The following is edited text of an illustrated lecture presented to the Angelica Center for Spiritual Living, Orleans, Massachusetts, on November 4th 2016 by:
Professor of Philosophy
Michigan State Univerity
[slide 1: title slide]
If I had to sum up, in three sentences, what this talk is about, here’s what I would say:
Medicine helped create transsexualism, and then had to come up with a cover story about it. The cover’s been blown. Now what?
If I was pressed to boil it down even further, to encapsulate what I’m hoping for in our time together, in one succinct sentence, it would be this: We are going to explore how the relationship between sex and sensibility is being reimagined, and re-experienced, in the contemporary world.
ACT ONE: Gender Identity Disorder: Creation, “Cure” and Cover up.
Lilli Ellbe (the “Danish Girl”)
Christine Jorgensen (first famous US transwoman)
The “Natural Attitude” toward Gender
Caitlin Jenner (former Olympian)
A group of women
Jeffrey Tambor (star of Transparent)
Sara McBride (first transperson to address the DNC)
When I say that medicine invented “gender identity disorder,” or that it “created transsexualism,” I don’t at all mean to say that that it injected Lili Elbe or Christine Jorgensen or me, for that matter, with some sort of curious concoction causing innocent men and women to develop the overwhelming desire to be innocent women and men, respectively. What we’re talking about today is not an Evil Scheme of Big Pharma and notorious surgeons to create a need to create a market for expensive hormones and costly surgeries.
What I have in mind is more like this: Medicine had brought to its attention a human phenomenon, a deep dissatisfaction with one’s assigned gender, that, evidence suggests, is fairly well distributed through time and across spaces and ways of life, but which is nonetheless generally regarded as recherché at best, and as an unnatural and ungodly aberration at worst.
People have dealt with having such rogue sensibilities in different ways over history and culture—there is some, albeit scanty, evidence that those who practiced healing arts were sometimes turned to for help. In the 20th Century West, medicine—or rather, some few medical practitioners—began to figure out ways to deal with that phenomenon, ways that drew on its toolkit of concepts and practices and powers, and that, for many who were dealing with it, was remarkably successful.
This took powerful kinds of scientific and clinical imagination; it took a courageous commitment to care; and it took a good PR operation.
But just what is this phenomenon, this deep dissatisfaction with assigned gender, this rouge sensibility? What is “transgender”? Some of us find that, despite all the social training that pushes us into our gender identities and roles, despite the enormous rewards for compliance and sanctions for nonconformity, we just cannot tailor that identity and those roles into a tolerable fit with how we make sense of ourselves as gendered beings.
Transgender people are, to different degrees, restive about what our families, our friends, our neighbors, our societies, and our worlds, demand that we be. We fashion alternatives out of the language-games our cultures play with sexual identity. And we do so in the teeth of the fact that the enmeshed systems of words and practices that constitute gender proclaim:
Listen up! Here is the “Natural Attitude” to take toward gender[*]: There are men and women, girls and boys, and there are only men and women, girls and boys. We are all one or the other, all either male or female, from the very start, to the bitter end. It’s an immutable fact of nature. Any apparent exceptions aren’t to be taken seriously. So very much depends on which one you are and it is right and natural that it should be so. To deny any of this is to become socially unintelligible. Resistance is Futile.
Yet, resistance springs eternal. In company with other queer folk, transpeople have introduced variations into forms of life proclaimed as unchangeable. We put together new grammars of gender, new ways of thinking, and feeling, and talking, and being—we deny the undeniable and affirm the unintelligible. In the face of some pretty nasty punishments for resistance to what is taken to be natural, yet we resist.
Of course, mainly we just try to muddle through lifejust like anyone else. Yet I wanted to sound this theme of heroic subversion—sparingly but clearly—because it provides a point on which one can pivot away from seeing transgender as an aberration, and transwomen and men, as more or less passive and abject subjects only—be it of care and compassion, or of ridicule and revulsion. Rather, we can come to see the phenomenon as just another instance of the startlingly rich diversity of the world, and trans folks as, well, folks—and therefore as moral agents living burdened, flawed, but honorable and distinctive lives. This will be particularly important as we get to Act III, although it’s worth bearing in mind throughout and on occasion I’ll refer to it.
