[I was following links to different “privilege knapsacks”¹ (via Shrub.com’s sidebar, and also via this post at New Game Plus), but the link to the “non-trans privilege checklist” had died. I found the text in the google cache, but since that might not persist, I decided to reprint it on “Alas” to keep it available.

I also considered renaming this “The Cisgendered Privilege Knapsack,” because I like the word “cisgendered” and would like to propagate it, but the original author (whoever it is) called it the non-trans privilege checklist, and who am I to change that?

Author unknown. If you happen to know who wrote this, please let me know in comments. Like all the “privilege checklists,” this owes a debt to Peggy McIntosh’s White Privilege: Unpacking the Invisible Knapsack. –Amp]

1) Strangers don’t assume they can ask me what my genitals look like and how I have sex.

2) My validity as a man/woman/human is not based upon how much surgery I’ve had or how well I “pass” as a non-Trans person.

3) When initiating sex with someone, I do not have to worry that they won’t be able to deal with my parts or that having sex with me will cause my partner to question his or her own sexual orientation.

4) I am not excluded from events which are either explicitely or de facto* men-born-men or women-born-women only. (*basically anything involving nudity)

5) My politics are not questioned based on the choices I make with regard to my body.

6) I don’t have to hear “so have you had THE surgery?” or “oh, so you’re REALLY a [incorrect sex or gender]?” each time I come out to someone.

7) I am not expected to constantly defend my medical decisions.

8) Strangers do not ask me what my “real name” [birth name] is and then assume that they have a right to call me by that name.

9) People do not disrespect me by using incorrect pronouns even after they’ve been corrected.

10) I do not have to worry that someone wants to be my friend or have sex with me in order to prove his or her “hipness” or good politics.

11) I do not have to worry about whether I will be able to find a bathroom to use or whether I will be safe changing in a locker room.

12) When engaging in political action, I do not have to worry about the *gendered* repurcussions of being arrested. (i.e. what will happen to me if the cops find out that my genitals do not match my gendered appearance? Will I end up in a cell with people of my own gender?)

13) I do not have to defend my right to be a part of “Queer” and gays and lesbians will not try to exclude me from OUR movement in order to gain political legitimacy for themselves.

14) My experience of gender (or gendered spaces) is not viewed as “baggage” by others of the gender in which I live.

15) I do not have to choose between either invisibility (”passing”) or being consistently “othered” and/or tokenized based on my gender.

16) I am not told that my sexual orientation and gender identity are mutually exclusive.

17) When I go to the gym or a public pool, I can use the showers.

18) If I end up in the emergency room, I do not have to worry that my gender will keep me from receiving appropriate treatment nor will all of my medical issues be seen as a product of my gender. (”Your nose is running and your throat hurts? Must be due to the hormones!”)

19) My health insurance provider (or public health system) does not specifically exclude me from receiving benefits or treatments available to others because of my gender.

20) When I express my internal identities in my daily life, I am not considered “mentally ill” by the medical establishment.

21) I am not required to undergo extensive psychological evaluation in order to receive basic medical care.

22) The medical establishment does not serve as a “gatekeeper” which disallows self-determination of what happens to my body.

23) People do not use me as a scapegoat for their own unresolved gender issues.

1. Which are universally referred to as “privilege checklists,” and that’s pretty much my fault, I fear. But McIntosh, who started it all, called it “unpacking the privilege knapsack.” (back)

I was searching for bloggy critiques of Levy on bois, and was surprised by how little I found. The two best critiques I found were buried in comments; I’m reposting them here, in the hopes of making them easier for future searchers to find.

So what is a boi? For the purposes of this discussion, boi means “a female-born or female-bodied person…sometimes transsexual, transgendered, or intersexed, sometimes not…who generally does not identify wholly or at all as being feminine, female, a girl, or a woman, though some bois identify as one or more of these. Bois almost always identify as lesbians, dykes, or queers; many are also genderqueer or genderfucked. Bois can prefer a range of pronouns, including ‘he,’ ’she,’ or gender-neutral pronouns; it’s usually best to ask to avoid offence.” (Quoted from wikipedia).

