists in mind!) do not require ‘extra rights and protection’ — they are fully protected by existing laws, and therefore they are seen as being outside the transgender movement and unworthy of any activists fighting for you. In fact, they even see such ‘outsiders’ as being examples of the kind of people (and behaviour) that they wish to eradicate from the mainstream’s minds, because the public in general, when they hear about ‘transgender’ people, immediately think of drag queens (rarely drag kings!) and fetishists!

This raises a huge problem. You can see the dilemma: on one hand, we have the so-called ‘true transgender people’ (according to the new definition of ‘transgender’), fighting for their rights and their acceptance into society, and who despise drag queens/kings and fetishists, because they see them as an obstacle in most people’s minds to increase tolerance towards transgender people; but on the other hand, it’s exactly those who are most hated and ostracised by the transgender activists that are in the minds of the mainstream as being ‘transgender’! So if you eradicate them from people’s minds… people don’t know what a ‘transgender’ person is.

It’s complicated. But it gets worse. What about those who are not labeled ‘transgender’ according to the current definition of the word, but are neither drag queens/kings, male/female impersonators, or fetishist crossdressers?

Oh, those pesky gender non-conforming individuals! Well, they are outside every group — which was something which did confuse me a lot, especially because I was so familiar with the former usage of the word ‘transgender’ and its inclusivity. Note how we started with the notion of ‘crossdressing’ for purposes other than performance, lifestyle, fetishism/erotic pleasure, etc. and had to ‘invent’ a new name, ‘transgender’, to apply to those who were neither transexuals (‘true transexuals’, that is!) nor part of the ‘other’ groups — those who had non-conforming gender presentation — but who also had a ‘gender issue’. In particular, such individuals, which also form a large spectrum, but are mostly male assigned at birth, nonetheless have ‘true transexuals’ at one extreme and ‘true crossdressing fetishists’ at the other extreme — somewhere in the middle, however, there is a huge group of people who crossdress for the most different reasons. Almost all, however, will at least consider that they have a ‘female inside’ in some form or other; some have narratives that are absolutely indistinguishable from ‘late onset transexuals’, even though they don’t label themselves that way, and for them, transition is just a dream; the pragmatism of a hard life of labour prevents them to take any step in that direction.

Interestingly enough is this notion that there are ‘rules’ for the ‘true crossdressers’; I have to say that I have rebelled now and then against the idea or concept of ‘rules’ to tell people what their identity and presentation should be, but, as time passes and I reflect more and more on the subject (while at the same time having met more such people over time), I think that I understand the point of those ‘rules’. In a sense, they are a speculum mundi, a reflection of the ‘gender role stereotypes’ that are evident and clear for those who have been born in those roles and identify with them — but which are a mystery for the ‘other’ gender, who has been raised according to a completely different set of rules and behaviour. So the issue here is the notion that ‘gender role’ equals ‘following (social) rules (and behaviours)’; in other words, in those groups of so-called ‘true crossdressers’ there is this notion that you can crossdress for whatever reason you wish, but if you go out with us, you will have to behave like a lady — and that means learning to behave like one. Either you agree and like it, or you’re out.

It sounds horrible and I’ve discussed this point several times, but what I actually find interesting is that, among the ‘non-conforming gender’ groups, this group — the one that originated the word ‘transgender’ in the first place! — actually demands conformance! How weird can it be?

Well, it turns out, it makes a lot of sense. Consider cisgender people — in particular, women — today: they can be whatever they want to be, without being subject to prejudice (this is what advocates, activists, and allies call cisgender privilege). But interestingly enough, this starts to be true about transgender people as well — namely, those that were formerly known as ‘transexuals’. They have actually broken the stereotyped concept that transexuals are just frustrated males who want to have gorgeous female bodies and become models — or prostitutes. Or, failing that — because they don’t have ‘good genes’ and no amount of surgery will turn them into good-looking women, much less women with gorgeous bodies — they just become advocates for their cause, join the ranks of activism, and just speak out for the rest. In truth, and in a very stereotypical way, the most visible transexual people in my own country are just in those two categories — either they are activists, or they become models or singers. Anyone who is neither… has no voice.

But this is not what we see on the YouTube channels. Sure, as I mentioned, only good-looking transexuals (especially MtF transexuals) are willing to expose themselves publicly; but they are not so ‘stereotypical’ any more. In fact, the younger generation is really indistinguishable in their looks, behaviour, and expectations for their lives from other cisgender people of their own age and social milieu. They have the same goals — it might be to go to university and study to become a doctor, for example — and even the same anxiety and stress. They talk much less about ‘transgender issues’ (although this varies from case to case, of course!) but pretty much about all sorts of issues that young people go through, cis or trans. And they don’t feel that they have to be ‘different’ in their goals and expectations — if they are free to choose like a cis person of the same gender, then they will do exactly that. And this also shows in the comments of their followers: unlike what happens on activist channels, this new generation of trans people attracts mostly cis people (after all, they’re so many more than us!), and their comments and conversation is focused on all sorts of issues that are not specifically trans — like relationships, dealing with anxiety at school, or with stress at their first job, and so forth. Typical issues that affect all sorts of people. ‘Being trans’, in a sense, is just felt to be a condition they had, something that was wrong with their bodies, but they quickly found a way to deal with that (i.e. hormones, surgery, transition…) and get on with their lives, just like everybody else who had to deal with a complex issue in their pasts. One very interesting aspect of the narrative of this new generation is that the concept of ‘gender dysphoria’ is not even present: there is nothing wrong with their minds. They just had a problem with their bodies, and got it fixed, and that’s all there is. They can accept that they have been diagnosed with depression, anxiety, obsessive-compulsive disorder, and who knows what else, but they shrug it away: it was just ‘a thing’ that had to do with having the wrong body, just like someone who has a physical defect that harms them and makes them suffer unnecessarily, but, once they get it fixed, they can go along with their lives.

This new narrative is interesting in plenty of details, and of course I hope that sociological studies start to take note of the differences, but the way these people express themselves, there is much less angst than with the previous generations. In other words, we didn’t even know that you could have been born transgender (in the current definition of the word). We had to figure it out on our own, sometimes with luck (in pre-Internet times it would really require a lot of luck!). We certainly knew that something was terribly wrong with us, mentally speaking, because we could clearly see that others were not affected that way. To give a very simple example, i.e., my own — by the time I was in my teens, and had absolutely no idea what transexuality was (and even homosexuality was thought to be a lifestyle, a choice…), I could nevertheless know that ‘the other guys’ didn’t masturbate themselves imagining themselves as being girls — which was absolutely normal for me. They did not entertain any dreams or fantasies about ‘living inside a woman’s body’, and the mere thought of that was repugnant to them; I learned that very quickly, and was rather confused, because I thought that all boys who were into girls did think just like me. Discovering that this was not the case just increased my confusion; in a sense, I struggled very hard to ‘become a man’, in the sense that I didn’t really feel I was one (yet), but since that was what everybody expected from me, it was clear that I had no real choice in there: I just had to work harder in behaving as a man ought to behave. And, of course, if you do that time and time again, over the years and the decades, it becomes your personal narrative, and you believe in it, i becomes part of what you are: your identity.

This might explain why many of the older transexual people I have met are so often very angry persons. They are mostly angry at society, of course, who forced them to be something they weren’t, and they are resentful of that, and will never forgive society for what it did to them. But often they are also angry at themselves, for not having transitioned earlier and experiencing the gender role they have always identified with; they are angry with friends, familiars, colleagues, etc. for their lack of support, or even their lack of understanding of their condition. And because so many (at least in my country) will never get a job again, they are angry because they are poor, driven to dependency from a caring parent or other family member, or sometimes dependency of a partner, simply because the alternative is to live on the streets as a sex worker. And not everybody is willing to do that (even if it’s such a common stereotype!).

So, are these Generation-X transexuals, full of their anger towards society, the ‘true transexuals’ — the ones who believe in stereotypes even for transexual people — or is it the Millennials, with their relatively careless attitude towards Big Transgender Issues  (they take for granted the rights that others have fought for), and who are far more concerned with ‘normal’ issues that young adults face —regardless of being cis or trans? Note, again, that there is a big difference between those who ‘pass’ perfectly as the gender they identify with, and those who will never pass (which is especially true of many — if not most! — MtF transgender people)!

