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Where are All the Cis Patients in Gender Identity Clinics?

Updated: Jan 28, 2023

“Let’s accept that the clinic is not only a sinister force, but an absurdity.” (Gleeson & O'Rourke, Transgender Marxism, p. 15)

The objective of the trans revolutionary struggle isn’t social tolerance for gender non-normativity, but rather the liberation from gender normativity in every human being. This appears to confuse a great number of people, most prominently Radical Transphobes™. For example, we can see that the prospect of gender-inclusive toilets is of greater interest to radical transphobes than to trans revolutionaries themselves.

For one thing, we have more pressing matters to attend to, such as biopolitical issues and dying our hair. For another, transphobes seem to believe that a person requires their birth certificate to enter into a gendered bathroom.

Capitalism = Mafia

When discussing trans politics, it’s of vital importance to bring attention to the way we think about rights.

Some trans people in the UK have the right to take hormones or change our birth certificates - although these rights come with a catch (money, citizenship, social safety, etcetera). Such rights, having been gifted to us by a cisnormative society, may be taken away or adjusted according to whatever said society thinks in the moment. If cisnormative society were a moody toddler, we’d be in for lots of pointless and horrific changes. Thank goodness we don’t have children in government!

It's important to note that in late-stage capitalist countries the protections and tolerance of trans people disguise an underlying need for cisgender society to absorb transgender people into its system.

By ‘tolerance’, I mean that government allows us to exist instead of actively (publicly) pursuing our demise. By ‘protections’, I mean that government allows us to exist instead of actively (publicly) pursuing our demise. For anyone already aware of gangster tactics, this might make some sense already – but for anyone unaware: imagine that a gang of people in suits and facemasks jumped you on the street, and the next day you were approached by a gang of people in suits but no facemasks who demanded that you give them money to protect you from the gang of people in suits and facemasks. ‘They look remarkably similar,’ one might think, before committing either to paying your oppressors or to getting beaten up every day. On a larger and more historic scale, this is how our society functions – especially for marginalised groups. For some trans people, this presents itself through such things as the commercialisation of the trans flag and absorption of trans culture into capital (money, monetary value), for others it is simply through acknowledging that we are indeed human beings (therefore allowing us to work, eat food, and so on). Pride is a great time to see this, as corporations sell trans colours and hashtags to the very same people that it oppresses [read more here]. We can see that despite the tolerance of trans existence, cisnormative society is not prepared to start treating us as human beings. Even The Guardian (the source quoted) frequently publishes transphobic content [just one example]. In other words, it is established that late-stage capitalist countries are performatively catering to trans people. Of course this is not merely a trans issue – we need only take one glance at the temporality of Black History Month, or ‘special episodes’ of popular TV shows that welcome ‘exotic’ guests to show that we are indeed tolerant of you others. The core of the problem is that cisnormative society has created a world where transgender people are victims – and now the very same society may protect us from itself. In other words, transphobia was invented by the very same people who wish to save us from it, and what’s more, they’d love it if we bought their flags at Trans Pride and did their dirty work for them.

To reiterate, trans people only require protections because of cisnormative society in the first place. We might point out that it’s impossible to find any evidence that cisgender society has helped trans people in any way. For some strange reason, all protections and/or rights for trans people has been found in transgender or intersectional activism. Further, these protections do little to aid us in changing the issues of our daily lives, as varying as they may be. For example, the UK government and EHRC has been head-scratching during debates around whether our human rights should be at all recognised - including the legality of trans conversion 'therapy' [VICE News], while asking themselves whether trans people are really human or not, UK institutions and transphobes have ran around leaking our private information [example], nonchalantly abusing trans staff/patients/customers/etc., and ignoring complaints of abuse at all angles [too many examples].