This is a comment that Starfrosting left on the Gender Theory Livejournal, regarding an article Ariel Levy wrote for New York Magazine. Levy later used a slightly-rewritten version of her article as chapter four of her book Female Chauvinist Pigs.

I have read her article “Where the Bois Are” and as it’s one of the most offensive pieces I’ve read in a long time. I’d like to comment on it. Where to even begin. Levy doesn’t critique misogyny there; she simply interviews some bois who are misogynist and goes on to extrapolate that boi-hood is misogynistic. She writes that the ‘phenomenon’ of boi gender is about “young lesbians [going] beyond feminist politics, beyond androgyny, to explore a new generation of sex roles”; that “boihood has nothing to do with earth mothers or sisterhood or herbal tea, and everything to do with being young, hip, ‘sex positive,’ a little masculine, and ready to rock”–

I don’t want to unpack this endlessly, but to do it briefly:

1) All bois are lesbians? Hmm. Considering that Levy consistently mis-pronouns her subjects throughout the article, I’m a little wary of that judgement.

2) Teleological much? Evidently lesbianism used to be all about valuing and liberating womanhood, and now these ‘bois’ who of course are lesbians regardless of how they self-identify have moved into some wonderful apolitical postfeminist space.

3) Because, you know, being transmasculine means you’re antifeminist and misogynist.

4) Throughout the article there’s this really gross and classist set-up where ‘butch’ comes to figure archaic, working class, and piggish and boi comes to signify hip, new, upwardly mobile, and sexy. Again with the teleology.

5) Elsewhere Levy says that bois “have the luxury to prioritize play and pleasure in a different way [since] worrying about things like male privilege seems old-school and uncool.” This sort of facile ‘feminist’ analysis does not give me much faith in her book, or much of a desire to read it at all.

I know the points I’ve made have been somewhat disconnected and only relevant to a bit of the author’s work, but I just had to say something as I found her article not only incredibly transphobic, but not at all rigorous in its analysis of masculinity and sexuality, to put it mildly.

(To be fair, the identification of bois with lesbians is pretty common, not something unique to Levy; see, for example, the Wikipedia definition I quoted at the start of this post.)

The second comment I want to highlight is comment by one by Piny, which he left on “Alas” last year:

I read that chapter, and have read some of the book. I agree with her central premise–that sexualization is not sexual autonomy, and that some people seem confused on this point–and understand that ftms and bois make up a brief chapter in a book that’s about, y’know, women. Still, for fuck’s sake.

She claims that transitioning has become (I may be paraphrasing slightly) “so widespread as to be faddish.” She has a great deal of evidence to believe that people, queer women in particular, fear this and believe it to be true. It’s certainly true that transition is more common than it was when it was virtually impossible. She has no reason to believe that transition is a hot new trend, or any reason to believe that it’s _too_ common, and she doesn’t cite any numbers at all.

She also based her ideas about ftms on an interview with exactly one ftm, IIRC. That’s like using any given lesbian (possibly Susie Bright) to form opinions about all lesbians (including Sarah Hoagland). She took a very heteronormative view of bois, which was disappointing, and she accepted the lone transsexual’s statement that you can draw a thick black line between “boi” and “ftm,” which a lot of people in both groups dispute. She decided that “bois” became bois because they didn’t want to be adults. I also recall a discussion on an ftm livejournal community about her article, “Where the Bois Are,” much of which found its way into this book. Most of the commenters were extremely disappointed by her language and her limited portrayal. One commenter said that a friend of his who was interviewed in the article had done a snarky, sarcastic impression of a stereotypical boi that was then quoted as though in propria voce.

All in all, I wasn’t terribly happy with it.

I’ll just say that I know a lot of feminist ftms and bois. I know a lot of ftms and bois who don’t feel compelled to present that kind of stereotypical brittle masculinity, but I don’t think it’s fair to see that as an act of courage on their part. Basically, we’re like everyone else: when we feel safe and comfortable being gendervariant, we are. When we have role models that aren’t traditional, we feel no need to be traditional ourselves. When our community doesn’t condone woman-hating, we don’t.

Although I think that critiquing misogyny is always a good thing, I’m bothered by critiques that read sexism among bois, butches, and ftms as a special phenomenon or something especially related to transition–or a new thing, considering that butches have been around for a long time. It’s how people behave when they live under patriarchy. Their sexism isn’t much different from that of other men.

