[Free to Disagree] Why I’m against gender affirmation

Almost nine years ago, I wrote a column on Rappler explaining LGBTQ plus issues.

I quote that column often. The paragraph I quote relates to my definition of the term “gender.”

Here is how I defined it in that column: “Gender is a social organizing force that encompasses the domains of the biological, intrapersonal, interpersonal and social and that determines a person’s access to and control of opportunities and resources. It is a system of difference and inequality that reinforces and is reinforced by other systems such as race and class, but is nonetheless distinct from these.”

In that column I had hoped to make the argument that LGBTQI issues, which involve such characteristics as sexual orientation (heterosexual, lesbian, gay, bisexual, pansexual, etc., gender identity (man, woman, non-binary, etc. ) and expression (feminine, masculine, androgynous, etc.), were different from gender as a system of oppression that mostly affects women. If the reader will look back on what I have just written, he or she will see that I have just explained the categories behind the acronym SOGIE.

One of the features of gender as a social system of oppression is heterosexism, the view that only heterosexuals are normal and most people are heterosexual. Heterosexism carries with it a related concept, gender roles, which states that certain traits and behaviors are more suited to certain sexes (here used in the biological sense as male and female) and that those people who take on the traits assigned to the other sex (manly females and womanly males) are abnormal or, at the very least, unattractive.

I do hope that the reader can see why some struggles against gender inequality can benefit men, children and non-heterosexual populations.

Confusion

Certain political philosophies such as those of Jacques Derrida point out that binaries such as masculine and feminine for example, create meanings. To simplify a sophisticated linguistic theory and its political ramifications, “deconstructing” to Derrideans involves pointing out how meaning is created by binary oppositions and then showing that social customs usually privilege one term of the binary. Hence one could argue that feminine/masculine is a binary and “masculine” is the privileged term in the binary. One can see why some feminist have a liking for Derrida. We could also see why “non-binary” might be nonsensical to some Derrideans but an interesting contestation to feminists when applied to man or woman.

As a women’s studies scholar you can imagine my chagrin when “gender” has now been interchanged for “sex.” It is also difficult for me when “non-binary” is reduced to a type of gender identity.

Unlike most university educated progressive young people, I, who actually taught students regarding gender, feminist theories, political theories and SOGIE, am as confused as the general public about these issues.

And, in an attempt to clarify my confusion and help the women’s movement and the LGBTQ plus movement, I have for the past 10 years tried to clarify my confusion.

Theories for activists

Among my many labels is that of  a public intellectual. It is not a matter of self-aggrandizement, it is a matter of accepting responsibility. As a professor of the national university, the University of the Philippines, it is my job to bridge my scholarship with the needs and concerns of the nation and particularly its most vulnerable sectors.

Thus when a social movement brings me terms and categories, I try really hard to understand what brought these about, what theoretical frames can strengthen its communicability and effectivity and, most especially for a poor nation, what applies to my society.

To be honest, I cannot find theoretical coherence in one strain of the current ideology espoused by some organizations of trans people and their LGB plus allies. The incoherence would not bother me except that I have always tried (and often succeeded) to make social movements and their ideologies more graspable to the general public. I am also beginning to see that the policy implications of this particular ideological strain has caused tensions between the trans movement and the women’s movement. Solidarity between social movements and particularly the LGBTQ and women’s movement has been one of the tropes of my academic and activist life.

Gender affirmation

Note that I am not criticizing trans people in general, nor am I trying to deny their existence, and genuine oppression I am not against trans peoples’ right to non-discrimination. I am critical of one form of ideology that has emerged very strongly from the West in the last decade or so. It is called “gender affirmation” theory.

In brief and again simplistically, gender affirmation accepts the feminist insight that gender is a social construction. The difficulty with gender affirmation ideology is the question as to how we come to label ourselves men or women.

I will take a randomly chosen definition from the University of Sydney, “Gender affirmation is the process an individual goes through when they to begin to live as their authentic gender, rather than that presumed at birth. This process can include all or any combination of social, medical and legal affirmation.”

As we can see, “authentic gender” is a far cry from “gender is a social construction”. The incoherence is clear here because many activists who espouse gender affirmation believe gender is a social construction which is why one can merely change one’s “gender” by repudiating the one assigned at birth for something else. Under this logic, one cannot have an “authentic” gender.

Furthermore,  there is a  wide gap between my definition of gender and the same website’s definition: “ Gender is part of a person’s personal and social identity. It refers to the way a person feels, presents and is recognised within the community. A person’s gender may be reflected in outward social markers, including their name, outward appearance, mannerisms and dress.” As I have said, it is difficult for me  to accept terms that reduce useful political and collective concepts to individual characteristics. It’s a bit like reducing political liberalism, the ideology that underpins such values as human rights, democracy and the rule of law to “that person is a liberal.” Forgive me for being uneasy over these definitions.

Gender critical

One term for those of us who disagree with gender affirmation theory is “gender critical.” Among the many differences I hold with those who, like me, are critical of  gender affirmation,  is that I am not gender critical as long as my definition of gender is used.