But we need to get back to the part that medicine played in this drama first. There are a couple ways that medicine’s role in making sense of transgender and transgendered lives has been spun. There’s what might be called the “Hard Left” view, which goes something like this:
Transgender people’s feelings are a symptom of the irrational cruelties of the prevailing system of sex and gender. They possess the potential to lead to what one pair of sociologists once called a “wildcat strike at the gender factory” (“Down tools!! Drop handbags! Everybody Out!”).[†] Alas, in its infinite resourcefulness, the wily hetero-patriarchal capitalist system has figured out a way to absorb and defang the revolutionary impulse lurking within trans-sensibilities, employing its running dog lackey, medicine, to turn these potential agendered revolutionaries into properly behaved (if faux) ladies and gentlemen, via syringe, and scalpel, and an individualistic psychotherapy insensitive to the distribution of social power
There’s a Hard Right view on transgender too, and I understand, it has taken up a pretty fancy local habitation: the (former?) governor’s mansion in Raleigh, North Carolina, home of the fearless defenders of the purity of womanhood. There reside those who are willing to forego tens of millions of dollars of federal revenue sharing, to say nothing of the NBA All-Star Game and concerts by The Boss, to preserve the safety of ladies’ public accommodations. From what, you ask? From the threat of hordes of leering and assault-prone men who violate the Scriptures by not wearing clothes that clearly proclaim to everyone that there is—or used to be, anyway—a penis in the vicinity. Hopped up on estrogen as they are, there is no telling the havoc these unnatural creatures will wreak. As Governor McCrory so graciously said, If Caitlin Jenner ever wants to work out at UNC Chapel Hill, she’d better be ready to take her shower in the men’s locker room.
The view from Hard Left portrays transpeople, and those in medicine who facilitate gender transition as fundamentally dupes, rather than responsible agents, whose views about their own lives deserve respect, not condescension. The view from Hard Right is even bleaker: transgender types are unnatural, perverted, deluded, and probably flat-out evil, and those doctors who try to further their delusions are just as bad.
In light of what the lefties would no doubt call the “hegemonic power” of the “Natural Attitude” about gender, medicine (the parts of it sympathetic to transpeople, I mean) has had more to worry about from those who share something of a Hard Right perspective on transgender. This included some of their own colleagues, of course. This is where what I earlier referred to as “Good PR” comes into it.
A segment of medicine offered transpeople a refuge—a sort of social recognition, a kind of identity authoritatively endorsed—as well as hormones and surgery. It was a package deal, one might say: to get access to medically provided forms of assistance, one had to accept the medically authorized identity. Which is to lay it down that one had to accept a diagnosis, and a diagnosis of a mental illness at that. This seems a tough bargain, perhaps even a coercive offer, to thrust a person, already dealing with a world of painful complexities, still further into one part of the dark woods, as part of a promise to lead them out of another glade.
The curious thing, from my own perspective, is how affirming the process of diagnosis and labeling could feel. I was eleven before I realized that there were other people like me, people called “transsexuals,” thanks to an article that I remember as appearing in Time magazine in 1965. The relief was enormous. In my early twenties I found my diagnosis, 302.85 in the old DSM-III, the Diagnostic and Statistical Manual of the American Psychological Association.
This was another watershed moment for me. In an earlier publication, I put it like this:.
The diagnosis didn’t lead to the solution of any of my
concrete problems. Yet it had an expressive impact
that went beyond the adequacy or otherwise of the
underlying science—one that helped me move from a
state that seemed idiosyncratic and largely inarticulate
to a place that was shared and could, at least in principle,
“Gender Identity Disorder in Adolescents and Adults” was hardly poetry. Yet like poetry [to borrow a phrase from Auden] while it made “nothing happen,” it seemed to me to open up “a way of happening, a mouth.”
Now I think of this as an example of what happens to even otherwise immensely privileged people, like myself, when they are thrown up against the limits of that heavily policed regimen of gender—they tend to overlook what is denied them, and the costs attached to what they are offered.
The way out of the dark wood that medicine offered was indeed a “straight way”—too straight, and not, as I now think, leading people well. It wasn’t merely that the social recognition that medical diagnosis offered carried with it the added stigma of a mental illness. It was that the official story authorizing the use of medical and surgical means to help was spun as a sort of faut de mieux accommodation. What was on offer to trans people wasn’t really an entryway into their longed for gender; rather, it was merely another one of the “half way “ medical technologies Lawrence Thomas famously discussed, intended only for symptomatic relief, until psychiatry got around to finding a real cure—which would involve the extirpation of the cross-gender identification and desire.