Jessant wrote: Levey bothered me because the impression you get from her portrayel of bois and trans-men was that these women were fleeing from their own gender to take on male privilege, and it’s even more damning if you look at it in the context of the book, which is basically arguing that some women are trying to take on more power by stepping on the backs of other women by accepting sexism and women-hating.

Yes, exactly! And don’t get me wrong, ftms get male privilege by transitioning. (There was a discussion of this on livejournal some months back, and one commenter wrote, “People assume I’m competent now!”) And bois _definitely_ receive a kind of male/masculine privilege in queer circles that are sexist. But that doesn’t mean either that we understand that when we do cost/benefit analyses, or that we transition because of it.

(Comment from elsewhere in the same thread: Lauren asking “When the hell are you getting your own blog, Piny?” Heh.)

[Crossposted at Creative Destruction. If your comments aren’t being approved here, try there.]

This is one of those essays I’ve been meaning write for a while. Let me start by making an observation: I think political progressives are more accepting of transgender identities than they are of transracial identities. If fact, the only time I ever read or hear the word transracial it is connected with adoption. It’s almost as if “queering” gender lines (blurring them for people who are not into queer theory), is hip and cool in some progressive circles, but I get the impression transracial identities are not. Now I should say that I do not think either transgender or transracial identities are accepted by the larger culture, but I definitely think there is a difference between how the two are treated among progressives. I understand that this is probably a controversial position, but the whole notion of a transracial identity hasn’t even been theorized in most of the literature I have read.

Race and Gender Drag Shows
One way of blurring/queering gender and racial lines is the use of drag. Drag tends to be a temporary thing used in performance. The person in drag changes their identity for the purpose of performance, but does not change their identity in all aspects of their lives. I first started thinking about this when the show Black.White came out. The show was roundly criticized by the blogs that I regularly read (Mixedmediawatch.com, Reappropriate, Blackademic). I watched the show, and I tend to agree with many of the criticisms cited by these bloggers. Personally, I am very uncomfortable with many aspects of racial and gender drag when they are used as a technique to get people to understand what it is like to be the other. I’m not so sure that dressing in race or gender drag can really teach people. It would be really interesting to compare and contrast contemporary racial drag and gender drag to see which one is more likely to be used to entertain and which one is used to teach. I get the sense that in this era gender drag is more likely to be used as entertainment, and racial drag is more likely to be used as a teachable moment. It seems that gender drag shows invoke gender stereotypes to entertain, and many people seem to think of gender drag as hilarious. In contrast racial drag invokes stereotypes, to entertain, but in many cases, like Black.White, it is viewed as entertainment plus education. Now I am not speaking in absolutes…I have seen cases where gender drag is used to teach, such as pregnancy suits, and I have seen racial drag used purely for entertainment purposes, such as most of the early Black face performances. However, I am particularly interested in how contemporary progressives view this issue, and my sense is that one type of drag seems to be treated in a different manner than the other.

Transgender and Transracial Identities
Unlike drag, transracial and transgender identities, are more permanent. If people are transracial or transgender, they are altering the gender or racial identity on a long term basis and integrating this view of identity and everyday life. (It should be duly noted that Microsoft word is marking transracial as a misspelling). In most of the literature I read transracial identities are referred to as racial “passing,” and passing is generally referred to in negative terms. Transgender identities are also viewed negatively, but more recently there is a move afoot to accept the transgender, and part of this movement (not all of it) seeks to explain transgender identities through a medicalized view of the “problem.” (I use the term problem here loosely because I personally don’t see it as a problem, but I think the medical profession does.) What I wonder about is what would happen if we started treating racial identities in the same way. To some extent it is already happening, according to research by Maggie Hunter. Hunter found that many textbooks used to train plastic surgeons tend to medicalize the eyes and noses of Asians describing them as in need of repair, although a similar trend does not seem to appear for Whites. But I wonder, will it be a matter of time before we talk about race reassignment surgery? And I wonder how the medical profession would frame this? I think people cold learn to accept and celebrate transgender identities and transracial identities without using a medicalization framework, but I digress from my primary point, which is that there does not seem to be an organized movement to accept transracial identities. So I wonder, what would such a movement look like, and is a movement necessary?

