When I started my so-called diagnosis in 2018, the questions I heard from doctors were about my favourite colour and games as a child. A car? Passed. A pink one? Failed. After a while, I started to understand that how I sit – astride or cross-legged – would affect how quickly I would get hormone replacement therapy
‘I want to look like who I am, but I don’t know what someone like me looks like,’ wrote Lou Sullivan in the 1970s.
He started to write his diaries, which are now considered one of the most beautiful literary testaments to being transgender, when he was 10 years old. He was a white kid, one of six siblings, growing up in a Catholic home in Milwaukee. He experienced what most teenagers experience: first crushes and disappointments, confusion and rebellion.
‘My problem is that I cannot accept life as it is. I feel there is something deep and wonderful underneath, which no one has yet found,’ he wrote.
The big secret he discovered over the years was precisely his transgender identity.
When he was growing up, the US was living with the high-profile case of America’s first gender correction surgery. The protagonist of the headline stories was Christine Jorgensen. ‘A former soldier has become a beautiful blonde,’ the newspapers wrote. ‘Nature made a mistake in my case, but it has now been corrected,’ were to be Jorgensen’s first words spoken after the operation she underwent in Denmark. Jorgensen seduced journalists: a Marilynesque voice and smile, declarations that she wanted to devote herself to a truly feminine role: caring for a man and a home. Conservative America, bored with suburban life, bought the story with unhidden fascination. Medicine, ah, medicine, brought us another beautiful white woman!
But others were struggling in the shadows to survive.
Sociologist Harold Garfinkel from the University of California conducted what was probably the world’s first quantitative study of transitions in the late 1950s. People from various social classes and races took part in it. Talking about themselves was supposed to be the ticket to the ‘treatment’ which helped Christine Jorgensen. This was about hormone replacement therapy and surgery masculinizing or feminizing the body. The story of the clinic is portrayed in the film Framing Agnes, which was awarded at the Sundance Film Festival in 2022. It shows what it was like to navigate trans people through a system based on distrust and capturing ‘disorders’.
The simplest route to medical procedures at that time was the declaration of intersexuality. The titular Agnes argued that, despite having male chromosomes, she had developed secondary female features in her teenage years. Just that she was lying. ‘She was tall and slim, with very feminine features. Her measurements were 38-25-28. She had long, delicate dark-blonde hair, a young face with nice features, a peach-cream complexion, no facial hair, subtly plucked eyebrows and no make-up except lipstick,’ Garfinkel wrote about her in his notes. Taken aback by her story and fascinated by her physis, he gave her the piece of paper that opened the door to her dream therapy.
Others, who did not resort to lies, were forced to prove that they were not the proverbial camels. Most were already living in accordance with their perceived gender. Some confined to their homes, others semi-concealed, the remainder exposed to daily violence and harassment. Doctors and researchers required them to be heroic, fully coherent and to prove their case for many years.
Lou Sullivan came into the same medical system. He previously had access to gay bars, where he discovered drag or, in other words, cross-dressing. He then found himself in support groups for ‘transvestites’, but they did not have any transmasculine people.
‘My great fear is that I will die before the gender specialists acknowledge that someone like me exists and then I won’t really exist to prove them wrong,’ he wrote back in the 1980s.
He was bouncing off surgeries because he did not meet the fundamental criterion: obligatory heterosexuality. His stubbornness and uncompromising nature eventually succeeded. Sullivan – in his later years, always shirtless or in a tank top exposing his flat chest in photographs – was not looking for gateways in the system, but was changing it from within. He lived and died on his own terms.
‘I feel that, in a way, a diagnosis of AIDS – because AIDS is still considered a gay disease – is, in a way, evidence that (...) I was successful. I took perverse pleasure in contacting clinics [ed. – corrections], sexes that rejected me. They had been telling me for so many years that it was impossible for me to live as a gay man, but it seems as if I will die as a gay man, a man among other men,’ he wrote.