No one ever really “changed sex,” crossed gender: the immutability, necessity, and bivalence about gender enshrined in the “Natural Attitude” was not challenged in gender identity clinics at Johns Hopkins, or the University of Minnesota, in operating theatres in Trinidad Colorado or in Montreal. It was oddly enough, affirmed. Or so the story went
The PR part of this process was, I think, designed to keep the pitchforks and flaming torches from the gender clinic’s door. It also helped some practitioners with their own ambivalence about how to understand transgender, and their own facilitative relationship to it. Too, it allowed them to help while hanging on to some scientific street cred—sex was a matter of one’s chromosomes. XX for females, XY for males, the ultimate vindication of the natural attitude, and a feature of transgendered people’s bodies that medicine didn’t even try to shift.
In part, of course, this was because no one had the first idea how to do anything about it. But perhaps even more significantly, it’s not clear that, past a prenatal developmental stage, adding or subtracting the information encoded on the second X chromosome would have any impact phenotypically—any impact either physically or psychologically on anything evident to the transgender person her or himself, or anyone else.
Let me just pause for a few moments on notion that your “sex chromosomes” determine, fundamentally, and immutably, your gender—thus confirming a central tenet of the Natural Attitude. I just want to note that there are other ways of responding to the facts. We might say, for instance, that your sex is a set of properties about you that can be grounded in different sets of underlying facts, not merely one such set. You might be female, for example, in virtue of having gone through a set of developmental stages in one’s earliest existence that ended up equipping you to play a certain role in the reproductive dramas of your species—bearing the young.
But this view is certainly too strong as a necessary condition for being female—there are lots of girl babies born who can’t themselves ever become pregnant. Some of those little girls are insensitive to the androgenic hormones to which they are exposed during their gestation. These children look like most of the other infants assigned a female gender in the nursery—their external genitalia conform quite unremarkably to the standard female pattern. However, they don’t have uteruses, nor ovaries—facts that come to light maybe a dozen or more years later, when they start to wonder why they have not yet started to menstruate.
[slide 10: A group of ordinary women]
These young women then learn that they aren’t going to start their periods ever, that they have the chromosome pattern usually associated with males—XY—but for various reasons, as fetuses they didn’t respond to the prompts that XY equipped fetuses usually do.
Now sometimes these folks are referred to as “genetically male”—but it seems to me that no rule of logic or rationality forces us to think that a deep fact of nature determines, despite what anybody might think about it, that these girls are really boys. It seems to me just as coherent, just as consistent with the facts as we know them, and a good deal kinder and more respectful, to regard the “genetic” in “genetically male” not as a synonym for “really” but as a carrying the force of “merely”—or “inconsequentially”. The femaleness, the womanhood of people with Androgen Insensitivity Syndrome is grounded in their self-concept, and their social reception, reflections of their available bodies, and in the gendered social norms that address them, and in those that pass them by.
And this—I hope—illustrates the point I made a few moments ago about different people’s sex and gender being grounded in different kinds of phenomena. You may have the sex you do, and experience yourself as the gender you are, in virtue of your chromosomes; the women in this picture have their sex, their gender, in virtue of other aspects of the social and natural worlds in which they live.
In fact, I want to press this point a bit harder still. I want to say, in the end, it is not the dimorphic character, not the fact that they are always with us, not the explanatory depth, of our chromosomal differences that justifies the factual core of the Natural Attitude—it is the prevalence and power of that attitude, that explains how we interpret the scientific data, the force and significance with which it has been invested.
OK—that is one poor, moribund horse that I really need to stop beating. But I hope it has cleared a bit of space for an alternative to the construal of sex and gender that medical professionals may have felt obliged to defend. In human beings, sex and gender may very well be thought of as standing upon a wider and richer range of reality than had typicaly been thought, and that this is one of the lessons transgender has to trahc us; I applaud the signs that such notions are starting to take root in the popular and even in some quarters of the official imagination.