What Do You Think?
I think one of the fundamental differences between race and gender is that the notion of racial mixture or multiracial identity is much more widely accepted than the notion of a mixed gender identity or multigender identity. My sense is that progressives have started to embrace transgender identities as a way to acknowledge such as multigender identity. However, mixed identities are not “trans” identities.

My sense is that progressives have started to embrace transgender identities but don’t even have a conception of such a concept when it comes to racial identities. In fact, many progressives have been critical of racial drag, and transracial identities are often called racial passing or cultural appropriation. My sense is that term term gender passing is something used in transgender subcultures, but the term passing seems to refer to behavior not really an identity.

I’m not firm in my views on this, but there does seem to be a fundamental difference is how transracial and transgender identities are approached (especially among progressives), but comparing how these two identities are theorized (and experienced), raises many questions for me…Why are transgender identities the subject of discussion among progressives, but the concept “transracial” seems to be virtually non-existent? Why do you think there is a movement among progressives to accept transgender identities, but no such movement to accept transracial identities (assuming you accept the premises of the question)? What differences do you think there are between trangender and transracial identities, and do those differences affect how you view each? If you are comfortable with one and not the other, why?

Oops, this is also posted over at my blog Rachel’s Tavern.

It’s been years - almost two decades - since the last time I wore makeup or a dress. Why? I like dresses.

I recently noticed that - although I’ve never given the matter any conscious thought - that I always tie my hair back in a low ponytail. Even though a high ponytail would often be more comfortable (for instance, in airplanes, cars, and other situations with high-backed chairs). But a high ponytail is seen as “feminine” in our society, and I unconsciously chose to avoid that.

I spend a lot of time thinking about feminism and sexism and the need to fight our society’s coercive gender role structure. Yet when I shop for clothing, I do so in a way that implicitly condones those very roles. I dress like a man. I tie my hair in a culturally masculine style. I’m helping to entrench the system I oppose.

Yawning Lion at Fem-muh-nist writes:

I have heard the argument that transitioning from one sex to the other challenges the idea of gender as binary. I don’t understand how. If one moves from male to female or vice versa, there are still only two genders at work, aren’t there? It may become harder to distinguish who is who, or who was born what, but the binary gender system remains intact, and women remain at the bottom. If this is truly a challenge to the system and to patriarchy, I would like to understand precisely how that happens. What I see is that it further entrenches the system, while at the same time challenging the legitimacy of complaints against the system - after all, could being a woman be so bad if some people choose to become women?

1) Nothing about transitioning necessarily challenges the idea of gender as a binary. Nor does not transitioning challenge the idea of gender as a binary. Challenging gender as a binary is something we do with advocacy, not by being transgendered or not.

2) However, it should be noted that “male to female or vice versa” with “only two genders at work,” while perfectly valid, is not a complete list of how people are transgendered. Some people have explicitly fluid gender identities, or in some other way refuse to identify as simply “male” or simply “female.” Insofar as their “fluid” gender identities are made public, these folks implicitly challenge the idea of gender as a simple binary.

3) Furthermore, as Piny points out in YL’s comments, transitioning from one sex to the other implicitly “challenges the gender divider that this society seems most invested in: sex assigned at birth defines your gender position, full stop.”

4) In a sense, transsexuals who move from one sex to the other “entrench the system” of gender as a binary, because they are willing to dress and be identified in society as one gender and not the other. But that’s true of the vast majority of us, transsexual or not.

All of us make compromises with the patriarchal society around us, whether it’s getting married to someone of the opposite sex, or shaving (for women), or shopping only in the “men’s” section of the clothing store (for men), or wearing a low ponytail (for me). There are a thousand ways to compromise with patriarchy - no, ten thousand - and I doubt anyone fights against them all. And all of these decisions and actions could be said to help entrench the gender-binary system.

We all do what we have to do - to survive, to express ourselves, and to feel comfortable with what we see in the mirror. It’s illogical to single out transsexuals for criticism on this score - and yet, transsexuals are constantly singled out for this criticism. I call that discrimination.

