I was hungover at my first gender clinic appointment aged sixteen. I was tired and aching, insufferably depressed and entirely unprepared to perform masculinity in a medical setting.
The waiting room was palpably tense. It was a children’s gender clinic, filled with fellow young trans masc boys dressed the same as me. Men’s jackets, jeans and button downs, blue, black and grey, with barely concealed apprehension on their faces. Trans femme girls similarly were exclusively in makeup, skirts and dresses, with brighter colours than us. We all looked uncomfortable.
We knew that we were performing, and that it was possible to fail at this performance: how well we conform to the clinician’s understanding of gender can set back our transition, when we receive treatment, and how ‘seriously’ others take our transition. Did we look the part of the tragic transgender child? Do we have correct amounts of bodily discomfort and desire for cisgender acceptance? At that moment, I knew on some level that I was doing this for them, not me.
My body was dissected that day. I was asked about my childhood – who were my friends? What toys did I play with? What clothes did I wear? Eye-rollingly simplistic questions, but nothing unexpected. Then it shifted. I was asked if and how I masturbated, if I liked my breasts, if I wanted to become pregnant at any stage, and how distressed I got about menstruation. The questions were always framed as if the clinician expected an answer that painted my experience as one of continual dissonance with my own body. I was expected to be in pain, to crave a different body, and to be dissatisfied until that change was wrought.
“Did we look the part of the tragic transgender child?”
The question of genitals was brought up. Now I have never had lower dysphoria, and have never desired phalloplasty. Yet in this appointment, and subsequent ones, I spoke of my hatred of my sexual organs and a desire to remove and replace them. I did this out of fear that treatment would be delayed and denied, and that my identity as male would be questioned. How could you be male if you don’t want a penis? I was petrified that clinicians would conclude that I was simply not trans enough.
One of my most vivid memories is failing to hold back tears as the clinician said I could not get medical treatment for at least three years – until I was eighteen, possibly nineteen. She watched as I cried and could not offer me any words of support. I did everything ‘right’ and it still wasn’t enough.
I am not a special case. My interrogation is not isolated. The questions I was asked are typical. The system of gender identity clinics has one model of ‘the transgender child’ against which all others are assessed. The archetypal transgender child is dysphoric, wishes to completely become the ‘opposite’ sex, presents entirely as another gender, and severs all ties with their old body. The dehumanised body of trans children are medical phenomenons before they are people; their physical health is extensively documented whilst their mental health often rapidly declines. Any nuance is viewed with at least suspicion, if not outright denial of the individuals identity.
“I was petrified that clinicians would conclude that I was simply not trans enough.”
Now, trans people know how archaic these gender clinics are. We have to become adept at constructing palatable narratives for their consumption – and we communicate what we find to one another. Before my appointment I was given tips and tricks from my peers about how to navigate them. The main tips I remember were to present a childhood of dysphoria and hatred of female socialisation, and present more ‘masculine’ at the appointments.
I was indeed a ‘tomboy’ as a child, but had no narratives of painful dysphoria as such. I played with dolls sometimes, and didn’t consciously identify as male until I was 14. I ended up speaking about my early childhood full of painful dysphoria, driven by a desire to halt my puberty and become entirely male. This advice I was given was not some covert scheme to trick unsuspecting children into identifying as trans. It was legitimate strategies for a powerless trans youth to obtain the treatment they need in order to live. It is necessary to lie for us to live as ourselves.
I am still trans, far more proud now than I ever was aged sixteen. Since leaving the gender clinics and developing as an adult, my gender and expression is less rigid than when I was attempting to convince clinics of my identity. I’m a walking rainbow, often attempting to look androgynous and confusing; now established on testosterone therapy and recovered from top surgery, there is no need for me to convince anyone anymore.
“I constantly want to scream that it is not trans people that perpetuate these stereotypes.”
Whilst I am content now, this is not enough. I spent my childhood desperately unhappy, attempting to appease a medical system that ultimately did not care whether I lived or died. And I nearly did. Trans people suffer so much under gender binaries enforced by these clinics – and we are often blamed for them.
Transphobic critics often point to the trans boys and girls getting treatment and claim that the ‘trans ideology’ is perpetuating misogynistic stereotypes that women must be hyperfeminine and men hypermasculine. This critique, deliberately or not, ignores the circumstances these children navigate: like me, they are terrified of being told they are ‘doing gender’ wrong, and the clearest way to express their seriousness is to conform to how these clinics perceive ‘male’ and ‘female’. Trans people are coerced into conformity then blamed for creating the conditions under which they suffer.
I constantly want to scream that it is not trans people that perpetuate these stereotypes. There is no ‘trans ideology’, least of all one that is stealing innocent children away from the safety of cisnormativity. There are communities with survival techniques attempting to navigate an increasingly hostile medical system to obtain our healthcare. If there is an enemy, it is the dangerously restrictive ideas of gender that flourish within the current gender identity clinics.
Eliott is a second year undergraduate historian at Oxford University – passionate about medical history, protecting trans kids, cats and informed consent care. @el__iott
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