When I talk to people inside trans communities the argument against transmedicalism is typically big tent logic. "We want to avoid having overly prescriptive definitions of what it means to be trans because that discourages exploration and leads to a lot of "am I *really* trans" which is counterproductive because goodharting, among other things.
That said, I can't think of anyone I know personally who simultaneously identifies as trans and is not at least taking cross sex hormones, surgery is somewhat less common but I'm an outlier among my trans friends in considering surgery to be completely off the table.
I think the critique here applies much better to non-binary people.
I think when trans people talk about what it is to be a woman there's a miscommunication, because for people early in transition their focus is often on passing. Passing is a goal because it makes you less vulnerable and means you'll be gendered correctly more consistently, misgendering tends to trigger neuroses because it reminds you of the ways you fail to pass, typically with a focus on secondary sex characteristics.
Ime it's pretty common for trans women far along in their transition to be much less overtly feminine because they no longer have anything to prove, to themselves or others.
This notion that trans people commonly focus on gender stereotypes as a defining aspect of their identity is, ime, just totally wrong. I personally consider myself a tomboy, one of my MtF friends considers themselves to be butch.
And, frankly trans people tend to focus much more on *trans* stereotypes than binary gender stereotypes i.e "I'm definitely a transwoman because I was so focused on an algebraic topology textbook I forgot to eat until 7pm"
If there is a better article that sums up my particular thoughts and feelings about this subject, I've yet to find one. I am 100% right there with you.
> If being treated like a woman is hard to put into words, is it easier to describe what being treated like a man was like? Would it be easier to describe it in terms of the difference between the two? I see the phrase "treated as a X" used often, but I find it very very odd how little elaboration there is.
I don't know where you grew up, but I grew up in a non-western society with a high degree of gender segregation. So many examples from there: I went to a boys' only school, I dreaded going to social events as a teenager because I'd invariably get called a male over and over again, I was never allowed to have female friends, I was told that all men went through puberty and that the feeling of hatred I developed towards my body during it was just something I had to deal with. I've heard the words in my native language for "boy" and "man" used thousands of times for me, and each time was a little cut on my soul. Now that I've transitioned, I can say with some confidence that "girl" and "woman" don't have nearly the same effect on me.
> For example I was able to decouple "appearing masculine" from "being attractive to attractive women", but I assume that most probably equate the two concepts as a single idea.
I don't think they're the same idea but I think (at least for heterosexual men) manliness is closely associated with being attractive in that fashion. In other words, I'm not sure that decoupling the two ideas is something most people would consider useful. (This is a recurring pattern in these discussions. We are a social species and our biology and social interactions are bound together. Is gender identity a social construct or something driven by biology? The answer is "yes, there are components of both".)
In any case, many of the cis men I've posed this question to were queer. Some of them said they experienced a deep revulsion at the thought of growing breasts, and of course gynecomastia can cause a great deal of anguish in cisgender men in an experience that reminds me a lot of my own gender dysphoria in the other direction: https://www.vice.com/en/article/vv5ajj/gynecomastia-chop-the-things-off-the-plight-of-boys-who-grow-breasts
I'm really happy people are exploring estrogen for topical uses such as scalp growth! People should feel free to mold their bodies into whatever works best for them. (For me, hair loss was a big worry since everyone in my family has rather severe forms of it. I transitioned before it became a relevant factor, though.)
Neither the puberty revulsion nor the inability to have female friends are things I directly experienced, but I nevertheless can still comprehend how they might be distressing to someone.
> I dreaded going to social events as a teenager because I'd invariably get called a male over and over again
> I've heard the words in my native language for "boy" and "man" used thousands of times for me, and each time was a little cut on my soul. Now that I've transitioned, I can say with some confidence that "girl" and "woman" don't have nearly the same effect on me.
I find it interesting that two of the four examples of gender-based treatment you mention have to do with what people called you. I don't intend to be dismissive of the pain this caused you, but my assumption is that it wasn't a result of the specific soundwaves of the words "boy/man/male" but rather it has to do with the evocative concepts those words conjure up. Am I correct? If so, are you able to outline what concepts those words conjure up for you?
That's been what I'm trying to get at when I originally wrote this post. It does not appear possible to have an attachment to a memeplex cluster (such as "woman") without an attachment to SOME branches within that cluster.
"I can only sort of maybe identify scenarios where constellation dredging is sort of maybe relevant/beneficial. Maybe if I told someone I intended to buy them a clothing gift and they told me that they identify as a woman, I would be expected to read between the lines and assume this to mean “I am hoping that you select clothing that is generally identified as feminine within our shared cultural understanding”. But it would be better for both of us if she just told me this directly, without inviting potentially insulting or erroneous assumptions. To the extent that woman is a cluster of traits, I struggle to contemplate a scenario where communicating the cluster is a more efficient or more thoughtful method of communication than just communicating the specific pertinent trait. Just tell me what you want me to know directly. Use other words if need be."