5) Regarding “after all, could being a woman be so bad if some people choose to become women?” You might as well say that being gay isn’t so bad if some are out of the closet, or that transphobia isn’t so bad if some people choose to be openly transgendered, or that racism isn’t so bad if some POC who could “pass” for white choose not to. (Piny made this argument, as well).

Bottom line: Patriarchy is a huge edifice. We should welcome a lot of different approaches to challenging it. And virtually everyone has to compromise with patriarchy sometimes.

Finally, in my opinion, feminism has never been at its best or strongest when saying “keep out” to oppressed minorities.

NOTE: I actively limit who can post comments on my threads on “Alas.” If your comments aren’t getting approved for publication here, please consider posting your comments on the exact same post at Creative Destruction.

The pro-choice movement can be a little insular; we are in a valley whose boundaries are defined by Roe v Wade on the one side, and the ever-shrinking practical access to abortion on the other. Cherry at Tortillas Duras has written a terrific post that attempts to look at reproductive rights from the hilltop, where a broader view is possible. What reproductive rights issues are those of us in the valley missing?

Here’s a sample of Cherry’s post. I don’t agree with everything Cherry says (for instance, would ending transnational adoption actually help “individuals who are not able to parent their children due to conditions created through imperialism,” and how do the needs of those individuals balance against the needs of people who are discriminated against by domestic adoption agencies?), but all of it is interesting; I’d really recommend reading the whole thing.

Does being fat feel at all like being transsexual?

Traditionally, untreated transsexuality has been described as feeling as if your body is wrong; that your true self doesn’t match your body. (I say “traditionally” because it’s unclear how often that’s been a genuine description of some transsexuals’ experience, and how often that’s been what doctors have pressured transsexuals to say). That’s what being fat feels like, to me. I’m supposed to be thin, aren’t I? Not thin-thin, you know, just - normal-thin. But I don’t feel normal. I feel constantly abnormal.

I feel like someone who, somehow, wound up in the wrong body.

Of course, there’s a huge difference between what I feel and what pre-transition transsexuals feel. Transsexuals feel “wrong” in their bodies despite enourmous social pressure to accept the sex and gender they were born and assigned. I, on the other hand, feel wrong in my fat body because there’s been enourmous, nonstop social pressure teaching me to hate myself and my body for most of my life.

Transsexuals are pressured - brainwashed, even - to want the sex they were born into. (All of us face that pressure, actually - it’s just that most of us give in with so little resistance that we don’t even notice). The fact that in the face of so much pressure some transsexuals still want to transition is an indication, in my opinion, to me, that their need to transition is genuine. In contrast, I’ve been pressured - brainwashed, even - to want to change. And despite all I know, all I’ve learned, and my genuine passion for fat acceptance, I still sometimes see my reflection in a store window and think - geez, I’m so fat! Can that really be me?

But that’s the brainwash talking. Research has shown that most transsexuals who transition experience relief and feel the quality of their life has improved. That’s because their need for change was genuine, not brainwashing. If I were thin, I would face less social prejudice, and some things - like sitting in an airplane - would become more convenient. Many people I don’t care about would treat me better. But I wouldn’t be happier.

(Of course you’d be happier! My brainwashing replies. Thin is happiness, you fool!)

There’s another comparison between transsexuals and fat people - both groups are told that there’s a surgical cure. Increasingly, transsexuals are rejecting this message; more and more transsexuals are transitioning without surgery, or with plastic surgery but without genital reconstruction. I think that’s a good trend; there’s nothing wrong with transsexuals getting reconstructive surgery, but there’s also no reason that should be the one-size-fits-all solution for gender identity disorder.

But as transsexual surgery is on the decline, weight loss surgery is on the ascent. And although people think of it as a less major operation, in many ways having one’s stomach banded is a more radical - and more dangerious - surgery, with a higher deathrate.

I’m not trying to say that being fat is worse than being transsexual; on the contrary, it seems to me that anti-transsexual and transgender bigotry is far worse than anti-fat bigotry. Nor do I have a conclusion at this time, which is a shame, since conclusions at the end of blog posts lend a nice feeling of closure.