Not only is systematic transphobia effective in preventing people from ‘daring’ to accept gender non-normativity, it actively encourages cisnormative violence: whether that violence be in ‘mutilating’ the bodies and minds of trans youth, or in more physically visible terms such as assault. This alienation, the othering of a group of people, is something that has greatly aided powerful groups in gaining popularity and further power in the past. It allows those in power much more leeway in their propositions: if the populace is taught to mock a group of people, to see them as less-than-human or corrupt in some way, there will be little pushback when the Powerful Group condemn the Oppressed Group to the basements and gutters of society – one that may be utilised in a myriad of ways, from cleaning said gutters to being blamed for the horrendous effects of Powerful Group Act Number 1321. Widespread social alienation, or oppression, is also a great way to quell the abilities of the Oppressed Group to protest – not only because they are exhausted from basic survival, but if the Oppressed Group has certain rights granted to them, their protests are liable to be softened: people assume things are getting better, that Oppressed Group is expecting too much, and so on.

Not all people under the trans umbrella may fit a direct parallel to Oppressed Group in this scenario, but it might be worth indicating that all trans people have a role to play in what we do with the ‘protections’ that the Powerful Group(s) have granted some of us. After decades of our own tireless trans activism, as we have stated, ‘protections’ are often intended to weaken and deafen our fight for liberation and our motivations. "If fifty years of trans activism has taken place," said Cisnormativity "give them a crumb of recognition." After all, if we’re granted this right and that right, the volume and ‘importance’ of our want for liberation is muffled – if not completely silenced. It could be said that trans people with more power, and our allies, would rather wait for the UK Government to remove all protections from trans people in order to protest, completely overlooking the more marginalised groups within the trans community who aren’t already granted these rights – who are already condemned to the gutters of society, and completely overlooked by the very same trans community that is supposed to stand up for them. I will get to why this is important in the face of ‘why aren’t there more cis people in gender identity clinics?’ soon, but the point is that we cannot be complacent in the face of rights that we have already been granted. To do so is to ignore the blatant lack of human rights in the UK as a whole, if not to condemn countless people of the present and the future to a life that, apparently, is not even worth recognising.

Even trans people involved in the liberation movement are not all completely aware of the need to fight for a fully revolutionary change, instead of the mere reform that is proposed by many LGBTQIA+ manifestos. Many ‘effective’ LGBTQIA+ groups are organised in a way that – at least in some semblance – perpetuate ‘patriarchal and reactionary’ dynamics. It’s important to remove cisnormative functions from our groups. Our role, therefore, is to continue a critical conversation of the trans liberation ‘movement’. Not to neglect the complicated circumstances of activism in an oppressive society, but to highlight and build upon the work that has already been done. However, much like an old machine, we cannot build ourselves upon rusty parts and expect great results.

“It was once that to be queer was to be in direct conflict with the forces of control and domination. Now, we are faced with a condition of utter stagnation and sterility.” (Toward the Queerest Insurrection)

The case is sometimes that a trans liberationist group is led by some person(s) of cisnormative ideology – intentionally or not, and with varying reasoning. One reason for this can be that the cis ‘relatability’ of the leader(s) allows them to attain recognition or power in an otherwise transphobic society. The question of how one may run a liberatory group – never mind a revolutionary one – in an oppressive society has been debated for seemingly forever. For some cisnormative/patriarchal/capitalist trans activists, there may be (to some extent or other) a subtextual trans guilt towards their own ‘betrayal’ or ‘deviance’ from what is popularised as a forgiving and understanding (at large, good) society. Trans people are encouraged to believe that they are betraying the ‘cisgender family’ – which many believe contains 8 billion members and counting: at least 50% of whom are “doing their best, give them time to learn”. That’s a lot of birthdays to buy presents for. And a lot of people to let down.

It certainly makes sense that the trans child may want to comfort their parents (in this case, institutions) in a period of stress – even when they are mourning ‘the death of their cisgender child’. And yet, we must consider what these trans kids inflict upon their trans peers. To comfort the institution, in this metaphor, is to encourage other trans people to do the same – to feed into stereotypes, and take upon a double-workload as they juggle being trans and everything else. After all, as is so often asked, why do parents rather accept the death of their children than accept who their children are? It is precisely because they are not mourning their child, they are mourning the death of their own normativity.