I’m raising this point here to show how the ‘transexual narrative’ (today we call it the ‘transgender narrative’, of course) is also changing. Age does make a difference — but not only in the way hormones may modify one’s body, but rather in terms of mentality. While certainly some Millennial transgender people are also angry, even aggressive, and not necessarily happy about their situation, it’s also true that much of that anger comes mostly from anxiety (both emotions have the same cause), and, as the transgender person progresses through transition and acquires more and more self-confidence in their ‘new’ role in the gender they identify with, that anger/irritation/ ‘rebel’ outlook starts to fade into the background, and the result is a person who is absolutely indistinguishable from any other person of that particular gender. Whereas the Generation Xers continue to be angry and resentful, even after what doctors would call a ‘successful transition’. And, in fact, it is mostly the Generation Xers, with some notable exceptions (Caitlyn Jenner, a Baby Boomer, conservative and Christian, comes to mind), who have been ‘fighting the good fight’ all along, and continue to do so, and have as their main goal and purpose in their lives to keep on the fight.

Indeed, I’ve often read about the claim — which I also share — that ‘transgenderity’ as a clinical condition, or, more precisely, a mental condition — gender dysphoria — might simply cease to exist in a generation or so. Not because people suddenly became more tolerant, but simply because, like doctors have for decades chopped bits off intersex babies and nobody would know what kind of genitalia they have been born with (except for possibly their parents), the same might happen with transgender kids routinely in the immediate future, as parents and school teachers are more alert to the signs of transgenderity — in other words, a girl born with a boy’s body might simply ask her parents what’s wrong with her and why she does have that dangly bit of flesh between her legs while other girls haven’t, get taken to a pedopsychiatrist and pedopsychologist, get diagnosed with transgenderity (possibly even before the mental condition described in medical literature as ‘gender dysphoria’ starts to set in and adversely affect her mind!), do the necessary surgeries and hormone replacement therapy, and start grammar school as any other girl. By the time she’s an adolescent, she might be surprised not to menstruate like the other girls, but their parents would just explain to her that she had a rare genetic defect at birth, doctors did the best they could, but they cannot give her the ability to bear children, so she will have to live with it — just like those unfortunate cisgender women with XX chromosomes and normal hormonal levels who sadly have some genetic deficiency preventing them to be fertile.

This is naturally the utopian (immediate) future for transgender people: the ability to make transgenderity, as a ‘condition’ or even as a ‘social issue’, disappear. The good news is that we are ‘almost there’. The bad news is that this still leaves many people without access to basic rights and protection.

And here we have to come back to why it was so important for ‘crossdressers’ to adhere to rules. What was their real purpose? General acceptance. And this requires a bit more explaining.

Accepting your own ‘label’, be accepted in turn? Not really, but…

A common misconception is that ‘labels matter’. This makes sense when we consider how hard transgender people fought for having the right to be called… transgender.

This seems paradoxal, but we have to go back a few decades… in fact, to the civil rights movements of the 1960s. What happened back then (and this was especially visible among people of colour in the USA) was the notion that discrimination would be much easier to overcome if one could pass the message that they were conforming to the rules, behaviours, and, well, stereotypes of society. In the concrete case of the rights of black people, the idea was if they dressedm, behaved, had the same tastes, routines, and habits as any other American, then they would be accepted as Americans as well. In short, the idea is that accepting society’s values will lead to better acceptance in tun.

Today, as identity politics have tried to create the notion that ethnic groups, sharing common values which, however, are different from those of the mainstream community, should have the same level of acceptance as any other group. Here the idea is that non-conformity is also protected as the right of personal self-expression – and that also means adhering to a set of values, costumes, behaviours, appearance, even religion of ideology, which is not commonly accepted by the majority of the society.

This generates an obvious problem, which comes from our ancestral built-in reaction to ‘strangers’, or, more correctly, ‘others’. Humans evolved by living in extended families, clans, or tribes, which might have recognised the existence of different tribes, but would (usually) be at war with them. Because physically humans were humans, and therefore indistinguishable on the basis of appearance alone, ‘something else’ had to be artificially created to distinguish one tribe from a different one, so that a member of one tribe, unfamiliar with someone they had not met before, could easily figure out if they were friends or enemies.

I’ve addressed this before, from the angle of the shaman or medicine man as the person who would embody a culture, in the sense of orally transmitting what would make a particular tribe or clan unique – a set of rules, behaviours, commonly shared values, external appearance, and, yes, gender roles and so forth. So we humans created stereotypes for our own societies in order to distinguish ourselves from our enemies. This is ‘wired-in’ in our brains; after all, we spent dozens of thousands of years doing that over and over again, across generations.

So we’re still equipped with what I would call ‘inborn xenophobia’, the natural fear of someone who is different from us. This ‘difference’ can be expressed in a myriad ways, but as it is obvious, the bigger that’s difference becomes, the more intensely this xenophobia is triggered.

This is not to say that everybody is a xenophobe. That would be a very wrong generalisation to make. What it says is that we all have a potential for xenophobia, but, because we are intelligent beings, and can learn new things, we can be educated in becoming more or less tolerant. ‘Tolerance’ could here be pointing at something we also have inherited from our remotest ancestors: altruism and collaboration. In other words, there are circumstances where the ‘greater good’ of the human species is more important than the small bickering among different tribes – consider, in pre-historic times, how populations of small tribes, all of them enemies of each other, reacted to a common threat, such as a forest fire or an earthquake. It’s very likely that in those occasions we were able to manage to overcome our mutual distrust and work together for the benefit of the survival of all.

Indeed, we could further argue that the growth of civilisation – literally, starting to live in cities – comes from our ability to overcome xenophobia, and are able to live with ‘strangers’ in the same crowded space (compared to the vast savannah where our ancestors live). And we have lived in cities for many generations now.

The city developed therefore its own culture, on top of each individual tribe’s cultural values. Thus, citizens (inhabitants of cities) acquired new values, new behaviours, new forms of appearance, just because they had somehow to create a sense of belonging towards a much greater structure, namely, the urban population living inside a city. And we had cities like Rome at the height of its glory with a million inhabitants, lots of which came from the fringes of the Roman Empire – where they had their own culture! – but became ‘romanised’ as they came within the sphere of influence of Rome, its language, its culture, its way of thinking. In China, a vast bureaucratic empire, something even more intriguing happened: they were invaded by several other populations and successfully conquered by them – one example everybody knows are the Mongol invasions and conquests, but even Tibet managed to conquer the Chinese Empire once or twice (something which today is absolutely impossible to imagine!). But what happened to China as a civilisation? Their new leaders, instead of imposing their values and cultures, became instead Chinese – they adopted the Chinese language and culture to become fully integrated and therefore more accepted by their subjects; after a few generations, those dynasties would look as Chinese as any other, their remote non-Chinese past long abandoned and forgotten. ‘Becoming Chinese’ was the notion that barbarians had of the ultimate degree of sophistication.

Something similar obviously happened on other civilisations; Germanic barbarians who were integrated into the Roman Empire quickly adopted their habits, learned Latin (or at least a dialect of it…) and tried to behave ‘as Roman as possible’. This lasted even after the collapse of the Roman Empire. The Iberian Peninsula, once the Roman Legions were disbanded after the collapse of the Roman Empire around the 5th century or so, were soon invaded by Germanic people, namely, the Goths (or more precisely the Ostrogoths), who quickly established their own kingdoms here. But they had already been Christianised, as the Romans were by that time; so even though their ways of thinking, their habits and costumes, their tradition, the way they looked, etc. were all different, they shared the same religion, and, of course, they had been in contact with Roman civilisation for many centuries, so that they were not ‘pure’ Germanic tribes any more.

But we do not need to go back as far as that. At least until WWII, it was common practice for US immigrants to change their names to a more ‘anglicised’ form of their names (both first names and surnames); ‘Drumpf’ eventually became ‘Trump’ over the generations. Even today, Chinese business persons living in mainland China are very quick to adopt at least English first names, because that will aid Westerners dealing with them (in English!) to remember their names. Some simply do business as an alias, with a full English name – and unless you’re transacting business over Skype or so, you won’t really know the race or culture of the person behind the keyboard.