But back in the days of Lili Elbe and Christine Jorgenson, and even back in my own salad days in the mid 80s when I started to attend the Gender Identity Program at the University of Minnesota, we didn’t have a popular TV program like Transparent that has won lots of awards for a non-disparaging depiction of a person—a retired professor actually—who late in life starts to live as a woman.
Nor could we see the national nominating convention of a major American political party include a speaker such as Sarah McBride, one of the first transgender Americans ever to work as a White House staffer.
Back in the bad old days, when it was still considered a deeply discrediting, stigmatizing and even dangerous thing to be recognized as a transperson, the cover of a diagnosis of mental illness could be seen as a decent accommodation to a difficult situation. It was a protection for transpeople—better ill than evil—and a protection for their medical helpers, who were simply doing their jobs in caring for the ill. They were progressive in choosing to serve this population, perhaps, but not radicals trying to overthrow the natural order. Yet the narrative they crafted about their patients and about transgender in general, denigrated both their patients and their own craft. Transgender people were so in virtue of an illness, rather than as an expression of a deeply interesting variation in the human story; transgender itself was a disposition to resist reality, not to reshape it; and the various therapies that transgender folk turned to were not means to the more authentic expression of deep regions of one’s identity. These wonderful expressions of medical skill and scientific knowledge were in effect dream weavers, efforts to reduce psychological harm at the expense of causing moral harm, justified only because there seemed no better way to help transpeople with their sad, twisted, and distressingly suicide-prone lives.
ACT II: FROM DISEASE TO SELF-DEFINITION
A basketful of abstractions
[Slide 13: Act II title slide]
Now, I’ve been painting in pretty broad strokes—there were always both transgender people who didn’t at all buy the story they were being told about their lives; always health care professionals who resisted condescension and affirmed the validity of the convictions of their patients.
Nor must discontent with having a central part of one’s identity regarded as a disease, a mental illness, be taken to imply that if “gender identity disorder” were a disease, any of the negative stigmas associated with it would be justified or even excusable.
Finally, it has to be acknowledged that transgender people, as a group, have an ambivalent relationship with medicine and its diagnostic schema. On the one hand, on the basis of some admittedly unscientific sampling, I venture to say that few transgender people take their gender identities to constitute or be symptomatic, of a mental illness—but some are willing to accept it as a form of paraphilia—a benign paraphilia in comparison with some, but a paraphilia nonetheless, called “autogynephilia”, an erotically tinged love of themselves as a woman (one hears less about “autoandrophilia” interestingly enough.) Others think of their condition as a disease, but as a physical disease, sometimes called “Harry Benjamin Syndrome,” after a physician who helped blaze the trail of the medical reception of transgender. On this view, the problem is with my body, not my mind, and it can be fixed, or at least significantly ameliorated, by medical means—surgeries and hormone regimens, both of which, it is to be hoped, will steadily improve, offering more complete and satisfying cures of the disease, including, ulitimately, fertility.
And while neither “Harry Benjamin Syndrome” nor “autogynephilia” are widely accepted causal accounts of why transpeople are as they are, by transpeople or by doctors, it isn’t hard to see why transfolks have been attracted, as well as repulsed, by the turning of a central part of their lives into a pathology. There is, for some people still, maybe, the attraction I mentioned earlier as operating in my own early life reaction to receiving a diagnosis: it’s a kind of social recognition, and a better one than offered by “pervert” or “degenerate.” I think however, that it is a real indicator of the progress that transpeople—and their societies—have made in the last ten or fifteen years or so, that there are wider and more satisfying forms of social uptake afforded them. The real issue is access to medical powers, and particularly to the gender-affirming surgeries and hormonal regimens they have on offer—to those who qualify. That is, to those who meet the diagnostic criteria.
This factor, I think, explains in part why transfolk have not campaigned with equal vigor to that shown by gay and lesbian people in their fight to eject homosexuality from medicine’s nosology, its list of diseases. More that 40 years after homosexuality was ousted, 302.85 lives on through its legitimate offspring, now appearing not as a disorder but as a “dysphoria.” Indeed, in the current DSM, and still more in the Standards of Care promulgated by WPATH, the world Professional Association for Transgender Health, there is sensitivity to the potentially stigmatizing features of diagnosis, which WPATH explicitly rejects. It states there is nothing at all wrong with gender nonconformity as such. “Stone the crows” as they say in Britain, “who ever would think that? Not us, that’s for sure.”