The idea that our institutional ‘family members’ need time to learn fails to mention that this mess is their fault in the first place. It’s a brilliant excuse for complacency and minimal change (protections, tolerance, yadda yadda) – gaslighting trans people into being okay with their oppression, because it’s better than nothing. However, it’s not enough that cisnormative, binary understandings of sex and gender have been disproven – or that trans people are allowed to change their name for a fee after they’re traumatised throughout childhood – or that we can pee in a Designated Pee Zone™ without being heckled about where our salty yellow liquid (granted, sometimes it’s not yellow) shoots out from. None of these tolerances, rights, or protections stop trans people from practically any form of suffering. Trans people are not safe in Designated Pee Zones™, trans people have to educate their own medical practitioners on basic biology, and who in their right mind would ask for money to change a name? Can you imagine paying your parents, your cat, and/or your best friend in order for them to recognise your name change? And, even then, many places will disregard the change of name entirely.

We must be careful not to unconsciously absorb this performativity. As some of you may know already, we must recognise capital (money) as a tool that we are forced to use in order to survive - or in order to ‘speak the language’ of capitalism. If we do not 'speak' its language, capitalism will leave us out of childish frustration - rather than taking the time to learn how to 'speak' our language. We must of course be careful to remember our own position in all of this. To not absorb this survival into our unconscious, day-to-day lives. We must be constantly aware that capital is the language of pain and suffering - as it created our suffering in the first place. Capitalism is far from - as the cis say - 'natural'. For some, it might help to reword the fact like this: I must engage in the language/exchange of pain to survive.

The belief that these pointless rights are signs of real change is a terrifying one. But this beast is just one way to tell how cisgender society has seeped into and ‘controlled’ even the most independent of trans-gender unconsciousness. If cisnormative society has managed to twist our unconscious so silently, and yet so violently – what else might we be missing? I propose that we start thinking about the answer in the language of the oppressor, essentially: what would the cis do?

Let’s Talk About the Title

You might be wondering what this all has to do with the question ‘where are all the cis patients in Gender Identity Clinics (GICs)’?

Since there is such a thing as performative inclusivity, and that we often see it as actual inclusivity, we might reach the conclusion that people often believe our current social structure is some kind of monolithic boulder.

Unable to be changed or moved until, by its own volition, it comes thundering down the mountain destroying everything in its path. Our efforts to chip away at the boulder only quicken its homicidal potentialities – and even if there are ten of us to hold the boulder up, this boulder is sentient and has close ties with the police, our parents, our schoolteachers, and even our friends. The boulder doesn’t know what ‘please don’t squish me’ means. All it sees is rage. We have only one choice: we must attempt to play the boulder at its own game. That is to say, we must give cisnormativity a taste of its own medicine.

Mario Mieli’s Towards a Gay Communism (Elementi di critica omosessuale) may be a torturous read at times, much like many books on critical theory, but the focus on turning heteronormative language against itself is a hilariously refreshing take on revolutionary theory. For example, we might propose that – since transgender people have to prove their ‘transness’, cisgender people must prove their ‘cisness’. We might say that, since there is such a thing as performative inclusivity towards trans people, we should performatively include cis people within trans spaces. But before we could do that, we must establish a functioning simulation of what it is to be trans in a cisnormative world.

Cisnormativity dictates that, unless a person expresses discomfort or dysphoria with their gender assigned at birth, people generally do not need to go to a GIC or related healthcare facilities. This would make sense if GICs were for people who wish to transition. Unfortunately, GICs are more like empty promises of acceptance for trans people – with long wait times, the constant need to provide some kind of transgender performance, and so on – the GIC represents cisnormative society’s misunderstanding of trans issues. There is absolutely no reason that the same treatment cannot be done by general practitioners, specialists, and nurses all over the country – no reason that any necessary psychiatric engagement may be done by general professionals, and so on. This article isn’t going to go into detail about general debates around trans healthcare, because I’d rather not waste valuable space relaying readily available information. However, we can point out that hormonal therapies and many surgeries related to transition are available on the NHS to cisgender people.

