recorded, disseminated, accessed, and preserved in ways untethered from traditional, offline, and analog practices of history’; the curated Digital Transgender Archive is a most impressive demonstration of that very potential.44 The Tretter Transgender Oral History Project of the University of Minnesota provides nearly 200 moving-image oral histories online.45 There is a growing portfolio of trans photography: most recently, Zackary Drucker and Rhys Ernst’s moving catalogue of a trans/trans relationship, and Mark Seliger’s beautiful images of trans masculinity and femininity, and those in-between – ‘endless possibilities of potential selves’, in Janet Mock’s words.46 Vice.Com has set up the online Gender Spectrum Collection, providing free stock photographs of trans and nonbinary models (taken by Drucker) to increase the visual presence and enhance the media representation of those ‘beyond the binary’.47 See Illustration 1. Although it has just stopped publication, for ten years trans men had their own, genuinely innovative, magazine, Original Plumbing, edited by Amos Mac and Rocco Kayiatos, which, both visually and in prose, shows the sheer range and vibrancy of trans male culture.48 See Illustration 2.
1 A transmasculine doctor in front of his computer.
Hence, it has become possible to ask, ‘Is Pop Culture having a Trans Moment?’49 Time magazine cover stories can proclaim a ‘Transgender Tipping Point’ (with the black, trans woman Laverne Cox on its cover) and ‘Beyond He or She’.50 The National Geographic, no less, has had a special edition on ‘The Shifting Landscape of Gender’.51
I will be using the literature of psychology, psychiatry, and modern surgery among my source material. But that does not mean that I have been captured by what is usually called the medical model, where trans is viewed through the lenses of the medical and psychiatric experts, the gatekeepers of transition. Some trans advocates, as we will see, are deeply suspicious of such influences; others have opted to work strategically within the system.52 The trans community has long been divided on such issues.53 On the one hand, the medical model provides (some) access to health care and (as a legitimizer) to legal advocacy, even if many of those involved do not really believe in the paradigm. On the other hand, it is resisted because it not only pathologizes but also privileges a particular kind of transgender, excluding more flexible forms of transness as well as those (the majority) precluded by poverty.54 As Riki Lane expresses it, the ‘tension between seeking approval for treatment and resisting pathologization is a defining characteristic of the relationship between clinicians and TGD [trans and gender-diverse] people, both as individuals and as a social movement’.55
Obviously, the medical model has framed discussion and shaped the lives first of transsexuals and then of transgender people; it has determined the rules, the parameters, the gates to treatment, and even self-perception. Austin Johnson’s labels ‘hegemonic’ and ‘normative’ are entirely appropriate.56 The sociologist Myra Hird was horrified by the attitudes of psychiatrists, physicians, and psychologists when she attended a gender identity conference in 2000, including ‘highly stereotyped notions of gender’ and the continued framing of transsex (and homosex) as pathology.57 Many commentators have pointed to the persistent gender essentialism and heteronormativity of the paradigm still present in the regime of DSM-5.58
Yet, despite this dominating role, there has still been room for trans agency, evidence of what Dean Spade has termed ‘a self-conscious strategy of deployment of the transsexual narrative by people who do not believe in the gender fictions produced by such a narrative, and who seek to occupy ambiguous gender positions in resistance to norms of gender rigidity’.59 Judith Butler once referred to San Francisco’s ‘dramaturges of transsexuality’, who coached trans men in the gender essentialism which they did not personally hold – yet needed when they approached the psychiatrists and doctors who were the gatekeepers to the sought treatment.60 ‘I braced myself for a conversation where not adhering to stereotypes and clichés could undo this whole plan’, the British trans woman Mia Violet recalled of her encounter with her therapist in the 2000s. ‘I recited my history of gender dysphoria on cue.’61 She carefully avoided complicating the expected narrative.
2 Original Plumbing, Issue 20, featuring Amos Mac and Rocco Kayiatos.
What clinicians took for patient duplicity could be interpreted as trans agency – as in the case of the famous Agnes, discussed in a later chapter. L. M. Lothstein, the psychologist at Case Western Reserve Medical School in Cleveland, whom we will also encounter later, held group therapy sessions in the 1970s in which patient power was evident. Some black trans women brought their street alliances (forged in sex work) into the clinic, where it became black patient versus white clinician. One, Ann, ‘argued that the real experts on transsexualism were the patients and that the therapists were learning a lot about them via the group therapy’. She claimed that therapists could be ‘bullied into recommending all patients for surgery’.62 When a surgeon was invited in to show slides of gender reassignment, ‘the group focused on the “ugliness” of the constructed vagina’.63 In a later study, Lothstein and his team claimed that such therapy revealed material that had been ‘denied’ and ‘falsified’ in earlier evaluations, again evidence of patient initiative.64
Elroi J. Windsor has outlined the strategies (apart from submission) available to trans men when negotiating therapy: what Windsor terms ‘manipulation’ (choosing sympathetic therapists, and/or seizing back the initiative in the patient–therapist interaction), and ‘resistance’ (avoiding therapy, challenging diagnosis, walking away when the therapy does not suit). There are overlaps between categories, but the essential point is that, other than merely just ‘doing what needed to be done’ on the therapist’s terms (which was also a tactic), trans men could operate within the medical model.65 Readers should afford me the comparable ability to work the sources analytically, to read against the grain, rather than assume that I am the prisoner of a literature of which I am very critical anyway.
This will apply, too, with the discussion of surgery, which will recur in the pages that follow. We will see that many trans people eschew such accounts because they objectify and pathologize the trans body and pander (again) to the medical model. In his account of his trans journey, Nick Krieger consciously edited out descriptions of the immediate results of his top surgery in an effort to avoid a ‘trans narrative cliché’.66 Yet, either in its practice or in its absent presence (its denial), surgery has always been part of trans history.67 As Eric Plemons frames it, ‘I am an ethnographer of trans- surgical practice not because surgery defines us as trans- people but because it is so very important to so many of our lives.’68
We have to be wary of essentializing categories. Just as we should avoid subsuming transvestism under transsexuality, we should resist transgender as a master category for all aspects of trans history: the danger of the Transgender Studies Readers is that they may do just that. When Megan Davidson interviewed over 100 transgender activists in 2004 and 2005, well into the second decade of the transgender turn, she found conflict as well as shared values.69 There were those for whom the medical model of transsexuality, with its binary and surgical certainties, was imbricated in their sense of self. Then there were those for whom fluidity was the key. The former sometimes saw the latter, especially those self-identifying as gender queer, as the province of white, privileged, college students. Davidson encountered an activist who clearly resented what they called the ‘girl in a tie with a crew cut who now feels male and yet is not