Such examples show how pragmatic people deal with ‘acceptance’. The barrier of xenophobia is often bridged if one adopts the culture, behaviour, and way of dressing of the region where one lives. My own country is a typical example: there are twice as many emigrants than inhabitants in Portugal, but there are no ‘Little Portugal’ communities in any other country, or Portuguese neighbourhoods. Except perhaps Newark in the US (which I have never visited), most Portuguese living abroad simply ‘blend in’, trying to learn the local language and customs and habits as quickly as possible, and dropping all the culture baggage they brought from Portugal – except perhaps for subtle things in the privacy of their homes, like what they cook, or what soccer club they favour. Recently, in the news, I came across a name of a typical second-generation Portuguese immigrant woman in France, who was the speaker for a small town there who protested against Muslim immigrants which were scheduled to arrive at that town. The irony is that a second-generation Portuguese – her own fathers immigrants in France – was at the forefront of a nationalist rally to claim ‘France for the French’. In fact, after a few more generations, such Portuguese lose all connections to the ‘home country’, and it’s often just by coincidence that they find that one of their grandparents or grand-grandparents were immigrants and try to figure out something about their country and customs… but this happens much more rarely than with other nationalities.

Portugal is also a good example of the opposite issue: immigrants coming from Slavic countries such as the Ukraine, Belarus, Romania, Moldova, or Bulgaria, (and a few from Russia as well), very quickly ‘fit in’, in spite of their different cultural background, and, of course, a totally different language (except for Romanians and Moldovians, who also speak a Romance language). After a year or so, they speak Portuguese with the fluency of a native, and often with merely a hint of an accent; they have adopted the culture of the country they now live in, and quickly establish friendships with the ‘natives’, who, in general, love them. Why? Because they make an effort not to look like strangers. Obviously their Slavic features will stand out in a Mediterranean crowd; but because they all make such an effort to ‘blend in’ we consider them ‘ours’. This is shown by sharing the strange tastes in soccer: it’s almost as likely for Ukranians to support the Portuguese national soccer team as having Portuguese joining the Ukrainins when they watch a game sporting the Ukrainian national soccer team. Generalisations always give a wrong idea of what’s going on, but such spontaneous events occur with frequency. People from the Slavic countries, as well as those from all over Europe and Brasil, do not live in ghettos – they live among all other Portuguese, and blend in completely. I believe I have once pointed out how quickly the Brazilian girls adapt to Portugal – there are obviously a lot of similarities (even if everybody denies those… just to find out there is much more in common than it’s usually remembered), and having a common language helps, but Brazilian girls will stand out immediately in the way they dress, do their makeup, their hair, and so forth; Brazilian society is far more sexist than the Portuguese one, and this is also shown in the way Brazilian girls look and behave. But give them just a year settled here and they are impossible to distinguish from a native Portuguese – after all, they will shop at the same places, and check what other women wear, and quickly make the change. Also, of course, they stand out much less than the Slavs – even though the Brazilian population is a huge mix of ethnicities, ours  is also a big mix, and even though the origins of those mixes are possibly different, the result, genetically speaking, is similar. In other words: it’s very easy for Brazilians to fully blend in. Slavs will stand out in a crowd, but, in a sense, sometimes they blend in so well, culturally speaking, that we often ‘forget’ their pale skin, blue eyes, very light hair and being on average taller than the average Portuguese – and that is especially true after getting a nice tan at the beach and being able to speak fluently with barely a trace of an accent.

I’m sure you might all have similar examples, where populations who belong to a particular ethnicity or culture, for pragmatic issues, simply ‘blend in’ so well that they are completely accepted – mostly because they are not even perceived as belonging to a different ethnicity or culture!

Now, this can be true for a relative majority of transgender people. Most – but by all means not all! – prefer, for pragmatic purposes, to ‘blend in’ so well that there is no practical way (short of using an X-ray machine!) to distinguish them from cisgender people: they will adopt precisely the same behaviour, form of language, and attire as cisgender persons of the same gender they identify with.

There is ‘safety’ in stereotypes: if you don’t draw attention to yourself, it’s far more likely to ‘get accepted’. One typical example is that of Lynn Conway, a pioneering computer scientist, who did seminal work on several areas in her field. One of her masterful inventions can be traced back to her work around 1965, when she worked at IBM; by then, she still tried very hard to live as a man, under a male name, but after reading Dr. Benjamin’s book, she contacted him and went through transition (hormonal and surgical) in 1968 – when she was immediately fired by IBM. In those days there were no laws to protect transgender people from discrimination, and the idea that the popular media had of ‘people changing sex’ was closely tied to female impersonators and prostitutes, and of course IBM could not allow such a person to work for them – no matter how important her work turned out to be.

Lynn did not despair. Instead, she entered into ‘stealth mode’ – becoming absolutely immersed in her role as a woman and cutting all ties with her past, starting her career from scratch as a lowly programmer, on a different city and under a different name. She was such a talented professional, however, that she quickly skyrocketed in her career and eventually became a computer scientist working for Xerox’s Palo Alto lab, where a lot of incredible inventions that we consider today absolutely commonplace – like the mouse and a graphic interface on the computer screen, using the window metaphor; or sharing files across a common computer network; or even using tablets inside the office for taking notes, each connected to a wireless network spanning the whole office space. We take all these things for granted, but they were all developed by Xerox in the 1970s and 1980s – and inspired companies like Microsoft and Apple to develop their own software and hardware products, a decade later or so. The main reason the mainstream public does not connect most of the technical gadgets to the brand ‘Xerox’ is just because, although Xerox spent lavishly in research and innovation, they had no incentive from their board to release any product which was not a copying machine. A lot of their technology eventually appeared on their high-end copiers and printers, but not the mainstream gadgets… anyway, I digress. The point here was just to show that Lynn, hiding her past, was able to be at the forefront of technological development in computer science, and got a lot of recognition for her work – eventually being invited to become a university professor and teaching about her own achievements.

It was just in 1999, 31 years after she entered ‘stealth’ mode, that some colleagues of her accidentally traced her work back to the astonishment development made by her – under her male name! – at IBM; until then, it was thought that her accomplishments were the fruit of several teams of researchers in different areas, all working independently and coming to similar research results; it came as a surprise to learn that it had been all the work of a single person, and it was not too hard to figure out who that person was.

In 1999, of course, society was much more tolerant about transgender people, and so Lynn ‘came out’ and became one prominent activist for the transgender community.

But it’s very likely that people like Lynn never came out – this was especially true in the past, when society was even more intolerant towards those who were perceived as ‘different’. In fact, even if they are not required to do so, several adult transgender people not only transition, but actively change their whole lives, severing their ties with their former lives, and starting from scratch in a new city with a new name. They might even have been very active in the community until they finish their transition; and then, one day, they simply disappear from sight.

Now, such ‘blending in’ is not only common to post-transition transexuals. Indeed, many transgender people, especially those that still believe in a mostly binary gender (they just identify – totally or partially – with the other gender), make a serious effort to ‘fit in’, no matter if their physical appearance is ‘all wrong’. This is also true for those who are genderfluid, or, more precisely, those who are gender fluctuating or oscillating; and of course it also applies to most non-fetishist crossdressers as well.

My own wife is constantly nagging me about this point in particular: why do so many MtF transgender people present themselves as very stereotypical women? The answer was the subject of one of my essays, and the simple answer can be ‘aesthetics’ (i.e. we like to look that way), but the more complex and pragmatic one is simply ‘to better fit in’, to be better accepted, to attempt to blend in and somehow escape (or at least diminish) transphobia, by showing that we can, if we wish, present ourselves as a gender that people are familiar with, even if we have physically the wrong gender. This, more than anything, is what makes people never misgender me when I present as a woman; people might be confused about ‘what I am’ (no wonder, I’m still confused too!) but at least they see a familiar appearance and behaviour, and treat me accordingly.