> but rather it has to do with the evocative concepts those words conjure up. Am I correct?
Yes. I'm sure there's some bouba/kiki-like effect but it is primarily the memeplex associated with male/man/boy, as you put it.
> It does not appear possible to have an attachment to a memeplex cluster (such as "woman") without an attachment to SOME branches within that cluster.
I feel like this is a truism, i.e. clearly true but I'm having trouble seeing what insight there is in that statement.
> I would be expected to read between the lines and assume this to mean “I am hoping that you select clothing that is generally identified as feminine within our shared cultural understanding”. But it would be better for both of us if she just told me this directly, without inviting potentially insulting or erroneous assumptions.
I actually agree with this in your example -- especially because the range of feminine-coded clothing is somewhat vast so it's much easier to say "I'd like a dress" or "a top" or whatever else.
> To the extent that woman is a cluster of traits, I struggle to contemplate a scenario where communicating the cluster is a more efficient or more thoughtful method of communication than just communicating the specific pertinent trait.
The reason I believe I'm a woman is that all of these:
1a. Thinking "I am a man" to myself.
1b. Saying "I am a man" to other people.
1c. Having male sex characteristics.
1d. Other people perceiving me like a man.
independently and together bring me distress, while all of these:
2a. Thinking "I am a woman" to myself.
2b. Saying "I am a woman" to other people.
2c. Having female sex characteristics.
2d. Other people perceiving me like a woman.
do not.
Rather than explaining 1a-1d and 2a-2d each time, it is generally more efficient to just say "I am a woman". There are specific cases where I'd go into more detail (for example, at a doctor's office) but compressing all of the above statements is pretty helpful.
I appreciate the time you took in replying to my comments. The part I continue to struggle to understand is why it's so difficult to articulate individual branches of the memeplex cluster I mentioned. I can understand the desire behind 1c and 2c, but it seems like the attachment to gender identity is largely incidental, because the phenomenon does not appear to be distinguishable from any other kind of body dysphoria (for example wanting to be thin when you're not).
a, b, and d still confuse me. When you think "I am a woman", what *exactly* pops up in your mind? I'm dying to know the answer to this. I can say I'm a male, and if I was asked to articulate the meaning behind my statement I would cite male sex characteristics (genitals, tall, muscles, bald, beard etc.). If I was asked to dig a little deeper, I might endorse traits that tend to be seen as manly/masculine (e.g. assertive and confident) but then I'd quickly run out of steam. A lot of my personality traits would be coded as feminine (e.g. empathetic, cries easily, affectionate, etc.) but I wouldn't interpret that as an indication that "I am not male" or "I'm really a woman".
The only consistent answers I get to this question tend to revolve around pronoun use and body characteristics. The latter is a clear answer, while the former seems almost ornamental to me. In between there is this chasm that people seem concerned about saying out loud.
> it seems like the attachment to gender identity is largely incidental
The attachment between gender identity and sex characteristics is highly correlated! It's not quite what "incidental" might suggest. While there are certainly exceptions, in general, expressing a male or female gender identity is correlated to preferring the sex characteristics that match their gender identity. This is certainly true for most cis and most binary/binaryish trans people. It is more complicated for nonbinary people -- some prefer a standard male/female hormone profile, some prefer something else or in between, like using estrogen with a breast development blocker, or using finasteride along with testosterone to prevent hair loss.
> because the phenomenon does not appear to be distinguishable from any other kind of body dysphoria (for example wanting to be thin when you're not).
This is not true, in general.
The term generally used is "body dysmorphia", not "body dysphoria". The terminology is important: there's a significant difference between dysphoria, which translates to "a feeling that's hard to bear", and dysmorphia, which translates roughly to "misshapenness".
The gold standard treatment for gender dysphoria is transitioning. That is because when you address the specific causes behind gender dysphoria, it resolves itself (as it did for me). This has been shown over and over again. A purely or primarily psychological treatment was the standard of care for decades and it simply does not work.
You mentioned "wanting to be thin when you're not". In general that can be fine: if your desire resolves itself once you reach your target weight, that's great. However, the term "body dysmorphia" is generally reserved for more extreme examples like anorexia. The gold standard treatment for anorexia is to restore the person back to a healthy weight and to address their concerns through therapy.
These are two completely different conditions with different modes of operation and different treatment plans, and they're as different as a heart attack is from a broken femur.
It is really, really important that this distinction be made very clear . A lot of misunderstanding of trans experiences comes from thinking that all conditions which look psychological are somehow similar; hence the refrain of "we don't play into schizophrenic delusions, why should we accept these?" Well, the answer is that they're just completely different at the object level! They arise from different processes, they work differently, and their treatment is completely opposite.
> When you think "I am a woman", what *exactly* pops up in your mind?