New York’s Rikers Island has long had a separate unit for gay and transgender prisoners, intended to protect those prisoners from abuses from the rest of the prison population. According to The New York Times, the unit is now scheduled to be shut down. Instead, gay and transgender prisoners who feel endangered can apply to be put in solitary confinement 23 hours a day.

I have to admit, I’m suspicious of the claim that the only reason to eliminate the special unit is concern for the safety of gay and trans prisoners; it hardly seems likely that they’d be safer in the general population. Furthermore, since applying to live in the unit was voluntary, why were any trans or gay prisoners applying to live there if they would have been safer in the general population?

Expect light posting from me until 2006 - I’m just too busy to spend a lot of time on “Alas.” But I wanted to point out this excellent discussion of transwomen and feminism, which took place in Feministe’s comments, mostly between three writers I respect a lot: Piny, Emma of GenderGeek, and Tekanji of Shrub.com. Tekanji, in particular, did a wonderful job of arguing that a definition of “women” that includes transwomen is compatable with, and desirable for, feminism.

From Tekanji’s final post on that thread:

That last paragraph in particular does a wonderful job of putting into words something I’ve thought about this question for years. Like Tekanji, I’ve long been disturbed by a strong streak of transphobia among some feminists; that was a major reason I grew disenchanted with the late, great Ms. Boards.

There’s more good stuff in the discussion at Feministe, so I’d recommend reading the whole thing.

This post was removed by request of the author.

The story of how the male contestants on Sky’s reality show “There’s Something About Miriam” are suing Sky Broadcasting has been getting press on air, on the blogs, and in print, so you may have read about it already, but in case you haven’t here’s a recap: (via The Guardian.)

Now, I’m not an expert on sexual assault laws, but it seems to me that the plaintiffs in this case don’t have a legal leg to stand on. Their kissing, cuddling, and fondling of Miriam (a pre-operative transsexual) was entirely consensual on their part (as near as I can tell) and is no more sexual assault against them than if they had picked up Miriam in a bar and taken her home with them.

It sounds to me like these six men (I’m tempted to make insulting comments about them, but it seems that everyone involved in the show was acting in a reprehensible manner) were profoundly embarrassed by what happened and are trying to find some legal ground to keep themselves from being internationally shamed. (For some reason, I can’t shake the idea that these were all uber-masculine, manly-man types. I can’t imagine a show that played so much off of homophobia that didn’t have contestants of this type.) But really, how can they claim that Sky is responsible for any personal injury (what personal injury? Finding out that the super-model-type you thought you had free reign to grope was actually a preoperative transsexual?) when any sexual acts they may have committed with Miriam were entirely consensual.

I’ve seen it argued that the men have a legal standing in their case because Sky may have told them that Miriam was a woman and therefore they were deceived into fooling about with a man who they had been told was a woman. Again, all the acts were entirely consensual, so as far as I’m concerned there was no sexual assault, but if Sky did refer to Miriam as a woman they weren’t really lying. Most preoperative transsexuals prefer to be referred to as members of the gender they wish to become (and already are, in my opinion; what’s an organ?) and so Sky may have been following the wishes of their employee, Miriam, or simply following what’s an established convention in the trans community.

I guess the question remains: when writing legal contracts, are preoperative male-to-female transsexuals referred to as men or as women? I’m not sure how much this changes; for instance, the men may not have read the contracts, or Miriam may have been referred to with a gender-neutral term (e.g., “the contestant”) and it was only the Sky people who referred to Miriam as a woman.

I’d be interested in the opinion of someone who is more familiar with sexual assault laws and laws with regard to preoperative transsexuals.

[Edited for accuracy.]

[The original form of this post referred to Sky Broadcasting as being owned by Fox. One of the commentators informs me that this is not true; in fact, Sky Broadcasting and Fox are both owned by News Corporation. I’ve corrected statements to the contrary in the post and have removed all references to Fox. Sorry for the inaccuracy.]

I had never heard of Body Integrity Identity Disorder, or BIID, until I read about it Blueheron’s livejournal.

So what is BIID? From an article in the Atlantic Monthly:

Folks with BIID are folks who want to have healthy limbs chopped off so that their external self can match their internal, idealized self. Some of these folks actually go through with it, cutting of one or more limbs. Although people with BIDD are rare, the condition - at least anecdotally - appears to be becoming more common.