There is a concept from computer games (and which was also adopted by studies in aesthetics) known as the uncanny valley. As computer games became more and more photorealistic, thanks not only to advances in software (‘borrowed’ from CGI techniques used in the movie industry) and hardware able to run that software, but also in the way computer game software houses wish to ‘show off’ their products, we have reached a point where we can almost synthetically replicate the way humans look and behave in a computer game; our brain is tricked to believe that these are ‘real’ humans in a ‘real’ environment.

But… we’re not completely tricked. There are still some minor imperfections (and these have become less and les noticeable over the years) which show that a scene or setting in a computer game is synthetically generated, and not an actual movie with real humans in a real scenario. While we can do that with CGI in movies, home computers and consoles, as I write this in 2017, are still not fast enough and powerful enough to accomplish perfect photo realism in real time. We come ‘close enough’, and this is what the the discoverers of the ‘uncanny valley’ effect have shown: as games approach closer and closer the point where the brain cannot distinguish any longer between a real and a synthetic image, the tiny little details stand out much more – it is as if the brain is trying to ‘believe’ that the image is real but fails at the last moment to classify it as ‘real’ because of a tiny imperfection.

Almost like a woman… but not quite!

This is what happens to people who see me for the first time, or from afar: they notice that I look somehow like a woman, since I have sort of the ‘right’ proportions for one. But when I come closer or they give me a second look, they figure out that something is wrong with me, but they might not figure out exactly what it is – the brain is saying that something is wrong, but the conscious mind is confused and does not really know what is wrong, there is just a feeling of wrongness which is somehow off-putting. This feeling is what we call the ‘uncanny valley effect’.

For computer game developers, ‘hitting’ the uncanny valley is not a good thing: research shows that players do not identify well with game characters which fall into the uncanny valley – that nagging feeling becomes overwhelming after a while, and people may stop playing the game and not really know why. The solution for the software industry is either taking the next step, going further into photorealism, literally bridging over the uncanny valley and totally fooling the mind (which is what the CGI industry can already do for movies, but the game software developers still cannot). The other alternative is actually less intuitive: make the characters less realistic. Strangely enough, when the characters are not realistic enough, we tend to identify better with them. Of course we all know about that in the animation movie industry: characters there are merely caricatures, but we still react to them (think about our feelings towards each of the characters in The Simpsons – how do they differ from the feelings towards characters in a soap opera?). In the game industry, this lead designers wishing to push for more photorealism to tweak the characters somehow so that they are ‘unrealistic’ enough to avoid triggering the uncanny valley effect: that’s why anime characters or comic characters from the Marvel or DC universes are popular – their canon proportions are not the same as of a human being, and we humans notice that immediately, even if just at a subconscious level.

Now, for transgender people, the rules are slightly different. Ideally, we wish either to ‘cross the bridge’ and present ourselves exactly as an average person of the gender we identify with; or, as an alternative, we are simply ourselves, even if that means looking very bizarre and not ‘fitting in’. The latter scenario might be easier to accomplish (no surgery needed!) but it also places a pointing arrow over our head, immediately labelling us as ‘outside the established norm’.  Of course, for many transgender people, this is exactly what they want, so they’re fine with that option.

For those who aren’t, crossing the uncanny valley is (or may be) the only option. Note that this does not only apply to those people who use the ‘transgender’ label as it is understood today. Some female impersonators, for instance, delight in fooling the whole audience about their gender; others deliberately do such exaggerated makeup that their true gender is not even being concealed. With occasional crossdressers, many join groups which impose enough rules – basically how to behave as a woman in public, and what to dress according to the occasion and one’s age – and either you follow the rules or you’re out – the point being that such people, when in public spaces, might not look like women, but they behave according to the ‘average’ stereotype of how a natal woman would also behave in public. Sometimes the ‘illusion’ can even come as far as to trigger the uncanny valley effect: this is especially true in mixed groups (which are more common than people think!), with both natal women and MtF crossdressers who have relatively androgynous bodies. An unknowing observer might not even be able to figure out who is male or who is female – I have once been out with a group of friends during Halloween, and we had all sorts: two genderfluid persons, one of which of the oscillating kind and currently presenting as a woman; a MtF transgender friend currently in transition to live her life full-time as a woman; myself; and a natal woman. Being Halloween, everybody except me was dressed for the occasion, meaning that the clothes reflected the character each of them was playing: witch, zombie, demon… Well, when we were sitting down having a drink, the attendant was confused enough and decided to treat us all as males – including the natal woman, who, dressed as a sexy demon, was flaunting her natural breasts with cleavage that had to be real… but nevertheless she was addressed as a man, too, which is still a laughing matter between us (our friend has a great sense of humour, so she didn’t even bother to correct that attendant).

So, labels matter if you want to be treated as the gender you present. In other words: if your goal is ‘fitting in’, then there is a set of rules to follow; if your goal is simply ‘be whoever I am’, then all rules are off, and you can pretty much adopt whatever label you think that fits best to you.

Living with your ‘label’

If you ever bother to read posts or essays from hard-core feminists, or even from those abominable TERFs (who hate transgender people and are even more transphobic than the general population!), you will have noticed that recent discussions have been around ‘what is a woman’ and ‘who defines what a woman should be’. Of course, these hard-core feminists believe that only they can define what a woman is or isn’t; with some hilarious conclusions as to figuring out if a woman without an uterus (because it failed to develop for some reason) is still a woman or not. Because such arguments about biology are so fraught to fail – for example, the notion that women have XX sex chromosomes and men XY, a discovery made in 1905 and only started to be accepted in the 1920s, only to be totally debunked in 1959, a few years after the structure of DNA was discovered, and soon scientists gathered enough evidence that humans could have a much richer variety of combined sex chromosomes, or even have different cells with different pairing of the sex chromosomes – and nevertheless be legally called ‘male’ or ‘female’ depending on a lot of external factors, such as genitalia (eventually after some ‘corrective’ surgery was applied to ‘fix’ intersex individuals, for example, a practice still  common in many countries) and, of course, gender identity. Nevertheless, chromosomes defining sex is still taught at school, contributing to outdated arguments based on the science of a century ago…

Feminists are not so easily caught in a trap, so they prefer to define ‘womanness’ as an experience – one that only a woman who was raised as female from birth can have. Everything else, no matter if the person had any choice in the subject or not, is not a woman.

Society, however, is not so harsh, as the example of Lynn Conway shows so well: if you can ‘pass’ totally as a person of the gender you identify with, then nobody will ask about your past. It’s not as if only feminist camps are allowed to rubber-stamp every legal document after certifying that a person is a woman according to their definition.

I’ve often mentioned that in my country there is no legal recognition of ‘trans men’ or ‘trans women’; in fact, such designations are considered transphobic! The law only recognises men or women; you’re only ‘transgender’ during the period starting with your diagnosis and ending when the transition is complete (which does not need to include hormonal treatments or surgery!); afterwards, no matter how you look or behave, you’re legally a person of the opposite gender of the one assigned at birth. You can think yourself as being ‘trans something’, but from a legal perspective, you’re not ‘trans’ any more. This means, for instance, that your employer cannot make notes about your former gender, or even make a note that you identify as ‘transgender’, even if that’s a ‘label’ you wish to tag to yourself.

Why this strict rule? The legislator was made aware that most transgender people, after transition, do not want to cling to their pasts, but move ahead in their new role and identity. Thus, ‘transgender rights’ are only applicable if you ‘fit in’ the common conception of ‘transexual’ (as doctors define it). And the idea here is to try to give to those who ‘fit’ in that label – and later will ‘fit’ in their new gender role – the maximum protection under the law.

Most LGBT organisations are fine with this, simply because this group is seen as the only one requiring protection under the law, and special rights to get access to highly specialised health care.

But what about all other types of ‘transgender’ people?

Well, the way I see things changing is that all these other types are being pushed out of transgenderity. Instead, they get under the common label of ‘queer’, or, more technically-sounding, non-conforming gender role/presentation.

