Curing the Stockholm syndrome of “stealth”: ending sympathetic responses toward cis gatekeeping

Over at the Transadvocate, a commentary series is re-examining “stealth” as a way to exist as trans within structural cisnormativity. “Stealth” is a relic in which as a trans person, one must never mention their being trans to another person, including (implicitly heterosexual) cis partners. As “stealth”, one must be placed consistently as cis by cis people. As “stealth”, one must also be commissionable in producing a narrative which would be implausible for many trans people. “Stealth” is treated as a lifelong pact. As a prescriptive approach, “stealth” owes its long shelf life to women who are trans — that is, relative to others who are trans and gender non-conforming (GNC). Of those women, the staunchest advocates of “stealth” have tended to share both white and middle class intersectional experiences. It was not uncommon for these women to begin their transition during the 1960s, the 1980s, and even the 1990s.

How “stealth” is being addressed by the Transadvocate series predictably overlooks the core causes why the practice even gained traction in the first place. The first to promote “stealth” as a way to live were clinical gatekeepers. That is, the gatekeepers were disproportionately white cis men who developed gender clinics with procedural systems to make access to trans medicine a prohibitive, intimidating ordeal for even the most determined of trans people. The staunchest evangelists of “stealth” were the beneficiaries of those clinics.

What is predictably bothersome about Suzan Cooke’s essay, “The many shades of stealth,” is its conspicuous absence of intersectional consciousness. What is equally bothersome about Cristan Williams’s piece, “A rant about MTF stealth,” is its propensity for victim-blaming those who consented, some under institutional duress, to a “stealth” existence for their own lives as trans people, as a precondition for their welfare. It also blames by association any trans person who lacks the situational affordance to live openly as trans, where forcible disclosure can be extremely hazardous, and where involuntary disclosure can jeopardize other basic securities. Further, one’s personal decision to not live openly as a trans person is not a tacit endorsement of “stealth” prescriptivism — a distinction which isn’t made in Williams’s essay.

However unintended, neither writer tries to challenge the structures laid by cis gatekeepers which made “stealth” a practice in the first place. Neither essay entertains an intersectional lens to critically examine how “stealth” has structurally excluded trans people of colour, poorer trans people, trans people with disabilities, opaquely visible trans people, queer trans people, and trans people who experience several of these concurrently. Neither explores the kyriarchical relationship between the word “stealth” and militarism. Neither recognizes that the word descends from the Old English root for “steal”. When women who are trans use the word “stealth” to describe themselves, they are tacitly admitting a disbelief of themselves as legitimately women or being female. Itself a patriarchal idea, “stealth” proposes how being placed by anyone as a trans person implies some kind of failure as, say, a woman. In militaristic terms, compromising “stealth” means being spotted, then shot down (and either punished, interned, or killed) by a cissexist enemy who, likewise, is also a product of the same kyriarchy. A life of “living stealth successfully”, should all go well, might then emerge as a paranoid, isolating existence.

Intersectional consciousness is no longer a discursive indulgence. It is now a basic cornerstone when having any critical discussion on which kyriarchical conditions of institutional marginality and structural impediments are implicated in one’s social welfare (and the quality of one’s life experiences).

The absence of Cooke’s intersectional consciousness is striking. Her essay speaks on experiences of living in a social bell jar, bereft of acknowledging the systemic structures which enabled, even coerced her to frame her experiences as a white, middle-class trans woman who still leans against the word “stealth” seriously, even endearingly. Her classism bleeds through as she refers to service industry labour as “peons working the concrete floors in big box stores.” Consequently, Cooke laments how she fears a social isolation in her twilight years from her own (similarly isolated) peers who are now beginning to pass on. Cooke believes that reaching out and forming meaningful connections with people who share her life experiences as a trans person betrays her being placed by cis people as “ordinary” (read: cis): “We walled ourselves off from people who provide support networks of friends.” In so doing, she and her peers left in the dark many more trans people who would later find the path of transition, themselves often spatially and temporally isolated by the experience. Cooke sympathizes more deeply with the old gatekeepers who coerced her to divorce herself from her own experiences as a precondition for being a cisnormative participant. Cooke is struggling with her own internalized cissexism — a world view in which cis people are valued more than trans people.

Earnestly speaking, the mistrust which a great many trans people have felt for cis gatekeepers of the medical industrial complex (overrepresented by white cis men) is well placed. Our mistrust comes from countless narratives of being impeded, stalled, and even shut out from exercising agency over our own bodies. It’s of little wonder why we are frequently displeased with being clinically reducible by cis people who will never grasp the many obstacles we must endure in order to have our lives on our terms.

That our narratives share a basic theme of fear is also no coincidence. We know our human rights are dissolved when our medical care is withheld. Our quality of life suffers needlessly whenever gatekeepers deny our agency for seeking that care.

Regimes of systemically denying people from access to trans health care have come with a body count, too. Innumerable suicides have been completed after learning that one “failed” to clear the bar which was stacked as deeply misogynistic, racist, and ableist to begin with — not to mention kept arbitrarily in constant motion by a gatekeeper’s own cissexist capriciousness. This is what many trans and GNC people have come to know as “the gatekeepers moving the goalposts.”