Until it crosses a line—a line determined by the gender nonconformist’s decision to seek physician assisted gender transition. Then, we need a diagnosis—with not only the threat of stigma that accompanies it, but also the need to subject oneself to the authority of mental health professionals, who will effectively function as gatekeepers to the desired interventions via the needed diagnosis, and (what I , in homage to Casablanca, like to think of as) letters of transit—corrected birth certificates, driver’s licenses, passports.
[ Slide 14: Peter Lorre confronts the gender police; Humphrey Bogart sticks his neck out for nobody]
One might wonder a bit about whether this effort to endorse gender nonconformity, while continuing to insist on psychiatric gatekeeping when “things get serious,” really makes a lot of sense. Some transgender folks permanently take up residence in their desired gender, without benefit of hormones or surgery. That’s just fine. What is it that transforms that praiseworthy expression of life’s rich tapestry into a diagnosable mental illness? The desire for some help from people with monopoly access to the power to make one’s life, from one’s own point of view, more resonantly expressive of who one is.
So let’s take a step into the weeds of the philosophy of medicine, and deal for a few moments with whether being transgender—or being transgender and wanting help from hormones or surgery to help you and others make better sense of your life—is really to be mentally ill. One simple question to start: does it hurt?
Well yes, rather a lot. But the distress touched off by “gender dysphoria” seems to me to be very largely a matter of the social and interpersonal and even subjective punishments that are an expression of the social need to maintain the “natural attitude” toward gender—the stigma, the rejection, the burdens of finding ways of making yourself intelligible as a, DIY project, the violence and the fear of violence. Under more enlightened social conditions, transgender sensibilities might express themselves somewhat as do one’s taste in the gender of one’s sexual partners—strong, pervasive, persistent, but not, in itself, at all painful.
So, that’s one general indicator that you might have something wrong with you, down. Further, it seems to me that, if transgender were a mental illness, it would have to be a highly focused one, a “delusion” about one particular feature of reality only. Being transgender certainly seems compatible with a reasonable standard of overall mental health, if I may be allowed to infer from my own case; one still can work and love, as Freud’s classic characterization of mental health would have it. And particularly if we accept the idea that gender nonconformity itself need not be an indicator of anything discrediting to one’s heart or head, it seems odd to think that transgender considered as a particularly strong expression of that nonconformity ought to be seen as a pathology.
Against these considerations, it could certainly be alleged that the very success of transgender-focused medical interventions—the very low rate of post-surgical regret, for example—is itself a reason to think that the current requirements of extensive psychotherapy, longish waiting periods, and sign offs by multiple mental health professionals is doing the job one would hope it would.
Further, there’s the hope that diagnosis might progressively become a key, not merely to the in principle availability of medical assistance, but to insurability, which in turn could expand access more widely, making the whole process more equitable.
I also want to mention, just in passing, the growing issue of whether quite young children, whose gender identities run athwart their birth assignments, ought to receive puberty delaying treatments, aimed at giving them more time to decide on their future course of life, without undergoing physical changes associated with puberty in the discordant gender, which may make their future transition more difficult and less generally satisfying. Without a recognized diagnosis, I would imagine access to such medication, and indeed, the very existence of gender identity clinics that work specifically with the young, would be in considerable jeopardy.
I can certainly identify with kids that are eager to get into such programs and get Lupron; I mourn the loss of my pre-puberty voice every day. But what I find particularly encouraging about transkids today , is the way they have so definitely found their voices—that many of them seem so forthright, so matter of fact, so brave about living out what seems to them to be a fundamental part of who they are. There are questions about the long term impact of Lupron, questions about its impact on bone density in particular, as well as questions about whether its use may actually accelerate a child’s path onto cross gender hormones, rather than delay it. But to me, there is no question about the value of hese children’s bravery, nor about the changes in society that make broader, richer, deeper expressions of who one is, possible in this time.
Yet apart from the potential losses to trans-children, there are of course examples of health care proceeding without diagnosis, or at least,,without serious ones—think of elective cosmetic surgery. Why couldn’t we treat various forms of gender confirming surgeries in that way, as prompted not by illness, but by…what? Well, what prompts elective cosmetic surgery generally? One possibility seems the hope for enhanced ` social or professional success? That seems unlikely as a motive, whatever that actual impact of surgical contributions to a person’s social or professional lives. Indeed, that seems to me the single largest impediment to accepting an elective cosmetic surgery model, quite apart from questions of equity and fairness of access—not much chance of expanding insurance coverage on that model—is the elective part, even more than the cosmetic part. Both seem to convey a air of superficiality that I think is no more in keeping with most transpeople’s sense of themselves than is the idea of being mentally ill.