Originally, that classification was assigned only to those who refused the notion that gender is binary, and who identified with none of the genders, both, or with genders that are not part of the binary (such as it exists in some Eastern societies). These people consisted a problem, from the strictly medical point of view: while they did not want to ‘transition’, in the classic definition of the term, many seeked surgery or hormonal treatments to subtly change their bodies to conform better to their identity and make their presentation more easy. Doctors had lots of qualms about this, since they have this Hippocratic Oath which disallows them to perform surgery to destroy or remove an absolutely functional organ (in this case, the genitalia), with the end result being something which cosmetically might look like familiar genitalia, but functionally they would be something ‘different’.

Note that there is no question for doctors to discriminate between functional and non-functional genitalia. Many women, for instance, may have been born with some kind of issue that prevented full development of their vulva, and in such cases, doctors also create a neovagina with whatever tissue they can get access to, in a way which is similar (but not the same!) as the sex reassignment surgery done on MtF transexuals; and, conversely, there is an astonishing number of elderly gentlemen who, frustrated with their sex life and the lack of an erection that can give pleasure to themselves and their partners, resort to a complex arrangement of pumps and plumbing which can restore the male organ to its former glory – using a set of procedures also not very different from what can be offered to FtM transexuals today.

So it’s not a question of technology; it’s a question of ethics. Suppose you have been assigned female at birth, but do not identify neither as female nor male, but a mix of both – you wish to change your female genitalia to male ones (even if at today’s abilities, it requires several surgeries and probably the same kind of pumps and plumbing used in elderly males). What should a doctor do? Especially, of course, if that person’s female genitalia are perfectly normal and under natural circumstances she could easily bear children. Is it ‘morally right’ to make a ‘strange’ surgery, just to please that person, and create more ambiguity in her gender, thus rendering her life even more difficult than it already is?

But the point here, from a social rights perspective, is that a non-gender conforming person is entitled to the same kind of treatment that a ‘transgender’ person has. Nevertheless, in most countries, this is not the case: such requests are often denied.

So, as you can see, the reason why so many formerly transgender people are ‘pushed out’ of the ‘transgender’ label and into the ‘non-gender conforming’ one is because of discrimination: transgender people, especially those that accept a binary gender, are much more likely to have an easier life after transition, since they will simply ‘blend in’ with people of the same gender they identify with; whereas non-gender conforming people, after doing whatever surgery they need, will very likely be even less accepted socially.

But that’s their choice, right? Not the choice of the gatekeepers?

Well… it’s really complicated. I wish it were simpler, but it isn’t…

You see, the trouble here is that there are conflicts of interests here. And I’m not talking about political things. But rather about the role doctors play in our society, and how that messes up with our freedoms, namely, the freedom of choice. These are ethical conflicts – which one shall prevail?

Suppose that you have a job as a bank manager in a very conservative city. One day you wake up and suddenly think it would be a wonderful  idea to depilaste yourself completely – including shaving all your hair – and do a whole-body tattoo. In fact, the more you think about it, the more you’re convinced that this is truly an awesome idea, and you go out of your home, ready to go to the nearest tattoo artist and get the job done.

But as you walk down the street, you realise that perhaps there might be some downsides to the idea. In fact, you have read that some people can be allergic to tattoo ink – it’s rare, but it’s a possibility. And clearly you cannot scratch yourself all over the body if you develop an allergy. Somehow, it’s best to ask the advice of a professional – and so you decide to go to your good friend the dermatologist to ask him to make some skin tests.

Now, this dermatologist is not only a professional, but he has known you for a long time, and your relationship goes a little beyond the doctor/patient scenario; let’s assume that you had developed some nasty sunburns in the past, and, fearing cancer or something, your dermatologist has given you good advice (and a special cream!) which solved your problems. So you trust his advice, and, in turn, he is fond of you and goes beyond his duty to help you out.

When you explain what you have in mind, your friend frowns upon the idea. You see, he can really make a simple test – and, as it turns out, you’re not allergic to tattoo ink at all – but there is a problem. He knows that you both live in a conservative city, and the moment you walk in the bank with your full-body tattoo, it’s almost certain that you’ll be immediately fired. In fact, except perhaps for the tattoo lounge, your friend cannot imagine any other place where they would hire you.

So he has a dilemma. He can say that you’re not allergic to tattoo ink, and thus keep his oaths to tell patients the truth (especially good, old friends!), but, by doing so, he knows that you’ll lose your job, your security, and possibly your home, cars, etc. as the mortgage and credit card payments start to roll in and you won’t have a high-paying job to deal with all those bills. But he can also say that you are, in fact, allergic (when you’re not), and, that way, ensure that you don’t do anything foolish or dramatic which would ruin your life. As a friend, he would rather sleep much better that way; but as a doctor, he should not lie to his patients, especially one you’re fond of; worse than that, you might get disappointed with him after the allergy exams, ask for a second opinion from a fellow dermatologist who has no relationship with you, and two things will happen next: you will lose your trust in your dermatologist friend (because now you know he lied to you, even if you don’t know that it was in your best interest to do so!), and you’ll go ahead with the tattoos anyway, since you can get a third, fourth, fifth opinion, all of which will show that you’re not allergic to ink.

What should your friend do? Such ethical dilemmas are complicated to solve. Your friend is both a friend and a doctor; and you have the freedom to ruin your life if that’s your wish. He, as a doctor, has no legal power to prevent you from making a fool of yourself. He doesn’t even have a medical reason to do so. But as a friend he ought to prevent you from harming yourself. You see, doctors have this terrible Hippocratic oath, under which they not only should be honest and straightforward with their patients, but they shall also never harm them deliberately or consciously. And this is something that your friend has a problem with: there is no medical reason for the tattooing to harm you in any way, but there are strong social reasons for getting harmed due to prejudice against tattooed people – especially in a conservative bank in a conservative city.

Now, this is just a hypothetical scenario, and if I were the doctor, I would obviously start a conversation asking you if you really have thought about what you are going to do – and possibly offer to buy you a few drinks and, outside the office and as a friend, try to persuade you not to do something so foolish, and explain about the probable consequences. If you still wish to go ahead and tattoo yourself (and ruin your life after being unable to get a job any more), then, as a friend, I did the best I could. Ultimately the responsibility is yours; but at least I tried to persuade you with reason and logic to abandon your crazy idea – even if you’re fully entitled to do whatever you please, tattoos are not illegal – and if I failed, well… the responsibility is just yours. But there is some responsibility that the doctor also has to tell you when you’re going to harm yourself; the doctor cannot prevent you from doing so, he can only tell you that you’re going to be harmed.

The problem here is that the harm happens outside the medical context, and, being a form of social harm, a doctor has no legal right to interfere. Perhaps the doctors is not even allowed to do so – it’s not been so long ago, after all, when drunk people who harmed themselves in catastrophic ways didn’t get treatment at hospitals just because doctors knew very well that it would be a waste of time and resources – once that drunkard is out of the door, he’ll get drunk again, and return in a worse state. So is it still legitimate to attempt to treat him?

Of course we know the answer is ‘yes’. Doctors – especially at hospitals – spend quite a lot of time patching up people who are in downward spirals of self-harm from which they will never emerge; nevertheless, their duty as doctors is to try to cure them as best as possible, no matter what happens next. That is not the doctor’s concern. Sure, you can give those persons some advice, or even schedule an appointment with a therapist, or whatever is appropriate for that particular case… but that’s the limit of a doctor’s power to prevent someone from getting any treatment. Ultimately, the right to self-harm is also a freedom everybody enjoys.

Now, this is just an analogy to show you the potential issues that transgender people face – and the dilemmas that their doctors go through. If someone is not ‘transgender enough’, should they be allowed to transition – and ruining their lives in the process? On the other hand, will it be better for those people who are not ‘transgender enough’ to be condemned to a life of gender dysphoria, and eventual suicide – or allow them to at least try to get along with their lives, in the gender role they have chosen? What about those who do not have a gender role that ‘fits’ into mainstream, heteronormative, cisgender society? They will be discriminated no matter what – so perhaps allowing them access to surgery and hormones and a change of legal documentation cannot make matters worse than they are? Also, we’re talking about adults making informed choices. Why would a doctor ‘know’ what is best for someone who might not only suffer from gender dysphoria but also from discrimination?