And for those who are granted conditional access to health care, many trans people must still sacrifice some of their human rights as they are coerced to appease their gatekeepers by whatever means necessary. They know their gatekeepers have the power to suddenly revoke trans health access and do so without compunction. Trans people who have adopted a semblance of “stealth” living have learnt to manage these threats through preemptive means. Four tactics are stand-outs. One, they develop an acceptable boilerplate of a narrative to satisfy gatekeepers (at the sacrifice of one’s own lived narrative). Two, as proxies for gatekeepers, they learn to condemn other trans people who aren’t functioning under the same set of cissexist, misogynistic rules. Three, they live in fear of deviating from gatekeeper expectations of gender which could have their own continued care revoked without notice (such as a woman arriving to a clinical appointment in trousers or sans makeup). And four, they are discouraged from commingling with other trans and GNC people in all but clinically-controlled circumstances. Each is rooted in kyriarchical tactics for invoking fear, conquering by division, and quashing civil unrest by proxy.

Needing to excise such basic parts of oneself to win approval (or even an illusion of respect) from cis gatekeepers means learning to conform to normative expectations inside the examination or therapy room. It’s a compromise. This capture-bonding between cis gatekeepers and trans people who are “stealth advocates” has also meant having the latter “patrol” and voluntarily browbeat those antisocial conditions into people who are trans and GNC. Any trans person who rejects this browbeating, as “stealth” rationalizing goes, probably wouldn’t have much of a chance inside the cis gatekeeping culture anyway. They would be failures of the “real” thing — in which “real” amounts to a gatekeeper-certified, bona fide transsexual person, “person of transsexual history”, or “post-transsexual.” Anything less than that means they must not be very serious about being trans. Consequently, as intersectional life experiences are brought into the fold, each becomes substantive barriers to access when that experience is valued as non-normative — being fat, experiencing physical disability, having a limited education, being a victim of economic injustice, experiencing mental health issues, being a person of colour, and so on. Each of these experiences has been known as real barriers to trans health care when cis gatekeepers are given the power to control the welfare of trans and GNC people.

Sometimes compromise means one’s own sexuality as a trans person must be compartmentalized or suppressed if one hopes to obtain access to trans medical care. The history of lesbian women, gay men, and asexual people[1] having to feign heterosexuality as a precondition for access to EEI, or support for surgical intervention, dates back to Lili Elbe during the 1930s, and in the U.S., Avon Wilson during the 1960s. When adherence to heteronormative behaviour has meant putting one’s life into potential danger — even when a trans person is heterosexual — outcomes have (disproportionately greater than for cis people) spanned from assault and rape to murder.

Place all of these conditions together, and it becomes easier to understand how “stealth” emerged as a kind of Stockholm syndrome — in which trans people, held as captives of deeply cissexist gatekeepers, had to learn to sympathize with (and even respect) their cis clinicians if they ever hoped to obtain what they sought from the arrangement. They learnt to echo what their gatekeepers advocated and proscribed. They believed that criticism of the cis gatekeeping model by trans people was more of a threat to their welfare than anything cis people could do to them — even when cis people, not other trans people, were the ones who disproportionately did the most harm to people who were trans.

Eventually, “stealth” as a concept is destined to an ignominious fate, a historical dark age for our collective history as trans and GNC people. What Cooke called the “trailblazers” will probably be remembered for being early victims of this capture-bonding with cissexist clinicians. The dissolution of “stealth” does not amount to disclosing oneself as trans in all social transactions. Rather, as trans and GNC people continue working together toward building care-giving policy models built around informed consent and dignity in doctor-patient relationships, the fear of cis people lording that health care over our heads will continue to wane — especially as cis people themselves continue maturing with their understanding and compassion of trans people’s life experiences.

Ostensibly “stealth” trans people who are still around now will continue to uphold their social isolation from other peers. This is unfortunate, even a bit tragic. Practitioners of “stealth” impressed the idea that once clinical oversight of transition was over with, trans people who went “stealth” were to never have interactions with other trans people, as it would foil their effort to stay perfectly silent about their narrative of being trans. As we come to recognize how cis gatekeeping methodologies have advocated a kind of divide-and-conquer over trans people, we can begin undoing its social harm and cultural impoverishment from within the community.

Perhaps Cooke could reconsider how her intersectionally oblivious remark hurts also herself: “Mandatory political correctness has rankled, especially given the awareness of how wonderfully politically incorrect so many of my sisters and brothers are.” An admission of political correctness means that one does not feel obliged to assume responsibility for her racism, sexism, homophobia, classism, cissexism, transphobia, ableism, and so on. It means that Cooke doesn’t pay mind to how her behaviour upholds the structural oppressions which keep her isolated from her senescing contemporaries.

Learning to let go of the word “stealth” as a community cannot arrive soon enough. Learning to dissociate what Williams calls “lying” from institutional brainwashing by cis gatekeepers means hastening the end of victim-blaming for trans people. By relegating the use of “stealth” to a historical artefact, we may accelerate the healing of each other by learning to respect the individual life choices we make for ourselves — choices we make without institutional coercion. Our greatest strength becomes our ability to share our narratives and experiential knowledge with one another as trans and GNC people.