The Atlantic author brings up an interesting question: Does the existence of a diagnosis and treatment (in this case, amputating a limb or limbs) for a condition increase the prevalence of the condition in society?

So the existence of sex reassignment surgery - and of an increasingly active and visible transsexual community - may be increasing the number of people who genuinely and sincerely need to have their sex changed. And a similar dynamic, ten or twenty years from now, may lead to a huge increase in the numbers of people who go to doctors and ask for a limb or two (or four) to be removed.

As blueheron points out, for those of us who are supportive of sex-change operations for transsexuals, it can be hard to find a reason to oppose amputations for folks with BIID:

That’s pretty much where I stand. The Atlantic article quotes a young woman who plans to have both of her arms cut off. That horrifies me, and yet - assuming she is sane - I cannot see a justifiable reason to not allow her to control her own body. Subjectively, I am horrified by the idea of someone choosing to be crippled; but I realize other people are just as horrified by the idea of someone choosing to change sex. My horror is my own problem, not the problem of someone with BIID.

Objectively I don’t think a life lived without arms is any less important, or potentially any less fulfilling, than a life with arms. So if someone feels they need to have a doctor remove their arms to obtain happiness, on what grounds could I disagree?

In the comments to my post “mutilating gender” last week, J. (a.k.a Mac Diva, author of two (!) notable blogs, Mac-a-ro-nies and Silver Rights) argued forcefully against sexual reassignment surgery (SRS).

J. has repeated this point on Silver Rights arguing that SRS isn’t a “proven medical treatment” and that it “may not be an actual remedy.”

Unfortunately, J. didn’t reference the specific research she’s relying on, so it’s possible that by posting this I’ll be smearing egg on my own face. But as far as I can tell, the evidence doesn’t support J.’s claims.

First, regarding John Money, J. is mistaken to think he is “the originator of the concept.” David Cauldwell, for example, was using the term “transsexual” in the late 1940s, whereas John Money’s work didn’t begin until the 1950s.

Much more importantly, J. is mistaken about outcomes of SRS. The most comprehensive study of post-SRS outcomes is “Sex Reassignment. Thirty Years of International Follow-up Studies” by Friedemann Pf’fflin and Astrid Junge (1992 in German, English translation 1998). Pf’fflin and Junge used data from over 70 studies, in total considering the outcomes of over 2000 patients from 13 countries. They found that outcomes - measured in terms of “subjective satisfaction; mental stability; socioeconomic functioning; and partnership and sexual experience” - of SRS are generally positive. Overall, 71% of male-to-female (MTF) and 90% of female-to-male (FTM) operations had positive results. When they limited their sample only to more recent patients (who benefited from improvements in techniques and procedures over the decades), the results were positive for 87% of MTFs and 97% for FTMs.

Of course, Pf’fflin and Junge’s article is now a decade old, but I’m not aware of any study of comparable scope since then which has discredited their work. And it may be that there are problems with the data which should prevent us from drawing conclusions; Dr. Anne Lawrence, summarizing more recent studies, points out that they have a distressingly low response rate.

On the other hand, as Lawrence points out, even the controlled study by Mate-Kole (in which MTFs were randomly selected to either be given SRS quickly, or to be in a control group which was waiting for the surgery) found that “patients who underwent expedited SRS demonstrated improved psychosocial outcomes, compared to the still unoperated controls. They were more active socially, and had fewer neurotic symptoms.”

On the important issue of regrets, Pf’fflin and Junge found 14 documented cases of patients who regretted having gone through SRS. Some of these patience appear to have been inadequately prepared, or to have had botched or incomplete surgeries. While it’s of course regrettable that anyone feel regrets, 14 out of 2000 doesn’t strike me as a high enough rate of regrets to discredit SRS, or to suggest (as J. did) that a typical SRS patient may seek to have their surgery reversed.

The evidence is imperfect; and, since I don’t know what J.’s sources are, it’s possible that she’ll post references that blow this post away. For now, however, it seems that the evidence indicates that SRS probably is effective; for those patients who choose to go through SRS, it provides real relief and life improvement.