Nothing much beyond a feeling that that statement resonates with me. It is actually quite interesting to me that you immediately moved to deconstruct it -- I, and most trans people I know, came to their conclusion by vibes. Some statements feel good and some feel bad at a deep level. There isn't much more to it than that.
Another way to put it is that the statement is atomic/axiomatic for me, similar to how "the empty set exists" is an axiom in naive set theory.
> In between there is this chasm that people seem concerned about saying out loud.
I don't think there's much concern about saying things out loud on my part -- it's just that there isn't much to say! Some things just feel good or bad for inexplicable but still very real reasons. This is why I believe it's in no small part an inherent attribute of the human experience.
> The gold standard treatment for gender dysphoria is transitioning.
This is an empirical claim and I won't dispute it.
It's not clear to me that we have a good explanation for the causes of gender dysphoria. But to the extent it describes the delta between mind perception and body reality, it seems like there are two sides of that equation. So one plausible idea is to give people suffering from gender dysphoria more of their natal sex hormones. Hypothetically, if there was a pill that completely cured someone's gender dysphoria and had far better effectiveness at improving mental health outcomes than the current blocker/hormone protocol by (crucially) making the person cis, would you have any reasons to discourage use of this pill?
To be clear, I mostly operate from a consequentialist framework for ethics in medicine in terms of just assessing the costs and benefits. So I'm agnostic on exactly what remedy we pursue. If puberty blockers/hormones/plastic surgery/etc. are the best way to deal with someone's distress then so be it (even if we lack a complete explanation of the cause, which is already true for many psychiatric disorders). I am also willing to be consistent with that position and accept that perhaps amputation might sometimes be the best remedy for someone suffering from body integrity identity disorder (BIID) or alien hand disorder (https://www.bbc.com/news/uk-12225163) if nothing else comes close to working.
> I, and most trans people I know, came to their conclusion by vibes. Some statements feel good and some feel bad at a deep level. There isn't much more to it than that.
I appreciate the time you took to elucidate your position and engaging with me on this topic. Even if it boils down to vibes mainly, I still think it would be helpful to continue working towards an articulable description of the phenomenon. How else can we compare our respective experiences? If I say "I am a Σ, are you?" how would you even begin to think about the question without having an idea of what I'm talking about?
Mar 13, 2023·edited Mar 14, 2023Liked by Yassine Meskhout
> This is an empirical claim and I won't dispute it.
Much, though not all, of the argument for trans rights lies on the empiricism, though. As I said earlier, the success rate of transition (both social and HRT) is near-miraculous as far as psychiatric interventions go. My surgeons have worked on hundreds of patients and can each count the number who regretted it on a single finger.
Testosterone clearly helped her and yet she refuses to take it for political reasons. She has the right to reject the known gold standard treatment. But it's shocking to me that a comment in there told her to "try vyvanse!" I have no problem with people taking vyvanse. It is an amphetamine that certainly helps a lot of people, but it also causes neurotoxicity and has a long list of side effects.
> So one plausible idea is to give people suffering from gender dysphoria more of their natal sex hormones
This has been tried (and still is routine in some non-western countries). It does not work.
> Hypothetically, if there was a pill that completely cured someone's gender dysphoria and had far better effectiveness at improving mental health outcomes than the current blocker/hormone protocol by (crucially) making the person cis, would you have any reasons to discourage use of this pill?
I'd be really doubtful about whether this can ever be made. Assuming arguendo: If it works as well as transitioning does, which is a very high bar, then ethically people would have to have a choice between taking this pill and transitioning.
> How else can we compare our respective experiences? If I say "I am a Σ, are you?" how would you even begin to think about the question without having an idea of what I'm talking about?
We've already explored this in some detail, right? Does the statement "I am a Σ" resonate with you at a deep level? The statement "I am a woman" feels like that to me. Womanhood has a lot of societal context associated with it, and at least in part I'm invoking that context.
(There are some aspects of womanhood like pregnancy that don't apply to me, but that's also true for many cis women.)
> One of the best ways to find out what a stereotypical woman is is to ask a transwoman why she "feels" like a woman. There is a high likelihood that long hair, high-pitched voice, make-up, dresses, breasts, etc. will be features that make the list.
As a trans woman who is also genderqueer -- no? I don't wear dresses or have a high-pitched voice. I do have a pretty strong sense that I'm a woman and that I should be treated by society as such, as well as a deep discomfort at my endogenous sex characteristics and feeling much better when I'm on female hormones.
There are many genderqueer and butch trans women, it's just that in the past in order to get the medical care you needed you had to present as a stereotypical woman. The selection pressure was strong.
Your statement could certainly be true in an alternate universe, but it isn't true in ours. If you say you don't have a "gender identity" -- would you really be OK if you had a female name, were treated as a woman day-to-day, used she/her pronouns and were on estrogen rather than testosterone? In my experience most cis men would answer no. Keep in mind that gender identity is the concept that we've created to explain gender dysphoria. It often manifests as an innate sense (like it does for me) but doesn't always have to do so.