Empowering, emboldening, and enriching each other will undo our social isolation.

[1] This means lesbian women who are trans (not cis), gay men who are trans (not cis), and asexual people — women, men, and otherwise — who are trans (not cis). As if this needs to be spelled out — unfortunately for many, it probably still does.

How to turn a living woman into disposable social sludge: the banal afterdeath of Cemia “Ci Ci” Dove

Cemia Dove

Yesterday morning, I read the story of a woman in Cleveland who was murdered in the most violent of ways.

She was stabbed multiple times.

The man who murdered her stripped her body naked below her waist as an act to humiliate her. He tied her body to a block of concrete to make sure she sank to the bottom of an artificial pond next to a rural highway. Her body was badly decomposed, which means she had been dead for some time before she was found.

Her name was Cemia “Ci Ci” Dove

Cemia “Ci Ci” Dove, a 20-year-old trans woman of colour from Cleveland, Ohio, was reported missing March 27th. Her body was found April 17th. Her body was identified by Cleveland police on April 29th.

Beyond these facts, everything about her struggles, the social obstructions she faced, and the loved ones she was forced to leave behind, were erased in a tacit act of complicity by not only her murderer, but also by police and local news reporters.

These three parties share the responsibility for the desecrating conditions which, postmortem, defiled a human being, a young personality, and a long life ahead — foibles, gifts, and all. It wasn’t enough to murder Ci Ci. It was important enough to both police and press to engineer a public argument of criminalizing her existence as a trans woman of colour and turning her into something else entirely.

The local newspaper, the Cleveland Plain-Dealer, didn’t write on the savage murder of a mother’s child. They didn’t write on the problems of systemic violence toward women, gender and sexual minorities, or persons of colour (particularly with a visibly sub-Sahara African heritage).

At the very least, we’re talking about three intersectional barriers which the Plain-Dealer ignored. Four, if you count how she was living in poverty, agitated no doubt by the previous three barriers. Five, if you count her limited access to education. I could keep going.

Defiling a woman: John Caniglia of the Plain-Dealer & Cleveland police

The Plain-Dealer journalist on the beat, John Caniglia, didn’t bother to report on leads, tips, or profiles which the police might have on the man who killed her. This is because Caniglia and the police acknowledge implicitly through their actions a mutual understanding that Ci Ci’s murderer disposed of somebody considered socially worthless. This is what cisnormativity looks like.

Caniglia reported the story as, crudely put, a dead black man with a police record, wearing women’s clothing and impersonating a woman. His core message was “how pathetic.” Quite the deliverance.

After police and the Plain-Dealer found Ci Ci’s assigned-at-birth name (the dead name which she no longer used except when legally coerced), Caniglia didn’t interview people who knew her well, like friends, family, or peers. He didn’t investigate why she was found in a humiliating, semi-naked state which revealed unambiguously how she voiced herself as a woman, punished as a trans woman, attacked violently as a woman, and murdered as a woman.

In fact, there wasn’t any investigative reporting by the Plain-Dealer.

Instead, Caniglia, a white cis man, did to Ci Ci what cis journalists have done with murdered trans people for generations: he manufactured a cisnormative fiction to calm down an uneasiness which he, as a cis person, regards for people who are trans.

He’s not a special flower for behaving this way. His professional misconduct, under the watch of his desk editor, Chris Quinn, was compounded by a complicity which reduced a woman to an object — not owing her the respect of being the human subject she was in life.

In case any doubt lingers, Ci Ci Dove was a woman. No amount of legal paperwork or resistance by cisnormative institutions could paint over that. That’s why this conversation is happening in the first place.

Caniglia reported on a rap sheet provided by Cleveland police highlighting Ci Ci’s own struggles with systemic cisnormativity — things like being arrested for possessing oestrogen, for voicing herself as a woman, for using mace on a city bus against physical assailants who endangered her safety. She was audacious because she was a black trans woman, and this needlessly cost her her life.

Caniglia didn’t go online to find her digital footprint on Facebook, YouTube, or Twitter, for a photo which Ci Ci would probably have been OK with sharing. Instead, he dug up humiliating mug shots from the Cleveland police from her past arrests — arrests indexical to her poverty and placement as a deeply marginalized young woman with a trans body.

Acquiring police mug shots took Caniglia more work than finding her Facebook photo album.

Caniglia’s story didn’t chase leads on the murder suspect or Ci Ci’s whereabouts on the day she was last seen alive. His story didn’t provide a police phone number for the public to report tips. Caniglia filed an open-and-shut case for what he treated as a disposable object. The salary he was paid by his employer to file the story helped to pay for his living expenses this week.

Caniglia described Ci Ci not as a woman, a trans woman, or even with feminine pronouns. He prescribed her as a man dressed in “odd” clothing. Caniglia expanded needlessly on what this “odd” meant with a passage which would never have appeared were the murdered body cis, white, or wearing clothes which showed that the victim voiced themselves as masculine. Caniglia detailed all the irrelevant elements of what it means to be a trans woman — the very banal elements which cis people time and again pay especial notice to.

