Monday, February 18, 2008

panelspiel on medical transition

This panelspiel is for a 5-minute time slot (don't laugh!) this coming Wednesday. I welcome feedback/impressions/responses any time, but they are especially useful if they come by Tuesday evening.

Good afternoon. My name is Davey [yes, blog readers, it really is]. I am an alum of the Social Justice Education Program at UMass, Amherst, and now I work as a consultant providing trainings and workshops about social justice issues, primarily focusing on trans/gender issues and issues related to class/classism. I am also a writer, and in my spare time I have a day job making water color paintings on silk clothing. I’ve been a member of this Speakers’ Bureau since about 2001, and I’ve done panels through other programs since 1997.

I identify as transgender (FtM) and as genderqueer. Today I’m going to do something that’s a little bit out of character for me, and focus on the part of my story that’s about medical transition.

People’s decisions about medical transition are one major way in which we categorize different kinds of trans people. I don’t think it’s necessarily a good or useful way to categorize trans people. Nevertheless it is true that medical transition is a pretty big deal in terms of how we’re likely to experience the world, and how other people, including other trans people, are likely to respond to us. I think there’s a lot of confusion about medical transition, and so I want to tell my story about it so that you can have at least one more perspective.

First of all, I should clarify the term “medical transition.” You probably learned from the other events in this series that “medical transition” can mean a lot of different things. Some people who are transgender choose to change their bodies, and some choose not to. Some of us stay on the fence about that more or less forever. Medical intervention is not a prerequisite for being trans. For those who do choose to do a medical transition process, it might involve hormone treatments, at various doses, for short periods of time or for the rest of one’s life; surgeries, including chest surgery, genital surgery, hysterectomy for FtMs, and for MtFs sometimes facial surgery; and sometimes other medical interventions. So when I talk about someone’s decisions around medical transition, it’s not only a decision of whether to transition but also a series of decisions about exactly how to transition, exactly which interventions are right for that person.

For me, being genderqueer is a big part of how I understand my trans identity. I do not see myself as “born in the wrong body,” or “a man trapped in a woman’s body,” or any of those sort of classic stereotypical phrases you might have heard. For the most part, I have been happy to be a genderqueer guy or a trannyboy in a female body. That works for me.

For a long time, I struggled with whether and how I wanted to do medical transition. I loved my body, and usually felt pretty connected to it. I also felt a desire to change my body to make it more masculine. This desire was sometimes so strong that I could hardly think about anything else, and at other times it was just sort of an idea that hovered in the back of my mind.

I had (and still have) several strong reservations about medical transition, related both to my own identity as a genderqueer and to my political convictions related to gender.

One of my reservations was that my transition would be in part for others. I did sometimes feel disconnections internally, in terms of how I was able to relate to my own body. But even more salient than that was the disconnection I felt because other people saw my body as female. I knew that if I were to transition, it would be at least in part for the convenience of others, to make it easier for them to see me as a guy, and therefore to make my interactions with them easier for them and for me. And I worried that that was not a good enough reason.

The medical model says that transexualism is an internal condition, and that transitioning is supposed to heal an internal rift. I thought the only acceptable reason to have otherwise unnecessary medical interventions was if my internal pain was so unbearable that I had no other option, and I knew that that wasn’t true for me.

Since I knew that I wasn’t that kind of transsexual, I worried that transition might be a cop-out for me. I worried that my desire to change my body was a way of avoiding doing my own internal work around being a genderqueer in my body. I felt that for me, changing my body would be confirmation that I was not strong enough to live as a non-transitioning genderqueer.

A second reservation I had, which is still very strong for me, stems from my mistrust of the institution of medicine as a capitalist institution and as a system of social control. Basically, I know that by putting myself in the role of “patient,” I am giving up some of my control over my situation. I am literally placing my body into someone else’s hands, and into the hands of a system that I believe to be driven by profit and not by human caring. That seemed like a bad idea.