Thank you for engaging and posting a comment, I really appreciate the opportunity to understand your perspective better.
> I do have a pretty strong sense that I'm a woman and that I should be treated by society as such
Can you describe what the "strong sense" feels like for you? In what ways would how society treats you be different if you were not a woman?
> If you say you don't have a "gender identity" -- would you really be OK if you had a female name, were treated as a woman day-to-day, used she/her pronouns and were on estrogen rather than testosterone?
I've encountered this question many times and I find it puzzling. First, I have an androgynous first name and even went to high school with a girl that had the same name as me. The only impact this had was causing some slight confusion sometimes.
Second, I understand that pronouns are very important to people and I do my best to accommodate preferences, but I never really understood the fixation. I'm a male and present as masculine and if someone used she/her pronouns, I would be confused but wouldn't care. I see pronouns largely as a convenient shorthand to refer to people without having to repeat names each and every time. This works OK for the most part, but does lend to some serious ambiguity (e.g. "John and Jim decided to go to the store after he finished work"). So I personally don't care what pronouns people use for me, especially since I'm rarely ever present when it happens.
Third, I don't know what "treated as a woman day-to-day" means, so I can't say whether I'd like it. I can try and conjure up examples based on some Bayesian assumptions but this feels low-resolution (e.g. Maybe if I was sparring with someone, they'd go easy on me physically?). I'd be happy to respond if you have concrete examples.
Fourth, I would probably not like the effects of being on estrogen, but I can't say for sure. I already do things to my body which ostensibly help me achieve goals important to me. For example, I lift weights and exercise for practical benefits, but also because I hope it helps me be better attractive to women I want to have sex with. So when I consider the possibilities of developing breasts and curves from taking estrogen, my overriding concern is less rooted in what I personally want to look like, and more concerned with whether my ability to seduce women will be compromised with these new features.
My intent is not to be dismissive but I see this question as analogous to fashion decisions. If I find out that wearing a specific yellow jacket made me irresistible to attractive women, I'd wear the yellow jacket. If I find out estrogen had the same effect, I'd consider the downsides and then seriously consider taking it if it was worth it.
I've spoken to a male-bodied individual who does not identify as a woman but nevertheless chose to take estrogen because they liked the effects it had. I don't share this person's preferences, but their decision makes sense to me. I'm working on an update of sorts to this essay, and part of the question I want to address is why these individual modification decisions have to be wrapped up in a convoluted framework about "innate identity".
> Can you describe what the "strong sense" feels like for you? In what ways would how society treats you be different if you were not a woman?
It's hard to put exactly into words, but the main effect when people used to call me a man or treat me as one, I used to feel really uncomfortable. I had clinical levels of social anxiety and body image issues. Those issues evaporated completely once I transitioned socially and physically, around 7 years ago. It is an almost miraculous treatment, unparalleled in the psychiatric world. I've found that my mind works better on estrogen as well -- I have a clarity of thought that I didn't used to, which has been important for my work as a scientist.
I've gotten several surgeries, but the most important one for me has been facial surgery. Because of that most people subconsciously gender me as a woman and use she/her pronouns for me when they see me -- in fact due to my dressing style I'm often read as a nonbinary afab person, which I'm comfortable with.
RE your own gender identity: based on what you've sasid it definitely sounds like your description of yourself as agender might be close to the truth. Most cis men I've talked to did not answer this way. Several of them have expressed revulsion at the idea of taking estrogen in particular.
I do know an amab guy who takes estrogen because he likes the softer skin and breast growth. (He says he's not cis, but also not trans, which makes sense to me.)
> when people used to call me a man or treat me as one, I used to feel really uncomfortable
If being treated like a woman is hard to put into words, is it easier to describe what being treated like a man was like? Would it be easier to describe it in terms of the difference between the two? I see the phrase "treated as a X" used often, but I find it very very odd how little elaboration there is.
> Most cis men I've talked to did not answer this way.
I'd be curious to see a rigorous survey done on this topic. My guess is that many people tend to answer reflexively and with little thought to "decoupling" ideas. For example I was able to decouple "appearing masculine" from "being attractive to attractive women", but I assume that most probably equate the two concepts as a single idea. I notice a similar phenomena with how much attachment some men place on their testosterone levels, almost as if they're chasing t-levels *on their own* rather than any secondary effects they might be responsible for.
As an aside, Derek from 'More Plates More Dates' is probably a good example of a high decoupler. For example, here's him extolling the benefits of topical estrogen gel for hair loss prevention: https://www.youtube.com/watch?v=dp2uUw0AVZs
Hi! Trans person here, here are my thoughts.