I’m conscious that this discussion of motives for elective cosmetic surgery is too quick, and slights what is likely a range of possible motivations. More needs to be said here.
But not, alas , today. Today, we look for other models—and here is one, that may surprise you, but has increasingly come to strike me as pertinent and helpful: pregnancy and delivery, obstetrical care. Apparently, women who chose to have medical care when they are expecting have to submit to a diagnosis for insurance coverage. But hardly anyone, to the best of my knowledge and belief, thinks of pregnancy as though it were really a disease. And yet medical care and assistance as an option is extremely wide-spread—without the requirement of therapy and screening before hand. Of course, there are disanalogies, obvious and important ways being transgender and being pregnant differ. But there are suggestive similiaries, too; both delivery and transition are possible without medical assistance In many cases, that assistance may nonetheless be important, even crucial to securing a good outcome, but may leave the recipient of care sometimes feeling as though she or he has been removed from the center of a crucial chapter of her own story. Further, just as it can change one’s identity forever to become a mother, so too, it seems fair to say, gender transition changes a person in basic ways too.
All I’m really trying to do here is to point out that medicine doesn’t need to portray everyone it is trying to help as if there were ill; apart from elective cosmetic surgery, apart from preventive medicine, there is routine OB/GYN care.
Nor do I want to deny that counseling—including peer counseling–can be an important part of transgender care. I am concerned about the idea that mental health professionals should be taken as gatekeepers to gender confirming therapies—entrusted with the task of separating sheep from goats, distinguishing between those who are just “mentally ill enough”to be bona fide sufferers from gender dysphoria from those who are flatly incompetent to decide such a matter as whether getting trans health care would actually help them or not.
There is another suggestive analogy between obstetrical and transgender care that I want to gesture towards as we prepare for our final act: the subtle connection between choice and compulsion.
Some women, and couples, facing birth-giving and family-making, confront a host of choices: where will be baby be born: Home? Hospital or Birthing Center? If so, which one: Who will assist with the birth? Family doctor? Obstetrician? Nurse-midwife? And so forth.
These are decisions that may result from careful research and reflection on facts and values, probabilities and personalities. The timing of the birth, too, may reflect similar patterns of human deliberation and decision-making, blending thought and feeling, calculation, and intuition.
But what of the decision to have kids at all? There are certainly good reasons to do so, as well as good reasons to forbear. I’ve had three of my own, as they say, and participated in the raising of three others: to say they are splendid people is to say far too little, and sharing my life with them has been, and continues to be, one of its most profoundly important features—in part, because it has been an occasion of great sorrow as well as great joy. Not one of these folks are in my life as a result of what I will call a decision—they all, as it were, just showed up, without invitation. But they were all heartily welcome when they came.
And why is that? I happen not to have done much choosing when it came to my kids being in the world. Some people do a lot. But the welcoming attitude, the desire to have children at all, seems to me not to have been a choice at all, but something rather that underlay and gave shape to such choices as I did make.
I want to say that something similar is true of people’s attitudes to their gender generally—it provides a context for choice, for action, for living. Nowadays, in particular, there is for many people, a certain degree of latitude when it comes to how one expresses it. But it itself, doesn’t seem a matter of choice.
Is this behind the patterns of almost visceral repudiation that many transpeople have had to face, and that their allies in health care have had to step so carefully around., Is it this sense that gender is not a choice, but part of the stage setting for choice, that stands behind the various tenets of the “Natural Attitude”?
ACT III: Choice and Necessity
Elinor and Marianne Dashwood
[Slide 15: Elinor and Marianne]
Harkening back to the “three sentences “opening of this talk, we’ve just about reached the “Now, what?” stage. But first, some Jane Austen. Austen’s first published novel, Sense and Sensibility (1811), chiefly concerns the two eldest Dashwood sisters, who personify the title themes. Elinor is measured, judicious, deliberative, thoughtful; Marianne, in contrast, not only is none of these things—she is excessive, impulsive, unreserved, and emotive. Elinor counsels that behavior should express convictions that we have reflectively endorsed. Marianne repudiates all this, holding that behavior should be the unfiltered expression of feeling.