Medicine is the mother of the notion of transsexualism. Today’s word, transgender, is its wayward, rebellious child trying to escape the trap of pathologization. For years, the term transgender was mainly thought of as a disorder that has to be diagnosed and then treated. Such an identity cannot simply be possessed or worn, it needs sound confirmation. It was as late as in 2018 that the World Health Organization (WHO) removed transsexualism from the list of mental disorders in the International Classification of Diseases and Health Problems (ICD-11). The WHO admitted that this perception of gender identity is incompatible with the latest scientific knowledge and contributes to the social stigmatization of trans people.
But testing still goes on in the privacy of doctors’ surgeries. At least two or preferably three certificates need to be obtained in Poland to be able to start hormone therapy: a sexologist’s, psychiatrist’s and psychologist’s certificates. Gender correction cannot be conducted in court without this. The whole system distorts the relationship between transgender people and specialists.
Instead of support and the necessary knowledge, we often receive grotesque inspections.
Many doctors reduce the process of giving an opinion to a reproduction of gender stereotypes. When I started my so-called diagnosis in 2018, the questions I heard from doctors were about my favourite colour and games as a child. A car? Passed. A pink one? Failed. I also took tests to establish whether I had an inclination towards necrophilia. On the masculinity axis, I was supposed to be put in my place by questions about self-confidence, pugnacity and perceived empathy. Just like Lou Sullivan, I was to be eliminated by questions about my favourite masturbatory practices and sexuality. Both I and many of my friends were forced to draw how we imagine our mothers and fathers, women and men, to be on pieces of paper. And to place ourselves within that.
After a while, I started to understand that how I sit – astride or cross-legged – would affect how quickly I would get hormone replacement therapy, which – according to rulings of the ECtHR – is treated as a life-saving therapy.
I can bet that the biggest shows of gender performance in Poland take place precisely in doctors’ surgeries and not on the stages of gay clubs or platforms during equality marches.
Doctors also require full grounding in identity, stability. It is good to be determined, to show that you really want it, to dismiss a tearful story, to use the template: ‘I have always known’. Although we are decades away from the previously mentioned stories of Agnes’s, Christine’s or Lou’s lives, has so much really changed? In a quiz show like this, even people who live according to the gender given to them at birth could struggle to make it through all the rounds.
The dam of specialists is supposed to stop us from making the wrong decision and the irreversible consequences of the medical transition. In the extremely conservative discourse, it is often said that a doctor or therapist is needed to help an individual come out of the confusion. Today, such a position is strongly explored by both the right-wing and the transphobic feminists (the so-called TERF), who defend girls and boys against ‘mutilation’. They often reduce declarations of transgenderness, contrary to the current state of medical knowledge, to a lack of acceptance of one’s own homosexuality.
In the prevailing debate, medical control built on distrust is essential to avoid confusion. After all, this discussion resembles the hype around the right to terminate a pregnancy. Abortion cannot be a normal medical procedure to which every woman has a right, because abortion has to involve suffering. Besides, is it possible to trust a person who wants to terminate a pregnancy to know for herself what she is doing? That she will bear the consequences of her own decisions?
The case is the same for transgender people. What if you make a mistake? The discussion about de-medicalizing transgenderism is to end with the slogan ‘detransition’. This refers to people who arrive at the conclusion at some stage of their transition that they do not want to continue the therapy or live with a gender other than the one they had at birth. The first major systematic review of scientific papers, which investigated feelings of resentment in connection with the decision to undergo gender-correcting treatments, was published in 2021. A meta-analysis of their results showed that 99.1% of respondents did not regret their decision. The 0.9% who were disappointed often included people for whom the results of the medical procedures – such as phalloplasty, namely the surgical creation of the penis – were not satisfactory.
Much of the history of detransition is also related to transphobia. Even so, the imagination is inflamed by individual testimonies of people described in a sensationalist tone: these are about people who went through a ‘leaky’ system, or deceived poor doctors, and are regretting it today. The whole of this discussion is missing the point of the contemporary understanding of transgenderism altogether. Gender identity is something singular which a given individual feels. There is no need for a diagnosis for that; there is no need to use the medical system at all. Everything is based on subjective self-declaration. So why do we want 100% certainty from transgender people? Why are we not allowed to have doubts? The debate is so sensitive that simple admittance that your fantasies differ from your real experience can discredit you. Transition is still presented as moving from point A to point B. A one-way street with no stops or junctions. Only life is not like that at all.