There is no doubt that there is a double standard presented here. For instance, a trans man with a large chest is judged and requires psychiatric evaluation to reduce his chest tissue, but for a cis woman with the same want these requirements are overlooked – both are likely to be judged, yet the trans man is likely to be harassed to a higher distinction. He is both trans and questioned about child-rearing, he is questioned about his mental state in terms of his gender identity, and so on. A better example might be the cis man who has high amounts of testosterone or oestrogen, and seeks to rectify this out of either necessity or personal needs – a trans woman would never be granted the same ability without extensive scrutiny and having to undergo the entire GIC trip. The problem here is simple: that cisnormative society takes pleasure from refusing transgender people, from pretending that there is something inherently different between it and the Other, and from insisting that it knows us better than we do ourselves.

In response, a simulative proposal could be for cisgender people who wish to change their name, to take hormone therapy, who wish to undergo aesthetic operations – and so on – to be required to undergo the same kind of scrutiny, wait list, and legal cross-country that transgender people do. Instead of just trans people having to be psychiatrically evaluated by certain doctors, we could propose that everyone must – just in case the patient is ‘doing it for the wrong reasons’. Another proposal might be for everyone, including cisgender people, to have recommended gender check-ups every 7 years or so: to determine whether they are somehow traumatised by binary gender standards, gender roles, misogyny, toxic masculinity, etcetera., as transphobes so often believe that trans people are traumatised or ‘mentally deranged’. However, these proposals wouldn’t cover the other problems within trans experience, such as institutional judgements and/or punishments, so we might have to expand our simulation to deeper levels.

Trans people often experience the effects of cisnormativity from birth. It’s also true that cis people experience the effects of cisnormativity, gender essentialism, misogyny and toxic masculinity, and so on from birth. In fact, we all experience these things – we live in a society. There are no reparative proposals that include the full categorisation of transgender experience, nor are there proposals for other experiences for those who have not had them. Indeed, if we accept that everyone’s human experience is different, then normativity runs into a great deal of problems. For cisnormativity this presents a particular issue: that it does not exist, that cis is not normal (since everyone’s experiences are different, there is no real normal), and that there is no ‘real’ way to tell if someone is cisgender or not. Many self-proclaimed cisgender people have said to me that they know they’re cisgender because they’re okay with their body, their pronouns, and with how they present themselves. Often there’s some sort of catch, such as objectification or dysphoria of some specific kind, but these are put down to beauty standards, gender norms, and patriarchal attitudes. The irony being that many trans people are similarly okay with themselves, but due to cisnormative categorisation, they are encouraged or forced to identify with the label ‘trans’, because of specific problems with objectification, dysphoria, and so on. Certainly, these people are still trans and those people are still cis – language is not negated by the mere existence of complexity – but the differences between these specific people appear to be purely within how we categorise their problems. And, as we have just established, we cannot fully categorise anyone’s experiences. The only thing trans people necessarily have in common with each other is a certain form of self-consciousness, and cis people (I assume) another. Even this is debatable, but we must move on.

As we have established, normative society performatively caters towards people within the trans community (especially those with money). The needed surplus of capitalism – what must grow every year for its function – is capital. This often motivates its absorption of ostracised communities, such as the transgender community, or the gay community. As we’ve established, there is no inherent ‘community’ in being gay or trans – this ‘community’ is an imposition upon non-normative individuals from normative institutions: the transgender ‘community’ exists only as a reaction to whatever cisnormativity dictates that it (itself) is not. Capitalism has, therefore, created us and absorbed us – the latter of which it could not do if it had not created us in the first place.

For us trans revolutionaries, our surplus must be ideas, criticisms, theories – but most importantly, freedoms.

The only way forward is to liberate ourselves from gender normativity, and to liberate ourselves from the categories of cisnormativity and capitalism. Perhaps that is to recognise that we are not actually transgender, or perhaps we must awaken the trans in cisgender people. Perhaps it is neither. What is certain is that all humans are required to adhere themselves to a label of gender in order to be accepted into society at large – and that cisnormativity does not recognise the inherent transness in this act. None of us beings have been the very same people we were brought into this world as – we are always transitioning from one self to the next. To stay the same – to be cis – is to ignore the inherent movement that living entails. Of course, there’s certain differences in such things as medical transition, social transition, and so on: but the fact of the matter remains – we are all always in transition.

By Dorian Rose (@generefuckere)


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