When I talk to people inside trans communities the argument against transmedicalism is typically big tent logic. "We want to avoid having overly prescriptive definitions of what it means to be trans because that discourages exploration and leads to a lot of "am I *really* trans" which is counterproductive because goodharting, among other things.
That said, I can't think of anyone I know personally who simultaneously identifies as trans and is not at least taking cross sex hormones, surgery is somewhat less common but I'm an outlier among my trans friends in considering surgery to be completely off the table.
I think the critique here applies much better to non-binary people.
I think when trans people talk about what it is to be a woman there's a miscommunication, because for people early in transition their focus is often on passing. Passing is a goal because it makes you less vulnerable and means you'll be gendered correctly more consistently, misgendering tends to trigger neuroses because it reminds you of the ways you fail to pass, typically with a focus on secondary sex characteristics.
Ime it's pretty common for trans women far along in their transition to be much less overtly feminine because they no longer have anything to prove, to themselves or others.
This notion that trans people commonly focus on gender stereotypes as a defining aspect of their identity is, ime, just totally wrong. I personally consider myself a tomboy, one of my MtF friends considers themselves to be butch.
And, frankly trans people tend to focus much more on *trans* stereotypes than binary gender stereotypes i.e "I'm definitely a transwoman because I was so focused on an algebraic topology textbook I forgot to eat until 7pm"
If there is a better article that sums up my particular thoughts and feelings about this subject, I've yet to find one. I am 100% right there with you.
> If being treated like a woman is hard to put into words, is it easier to describe what being treated like a man was like? Would it be easier to describe it in terms of the difference between the two? I see the phrase "treated as a X" used often, but I find it very very odd how little elaboration there is.
I don't know where you grew up, but I grew up in a non-western society with a high degree of gender segregation. So many examples from there: I went to a boys' only school, I dreaded going to social events as a teenager because I'd invariably get called a male over and over again, I was never allowed to have female friends, I was told that all men went through puberty and that the feeling of hatred I developed towards my body during it was just something I had to deal with. I've heard the words in my native language for "boy" and "man" used thousands of times for me, and each time was a little cut on my soul. Now that I've transitioned, I can say with some confidence that "girl" and "woman" don't have nearly the same effect on me.
> For example I was able to decouple "appearing masculine" from "being attractive to attractive women", but I assume that most probably equate the two concepts as a single idea.
I don't think they're the same idea but I think (at least for heterosexual men) manliness is closely associated with being attractive in that fashion. In other words, I'm not sure that decoupling the two ideas is something most people would consider useful. (This is a recurring pattern in these discussions. We are a social species and our biology and social interactions are bound together. Is gender identity a social construct or something driven by biology? The answer is "yes, there are components of both".)
In any case, many of the cis men I've posed this question to were queer. Some of them said they experienced a deep revulsion at the thought of growing breasts, and of course gynecomastia can cause a great deal of anguish in cisgender men in an experience that reminds me a lot of my own gender dysphoria in the other direction: https://www.vice.com/en/article/vv5ajj/gynecomastia-chop-the-things-off-the-plight-of-boys-who-grow-breasts
I'm really happy people are exploring estrogen for topical uses such as scalp growth! People should feel free to mold their bodies into whatever works best for them. (For me, hair loss was a big worry since everyone in my family has rather severe forms of it. I transitioned before it became a relevant factor, though.)
Neither the puberty revulsion nor the inability to have female friends are things I directly experienced, but I nevertheless can still comprehend how they might be distressing to someone.
> I dreaded going to social events as a teenager because I'd invariably get called a male over and over again
> I've heard the words in my native language for "boy" and "man" used thousands of times for me, and each time was a little cut on my soul. Now that I've transitioned, I can say with some confidence that "girl" and "woman" don't have nearly the same effect on me.
I find it interesting that two of the four examples of gender-based treatment you mention have to do with what people called you. I don't intend to be dismissive of the pain this caused you, but my assumption is that it wasn't a result of the specific soundwaves of the words "boy/man/male" but rather it has to do with the evocative concepts those words conjure up. Am I correct? If so, are you able to outline what concepts those words conjure up for you?
That's been what I'm trying to get at when I originally wrote this post. It does not appear possible to have an attachment to a memeplex cluster (such as "woman") without an attachment to SOME branches within that cluster.
I tried to ask the same question in a different manner more recently in another post of mine that I'll just quote again below: https://ymeskhout.substack.com/p/what-boston-can-teach-us-about-what
"I can only sort of maybe identify scenarios where constellation dredging is sort of maybe relevant/beneficial. Maybe if I told someone I intended to buy them a clothing gift and they told me that they identify as a woman, I would be expected to read between the lines and assume this to mean “I am hoping that you select clothing that is generally identified as feminine within our shared cultural understanding”. But it would be better for both of us if she just told me this directly, without inviting potentially insulting or erroneous assumptions. To the extent that woman is a cluster of traits, I struggle to contemplate a scenario where communicating the cluster is a more efficient or more thoughtful method of communication than just communicating the specific pertinent trait. Just tell me what you want me to know directly. Use other words if need be."