(After some social media pressure, either Caniglia or his editors altered his story, revising Ci Ci as “sometimes self-identified as a transgender woman.” This was also not the case. Ci Ci’s recorded history and her digital footprint agree that she was a woman with a trans body. There is no room for debate about this history, either.)

Caniglia committed a journalistic malpractice, but he faces no jury of peers to explain his lack of professionalism. For Caniglia and the other reporters who abrogated their journalistic duty to report on a story of a murder victim’s life and to write a story which could help to find her killer, tomorrow will be another day to chase another story and have another lede with his byline on it.

Journalists like Caniglia are numbed from the human condition. They walk a slippery slope along a path to sociopathy.

Structural cisnormativity: how to make human subjects into banal objects

Caniglia was complicit in reducing Ci Ci’s life to a disposable and toxic thing. He wrote of her like she was a sludge — not a young mind with ideas, dreams, talents, and hopes for things to get better, despite the cisnormative barriers punishing her at every turn.

Contrary to the Dan Savage campaign, it doesn’t get better when you’re murdered as a trans woman.

Caniglia’s story reported on a name Ci Ci had all but legally abandoned. Were barriers to changing one’s legal identification in Ohio as a trans person not so punitive, much less impossible, then Ci Ci could have had this barrier out of the way a long time ago.

Ohio is a state in which a trans person’s birth certificate cannot be changed under any circumstance. Ohio is also a state where the procedure and cost for changing one’s name as a trans person are reasonably difficult for trans people living in poverty, as an attorney is needed for the probate court hearing on the name change.

Getting money for an attorney is pretty hard when having obsolete paperwork makes finding an over-the-table job prohibitive for even the well-educated and experienced. It’s nearly impossible when you have no more than a high school education, if even that. Add, of course, that overarching problem of applying for work while black which never goes away, presenting yet another systemic barrier.

What kind of odds remain that working within the law would have kept her alive, safe, and kosher with the state? Is it any wonder that working within the system doesn’t work when that system penalizes your intersectional experiences? Who voluntarily chooses to live on the hard setting?

No one. That’s why we are all responsible to eliminate the social conditions which keep the hard settings in place.

The banality of a dead trans woman of colour

Ci Ci was one woman of hundreds murdered violently every year for having a trans body of colour.

This entire discussion is a banal one, because how we treat the victims of systemic violence should be so much better than this. The attention which all women — cis, white, and heterosexual especially — should be paying toward this co-ordinated epidemic simply isn’t there.

That we see, over and over, murdered trans women of colour being forgotten by nearly everyone but socially aware trans people speaks to how devalued one’s life becomes with each intersectional barrier she is forced to endure in life (and burdened to obscurity in premature death).

At its core, though, to be forgotten (or far worse, to be remembered with a dead name and a narrative which isn’t valid at all) is a stirring fear which grips nearly every trans person I’ve ever known. We mortally fear being buried and memorialized (or denigrated) as something we never were. We fear that what we leave behind will be cisnormatively undermined, our work judged against our being trans — rather than our work being judged on its merits, full-stop. These are real fears which no cis person I’ve ever known has ever has to reckon.

In death, social media is undoubtedly trying to restore Cemia Ci Ci Dove’s name and her memory.

Support from Cleveland city councillor Joe Cimperman, who is pushing the Ohio attorney general to investigate Ci Ci’s murder as a probable bias crime, is helping to restore her name in ways which should have happened when she was living.

But a root cause remedy means overhauling the way legal paperwork for trans people is managed in Ohio. This must change as a precondition to empower and respect trans people as valued citizens. Fixing such simple, but fundamental civil dysfunction can count a long way toward ennobling a civil society in which systemic violence is reduced, as are systemic barriers which wastefully impede a living trans person’s quality of life, potential for making a livelihood, and ability to enrich the world.

When the banal becomes the omnipresence of trans women of colour as leaders, spokespeople, mentors, innovators, teachers, mothers, and pioneers, then this discussion will no longer matter. I’ll also die a happy woman.

Ci Ci, I’m sorry we all let you down. We’ll try harder. We must.

An open letter to Atlanta’s Feminist Women’s Health Center on its refusal to treat certain women and its willingness to treat certain men.

Dear Feminist Women’s Health Center:

Once upon a time not long ago, I was struck by a car. Paramedics brought me to trauma care in critical condition. I was alert throughout. One of the questions an urgent care doctor asked was what medications I was taking. I mentioned to her an antidepressant and oestradiol.

One more question was asked a few hours later: another physician in the recovery ward double-checked my medications. He asked why I was on oestradiol. I replied truthfully: my body does not produce it on its own. I forgot what he wrote on the patient file. I think he jotted down that I had completed a hysterectomy at some indeterminate time in the past.

A couple of weeks later, just before I left, I carefully went through the 300-plus-page binder that had accumulated all the tests, the blood work, the scans, the vitals, and other remarks. There was nothing unusual about it, and its ordinariness is what taught me something profound.

Even after invasive surgical procedures and several days of recovery before discharge, there was nothing extraordinary (at least not to these physicians at a highly respected university research hospital) about my being prescribed oestradiol for life.

My endocrine system is exogenously assisted with the same 17β oestradiol molecule that the ovaries produce. I’m also a woman with a transsexual body. That means I was not born with ovaries.