A curious thing about the relationship of these sisters is Elinor, who is such a woman for careful choice, seems formed by circumstance to be so—she takes after her dad, who did what he could, ineffectually as it turned out, to secure the welfare of his wife and three daughters after his death. She is a chooser, but not altogether as a result of her choices.
Marianne, on the other hand, seems the furthest thing from a creature of deliberative choice—one might think her as her mother’s daughter, only brighter and more forceful. But Marianne’s romanticism is a result, at least in part, of her reading of philosophical and aesthetic romantic textss. One might say that her rejection of reflection is at least in part a result of reflection on its rejection. For Marianne, feeling, not philosophy is the proper guide to life—and she can quote several philosophers who have argued in support of this very thesis.
Austen, then, as I read her, shows here her delightful and instructive penchant for revealing some of reality’s underlying complexities, obscured by the dichotomies that tend to shape our thinking.
And I, of course, hope to be equally instructive, if not alas so delightful, in imparting a similar message about choice and gender. I want to bring this talk to a close with an argument that transgender people don’t necessarily—and perhaps even typically—have much more choice about their fundamental gender identities, about how their overall sense of life is affected by norms of gender, than anyone else. Yet gender is a problem for these folks—one that demands some decision about how to respond—even if that decision is to tough it out, and to all appearance do nothing at all. I also want to maintain, in an Austenian spirit, that we, our communities, our societies in general, have something important to learn (or possibly relearn) from the choices that transgender people do make concerning how to live lives more finely and fully expressive of who we are. So here’s a stab at a statment: our sense of ourselves as women and men is typically not something we chose, whether we be transgender or no. But it is choice-worthy.
No one, that is, should be disturbed, or threatened, by people who leave their birth-assigned gender, and migrate to another; it typically does not threaten the idea that gender is fundamentally not a choice, but a context for choice; in an important way, it affirms it. And in the choices that transpeople do often make, in the context of their gender identity, ought to seem an endorsement that both male and female ways of living can be worthy and honorable. Deciding to settle in either of them is perfectly intelligible, as they both have manifold attractions. We shouldn’t really need this reminder at this time in history. Alas that we do.
One of the important lessons of feminist thinking over the past several decades has been its careful excavation of the many ways that gender can be difficult, limiting, and dangerous, particularly (though not exclusively) for women. At the same time, gender is, or can be, a source of delightful human variety, a font of intimacy, a well-spring of joy. We need to do what can be done to make gender (as well as sex),be safe, sane, and (in its expression) consensual.
Transgender, seen as a grace note in the human symphony., rather than a mental illness, still less as a perversion, and transpeople, seen as friends, neighbors, and ordinary folk, whose lives reflect and reinforce the value of everyone’s experience of gender, rather than as threats to the peace and decorum of women’s rooms, can help shift the valence of gender in the direction of joy, and away from danger.
Medicine can help with this by relaxing any residual defensiveness or anxiety about the assistance it offers transpeople, and allowing “gender dysphoria” to slip quietly away into the oblivion reserved for obsolescent diagnoses. It can also work to be sure, via med school training, and authoritative professional standards that transpeople get quality care and respectful engagement whenever they present themselves for any kind of health care.
In other settings—in state legislatures where specious rationales for excluding transpeople from appropriate bathrooms have been on the upswing, for example, or, alas, in the Supreme Court where a case involving whether a young transman may go in his school to relieve himself will absorb the attention of eight (or nine) of our most distinguished legal minds, my advice to those who are concerned that something important about gender is under threat, is just to Relax. Try to get to know a few transpeople, watch a few episodes of Transparent. Oh, and read some Jane Austen. There’s only one tiny allusion to anything touching on what might be construed as transgender in the novels. Still, it’s hard to read any of her work, and not come away feeling calmer, a bit more centered, with a mind more alert to the intricacies of reality, and overall, just a little saner.
[*] The notion of the “Natural Attitude” was pioneered by Irving Goffman and applied to transgender in Kessler and McKenna, Gender: An Ethnomethodological Account (U Chicago Press 1978.)
[†] Billings and Urban in Social Problems 29 (3): 1982.