And finally, I had reservations about putting so much time, energy and money into my own physical transition. I had experiences in trans communities friends and colleagues who had been really involved, sociable, leaders in my communities decided to physically transition, and all of a sudden that’s all they had time for. Every time we talked it was all they could talk about. They stepped down from leadership positions to put time into their medical transition process. They took extra jobs to pay for surgery, and therefore had no time anymore to be part of the community. I didn’t want to put so much energy into my physical transition that I had nothing left for other aspects of my life that are also important to me, including not only stuff that I do, but also other aspects of my internal life, other stuff I like to contemplate and reflect on.

And related to that, I worried because I had seen some people transition and then leave the community entirely. Some trans guys I knew, who had been really radical, involved people, would start taking testosterone, and start passing as male, and all of a sudden their radical politics seemed to evaporate, and they didn’t want to be out anymore, and sometimes didn’t even want to be seen with people who were obviously, visibly queer like me. And I didn’t want to be that guy.

I agonized about these questions on and off for about five years before I took any steps toward medical transition, and I am still agonizing about some of them. Here are the conclusions I’ve come to so far:

With regard to my concern that I would be transitioning in part for others, I decided that that is true and I’m okay with that. Identity is social. The social pain and disconnect that I was experiencing and still experience are just as real and just as legitimate as the internal struggles depicted in the medical-model transsexual literature. I am glad that I have the opportunity to reflect on the various reasons for my desire to change my body, and even though the reasons are not entirely internal, I think they are good enough.

If I were to define my strength as a person based on my willingness to put up with unnecessary pain, both internal and external, I would be buying into the myth of masculinity and embracing the victim role that this system of oppression has assigned to me. That’s not healthy! I can treat myself more kindly than that.

I am strong enough to be genderqueer, and I am strong enough to acknowledge that being genderqueer means something different to me now than it did five years ago. After all, the freedom to constantly reevaluate and redefine my identity is part of what attracted me to the genderqueer label in the first place. With or without medical transition, I trust myself to have the integrity to continue doing my internal work, and to continue being the person I want to be in the world.

Regarding my reservations about entering the medical system – That is true, and it sucks. But that’s what’s available to me right now. And I have to be part of that system anyway, just to get regular necessary primary health care.

And finally, regarding my concern about how I allocate my energy: I realized that I was putting a whole hell of a lot of energy into not transitioning. At times, it was all I could think about. It was already distracting me from other things that were important to me. So I thought, if I put some energy into medical transition, maybe I could come out the other side of that process more able to pay attention, commit myself to community-building, and make good decisions about where to focus my energy.

And I don’t have to worry about being “that guy” who transitions and then deserts his community, because, I’m not that guy. I have a choice about that.

And perhaps most importantly, I realized that even in entering a medical transition process, I still have choices in every moment. It’s not like I crossed over to the “dark side” and now I’m a transsexual instead of a genderqueer, which is how some of my genderqueer comrades might see it. It’s not a slippery slope, where once I took that first injection of testosterone I was hooked, which is how some transitioning FtMs have described it to me.

I give myself an injection of testosterone once a week or so. Each time, I make a conscious decision about whether or not to take that dose. Every day, ever moment, I get to decide how to do my gender, and what it means to me, and that is as true now as it ever was.

I want to be clear that these are ways I’ve found to resolve my dilemmas that work for me, for this moment in my life. I don’t intend to say these are the answers for all trans people, or even for me forever.

By now I am undoubtedly out of time. To wrap up let me say that I welcome all questions, whether personal, political, or factual. I have been doing panelspiels like this since I was sixteen. I promise I have heard it all. If you ask an honest question that offends or shocks me, I will give you a prize.

1 comment:

Sarah & Amanda said...

Hey! You've been added to the the Association of Smith Alum Blogs! (

We're a couple of Smith alums ('05 and '06) looking to build an archive of Smithie blogs. Please let us know if it's not ok that we added you, or if you know of more blogs we should list!

Sarah & Amanda