For those who need them, medical transition and contraception or abortion are – or should be – about the bodily autonomy of the individual, their right to mental well-being and the freedom to carve out their own destiny in defiance of prevailing gender roles. (These roles, should we need reminding, frame women as vessels for reproduction and trans people as threats to the strict separation of male and female sex roles on which patriarchy depends.) Access to abortion and access to trans healthcare are often attacked in similar ways: principally by overstating the incidence and likelihood of regretting either process, and an intense, disproportionate focus in the media on the stories of individuals who do regret their personal choices, as a way to undermine the principle of choice generally. Only about 5 per cent of women experience any degree of regret over their abortion. Multiple studies show the regret rate for gender reassignment surgery is even lower: about 0–2 per cent. Despite this, the fear of regret has become a powerful tool used to justify the delay or withholding of treatment. Little wonder, then, that it is conservative politicians who attack trans healthcare and women’s in the same breath.
British writer and activist
(born 27 March 1988) is an English writer, editor, journalist, and presenter, known for her commentary on LGBTQ+, women's, and mental health issues. She hosts the podcast Call Me Mother and is the author of the 2021 book .
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Dysphoria, it should be said, is not a precondition of being trans. According to some research, as many as 10 per cent of those who positively identify as trans men, trans women, non-binary people and various other terms do so without any feelings of dysphoria. It is sometimes incorrectly assumed that trans men and women experience dysphoria and non-binary people do not, when in fact some non-binary people feel themselves to be in great need of medical assistance, and some trans men and women seek none at all. Nevertheless, most trans people experience dysphoria to some degree.
Gender dysphoria is a rare experience in society as a whole, affecting about 0.4 per cent of the population, which can make it hard to explain to the vast majority of people, who have not experienced it. To get around this, we often rely on metaphors. The clumsy phrase ‘born in the wrong body’ has become the favoured soundbite in popular media. Clumsy because – and this must be stressed – many trans people do not think this describes dysphoria at all well. To my mind, the trans writer expresses it more accurately: ‘Dysphoria,’ she says, ‘can feel like heartbreak.’ Heartbreak, its incapacitating grief and the sense of absence and loss which activate the same parts of the brain as physical pain, can be so all-consuming it interferes with your everyday life. So, too, dysphoria. For me, at least, this is a much richer way of describing how many trans people experience distress with their bodies – indeed, how I felt until I medically transitioned.
First, one of the most important – and, for many, confusing – questions: why do some trans people need medical intervention at all? Dysphoria, the antonym of ‘euphoria’, is the clinical term now used to describe the intense feeling of anxiety, distress or unhappiness some trans people feel in relation to their primary sex characteristics (genitals), their secondary sex characteristics (breasts, facial hair, menstruation, face shape, voice) or how these physical traits cause society to interact with them, by perceiving them as a male or female. Previously called ‘gender identity disorder’ and, before that, ‘transsexualism’, gender dysphoria is the name given to an experience many trans people struggle with, which can be helped by medical intervention. Although the term is widely used within the community, different trans people can experience dysphoria in very different ways, and so might have different clinical needs.
In all this, it cannot be emphasized enough that the political demands of trans people align with those of disabled people, migrants, people with mental illnesses, LGB people and ethnic minorities (and, needless to say, trans people can be found within all of these groups). This overlap between the needs of different marginalized people must be stressed because the illusion that trans people’s concerns are niche and highly complex is often a way to disempower them. The emphasis on the ‘minority’ status of minorities keeps them focused on explaining their difference in public discourse, so that they can be continuously batted away as an aberration or minor concern. In the specific case of trans people, this disempowerment begins at the most fundamental level: with our bodies and our right to exercise autonomy over them without interference by society. If we are to liberate all trans people socially, we must begin with the liberation of the physical trans body.
Trans people may have relationships with cisgender people or other trans people, and date men, women or non-binary people. This reality is not often represented in mainstream media, with the result that lots of trans people are led to believe that transitioning may mean the end of their love life. At one point, I was one of the many trans people who believed, incorrectly, that I would be fundamentally unlovable to anyone who knew I was assigned a different gender at birth. While I soon learned that this wasn’t the case, I also realized – as a trans woman who onlydated men – that there were men out there who could simultaneously be attracted to me and also be abusive. This was particularly apparent on dating apps, where I was always open about being trans. If men initiated messaging and I declined their advances, it was not uncommon to receive a torrent of misogynist and transphobic abuse. Online, you can simply block a stranger who exhibits such malicious behaviour. Real-life domestic abuse, however, is often insidious and incremental, with the abuser creating a sense of dependence in the abused while eroding their self-esteem. The negative messages trans people receive from society about their bodies, their desirability as partners, and their worth as individuals can make them especially susceptible to emotional, sexual and physical abuse by partners.
Conversations around domestic abuse and the dwindling provision for survivors usually focus on the most common scenario: heterosexual couples with a (cisgender) male perpetrator and a (cisgender) female survivor. Yet trans people face extraordinarily high rates of domestic abuse at the hands of their partners.
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In the media, much of the focus on ‘trans rights’ in recent years has been on legislative rights (such as streamlining the process for legal gender recognition or having a gender-neutral passport), and on social conduct, such as checking a person’s pronouns. This emphasis stems in part from a media agenda set by cisgender people, often – as we’ve seen – for the purposes of creating controversy and fuelling a culture war. As a result, like many movements formed around an aspect of personal identity, class politics and a broader critique of capitalism have become sidelined in the trans movement. Besides the time and energy trans people have to spend defending civil rights and social courtesies, there’s a pretty straightforward reason for this. In any minority group, those who have the time, resources and political access to lead the charge for recognition and better treatment tend to be the middle-class members, who don’t appreciate the urgent issues of poverty and homelessness that for many can impede participation in activist movements. This representational imbalance leads to ‘single issue’ priorities, which emphasize the personal freedoms of the individual over the economic liberation of the entire minority group. Trans politics is no different. Poverty and homelessness are rarely framed as ‘trans issues’ in the media – or even by large LGBTQ+ lobby groups.
Family rejection and estrangement have devastating long-term health implications. They also have a material impact. For some kids, the only option is leaving home. Others have no option at all: their parents kick them out. As a result, trans teenagers and young adults in Britain are much more likely to experience homelessness than their cisgender peers. [...] A minority within a minority, trans young people are disproportionately over-represented in the homeless population: one in four trans people have experienced homelessness.
The shadow of fell heavily: the effect of suppressing education about LGBTQ+ issues was not only to prevent LGBTQ+ children existing openly at school but, just as perniciously, to create a culture of silence that allowed prejudice among kids and staff alike to flourish unchallenged. Queer young people, for their part, were forced to internalize a constant drip-feed of humiliation, often (like me) not wanting to speak out for fear of making a horrible situation even worse. Having to absorb such humiliation in childhood is, unsurprisingly, something associated with a range of negative mental health outcomes later in life. Section 28 must be remembered and condemned for what it was: a staggering dereliction of duty on behalf of Britain’s policymakers towards the country’s young people.