> but rather it has to do with the evocative concepts those words conjure up. Am I correct?
Yes. I'm sure there's some bouba/kiki-like effect but it is primarily the memeplex associated with male/man/boy, as you put it.
> It does not appear possible to have an attachment to a memeplex cluster (such as "woman") without an attachment to SOME branches within that cluster.
I feel like this is a truism, i.e. clearly true but I'm having trouble seeing what insight there is in that statement.
> I would be expected to read between the lines and assume this to mean “I am hoping that you select clothing that is generally identified as feminine within our shared cultural understanding”. But it would be better for both of us if she just told me this directly, without inviting potentially insulting or erroneous assumptions.
I actually agree with this in your example -- especially because the range of feminine-coded clothing is somewhat vast so it's much easier to say "I'd like a dress" or "a top" or whatever else.
> To the extent that woman is a cluster of traits, I struggle to contemplate a scenario where communicating the cluster is a more efficient or more thoughtful method of communication than just communicating the specific pertinent trait.
The reason I believe I'm a woman is that all of these:
1a. Thinking "I am a man" to myself.
1b. Saying "I am a man" to other people.
1c. Having male sex characteristics.
1d. Other people perceiving me like a man.
independently and together bring me distress, while all of these:
2a. Thinking "I am a woman" to myself.
2b. Saying "I am a woman" to other people.
2c. Having female sex characteristics.
2d. Other people perceiving me like a woman.
do not.
Rather than explaining 1a-1d and 2a-2d each time, it is generally more efficient to just say "I am a woman". There are specific cases where I'd go into more detail (for example, at a doctor's office) but compressing all of the above statements is pretty helpful.
I appreciate the time you took in replying to my comments. The part I continue to struggle to understand is why it's so difficult to articulate individual branches of the memeplex cluster I mentioned. I can understand the desire behind 1c and 2c, but it seems like the attachment to gender identity is largely incidental, because the phenomenon does not appear to be distinguishable from any other kind of body dysphoria (for example wanting to be thin when you're not).
a, b, and d still confuse me. When you think "I am a woman", what *exactly* pops up in your mind? I'm dying to know the answer to this. I can say I'm a male, and if I was asked to articulate the meaning behind my statement I would cite male sex characteristics (genitals, tall, muscles, bald, beard etc.). If I was asked to dig a little deeper, I might endorse traits that tend to be seen as manly/masculine (e.g. assertive and confident) but then I'd quickly run out of steam. A lot of my personality traits would be coded as feminine (e.g. empathetic, cries easily, affectionate, etc.) but I wouldn't interpret that as an indication that "I am not male" or "I'm really a woman".
The only consistent answers I get to this question tend to revolve around pronoun use and body characteristics. The latter is a clear answer, while the former seems almost ornamental to me. In between there is this chasm that people seem concerned about saying out loud.
> it seems like the attachment to gender identity is largely incidental
The attachment between gender identity and sex characteristics is highly correlated! It's not quite what "incidental" might suggest. While there are certainly exceptions, in general, expressing a male or female gender identity is correlated to preferring the sex characteristics that match their gender identity. This is certainly true for most cis and most binary/binaryish trans people. It is more complicated for nonbinary people -- some prefer a standard male/female hormone profile, some prefer something else or in between, like using estrogen with a breast development blocker, or using finasteride along with testosterone to prevent hair loss.
> because the phenomenon does not appear to be distinguishable from any other kind of body dysphoria (for example wanting to be thin when you're not).
This is not true, in general.
The term generally used is "body dysmorphia", not "body dysphoria". The terminology is important: there's a significant difference between dysphoria, which translates to "a feeling that's hard to bear", and dysmorphia, which translates roughly to "misshapenness".
The gold standard treatment for gender dysphoria is transitioning. That is because when you address the specific causes behind gender dysphoria, it resolves itself (as it did for me). This has been shown over and over again. A purely or primarily psychological treatment was the standard of care for decades and it simply does not work.
You mentioned "wanting to be thin when you're not". In general that can be fine: if your desire resolves itself once you reach your target weight, that's great. However, the term "body dysmorphia" is generally reserved for more extreme examples like anorexia. The gold standard treatment for anorexia is to restore the person back to a healthy weight and to address their concerns through therapy.
These are two completely different conditions with different modes of operation and different treatment plans, and they're as different as a heart attack is from a broken femur.
It is really, really important that this distinction be made very clear . A lot of misunderstanding of trans experiences comes from thinking that all conditions which look psychological are somehow similar; hence the refrain of "we don't play into schizophrenic delusions, why should we accept these?" Well, the answer is that they're just completely different at the object level! They arise from different processes, they work differently, and their treatment is completely opposite.
