Transgenders and transitions

A deeper look at what the "trans" effect might be on us all

vol. 1 issue 45


Until about three years ago, when I thought of transgender persons, like so many other Americans, I envisaged only transvestites. But that is an incomplete understanding. The former is an inclusive term for the many emergent forms of gender and sexual expression we see today; it is the T in LGBTQ. The latter is one form of many such expressions, involving a predilection for feminine fashion.

My education on this issue came by way of my job as a reporter of clinical psychiatry when I wrote a series of articles on how medicine was sputtering to catch up to the specific endocrine, oncological, basic primary care, and emotional support needs of the transgender population.

A series of discussions I had with Jack Drescher, MD, was particularly enlightening and resulted in this article for Clinical Psychiatry News in 2017. It includes a glossary of terms used when discussing gender in the clinical setting. Here’s a bit from the article:

"There are so many moving parts to our understanding of gender," said Jack Drescher, MD, during a plenary session at the annual meeting of the American College of Psychiatrists. For that reason, "language is very important" when addressing children who might have questions about their gender identity, he said.

A psychoanalyst and psychiatrist in the greater New York City region, Dr. Drescher has for years worked at home and abroad to destigmatize non-hetero expressions of sexuality which until only recently have been classified largely as mental disorders.

Among his many advocacy activities is the maintenance of a private listserv that tracks how the LGBTQ community’s mental health is portrayed in the media. Yesterday’s posting from Dr. Drescher was this article from the Washington Post about the drag queen culture in a time of Trumpism, for example.

In one of an increasing number of synchronous moments that occur in my life and work exploring the American psyche in these acutely felt times, Dr. Drescher’s email arrived as I was working on this piece on the deeper metaphors of the “T” culture.

I had been wondering why we see so many expressions of gender fluidity, now more than ever before, at least in my lifetime, anyway. Certainly, we can attribute some of this to social media. And, as is implicit in the WaPo article, we can also see it as the ballast to the reactionary extremes ascendant in our politics now.

That’s the explanation that most intrigues me: The idea that there is some universal tug toward equilibrium. Too extreme on one side? Not to worry. The natural forces that govern us all will instinctually pull toward the other pole. Ahhh. Hear the earth sigh as balance is restored.

Except what if what used to constitute balance is weighted differently now? What if the binary nature of old is becoming extinct, or at least obsolete? All the resources, natural and “man” made that we used to account for in our economics no longer add up. There is no way we can sustain a 99:1 ratio in anything, be it money or masculinity.

And that is really why I was thinking so much about transgenders: are they showing us something else “trans”, namely, transcendence?  Are they the leading edge of a new way to be human? Could they possibly be the bridge, or at least a bridge to a world where humans live peacefully with artificial intelligence? After all, so many transgenders, especially transvestites who have elevated the art form to drag, are expert at artifice, emphasis on “art”, the root that is common to both “artifice” and “artificial”. Drag queens know now to transform themselves in ways that at first seem utterly impossible.

So much of the controversy around transgenders, both within and outside of their own community, is to do with the language used to describe them and their reality, as Dr. Drescher and I discussed, and as he further elucidates in this recent podcast interview with my friend and colleague, Lorenzo Norris, MD.

Some are dismissive of the LGBTQ community’s insistence on being discussed within the lexicon Dr. Drescher describes, attributing it to tiresome identity politics. I am even among those wary of identity this and identity that, and feel somewhat annoyed I can’t just say “he” or “she” and get on with things, and what the hell does it mean that I am cisgender anyway?  

And yet, I also accept that my annoyance is paradoxically irrelevant and important at the same time.

Irrelevant because this is not about me and my perceived inconvenience at having to learn new pronouns, and important because if I am annoyed, it’s a signal I am about to learn something by untangling it and engaging in a larger truth.

In this case, I think it’s a deeper appreciation for the notion that whoever controls the language of something, controls its destiny. That is to say, there are very real, practical implications of how we define and describe a person and the group to which that person belongs. After all, it costs money to take care of people. How we prioritize where that money will come from and who should get how much of it hinges on the language of value we ascribe to each group.

Nazi Germany is a classic, if extreme, example: by using dehumanizing language to describe Jews, it was easier to devalue them culturally and ensure they not only received any necessary accommodations in society, but were eradicated. Murdered.

Ultimately, I do not believe that the kinds of questions the “T” community place before us are about identity politics, even if they are being worked out through identity. It’s to do with a larger challenge, namely one to the status quo.

It challenges us to ask us how willing we are to let others who have no sense of what matters to us based on our life experience and personal interpretation of it, tell us who we are and what we are worth.

On the face of it, it seems like these are the same thing, and that there is nothing novel in what I am saying, as in, Duh! That’s exactly why we’re so polarized right now. The reds don’t want the blues to tell them how to live their lives. Yada, yada.

But look deeper. Before something can become political, it has to be personal. Maybe the truth of who each of us is has yet to be described, not by policymakers, not by anyone else. Maybe we’re evolving into something else, possibly more whole and beautiful and if we have the patience to see just what something so dramatically different as transgenderism has to show us, we will be delighted and amazed.

Or, maybe what we think we know is already accurate, and the question then becomes less about arguing over whose interpretation of what is “right” and “wrong” when it comes to defining personhood, and instead becomes refocused on democracy: How do we make room to hear and reflect on all voices?

The solutions for how to provide for many with finite resources can only come after listening. The listening begins with sharing a common language. A common language begins with the group who doesn’t speak it learning it from the group that does. When everyone speaks the same language, then it’s easier to agree – and disagree – on things.

Some of us will decide the language of the old world order is fine, thank you very much, but tradition is only one side of the scale. Something else must counterweight it, or it will crash and shatter.

One of the most important take-aways from my interview with Dr. Drescher was that in the Netherlands, the approach to working with youths who are exploring whether or not they are transgender, is to react as little as possible:

“[doing so] assumes that it is better not to actively transition a child socially but to remain neutral to the way in which the child expresses gender identity. If children persist into late adolescence in this model, they are assisted in transitioning. If not, they are supported socially as they adjust to their natal gender. Puberty may sometimes have to be suppressed until the time one of the two paths has been decided.”

Not all persons who experiment with being transgender will remain experimental, is the point. If left to their own devices, they will learn to trust themselves and go with what they know is inherently true for them.

Individuals within the transgender community may or may not insist on policies that reflect their private struggles and respective life journeys. But as a group, if they can teach the rest of us something just by their very existence, I suggest it is to question the sustainability of our old world order and how it has inaccurately defined me, you, all of us.

By listening to the language of transgenders, I suspect I will find a new way to define myself on my own terms.

For your enjoyment during breakfast, lunch, or tea:

A funny, serious, and no bullsh*t interview about transcending the pain of being shunned into making the most of this life in this podcast interview of RuPaul by ABC newsman Dan Harris. RuPaul says that it was through studies of Eastern philosophies that he had an epiphany that changed his life: the material stuff of which we are made is fluid. We can do whatever we want with it. I personally love this interview.

The podcast between Dr. Drescher and Dr. Norris:

This STAT article about how not understanding the nuances in working with this community leads to tragedy and crises.

If you want to read an “as told to” first person account of Emma as she shared with me what it was like being a young adult transitioning from male to female, there is also my essay in this textbook (p. 153).