When I was 12, I thought I was a girl. I soon decided I wasn’t. When I was 16, I met a non-binary person. When I was 18, I began to realize I was non-binary. On November 25, 2018, at 21 years old, I read Andrea Long Chu’s column in the New York Times.
Her piece is called “My New Vagina Won’t Make Me Happy: and it shouldn’t have to.” Chu is a doctoral candidate in Comparative Literature at New York University. She is a writer and trans feminist critic. I had just read her piece in n+1 the day before, and was eager to read more. So when the column came up on my Twitter feed, I immediately clicked the link.
Her piece addresses the prevailing mindset that medical professionals, liberal allies, and even trans people ourselves have in regards to transitioning: that gender dysphoria, the discomfort and distress that trans and gender-nonconforming (GNC) people feel being in a body that does not match their gender identity, is a symptom of being trans that must be alleviated through transition. This assumes that if dysphoria is the cause of sadness for trans people, then transitioning will make them happy. Chu argues that this is a dangerous assumption—it makes optimism a medical requisite for the doctors who hold the keys to our transitions.
I assume, and yes I know assuming can be dangerous, that many of you have heard of the arguments against transition that go something like: “…but what about the people who have reported feeling worse? People who regret transitioning? People who it doesn’t work for?” This reifies the notion that transition is always linear, and that a successful transition is a happy transition.
This is the narrow definition of trans experiences that Chu is going up against. She is a wonderful example of what the medical world might call a “bad” outcome. She says it herself: “I feel demonstrably worse since I started on hormones. One reason is that, absent the levies of the closet, years of repressed longing for the girlhood I never had have flooded my consciousness. I am a marshland of regret.” She is one of these bad scenarios that transphobes so desperately want as proof that people should not be encouraged or allowed to transition. She is not what they’ve imagined.
But her regret is not that of the man who had a sex change only to realize he wanted to be a man again. Her regret is not about who she now is, but rather who she never got to be. Surgery is not going to make Chu happy, but she’s still trans, she still wants this, and she still deserves the procedures that she desires.
Chu highlights the two narratives that surround trans people in the medical world. The conservative viewpoint, as told by Heritage Foundation fellow Ryan Anderson, states that “we must avoid adding to the pain experienced by people with gender dysphoria, while we present them with alternatives to transitioning.” In his view, caring for trans people means refusing them transition and erasing identities. Chu also goes on to explain the liberal counternarrative courtesy of the World Professional Association for Transgender Health, which says that, “gender dysphoria can in large part be alleviated through treatment” and this treatment can “prevent some of the traditional horrible outcomes that transgender or gender-nonconforming youth have ended up with…depression, suicidal ideation, and substance abuse.” This is a reality faced by many, and is one of the reasons why easy access to transitional tools is so crucial today. However, the rigid narrative of transition “success” as directly correlated with attendant happiness has taken the reigns, and stampeded over more nuanced and less linear trans experiences.
Happiness, Chu is telling us, should not be the only rubric for a ‘successful’ transition. I agree. Through my non-medicalized transition so far, my discontent and heightened dysphoria have left me confused. I was arguably happier as a naïve bisexual boy than as an unbelievably aware non-binary queer person; according to the standards outlined above, my transition into who I am now didn’t “work.” Where does this leave me? With de-transitioning? I already occasionally do this on a small-scale—presenting more like a boy, letting people misgender me. When I do this, when I am unhappy, it does not mean I am wrong; it does not mean being non-binary is not “working” for me. Sure, I meet the mark of happiness fairly often. When I don’t, however, I want to retreat back into boyhood. Maybe I was the boy who made a mistake thinking he was anything other than that. I feel like I’ve failed.
My receding hairline mocks me in the mirror: it never used to. I’ve wanted to cry while shaving my face: I never used to. My sex-drive makes me feel gross: it never used to. Anti-androgens, or Testosterone blockers (t-blockers), are a form of HRT that slow down/stop the recession of male-pattern baldness, soften (but not eliminate) facial and body hair, and can reduce sex drive. For these reasons, I’ve seriously considered starting to take them.