> When you think "I am a woman", what *exactly* pops up in your mind?
Nothing much beyond a feeling that that statement resonates with me. It is actually quite interesting to me that you immediately moved to deconstruct it -- I, and most trans people I know, came to their conclusion by vibes. Some statements feel good and some feel bad at a deep level. There isn't much more to it than that.
Another way to put it is that the statement is atomic/axiomatic for me, similar to how "the empty set exists" is an axiom in naive set theory.
> In between there is this chasm that people seem concerned about saying out loud.
I don't think there's much concern about saying things out loud on my part -- it's just that there isn't much to say! Some things just feel good or bad for inexplicable but still very real reasons. This is why I believe it's in no small part an inherent attribute of the human experience.
> The gold standard treatment for gender dysphoria is transitioning.
This is an empirical claim and I won't dispute it.
It's not clear to me that we have a good explanation for the causes of gender dysphoria. But to the extent it describes the delta between mind perception and body reality, it seems like there are two sides of that equation. So one plausible idea is to give people suffering from gender dysphoria more of their natal sex hormones. Hypothetically, if there was a pill that completely cured someone's gender dysphoria and had far better effectiveness at improving mental health outcomes than the current blocker/hormone protocol by (crucially) making the person cis, would you have any reasons to discourage use of this pill?
To be clear, I mostly operate from a consequentialist framework for ethics in medicine in terms of just assessing the costs and benefits. So I'm agnostic on exactly what remedy we pursue. If puberty blockers/hormones/plastic surgery/etc. are the best way to deal with someone's distress then so be it (even if we lack a complete explanation of the cause, which is already true for many psychiatric disorders). I am also willing to be consistent with that position and accept that perhaps amputation might sometimes be the best remedy for someone suffering from body integrity identity disorder (BIID) or alien hand disorder (https://www.bbc.com/news/uk-12225163) if nothing else comes close to working.
> I, and most trans people I know, came to their conclusion by vibes. Some statements feel good and some feel bad at a deep level. There isn't much more to it than that.
I appreciate the time you took to elucidate your position and engaging with me on this topic. Even if it boils down to vibes mainly, I still think it would be helpful to continue working towards an articulable description of the phenomenon. How else can we compare our respective experiences? If I say "I am a Σ, are you?" how would you even begin to think about the question without having an idea of what I'm talking about?
> This is an empirical claim and I won't dispute it.
Much, though not all, of the argument for trans rights lies on the empiricism, though. As I said earlier, the success rate of transition (both social and HRT) is near-miraculous as far as psychiatric interventions go. My surgeons have worked on hundreds of patients and can each count the number who regretted it on a single finger.
Don't just take it from me, take it from a political detransitioner: https://twitter.com/EllePalmer1/status/1634723042810286080
Testosterone clearly helped her and yet she refuses to take it for political reasons. She has the right to reject the known gold standard treatment. But it's shocking to me that a comment in there told her to "try vyvanse!" I have no problem with people taking vyvanse. It is an amphetamine that certainly helps a lot of people, but it also causes neurotoxicity and has a long list of side effects.
> So one plausible idea is to give people suffering from gender dysphoria more of their natal sex hormones
This has been tried (and still is routine in some non-western countries). It does not work.
> Hypothetically, if there was a pill that completely cured someone's gender dysphoria and had far better effectiveness at improving mental health outcomes than the current blocker/hormone protocol by (crucially) making the person cis, would you have any reasons to discourage use of this pill?
I'd be really doubtful about whether this can ever be made. Assuming arguendo: If it works as well as transitioning does, which is a very high bar, then ethically people would have to have a choice between taking this pill and transitioning.
> How else can we compare our respective experiences? If I say "I am a Σ, are you?" how would you even begin to think about the question without having an idea of what I'm talking about?
We've already explored this in some detail, right? Does the statement "I am a Σ" resonate with you at a deep level? The statement "I am a woman" feels like that to me. Womanhood has a lot of societal context associated with it, and at least in part I'm invoking that context.
(There are some aspects of womanhood like pregnancy that don't apply to me, but that's also true for many cis women.)
> One of the best ways to find out what a stereotypical woman is is to ask a transwoman why she "feels" like a woman. There is a high likelihood that long hair, high-pitched voice, make-up, dresses, breasts, etc. will be features that make the list.
As a trans woman who is also genderqueer -- no? I don't wear dresses or have a high-pitched voice. I do have a pretty strong sense that I'm a woman and that I should be treated by society as such, as well as a deep discomfort at my endogenous sex characteristics and feeling much better when I'm on female hormones.
There are many genderqueer and butch trans women, it's just that in the past in order to get the medical care you needed you had to present as a stereotypical woman. The selection pressure was strong.