That’s why the routine of this hospital convalescence felt so unprecedented, startling, and instructive. It’s because the already scary experience could have gone a lot worse through absolutely no fault of my own, but through the fault of a socially-embedded cissexism maintained by so many people with cissexual bodies.

I’ve been transitioned for more than half of my life. This is my entire adulthood. Experiential hindsight informs that, no — to the trauma specialists, doctors, and nurses who helped me when I was pretty badly banged up — I certainly would not have received as respectful, as dignified, or even as comparable a calibre of care had it been disclosed to them that my body was transsexual. Instead, I might have died.

Welcome to my reality. This is the unvarnished fear of every trans woman (and trans man) who seeks medical care from cis — that is, non-trans — healthcare providers. This barrier of dignity and access persists because the cisnormative clinicians who should be there for us instead reduce our health needs to a morphological history — treating us as conditional and elective women.

[side note: there is a PDF of that last link you can download without buying a subscription; I recommend that your staff earnestly read it].

As women with transsexual bodies, we are not conditional, and we are not elective. I want to remind you of this again of this inequity a little bit later.

Had I disclosed to any of those hospital physicians a summary of my body’s morphological history, it’s clear why the fear I have of saying anything about my being trans has not been borne in some vacuum.

I fear being reduced to another statistical Tyra Hunter — a trans woman of colour whose life-threatening injuries from being hit by a car killed her only because cis paramedics laughed at her body’s morphology while she succumbed to shock and haemorrhaging.

When you’re a trans person — and especially when you’re a trans woman — you fear the doubt, incredulity, and even horror lurking just under the surface which cis people around you are well known to express when they come into possession of privileged knowledge about your body. This is the kind of privileged knowledge whose discretion should be valued, respected and, most of all, understood no differently than with the privileged knowledge a cis body contains.

But it isn’t. That’s why so many medical facilities — hospitals, clinics, offices — bar trans women with the thinnest of equivocations. “We’re not equipped to treat your kind.” “We lack the knowledge.” “We don’t understand your bodies.” “Go see a gender clinic.” “We’re sure there’s another clinic for you.” “You lack ovaries and a uterus.”

All of these say the same thing:

“We would rather you die than for us to treat you. We really do know enough — we earned our medical licences somehow — but we’d like to tell you that we’re just not qualified to treat your kind of body or face your kind of person. We’re not being truthful, but we hold the power. Go away.”

This onus and responsibility of extending respect, expected without hesitation, must fall not to the person with the trans body, but to the cis people whom that vulnerable trans person must engage as a precondition for receiving equitable, routine, and ongoing medical treatment.

As a trans person, you don’t want cis people — the very caregivers whom you want to entrust with a basic ethics entwined with the Hippocratic oath — to be the key agents behind why you got sicker or why you succumbed prematurely. You want an advocate who takes the lead on assuring equitable care each and every time it is needed.

Primum non nocere. Do no harm.

So why this open letter?

Your treatment policy and core values at the Feminist Women’s Health Center were recently brought to light online before several feminist communities — including fourth-wave trans feminists like me — on how your clinic adequately treats cis women and trans men.

Your clinic, in contradiction to its name, the Feminist Women’s Health Center, categorically treats men (trans men are still men), while it categorically refuses to treat women — that is, any woman who discloses that she has a transsexual body. Your core values categorically begin with this statement: “We provide quality healthcare and community education regardless of race, ethnicity, sexual orientation, gender identity, socio-economic or immigration status.”

But you categorically don’t.

As with my situation in triage, there are trans women who do not disclose their bodies as transsexual. Some have the affordance of not having to do so because their morphological transparency gets them placed as cis by other cis people. Because of this, these women also sometimes escape being denied treatment under structural systems like your clinic’s own.

That a woman must withhold useful knowledge to assure the best quality of care is a vetting of the days when women had to reach out to find Jane.

That’s where we, an entire populace of women — trans women and cis women (who advocate for trans women) alike — find ourselves at stark odds with your policy of declining women as patients whose bodies were not equipped at birth with ovaries or a uterus.

And yet, the endocrine needs of women with transsexual bodies are no different than cis women of their age: a healthy endocrine system not only facilitates proper bone density, but it also makes the difference between life and death. It is a holistic concern.

Let me repeat that: the endocrine needs of trans women are no different than cis women. The end objective is that women, for a great deal of our lives, require baselines for oestrogen in the body; progesterone for the regulation of much more than just menstrual cycling; and an assurance that free testosterone is kept to a nominal level.

Try this exercise:

Subject a cis woman to regular testosterone injections and wait to see how long it takes for her neurochemistry to shut down — that is, for her to slip into depression and even suicidal ideations. That’s because her neurological sex is incompatible with that exogenous endocrine intervention, or EEI for short. That’s what trans people face. Every day. (And no, you wouldn’t in your ethical mind subject a woman with a cissexual body to that kind of, well, torture).

The policy at Feminist Women’s Health Center fails not at the argument that your staff are not yet “qualified” or “equipped” to accept as patients those women whose bodies are transsexual. No. If that is the rationale for rejection of treatment your clinic is electing to advance, then that means your policy failed at pre-med and med school — namely, on those days when the endocrine system was reviewed.