My first step in contemplating medication was looking on the Tufts University Health Services information page. I found the steps that I would need to take in order to gain access to HRT. This is what I read:
The offices of Health Service (HS) and Counseling and Mental Health Service (CMHS) support trans and non-binary students who are wishing to feel affirmed in their gender… With respect to Gender Affirming Hormone Treatment (GAHT), CMHS coordinates care with HS. This includes a discussion about potential mental and medical health-related concerns that may interact with the effects of hormone treatment. We aim to make this process as smooth and quick as possible. The timeline varies case by case. These steps and projected timelines are approximate to help with planning and preparing. The first step is to start with an appointment with a CMHS clinician.
From talking with other trans and non-binary friends on this campus, I’ve gathered that this isn’t even the whole story. It doesn’t mention the two letters I would need from a counselor and psychiatrist deeming me eligible, worthy, and a legitimate enough trans person to receive HRT. These letters are written after an indefinite process of proving to mental healthcare professionals that HRT will make me happy—that I not only want this, but that I need it to reduce my pain.
Next, I looked at the policy for Blue Cross Blue Shield of Massachusetts—my personal insurance provider. According to Policy 189, the policy on transgender services, candidates for all medicalized forms of transition must be “diagnosed with gender dysphoria,” must have “the desire to live and be accepted as a member of another sex other than one’s assigned sex, typically accompanied by the desire to make the physical body as congruent as possible with the identified sex through surgery and hormone treatment,” and “the new gender identity” must have “been present for at least 12 months.” Beyond this, they require that “the candidate has completed a minimum of 12 months of successful continuous full time real-life experience in their new gender, with no returning to their original gender. This includes members who identify as genders other than male or female.”
By these standards, I will be forced into performing an unattainable version of transness to get the so-called “care” that these professionals are able to give me. I have no way of knowing if my story will meet their benchmark of a “successful congruous full time real-life experience.” When they inevitably walk me through the effects of T-blockers, determining if they will alleviate my dysphoria, one side effect will make me pause: slight breast development. I don’t think I will be able to tell them the truth. I lived for years as a chubby boy with ‘man-boobs,’ and I know that even now in my queerness, breast development will at times destroy my body image. I don’t want this, yet I still might seek out hormones. I will not be able to tell the truth when asked if I have the “desire to make the physical body as congruent as possible” with my gender, because “non-binary” has no scientific or legal body. If I am honest about my experience, I might not be allowed to medically transition. To go through with this process, I will have to lie.
On Sunday November 25, after reading Chu’s piece, I returned to my twitter feed and immediately saw the criticism pouring out in response. One expected misread from conservative radio host Erick Erickson read: “The New York Times helpful[ly] reminds us, however unintentionally, that transgenderism is a mental health issue and is not normal.” Another criticism came from both cis liberal “allies” and other trans people, calling for trans people to only publicize happy narratives that can’t be flipped to bolster transphobic rhetoric put forward by people like Erickson. Over and over again I saw the desire to silence voices like Chu’s for their potential to give fuel to the fire of transphobic reactionary politics. I argue, however, that without these voices, the fire will never be extinguished.
As I refreshed my feed again and again, I saw more and more reactions to Chu’s piece. Trans twitter was blowing up with tweets that re-stating personal statements along the lines of “But I am happy!” or “so many of us are happy!” This frustrated me, because those responses miss the point. The response I want is “I am happy, but that shouldn’t matter, because my experience is not the experience of all trans people.” These reactions felt like an attempt to save face in fear of the possible blowback. These reactions do not change the narratives that uphold the very system we fear. The fire continues to blaze.
It is not that I, nor other trans people who see themselves in Chu’s story, will never be happy, or that we will never have moments of bliss; but rather, that we are more than our joy. My transition is so much more than my euphoria. It is loving and hating my body in new ways. It is my childhood making so much sense that it hurts. It is celebrating never having to be someone’s “boyfriend” again; it is mourning that I couldn’t have been her “partner” all along. It is trying to hide from stares in public. Dysphoria chips away at both our bodies and our experiences, and no amount of medical aid can fix those experiences. Transitioning is not a cure for a transphobic world.
By working on the principle that eradicating our pain is the only way to take care of our dysphoria, the medical and mental health professionals who aim to affirm our gender have built a system that forces us into silent misery. We should not be expected to find happiness by conscribing to compulsory medical and societal gender systems and narratives. We should be granted autonomy over our bodies not based on external rubrics of need, but rather on our own desires. Our personal, and not always easily navigable, trans experiences should be paid attention to—this is the care we deserve. We need to care about each other and we need to care for each other, but we are not something that needs to be taken care of.