Your statement could certainly be true in an alternate universe, but it isn't true in ours. If you say you don't have a "gender identity" -- would you really be OK if you had a female name, were treated as a woman day-to-day, used she/her pronouns and were on estrogen rather than testosterone? In my experience most cis men would answer no. Keep in mind that gender identity is the concept that we've created to explain gender dysphoria. It often manifests as an innate sense (like it does for me) but doesn't always have to do so.
Thank you for engaging and posting a comment, I really appreciate the opportunity to understand your perspective better.
> I do have a pretty strong sense that I'm a woman and that I should be treated by society as such
Can you describe what the "strong sense" feels like for you? In what ways would how society treats you be different if you were not a woman?
> If you say you don't have a "gender identity" -- would you really be OK if you had a female name, were treated as a woman day-to-day, used she/her pronouns and were on estrogen rather than testosterone?
I've encountered this question many times and I find it puzzling. First, I have an androgynous first name and even went to high school with a girl that had the same name as me. The only impact this had was causing some slight confusion sometimes.
Second, I understand that pronouns are very important to people and I do my best to accommodate preferences, but I never really understood the fixation. I'm a male and present as masculine and if someone used she/her pronouns, I would be confused but wouldn't care. I see pronouns largely as a convenient shorthand to refer to people without having to repeat names each and every time. This works OK for the most part, but does lend to some serious ambiguity (e.g. "John and Jim decided to go to the store after he finished work"). So I personally don't care what pronouns people use for me, especially since I'm rarely ever present when it happens.
Third, I don't know what "treated as a woman day-to-day" means, so I can't say whether I'd like it. I can try and conjure up examples based on some Bayesian assumptions but this feels low-resolution (e.g. Maybe if I was sparring with someone, they'd go easy on me physically?). I'd be happy to respond if you have concrete examples.
Fourth, I would probably not like the effects of being on estrogen, but I can't say for sure. I already do things to my body which ostensibly help me achieve goals important to me. For example, I lift weights and exercise for practical benefits, but also because I hope it helps me be better attractive to women I want to have sex with. So when I consider the possibilities of developing breasts and curves from taking estrogen, my overriding concern is less rooted in what I personally want to look like, and more concerned with whether my ability to seduce women will be compromised with these new features.
My intent is not to be dismissive but I see this question as analogous to fashion decisions. If I find out that wearing a specific yellow jacket made me irresistible to attractive women, I'd wear the yellow jacket. If I find out estrogen had the same effect, I'd consider the downsides and then seriously consider taking it if it was worth it.
I've spoken to a male-bodied individual who does not identify as a woman but nevertheless chose to take estrogen because they liked the effects it had. I don't share this person's preferences, but their decision makes sense to me. I'm working on an update of sorts to this essay, and part of the question I want to address is why these individual modification decisions have to be wrapped up in a convoluted framework about "innate identity".
> Can you describe what the "strong sense" feels like for you? In what ways would how society treats you be different if you were not a woman?
It's hard to put exactly into words, but the main effect when people used to call me a man or treat me as one, I used to feel really uncomfortable. I had clinical levels of social anxiety and body image issues. Those issues evaporated completely once I transitioned socially and physically, around 7 years ago. It is an almost miraculous treatment, unparalleled in the psychiatric world. I've found that my mind works better on estrogen as well -- I have a clarity of thought that I didn't used to, which has been important for my work as a scientist.
I've gotten several surgeries, but the most important one for me has been facial surgery. Because of that most people subconsciously gender me as a woman and use she/her pronouns for me when they see me -- in fact due to my dressing style I'm often read as a nonbinary afab person, which I'm comfortable with.
RE your own gender identity: based on what you've sasid it definitely sounds like your description of yourself as agender might be close to the truth. Most cis men I've talked to did not answer this way. Several of them have expressed revulsion at the idea of taking estrogen in particular.
I do know an amab guy who takes estrogen because he likes the softer skin and breast growth. (He says he's not cis, but also not trans, which makes sense to me.)
> when people used to call me a man or treat me as one, I used to feel really uncomfortable
If being treated like a woman is hard to put into words, is it easier to describe what being treated like a man was like? Would it be easier to describe it in terms of the difference between the two? I see the phrase "treated as a X" used often, but I find it very very odd how little elaboration there is.
> Most cis men I've talked to did not answer this way.
I'd be curious to see a rigorous survey done on this topic. My guess is that many people tend to answer reflexively and with little thought to "decoupling" ideas. For example I was able to decouple "appearing masculine" from "being attractive to attractive women", but I assume that most probably equate the two concepts as a single idea. I notice a similar phenomena with how much attachment some men place on their testosterone levels, almost as if they're chasing t-levels *on their own* rather than any secondary effects they might be responsible for.
As an aside, Derek from 'More Plates More Dates' is probably a good example of a high decoupler. For example, here's him extolling the benefits of topical estrogen gel for hair loss prevention: https://www.youtube.com/watch?v=dp2uUw0AVZs