“The transgender community is the only group I have ever known to refer to a therapist as ‘the rapist’,” I heard one professional say.
One key line between transpeople is how much they like the idea of their nature being medicalized.
For many transsexual identified people, their diagnosis is a key to identity. “You see, I have had the docs say that I am really gender dysphoric, so I require treatment, just like anyone else who has a syndrome resulting from a birth defect!”
When they get challenged in the world, they defend their choices and actions by pulling out the judgments of clinical professionals. “I am different than crossdressers and drag queens because the professionals have diagnosed me! I am a true transsexual!”
For others, though, the idea that somehow, their nature is an identified medical condition just makes them crazy. “Sometimes, humans just turn out like me. We have existed in every human culture across history. It’s only the heterosexist binary view of this particular culture that chooses to see us as diseased!”
Of course, even for people who reject the idea of transgender as sickness, we often still need medical sign-off to get the resources we choose, including exogenous hormones and body modification. We need to satisfy the medical gatekeepers to get access to resources.
This division, between transpeople who love their diagnoses as justification, those who need their diagnoses to get resources they require, and those who reject diagnoses as an unwarranted judgment upon our nature is at the heart of much warfare between the interlocking communities around trans.
In many communities, like around disability, they don’t like phrases like “disabled people.” Instead, they prefer phrases like “people with disabilities,” choosing to emphasize that they are not primarily their disabilities, but rather they are primarily people, who are exceptional in some way.
I will often choose “people of transgender experience” when I am writing in a formal way, just to make this distinction.
Still, I do know that this phrase will be rejected by people whose identity is very medicalized. These people often reject the idea that they are at all transgender, rejecting links to other people who identify as or who could be identified as transgender, instead demanding that they be identified as people with a diagnosis of transsexuality. Often, they see that diagnosis as a form of intersex diagnosis, even if the only identifiable symptom is their subjective knowledge of self, which, for example, they claim proves they have a “female brain”.
They have always been transsexual, and all they need is appropriate corrective medical intervention to be set right. After that intervention, others will then be required to see them as doctors identified them as always having been, not at all as some kind of gender crossing individuals. If, after intervention, others do not see them as cured, then that is only due to interference, usually the interference of those not properly diagnosed who want to colonize the structures of transsexuality without true acceptance and engagement of those canonical structures.
The flip side of this idea is important. What is the cost of giving medical professionals the power to define and diagnose trans conditions?
Many therapists seem to believe that the very fact that someone comes to a therapist means that they are submitting their life to the therapist for judgment. Even with therapists who believe that transgender is not a sickness in itself, they may believe that no trans-identified person can survive in this culture without damage that makes them sick, too sick to make good choices.
It’s these therapists who feel empowered to judge us that we often identify as “the rapist.” The system that empowers them as gatekeepers over the choices we feel called to make in life may give them the assumption that somehow, they are responsible for controlling the choices we make in all areas. Rather than just helping us understand the patterns and ramifications of our choices, they want to control them.
It’s clearly this assumption of control by medical professionals that makes so many of us reject the idea of trans as sickness, reject the idea that trans expression is something that should be medicalized. I don’t want to be seen primarily as a patient, because I know how the idea of sickness can be used to deny standing and disempower us from making our own choices to claim who we know ourselves to be.
I have been fighting against medicalized models since the early 1990s and see no reason to change that position. That doesn’t mean that I have seen uniform change in clinical professionals; too many of them still assume that there is some kind of power separation between client and professional, that trans clients should always be seen as less than, as someone who presents with illness, as someone who needs to submit to professional authority.
I do acknowledge that there are many transsexual people who feel comforted surrendering to medical authority and using that authority to deflect responsibility for their own choices. I just still think they are wrong, as I did in 1996.
I’m sick of having people define having a trans nature, and those who have a trans nature as sick, for whatever reason.