Last but not least, who defines who is ‘transgender enough’? While transgenderity is certainly a spectrum, and gender dysphoria has several levels of intensity, the truth is that you either identify with the gender you have been assigned at birth, and do it all the time (and are therefore cisgender), or you’re not, and by definition you’re somewhere on the transgender spectrum. There are no people who are ‘more’ or ‘less’ transgender than others; you either are, or you aren’t. And while some cisgender people may question their gender identity once in a while, the difference is that transgender people question it all the time, or at least for very extended periods and recurringly.

There is no ‘authority’ who measures the ‘level of transgenderity’ although the tables from Dr. Benjamin did exactly that, and for precisely the reason I’ve pointed out: doctors wanted to make sure their patients had a great life after transition, and that meant having the required conditions for that – having a great body for the gender they identify with, being single and without kids, etc. While all these ‘requirements’ are seen today as a means of controlling appearance and behaviour by the doctors, we ought at least to make an effort to put ourselves in their shoes: some of these doctors were not horrible emotional manipulators, ready to decide over every aspect of one’s lives, but I can imagine that some were well-intended (even if for the wrong reasons, namely, non-medical ones) and really wanted their patients to live their lives as free from discrimination and ostracism as possible.

A recent video explainer from popular e-zine Vox tried to explain why White Suprematists can create a message that is not immediately rejected by a minimally intelligent person – not all White Supremacists are absolute morons (at least not in terms of IQ!), so how can they assimilate or even believe in the kind of nonsense spawned by their ideological leaders? One thing that makes that possible is the association between being different and being dangerous. This is, I think (and the Vox journalists certainly agree), the essence of the appeal of the White Supremacist message. And as I’ve said before, it’s something that is deeply buried in our genetic makeup and in our brains: fear those who are different from your tribe, because they are from another tribe, and therefore enemies. Difference becomes danger – and our brains are pre-wired to do so very easily. Once I realised that, it suddenly dawned on me why so many people who I consider reasonably intelligent – even having some ability for constructive criticism and analysing ideas on their own – are able to subscribe to the fear-inspiring techniques used by racists all over the world.

Obviously the message of fear who is different is not an exclusive of White Suprematists – it can be used, to the same effect, by any other group, irrespective of skin colour or ethnicity. After all, it’s the same argument made by radical Islamists as well. And the trouble is that we don’t even need to look at the extreme version of that motto – kill all those who are different, because they are dangerous – and which is more familiar to White Suprematists and radical Islamists and all sorts of psychos around the world; no, even the watered-down version used by conservatives – be wary of those who are different; stay away from them or the slightly stronger variant those who are different are dangerous so we should keep them away from us – are seen as a ‘moderate’ form of xenophobia which is almost politically correct among conservatives. In other words: we can accept those who come outside our community so long as they behave as members of our community, i.e. if they effectively discard their ‘difference’ and blend in. For me, as an European living in a country where it’s strictly forbidden to take down a person’s skin colour or perceived ethnicity, it is inconceivable to understand how in the US many African-Americans did not empathise with President Barack Obama because he was not seen as a ‘black person’, but rather as a ‘white person who happened to have dark skin’ – this is because President Obama blended so well in the white-dominated culture and society of the US that it was felt that he wasn’t really a ‘black person’. I found that absolutely ridiculous; but then again, I also found it ridiculous when some Americans commented that our country was so tolerant that we had a ‘black’ mayor of Lisbon (who then went on to become a ‘black’ Prime Minister) and I was ‘huh? But António Costa is not black‘. Well, technically, he’s ethnically Indian, from a region in India who belonged to the Portuguese for half a millennium, and still boasts of having some of the oldest Portuguese families around; but, really, after five centuries, they are even more culturally Portuguese than the mainland Portuguese. Oh, sure, he has a tanned skin, but so have millions of Portuguese after the summer vacation is over, the fact that his tan is permanent is more a question of envy than of racism. In other words: because Costa (and all his fellow Portuguese-born, ethnically-Indian citizens) has blended in so perfectly within our society – and his family has done that for centuries – it’s hard for anyone around here to think of him as being different. It’s not the skin colour that makes such a difference – it’s the cultural background and how it affects behaviour and speech. In other words: people like Costa ‘pass’ so well as mainstream Portuguese that most of us never even notice that his skin is permanently tanned in a lovely golden-brown colour that most of us would spend thousands of Euros in solariums to achieve.

At a company I work with, by sheer coincidence, one of the co-founders is actually close to Costa (yes, it’s really just a coincidence). It took me a whole decade to realise that he was Indian. The fact that he has blue eyes and a wonderful natural tan certainly doesn’t make him stand out in a crowd; as Bollywood fans know, the best-looking actors and actresses in India have soft-tanned skins and clear eyes, blue or green or sometimes even more exotic colours. They look much more European than Indian… and that’s absolutely no coincidence. We can’t say those things in this politically-correct world, but Europeans and Indians spring from the same root (even our languages have a common root, namely, Indo-European)… and our direct ancestors were called… Aryan.

Obviously, we don’t say these things out loud these days – we would just be feeding racism, xenophobia, and, worse than that, giving White Suprematists even some more fuel to add to their fire. My point here is just to show actually how ‘alien’ and artificial that notion of ‘difference’ is. My point here is that, while the extreme version of ‘different is dangerous’ calls for killing those who are different, at a much more moderate level, and one that is still politically acceptable in many circles, simply staying away from those who are different – or keeping those who are different away from us – is rather common.

Doctors in the 1960s and 1970s were quite aware of that, and this is one of the reasons why they picked out those transexuals who were as little different as possible from ‘ordinary people’ to allow them to transition, while ‘keeping away’ everybody else. That was also one of the major reasons for the great success among people who went through transition: because they ‘blended in’ so perfectly, and didn’t look ‘different’ at all, they were accepted as full members of the community, so long as their ’embarrassing past’ was never revealed.

While we can easily imagine that to be the case in less tolerant societies of earlier times, it’s also true for today’s more open-minded (Western) societies, which, almost without exception, consider difference – or the right to individuality – as an unalienable right of every citizen. Our societies, at least on paper, embrace diversity, by looking at was is common among us – we are all human beings – and impose, from above, the notion that ‘difference is natural’ (as opposed to being dangerous). Obviously this clashes with the ‘difference is dangerous’ meme imprinted in our minds. In other words, we must be educated to accept that it’s fine to be different; while, left alone, most people will fear difference, since it’s part of our evolutionary baggage.

Now, this is not an apology for White Suprematism!! Rather, it’s a warning about their techniques, and a further warning that many people despise White Suprematists and similar extreme groups, but nevertheless repeat their motto, ‘different is dangerous’, which even in a watered-down version continues to be a source of racism, xenophobia, and, of course, homo and transphobia. We ought to be alert to such signs and understand where their argument is coming from to simply say that we humans are much more than a bunch of genes conditioned by evolution: we are intelligent creatures, able to devise moral systems that are above and beyond our biological limitations: this is a counter-argument for both religious and non-religious people, at least for Christian faiths, which, in general, consider their own morality, allegedly inspired by God, to be much above basic human instincts; part of the Christian teachings directly imply that all humans are equal at the eyes of God, and that Christ’s message is universal, i.e. it applies to all humans, not just a few ‘elected’ ones (even though some Christian sects have a different message, this is a departure of what is recorded in the Bible as being the words of the Christ; similarly, some of the extreme Islamic views are also arbitrary interpretations of the Koran… but I digress!). Non-religious people, of course, are fiercely convinced that by reason and intellect alone, we ought to be driven to an ethical stance that maximises the benefit the whole of society, and this means that every human being participates in society (has duties) as well as being a recipient of those benefits (has rights) – something which can only be achieved if all are held equal under the Law (or else, some would have more benefits or rights than others, while some would have more duties than others, which means that not the entire society benefits, but just a few – thus, all must be held equal under the same set of laws).