The medical legacy has a strong influence on the categories in which transgender people are thought and spoken about today. Especially as the topic has been developed by current politics, which fuels emotions. And places the subject of gender in the realm of new cultural struggles. In such a framework, there are only a few positions for us to take (or into which we can be pushed). Victims and heroes. Saints and villains. Lost, led astray, susceptible to suggestion, dependent, in need of help. Brave, self-confident, fighters, revolutionaries.
It’s hard to believe that, today, such a subtle and fundamentally fascinating subject has two extremes, no grey area. In response to the argument that there are only two sexes and nothing more, we present ‘hard scientific evidence’ that nature sees gender as a spectrum. Does this exhaust the subject or convince the unconvinced? Not necessarily. So we reach further, for inalienable human rights and moral superiority. Doesn’t it work? We can still invoke the old emancipatory slogan: ‘we are the same, we have equal rights’. But will sameness certainly imply equal rights? No metaphor, not even the most sophisticated, will convey the experience of dysphoria.
It’s also difficult to describe what it means when you experience gender plasticity on your own body. Or what it’s like to mature at the age of 25. Have any of you ever mourned for yourselves? Or at least a certain version of yourselves? These are all experiences that not even two transgender people feel the same way. So perhaps the right to self-determination will come to our assistance? Better, but without systemic support, reaching a point of having unique identity will be restricted for the most privileged.
A strong current creating a shield around trans people is a family story. It is about placing us in a social network where we are loved and supported. We are someone’s son, daughter, grandson, granddaughter. This, in a way, legitimizes our existence and allows us to develop. And if anything pierces today’s strong social divisions, it is the voice of our parents. Trans people can, of course, complain that they need media for their message, but nothing is as heart-breaking as a mother or father speaking lovingly about their transgender child. In Poland, the choir of parents, whose most recognizable voice belongs to Piotr Jacoń, the father of a transgender daughter and a TVN24 journalist, has been hugely successful.
And finally we have pop culture, namely visibility without rights. Trans people smile at us from billboards and wink at us in Netflix productions. This certainly encourages asking questions, takes the subject to deep waters, but it’s still probably not all we can dream of.
I think what pushes the discourse forward is a completely new, fresh view. Not reactivity, not defensiveness, not ‘warming of the image’. Sometimes, a table (or two) needs to be overturned. Perhaps there’s nothing to be scared of, as everything we come up with today will probably be mainstream tomorrow?
Paul B. Preciado, a transgender philosopher, is such a hacker-dreamer. In his book ‘An Apartment on Uranus’, he draws an absolutely terrifying vision for the Polish right-wing, in which homo sapiens with XY chromosomes no longer necessarily has to rule the entire world. We can also come down to Earth.
Suffice it to say that the discussion on transgenderism is part of a wider debate about the crumbling patriarchy. Notions on which the social order was based are eroding.
In such a situation, it is entirely appropriate to ask: what can you learn about your own gender from a transgender person like me?
There are also derivative questions: what is heterosexuality without reproduction? Where should masculinity without power and without the role of the ‘provider’ of all goods be positioned?
Such a discussion might sound like a parlour game, but avoiding it will not mean that we do not suffer the consequences of major social change. This can be seen in the youngest generations: some look longingly at the old order, others boldly enter the unknown.
And in the meantime, to quote the classics of queer culture, ‘being playful is how we survive‘.
Dziennikarz i reporter. Uhonorowany nagrodami: Amnesty International „Pióro Nadziei” (2018), Kampanii Przeciw Homofobii “Korony Równości” (2019). W OKO.press pisze o prawach człowieka, społeczeństwie obywatelskim i usługach publicznych.
Dziennikarz i reporter. Uhonorowany nagrodami: Amnesty International „Pióro Nadziei” (2018), Kampanii Przeciw Homofobii “Korony Równości” (2019). W OKO.press pisze o prawach człowieka, społeczeństwie obywatelskim i usługach publicznych.
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