If I’ve followed her arguments correctly, J.’s main concern is whether or not tax dollars should be used to pay for SRS. My feeling is that all necessary and effective medical treatments ought to be paid for out of tax dollars, preferably in a single-payer health care system akin to France’s. Since I think the evidence shows that SRS is an effective medical treatment, I think it should be covered.

(To read J.’s thoughts on transsexuality for yourself, read through this comments thread - if you don’t want to read the whole thing, you can find her posts with a text search for “Mac Diva.” On her blogs, read this post and also this post on Silver Rights, plus this post on Mac-a-ron-ies.)

Note: Due to this post being published as Alas was switching commenting software, the original comments to this post have been “stranded.” They can still be read here. However, please leave any new comments in the new comment system (link below).

Transsexuality sometimes presents a problem for feminists. On the one hand, many feminists come from an intellectual tradition of sympathy for the downtrodden, the oppressed, and the discriminated-against, and transsexuals certainly seem to fit the bill.

But on the other hand, a major tradition in feminism is that gendered behavior is not inherent. That is, one does not have to be biologically male to be an effective leader; one does not have to be biologically female to be a good nurturer of children; and so forth. Transsexuality can seem like a slap in the face to all that. “I was a woman trapped in a man’s body; I wanted to be soft, I wanted to express my emotions, I couldn’t relate to any male things.” One of feminism’s Big Projects, arguably, had been to give society a slap on the face and say “snap out of it! Gender’s not a big deal! Sex does not predict behavior!” And along comes transsexuality, with exactly the opposite notion - sex does predict behavior, so much so that if you “behave” like the “wrong” sex, you might consider surgery to bring your behavior and your private bits into accordance.

Some feminists saw something even worse in transsexuality: double agents. Men who dress as women and then try and take over the feminist movement from within. Challenges to women-only space. Other feminists - including me - tend to see the opposite danger: some feminists using such fears as a way of legitimizing anti-trans bigotry.

The real story is more complex. Which brings me to Dean Spade’s article Mutilating Gender, which I’ve been meaning to blog since I read it via Blargblog last week. It’s a terrific article (although if you read it I do recommend following “Ampersand’s rule,” which is to skim right past any paragraph that mentions “Foucault”).

The article admits forthrightly that transsexuals - and, particularly, transsexuals seeking help from the medical community - have been extremely dedicated to maintaining and supporting gender stereotypes. However, that dedication is a response to the desires of the medical community. Doctors, in effect, latched onto a biography of “the life of a transsexual.” In this biography, little Billy Pre-Transsexual was Always Miserable as a boy. He was No Good at sports (because he’s a girl inside, and we all know girls are never good at sports). Little Billy played with dolls and makes drawings with lots of flowers and hates his penis… and, eventually, Little Billy gets the surgery he wants without any ambiguity at all and becomes happy Suzy Transsexual, a woman who is entirely feminine and not even slightly butch, since we all know butch women aren’t real women.

If you wanted SRS (sexual reassignment surgery), then you’d better have a biography just like little Billy Pre-Transsexual’s (or just like his opposite-sex counterpart, little Wendy Pre-Transsexual). The doctors will test and interview you to make sure you have little Billy’s biography; and if you don’t have it, then they won’t help you.

With hindsight, the result of this medical requirement was predictable. Sooner or later, everyone wanting SRS learns that there was only one set of “right” answers doctors wanted to hear. Of course, some patients really did have a “little Billy” or “little Wendy” biography. But other patients learned to manufacture those same biographies; tell the doctors what they want to hear, and the doctors will give you the medical treatment you want. From the article:

In effect, medicine said to transsexuals: “Be as conservative about gender as you can. Conform to all the gender stereotypes you can think of; if you want to be a woman, be a stereotypical woman, if you want to be a man, be a stereotypical man. Wipe all traces of ambiguity from your life story. And if you do that, medicine will be willing to help you.”

The alternative is difficult to imagine - but it’s worth a little effort. From the article:

Even those of us who support SRS can - and should - question the way that the medical community has used SRS to enforce very conservative views of gender on patients. Gender is a spectrum - and everyone, including people seeking SRS, should be free to place themselves where they want on the spectrum.