The ‘right to individuality’ is by no means an obvious, much less a trivial matter. It is a sign of the current times, but it’s anchored in the Western view that each of us has the free will to become whatever we want – something that has been philosophically true for centuries, even if it only became enshrined both legally and socially in the West countries relatively recently. The Baby Boomers, for instance, were born in an age that inspired conformity to very specific roles in society (a return to a mythical Golden Age of the past) – against which people quickly started to rebel, and which culminated in the many civil rights rallies during the 1960s and the 1970s. In fact, the recent history of the Western civilization can often be seen in the way individualism confronts conformism; in the tension that exists between the return to a mythical Golden Age in the past (conservatism) and the drive to further progress towards a better society in the future (progression/social liberalism). Those forces have always been present, at least for several decades (even if not formally expressed as such), if not a couple of centuries – and they pretty much explain the dynamics of the Western civilization.

Those forces are antagonistic, but both drive our civilisation ahead. Ironically, the best example how both forces can be applied at the same time is seen among teenagers, at least from the X Generation onwards: they want both to belong to a group (which establishes the rules of behaviour, interaction, dress code, etc.) and be free to express their individuality, especially against their own parents (who always represent conservatism). Nothing can seem so ambiguous and paradoxal as the desire (even right!) to express one’s individuality by dressing and behaving as everybody else 🙂

So, to summarise: the ultimate right to decide about your identity relies upon yourself; no one else has the right – or even the ability – to determine that identity, and this is deeply rooted in the Western way of thinking. There is, however, an exception, and it’s grounded on this objection that so much harm can be done.

You see, another fundamental tenet of Western civilisation is the notion that you are responsible for your actions and behaviour – that’s the basis of our judicial systems. We could not have a legal system if it were otherwise. But even in the strictness of that conceptual model there is room for exceptions: for instance, if you are mentally ill in some form, society considers you to be unable to be responsible for your own acts. If you commit murder while ‘being insane’, you’ll escape the most severe and extreme penalties under the law, and will get assigned to a mental institution instead, where hopefully you can be treated until you fell well again – ‘feel yourself’ again.

Being mentally ill, therefore, is an ‘acceptable’ excuse for relieving one’s responsability. Because we have created social stigmas against mentally ill people, we’re conditioned to avoid, as much as possible, to ‘become crazy’ – this is how society makes sure that people do not plead insanity willy-nilly, just to avoid jail; and we have professionals who are trained to figure out who is insane and who isn’t. They will be brought in at a trial as expert witnesses to testify if someone is insane or not.

But this is also true outside the criminal courts. For instance, I get a grant to finish my PhD in a certain amount of years (or else, I will have to return all the money!). Having developed a clinical depression which prevents me to work, an exception was opened in my case: because I’m ‘mentally ill’, I’m temporarily relieved from my obligation of finishing my work in a specific amount of time; instead, I’m allowed to treat myself first, get cured, and then I can return to my work.

In other words: doctors, when evaluating a person’s mental stability, are allowed to override the normal rules of society, in the person’s best interests, since their mental condition may be clouding their judgement and therefore such a person would not be acting responsibly.

We find all the above quite obvious and logical, since we also know that such a system protects those who are really ill, and who will be a minority in any case; in other words, doctors will hardly have anything to say in most scenarios. It’s just when we are unable to perform our duties that the doctor’s orders can override our own ‘right to individuality’, expressed in the way we act and behave.

You can now understand the role of doctors as gatekeepers for transgender people: because most transgender people do not suffer only from gender dysphoria, but likely from other mental conditions as well – anxiety, depression, etc. – doctors can question that one’s behaviour and even identity might be clouded by one’s mental conditions; and that’s why they follow the WPATH guidelines and treat their transgender patients first for all other conditions they might have. Once all these are treated, if symptoms of gender dysphoria persist, then the doctor will give that person the green light to go ahead with their transition. If not… well, that person will be very happy to know that they weren’t really transgender and do not need transition, which would have been a nightmare to endure for someone who does not truly suffer from gender dysphoria!

Even the argument that a truly transgender person will be absolutely sure about their gender identity in spite of whatever other conditions they might have is not true: to give an extreme example, schizophrenic people will really hear voices. Such voices are real for them, and as clearly heard as if someone is physically near them and uttering those words. But of course we know that such voices are illusory; nevertheless, from the perspective of the schizophrenic person, they are unable to separate real from imaginary voices. Both sound and feel exactly the same way. It’s only thanks to the therapy work with a specialist (and some medication) that they might learn to distinguish what is real from what isn’t.

One might argue that one thing are voices, or other illusions of the senses, but identity is so deep in our core self that it will not be affected. And yet, we know of so many documented cases where people truly believe to be Superman and try to fly out of their window – with dramatic (and often deadly) consequences. Even in the case of survival, a person with an altered state of mind will create a plausible explanation for what happened which will be consistent with their identity: maybe someone had put a source of kryptonite nearby, thus preventing Superman’s powers. Maybe even those alleged doctors who try to treat Superman so kindly have their pockets full of kryptonite, to weaken him – how can you know what is reality?

I have met people in such states of mind, and they are really weird, because they might be highly intelligent and have a vast culture and knowledge; nevertheless, they will experience their environment in an illusory way, and it’s confusing for an external observer to recognise how such a person is unable to find the flaws in their logic, to notice that they are constantly coming up with the weirdest theories just to explain the divergence between reality and what they believe to be real. It’s a bit uncanny, because you can clearly see that they believe in their perceptions of reality with the same eagerness and degree of conviction as you believe in your own perceptions; it’s just because you’re outside that perceived reality that you can see how illogical it is; but the person trapped inside it has no such insight, and no reason to have it, since they totally accept their perception of reality – even when it has nothing to do with ours.

Now, I’m not saying that transgender people are schizophrenic!! We have to be very careful with correlations and extrapolations; only a tiny, insignificant amount of people who have a gender identity different from the one assigned at birth have a wrong perception of reality (and themselves!), and it’s really important never to forget that!

Nevertheless, because that number of people is not zero, we have allowed doctors to act as gatekeepers – and allow others, not ourselves, to define ‘what we are’, using methods that we didn’t have a saying in.

It matters little for a transgender person if who defines ‘transgenderity’ is a doctor, a philosopher, an activist, a lawmaker, or a White Suprematist. The transgender person knows what it means to be transgender: there is no need for an external validation of what a transgender person knows to be true.

The problem is that we cannot see inside people’s minds: all we can see is how they present themselves. And here comes the big problem: a gender presentation which is visibly inappropriate for what others perceive the gender to be falls into the realm of ‘different’. And different, as said, is dangerous. In other words: if we had mind-to-mind direct communication (don’t laugh, some scientists have achieved a very crude way of thought transmission – at a very basic level. But once the feasibility of a theory is shown, it can be improved upon, in what are more engineering problems than scientific ones), then we would not question a transgender person’s ‘true’ identity, because we could experience it ourselves. In other words, a MtF transgender person – a trans woman – would communicate telepathically in a way that she would be perceived as ‘fully woman’, and nobody would feel any ‘strangeness’ or ‘differentness’ in such a mind.

But because we don’t have telepathic powers (or telepathy devices), we have to experience how others present themselves to infer their identity. And since the brain is such a powerful pattern-matching device, we are very good at recognising faces, and uncannily experienced in distinguishing the tiniest detail in a face or a body that ‘feels wrong’.

Of course this does not apply only to transgender people! It is a common human trait, the ability to figure out who ‘belongs’ to the group, and who doesn’t. That’s why police agents infiltrated in a criminal group are always at the risk of ‘discovery’ – not necessarily because they will be recognised as police, but because they fail to present themselves as criminals. Naturally enough, such agents are trained to delude even the most knowledgeable of criminals; it’s a job that is not for everybody (not even for most agents) because it requires the ability to totally ‘pass’ as a member of a certain and very specific group. And this involves a lot of tiny details, from overall presentation to ways of speaking, even to ways of thinking, because even thinking ‘wrongly’ might subtly influence one’s behaviour and therefore lead to discovery.

Now, being transgender and interacting with fellow human beings falls into the same kind of pattern-matching our brains are so good at. You can be a trans woman and look perfect as a cisgender woman – but the slightest indication of something that feels ‘wrong’ (imagine something so simple as the way the wrist moves – because men and women do it ever so slightly differently), and the illusion is shattered.

