How does it feel to live in a time in which the grand establishment newspaper of record will publish, with grave seriousness and implicit nodding approval, the self-pitying posturings of a crazy who has created a personal identity and political ideology based on maladjustment and futile, self-destructive efforts to rebel against Nature and Reality?
Next Thursday, I will get a vagina. The procedure will last around six hours, and I will be in recovery for at least three months. Until the day I die, my body will regard the vagina as a wound; as a result, it will require regular, painful attention to maintain. This is what I want, but there is no guarantee it will make me happier. In fact, I donâ€™t expect it to. That shouldnâ€™t disqualify me from getting it.
I like to say that being trans is the second-worst thing that ever happened to me. (The worst was being born a boy.) …
I feel demonstrably worse since I started on hormones. One reason is that, absent the levies of the closet, years of repressed longing for the girlhood I never had have flooded my consciousness. I am a marshland of regret. Another reason is that I take estrogen â€” effectively, delayed-release sadness, a little aquamarine pill that more or less guarantees a good weep within six to eight hours.
Like many of my trans friends, Iâ€™ve watched my dysphoria balloon since I began transition. I now feel very strongly about the length of my index fingers â€” enough that I will sometimes shyly unthread my hand from my girlfriendâ€™s as we walk down the street. When she tells me Iâ€™m beautiful, I resent it. Iâ€™ve been outside. I know what beautiful looks like. Donâ€™t patronize me.
I was not suicidal before hormones. Now I often am.
I wonâ€™t go through with it, probably. Killing is icky. I tell you this not because Iâ€™m cruising for sympathy but to prepare you for what Iâ€™m telling you now: I still want this, all of it. I want the tears; I want the pain. Transition doesnâ€™t have to make me happy for me to want it. Left to their own devices, people will rarely pursue what makes them feel good in the long term. Desire and happiness are independent agents.
As long as transgender medicine retains the alleviation of pain as its benchmark of success, it will reserve for itself, with a dictatorâ€™s benevolence, the right to withhold care from those who want it. Transgender people have been forced, for decades, to rely for care on a medical establishment that regards them with both suspicion and condescension. And yet as things stand today, there is still only one way to obtain hormones and surgery: to pretend that these treatments will make the pain go away.
The medical maxim â€œFirst, do no harmâ€ assumes that health care providers possess both the means and the authority to decide what counts as harm. When doctors and patients disagree, the exercise of this prerogative can, itself, be harmful. Nonmaleficence is a principle violated in its very observation. Its true purpose is not to shield patients from injury but to install the medical professional as a little king of someone elseâ€™s body.
Let me be clear: I believe that surgeries of all kinds can and do make an enormous difference in the lives of trans people.
But I also believe that surgeryâ€™s only prerequisite should be a simple demonstration of want. Beyond this, no amount of pain, anticipated or continuing, justifies its withholding.
Nothing, not even surgery, will grant me the mute simplicity of having always been a woman. I will live with this, or I wonâ€™t. Thatâ€™s fine. The negative passions â€” grief, self-loathing, shame, regret â€” are as much a human right as universal health care, or food. There are no good outcomes in transition. There are only people, begging to be taken seriously.
Personally, I think that we sane and normal people have a lot more reason for melancholy based on sheer embarrassment over the contemptible intellectual state of our culture and establishment than does some nutcase who does not like the sexual characteristics he was born with.
I fail to understand how Society and the medical profession and government are all supposed to adapt to whims connected with sex on the part of an infinitesimally small number of deeply neurotic malcontents without feeling exactly the same obligation to “take seriously” and accommodate the wishes of every madman who thinks he is Napoleon.