When the Feminist Women’s Health Center uses the suspect language of “biological women”, it undermines everything taught in med school with a shifty language. This language’s entire raison d’être is to produce a separate-and-not-really-equal equivocation for which women are proper enough and which fall below this threshold. It is a cattle guard. It is a velvet rope. It is a moveable goalpost.

“Biological women/female/vagina”, as biologists will readily share, are the province not of the clinical sciences, but of the social sciences. In other words, “biological” as a qualifier is quite political and lacks both scientific and therapeutic basis. “Biological women/female/vagina” is spoken in one spirit: a harmful one. “Biological women/female/vagina” serves as a subjective device for the thinly-veiled exclusion of women and, as your clinic realized in the not-very-distant past, for men — that is, trans women and trans men, respectively. Where your clinic rose to the challenge of trans men at the expense of trans women is baffling and broken.

The same harmful spirit applies to “genetic” or “chromosomal” qualifiers as weapons of social-institutional exclusion, as we are well aware that probably 90 per cent of every person’s dimorphic morphology is dictated and shaped by what its endocrine receptors are tasked to do: the presence of sufficient oestrogen produces one dimorphic morphology, while the presence of sufficient testosterone produces another dimorphic morphology. And that morphology is quite malleable, especially if EEI begins early enough.

You see, much of what makes gynaecological care what it is is that healthy endocrine function informs quite directly the state of one’s entire body — holistically so. Yes, some of gynaecology addresses PCOS, pregnancy, birth control, and cervical exams (incidentally, sexually active trans women who have vaginas also require pap tests, and the procedure is pretty much the same — speculum, scrape, and all).

But as the Feminist Women’s Health Center clinical staff are I’m sure quite aware, a woman’s health is only partly informed by the activity of a reproductive-age uterus, ovaries, or cervix. There is so much more to what a woman faces which a clinic like your own is charged to address. A women’s clinic is a source point of education for women to make healthy choices for their lives — including keeping themselves safe from social relationships which could otherwise harm them.

There’s an essay I want each of your staff at the Feminist Women’s Health Center to read. It’s pretty short — much shorter than this letter is. Astrid Lydia Johannsen’s essay marks the inextricable relationship between reproductive medicine and trans medicine since their inceptions. They are two halves of the same endocrinological whole. They are both medicines birthed in the 20th century. One cannot be wrested from the other.

Once you’ve read that, then come back. We’ve more to talk about.

Clinics by and for women share their historic urgency in the poor, obstructed, and even nonexistent quality of care which women have long been forced to confront time and time again.

When the Feminist Women’s Health Center denies health care for an entire class of women, it wilfully betrays the integrity of clinic’s name. When it then proceeds to treat men while continuing to deny care for those women, it flatly contradicts any kind of feminist mandate. When women are denied care, it is inherently misogynistic and deeply counter-feminist.

And yet, the very systems of obstruction — which women-oriented and reproductive care clinics were organized to put a halt to such barriers — are the same systems of obstruction which your clinic is now actively facilitating when you reject known trans women from your care. The master’s tools are still the master’s tools regardless of who holds them.

What your present mandate is actually doing is treating only those people who have (or had) a uterus. You are no longer just treating some women. In short, your clinic is only open to people coercively assigned female at birth. This is CAFAB. You’re going to have to get used to hearing this and the complementing CAMAB (coercively assigned male at birth) and CASAB (coercively assigned sex at birth).

The Feminist Women’s Health Center must understand that by excluding all non-CAFAB women, it is validating and perpetuating a specific, complicit violence towards these women — these CAMAB women — which has been branded onto their bodies for their entire lives. Women’s health, in its holism, is to advocate the stoppage of abuse, to stop the systemic social and institutional harm.

This is not what the Feminist Women’s Health Center is doing.

Other women-oriented clinics have begun to realize the faults of this obstruction on which your clinic is now being challenged by both feminists and women — in both Atlanta and far, far afield. In the last couple of years, Planned Parenthood updated their care policy to provide at a national level to open their clinics to all women — irrespective whether they were CAFAB or CAMAB, and irrespective whether their bodies are cissexual, transsexual, or intersexed.

This isn’t progressive medicine. This is a best practice. This is an affirmation that womanhood is not reducible to a handful of reproductive organs on a checklist — the same checklist which men in medicine used to bar women so systemically that an entire generation of women-oriented clinics were chartered by necessity.

Planned Parenthood, as with an increasing number of women’s clinics, are now recognizing with less and less difficulty the inextricable, sinister relationship between a history of back-alley and coat-hanger abortions, and a living history of black-market hormones of questionable provenance; back-alley silicone injections; and the many complications arising from a clinical depression brought on by a neurochemically incompatible endocrine system.

Planned Parenthood and others affirm that women’s blood is continuing to pour. They recognize that women’s bodies are continuing to appear on cold metal slabs as a direct function of the systemic barriers which women face when they cannot access woman-positive health care.

When your clinic, the Feminist Women’s Health Center, then goes out of its way to provide endocrine care for men — for men who, yes, started their life with a uterus — but not for a class of women you refuse to receive as clients, it begs the question: how do you reconcile your feminist mandate?