This doesn’t mean that the only goal for transgender people is to ‘pass’. The story about passing has been evolving over the years: at the time of Dr. Benjamin, it was ridiculous to even consider to give hormone therapy and access to surgery to someone who didn’t pass 100% of the time (and most would already live as a person of the gender they identify with well before talking to Dr. Benjamin and his followers to get access to hormones and/or surgery). Time passed, yes, but the criteria for successfully going through transition certainly included being able to ‘pass’ – and the reason for that was simply to avoid being experienced as ‘different’ in any way. The more one could blend in, the more likely it would be to get a successful transition and a happy life thereafter.

Such a feeling was extended, in the 1980s, to MtF crossdressers as well, among those who did not identify as women but who routinely or regularly presented themselves as female in public. And for reasons of safety – among others – it was expected that such persons would blend in and ‘pass’ as best as possible; those who deliberately failed to ‘pass’ were scorned and laughed at. They were not seen as ‘taking it seriously’.

It is just in the past two decades or so that a different mentality came to predominate: the notion that ‘passing’ is just another constraint, artificially placed by gatekeeping doctors, to exclude trans people from transition (and treatment!) just on the basis of how they looked like. This is, from a civil rights perspective, a form of discrimination. Just because someone identifies as a trans woman doesn’t mean that they have to be candidates to catwalking on Fashion Week New York. People come in all shapes and sizes, and trans people are not different. And there are those who do not identify with either gender, or with both simultaneously, and their outwards presentation match their non-conforming gender identity. Are they going to be excluded simply because they do not look like ‘common people’?

On a blog of corsetry where I’m learning a few things (in order to understand the topic well enough to know what to get in the future), there were discussions and arguments brought by trans people who took offence to the way the author of the article said something like ‘[…] corsets made for those with male body proportions and wish to have female body proportions’. This awkward way of putting things was to avoid talking about ‘[…] those with male bodies wishing to look more feminine’, because some trans people said that they were women and their body was a woman’s body, even if it did not look like the body of an average woman. In other words: trans women have obviously a ‘female penis’, there is nothing ‘male’ about their bodies since they identify with a female gender identity, so everything in their body is, by definition, logically ‘female’. Trans women, after all, are not to blame that their body doesn’t look like the average female body, but, then again, so many women’s bodies fall beneath the average, so why should trans women be seen as ‘different’?

That point is well made, from the perspective of activism: today, it’s more than fine to be female and have a penis and male body proportions; one thing is identity (being female), the other is presentation (looking male). Those are connected, correlated, sure, but they’re not identical. A good, solid case can be made that a woman is a woman, no matter what she looks like, and it has nothing to do with the body one has. Not even with the kind of personality or behaviour they have!

This is common knowledge among all trans people: after all, trans people should be at the forefront of any civil rights battle to end discrimination against diversity. They also campaign for the abolition of stereotypical gender roles. It’s rather a cliché to see how earlier generations of trans women, for instance, would get married and all they wished was to lead the life of a submissive wife and companion, secluded at the home, eventually taking care of adopted children and her husband only – the image of the ‘perfect’ woman in the 1950s! Lynn Conway, transitioning in the late 1960s, refused the stereotype and proceeded in her chosen career as a computer expert – first in software (back then, men worked on hardware, all programmers were women), but later eventually returning to hardware and re-establishing her name in the computer industry. And, indeed, quite a lot of trans women I personally know have kept their jobs in industries more typically male than female; they kept their love for big cars or trucks, or guns, or typically male hobbies and tastes in sports, beer, and similar ‘male stereotypes’. They are not ‘lesser women’ because of that!

So the problem at this stage is partly medical (an issue that requires the intervention of doctors), partly politics (namely, identity politics). While doctors, and the mainstream at large, are relatively at ease with a very feminine-looking boy wanting to live their live as a woman, and having that desire since birth which can be validated by family and friends, and that, in turn, easily leads to a straightforward transition, accepted by all (well, by most), and one that very likely concludes with the trans woman being impossible to distinguish from a natal woman (except through an ecography…), everything else in the transgender spectrum is not that easy. Specifically, the risk of a failed transition is much higher. That, in turn, means that doctors willing to accept that transition to take a much higher risk as well. Such a person will be literally walking around with a huge arrow pointed at their heads saying ‘hey, I’m trans, and proud of it!’. They will have to have an iron will and determination to deal with constant transphobia – something which might not be that frequent among transgender people who come to the doctors in despair, crushed with their gender dysphoria and all other sorts of possible mental issues. It is therefore hard for a doctor to believe that this person sitting in front of them, a total wreck which is merely a shadow of a human being, may, after transition, suddenly become a person full of confidence and assurance, able to deal with the constant ‘pointing out’ that they are different and do not ‘fit’ in society. In other words: why should a person crushed by gender dysphoria not be crushed by constant transphobia as well? What makes gender dysphoria so different, that it cannot be tolerated, while transphobia is seen as being ‘comparatively easy’ to handle?

Well. I have no answer for that, mostly because I have never bothered to ask enough people what they thought about the issue – not even doctors. In general, transgender people talking about the issue just say that ‘during hormonal therapy all symptoms of depression disappeared’, something which a few of the doctors I consulted also agree with. The process of transition is, by itself, therapeutical. Both doctors and patients alike tend to agree, therefore, that coping with gender dysphoria is far, far worse than coping with transphobia on a daily base – especially because they can help with ‘coping wither transphobia’ (while gender dysphoria is another story!). I will need to take their word on that. I was asked once if I would be willing to change the current drug cocktail I take to deal with depression/anxiety for hormonal treatment, and of course I easily agreed with having HRT! Maybe I was too eager… in any case, the depression came under control (sort of) so doctors reasoned that gender dysphoria was not necessarily the most important influence on the depression. Oh well. My point here is that nobody wants to be depressed, and anything that fixes it and makes it go away, will be gladly accepted. There is a strong placebo effect attached to hormonal treatments (and this applies to both transgender people as well as, say, women in menopause, or afflicted with hormonal issues and their consequences). Then again, seeing one’s body become more and more aligned with one’s gender is certainly a huge boost in one’s mood – and, again, this also applies to cisgender women (at least, I know about some cases in my circle of friends and familiars where this was the case).

To resume and conclude: there are a lot of issues surrounding ‘labeling’ transgender people, and they have consequences. Some parts of the transgender spectrum are currently protected and defended by law, and they get all the treatments they need, and the full force of the law to deal with discriminatory actions (as well as medical help to cope with transphobia and discrimination – which is free in most welfare states, or at least very affordable). Other parts of the transgender spectrum are completely outside any jurisdiction – they simply aren’t seen as ‘transgender’ at all. This confusion comes from the appropriation of the word ‘transgender’ by the transexual community, mostly because there was a very rigorous step-by-step plan to ‘deal’ with transexuality – including things like sterilisation, having the ‘correct’ sexuality (heterosexuality after transitioning),  and a certain amount of mandatory surgeries. Many transgender people who genuinely suffer from extreme cases of gender dysphoria may disagree with such a ‘boilerplate’ solution – and therefore do not identify with what used to be called ‘transexuality’. So we got a new class of people, all of them suffering from gender dysphoria, not all of which, however, are subject to the same treatment to deal with their dysphoria. All get protection under the law, all get access to treatments, all get access to administrative changes regarding their documentation.

This still leaves a lot of people out. What about them? More to the point: they are the majority. And they get simply pushed out of the discussion; many are being ‘labeled’ as something other than transgender – for instance, gender non-conforming, a designation that may have clinical and sociological meaning, but not real legal meaning. But there are many more labels. The LGBTQI+ ‘meta-community’ does not always accepts those labels as being part of their community at all; definitely there are no activists behind them, either. And I’m not even talking about those who are self-labelled fetishists and enjoy themselves a lot (and most certainly have very clear ideas of their gender and sexuality and no doubts about either, even if their presentation may ultimately have sexual purposes only). I’m rather talking about all those who are not fetishists in the strict sense of the term, but are excluded from being called ‘transgender’ simply because they do not ‘fit’ into any category (or do fit in a category that nobody wants to link to ‘transgenderity’ at all).

So we need a new movement to deal with them 🙂 And that shall be the topic of a future article…


Also published on Medium.

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