Why are you called the “Feminist Women’s Health Center”, when your clinic does not prescribe or administer oestradiol, which is not a controlled substance, to neurologically female women with transsexual bodies?

Why are you even called the “Feminist Women’s Health Center”, when your clinic readily prescribes and administers testosterone, a Schedule III controlled substance, to your neurologically male clients?

How is it that you purport that your clinicians are “less qualified” to treat trans women? The only way they could be less qualified is if some of them bombed med school because of that day they skipped out on endocrinology 201, 301, and 401.

Your differential treatment of men with transsexual bodies against the rejection of women with transsexual bodies is a double contrariety: by denying some women and admitting some men, you not only contradict the “Women’s” component of your name. You also advocate for and perpetuate a misogyny which contradicts the “Feminist” component as much as men who pine for a return of women to the kitchens of Atlanta, America, and the world.

Yes. This kind of misogyny is transmisogyny. Cis women are no less susceptible to being misogynistic than men are. The key difference is that with women — cis or trans — that misogyny is deeply internalized, and it still hurts other women.

In the end, that misogyny hurts all women — both cis and trans.

The Feminist Women’s Health Center exists to be there for women. It’s in your name. But you’re not actually there for women, and this is a fundamental problem.

Should the Feminist Women’s Health Center maintain that it is there for women, then trans women should be no exclusion to your mandate. Should the Feminist Women’s Health Center continue to categorically exclude known trans women under whatever reasoning you please, then you are operating in poor faith — even deception — under your clinic’s present name. In this case, call a spade a spade, then: you are simply a Uterine Health Center — nothing more.

I don’t have a specific investment in turning to the Feminist Women’s Health Center for holistic health care, because Atlanta is nowhere near where I live. But I would be remiss to ignore how other women — my sisters in struggle — are continuing to needlessly struggle in what amounts to an abusive policy of exclusion.

I’ll end this open letter as it began: on my medical narrative.

A dozen years prior to my accident, I sought out health care services at a women’s clinic in upstate New York. It was my very last option in a region which was extremely hostile to the medical treatment of women with transsexual bodies.

I was more naïve then. Having been on EEI for a few years, I thought it was the “right thing to do” to voluntarily disclose to the clinic before my first visit that my body was transsexual. That voluntary disclosure resulted in the clinic sending a terse letter, via post, one week before the appointment — some five weeks after the appointment was first made by phone. The letter informed that the clinic had taken it upon itself to cancel my appointment without further comment.

A respected friend — a cis lesbian woman — referred me to that clinic. It’s where she went for routine health care. Upon hearing the cancellation, she was stunned to learn that her clinic had treated me so crudely (her word, not mine).

This non-consensual cancellation meant I had to forcibly halt my EEI regimen for several months until I was able to move to a new region and have it prescribed again. The disruption resulted in a lowered bone density, which was the probable contributor to a micro-fracture of one of my toes about six months later.

That experience taught me a sharp lesson: for a woman like myself, I had to shut up to live, or I could speak up to hurt myself further. This is why I was dead silent in trauma care on the day of my accident, and this silence is probably why I was able to recover fully from my life-threatening injuries.

Holistic care should never have to come down to conditional humanity, under any circumstance.

The Feminist Women’s Health Center, as it now operates, advocates for a conditional humanity. This is neither a feminist precept, nor is it beneficial for a lot of women whose numbers are too small to produce exclusive clinics locally, but far too great to simply be barred at the door of a purportedly feminist-forward women’s health resource.

The Feminist Women’s Health Center has made a mistake which it can remedy. Please do so posthaste. Please do so, knowing that women like me are never going to go away.

If anything, more and more of us as trans people are voicing ourselves in earlier cisnormative corridors. It behooves your clinic to admit, treat, and respect all trans women under a best practices care model of informed consent so long as you publicly maintain that you’re a feminist women’s health resource.

Try to use this as an opportunity to take the lead, to educate, and to advocate for some of the most vulnerable, most underserved women you’ll ever know in your locality: CAMAB women. Stop worrying and learn to accept and embrace the plurality of our experiences as women.

We bleed, too.


Sincerely striving for feminist social justice,
|||| Patience Newbury

Posted in LiveJournal in 2002: The other side of the mirror.

|||| Patience Newbury

[Background note: I wrote this piece back on 30 June 2002, during the first year I stopped attending Pride. Even with ten years in between, some of the content still feels as relevant in 2012. I’m not sure I feel about pride now the same way I did then, since I tend to downplay the word “pride” in pretty much every context of the word (too much internal association between “pride” and the word “hubris”). I’m not as pessimistic in 2012. I am a lot more pragmatic in 2012. But whatever. Onward to the younger-me retro-piece from 2002.]

2002-06-30 20:41:00

I’ve never experienced a Pride like this before, like my friend did today:

Pride 2002

This year has been the first year I felt like Pride is for me. Everyone in my circle wishes everyone else a “Happy Pride.” Like it’s New Year’s or something. It’s charming.

The process of coming out has been circuitous for me. I’ve joked about my attraction to women since high school. In college, I said “I’ll never find another man that good, I’ll just have to switch to women.”

And I started noticing the women I was attracted to. But they were straight. Or at least I thought so.

I didn’t really put my life in that framework. I was busy having relationships so I could avoid my pain and growth.

Then I moved here. And got single. And met Patience. And learned a whole mess of things about life.

I looked back at my teen years and college and could see every single person I had ever been attracted to. I could tell that what I had felt for Jane in High School was NOT just a deep desire to be her friend.

I was scared that the queer community wouldn’t accept me. Because I identify as bi. Because I hadn’t had sexual relationships with women. Because I wanted to be part of the community so badly and, in my life till now, that has almost always meant I would be excluded.

This weekend I went to Pride. And found more of my community. And took ownership for building the kind of community I want.

Happy Pride!

At Pride, it’s never about the people whom I choose to be attracted. It’s always about what I look like or represent to the other pride attendees, since I’m really just some kind of errant asexual being, of course.

At Pride, I am never an object of affection. Except for chasers. And chasers aren’t people. They are predators.

At Pride, it’s always about resting upon the laurels of the few and privileged and never about realising just how little has been accomplished in the big scheme of community harmony or civil and criminal justice since a big riot went down on Christopher Street.

At Pride, I am an oddity, an oddity to every G-person, every L-person, every B-person and every T-person. It’s because I’m far more complex than a mere container will allow.

At Pride, it’s always about typecasting and political correctness. It’s never about plurality.

At Pride, I feel like i have to prove to boundless sceptics that I’m even a human being.

At Pride, it’s no longer a march by the whole community, which, of course, might come across as too powerful and symbolically unified (which might even teach the community itself a thing or two) by those whom freak out at the thought of a “Queer Agenda”. The riot police would ensue for sure.

At Pride, I am not a part of “The Movement”. I never have been. Unless I play by the master’s rules, I am not welcome to “The Movement”.

At Pride, it’s all about exclusion, bread crumbs, hierarchy, judgmentality and who has the money, the Lexus and the Subaru.

At Pride, I am an alien. an illegal alien.

At Pride, it’s all about the cliquishness of the high skool lunch table brought into the macrocosm of the “real world”. People know when they’re “in”, and people know when they’re “out”.

At Pride, I get to sit at the misfits and troublemakers lunch table, next to the artists, the musicians and the future anarchists, if I’m even that lucky.

At Pride, it’s always about head count. Never about strength in numbers.

At Pride, I must pretend to be something i’m not — just to be tolerated.

At Pride, it’s all about the price of access. Who has it. And who doesn’t.

At Pride, there is never a central voice for the poor, the non-white or the non-privileged, and anyone making a complaint as such is no better than a cranky whiner. Or a pinko-commie.

And at Pride, I no longer need a complacent, feel-good, upstanding-homo-only-if-you-have-the-right-inherited-tools-and-play-by-our-rules meat market fest sponsored by Bud Light, I.D. lube, and the HRC to know who I am and why I’m proud to call myself a survivor of both the real world and of the community.

I’m proud every day. Not just Pride weekend.

Mood: very hurt
Music: kissing the pink — certain things are likely

EDITOR NOTE: on Erica’s piece and “triggers” of denying her narrative

|||| Patience Newbury

On Reddit, after Erica’s debut piece was filed, a trans woman felt aggrieved by having to read that a girl in her mid-teens had transitioned with EEI during the pre-WWW 1990s, at an age before she herself could. I called foul on this because, quite bluntly, every trans narrative is valid, and no less valid than any other. She had no authority to deny Erica or anyone else of their trans narrative on any grounds.

Eventually, we learnt the trans woman making this grievance was not someone who voiced themselves well into their last cisnormative corridor as we expected. I made this error because the internalized trans misogyny and internalized cissexism this woman was spewing was very boilerplate to much of I’ve heard over more than half my own life from many trans women who did not get to assert their transition during one of the first three cisnormative corridors.

It was only after a little more reading before I realized this fury toward Erica was coming from a 20-year-old who first tried to say something at 13 but was denied by her parents until the third cisnormative corridor. She eventually grasped what I was trying to say. I had affirmed her trauma, but what I said to her sank in. Her response was a hope that more people might read what I was trying to tell her. While I expressed my doubt about this, I will at least try to pass it along on the Cisnormativity blog.

For those without time to read below the fold: cis people don’t want us to ever transition, no matter the corridor. Cis people stand back and watch as a faceless assailant — the endogenous endocrine system — brutalizes during first puberty the bodies of trans children who never offered consent to permit that violence to ever happen to them. It is a violence whose physical scars stay visible for the rest of their lives (and whose psychic scars remain hidden). Cis people, when they can see them, use those scars to stigmatize trans people. Cis people are complicit in allowing a violent attack to happen when they ignore a trans person’s voiced assertion to transition, especially when they are still a minor. This is why Alex Kaminsky’s heavily publicized narrative is so horrifying to watch in real time. It is akin to idly reporting on a public raping as ordered by a quote-unquote justice system. It is horrifying because it is a trauma (and even barbarism) so many trans people have survived (and so many more have not).

But please, read below the fold. Continue reading