But let me go on about my critique of gender affirmation. As the definition of the University of Sydney states, such theories believe that there is an “authentic gender,” such that a transperson somehow just has a sense of whether they are a man or a woman. Where such an innate sense should come from differs in the literature. There is apparently an assumption that gender identity is innate or inborn. In some of the literature trans people have a gendered soul.

Being an agnostic, I cannot buy into the idea that a political movement or theory I could support starts with the idea of a soul. Again, I respect all religions and some religious movements such as liberation theology are movements I respect.  But I cannot see religion-based theories as inclusive.

As for having an innate sense of gender as a neuro-psychological matter, the debate about how people become gendered is a never-ending and ongoing one in psychology, and one that remains unresolved.

My position

I have my own position on these issues.  My first premise is that human biology exists. For most mammals including homo sapiens, male and female are important material categories. They are not merely “assigned at birth” but are observable. It is, how we interpret biological materiality that determines “gender” and these can include chromosomal and other deviations that make some bodies diverge from what is, to a large extent, the binary of male and female. In other words, I am not ready to leave my Marxist inclinations and deny the materiality of the body. I have not struggled so long for an embodied politics that includes sexual and reproductive rights such that I would say that sex and gender are the same and it’s all a social construction.

The part of gender affirmation I agree with is that people should be able to specify whether they want to live as a man or a woman regardless of what their bodies may be. I am more opposed however to the policy implications of the obfuscation between sex and gender and the misapprehension of gender as merely a personal characteristic related to the individual and individual will.

For one thing, doctors and medical researchers often need to know what sex a person has regardless of whatever meaning you attach to your body. It is crucial to correct diagnosis, treatment and good outcomes.

However I can conceive that when gender oppression ends, it will also mean that categories of men and women will end too. Because whereas sex is more long-term, how we give meaning to male and female is more malleable.  Hence there is a regressive aspect to gender affirmation wherein many adults, even psychologists, are told to affirm feminine boys and masculine girls who declare they are trans. We should first assure them that it’s ok to have what society considers traits of the opposite sex,

This is not a trivial matter. For a while, in some Scandinavian countries and the UK, gender affirmation often led to the use of puberty blockers in adolescence, hormonal therapy thereafter and then, if the patient chose, surgery. As of today however, such pathways of  what is called “transitioning” have been stopped or paused in those countries which first approved those protocols, essentially a repudiation of trans affirmation ideology.
There was a time I was the only psychologist helping LGBT people in the Philippines. In the beginning, when I worked with LGBT people it was precisely to assure adolescents it was ok to be gender non-conforming, to be heterosexual or lesbian or gay or trans. In my experience, as is the case today, many pre-teens and teens who expressed wanting to be of the opposite sex would eventually say they were gay or lesbian after going through adolescence.

A few of them never gave up on their sense of being trans. Usually these were older men who I would then help to transition. These older men usually wanted to “pass” as women. Many trans people still have this kind of profile and are unlike some trans women who talk about the thrill of using bras while scratching their balls. Not that I mind that there are differences among trans people, only that current expressions of what gender affirmation means do not cohere with all trans experiences. As an activist, I abide by the principle that one’s theoretical positions should be able to accommodate as many lived experiences as possible. Celebrations of male physicality as not being relevant to the category “woman” may be contrary to how other trans women wish to negotiate their trans identities in the world.

It is certainly of concern to me that the current population of trans people in countries where we have good statistics is that these are adolescent females. This is a marked change from the older males that psychologists and psychiatrists had been helping transition for decades. Many of these adolescents  have other issues such as depression, being on the autism spectrum, and having a history of abuse. Such sudden changes in population profiles requires as to look into what social factors are causing such changes and to look at these critically, instead of merely accepting the end result as “good”. That should be the case unless we are blinded by the idea that somehow these people are suddenly finding their authentic gendered selves or souls in astounding numbers in the past 20 years or so.

Anyone who wishes to look into the medical or psychological issues involved might read the Cass report, commissioned by the UK government and the basis for the decision of the UK health service to restructure their services away from gender affirmation.

Policy implications

Other policy implications are better known and debated such as the participation of transwomen in women’s sports. Again, if biology is not to be denied, a body that goes through male puberty has a marked advantage in many sports. I will point the reader to the advocacy of Riley Gaines

who after years of working towards her goal for a national record was displaced by a trans woman who without any attempt to change her physique entered the women’s swimming category. The transwoman demolished all competition. When the female swimmers protested they were essentially told they were bigots. Riley Gaines is a political conservative and I disagree with most of her political stances but her story speaks very plainly of this unfairness and the demolition of the gains of the women’s movement in fighting for females in sports. I will point out that there is something gendered about this inequality because transmen are unlikely to threaten records in men sports.

This would also be true of rape crisis centers where I as a psychologist would contend that the claim “transwomen are women” allows for the transgression of a sacred principle that the traumatized must be made to define their safe spaces in therapy. It is also an undeniable fact that the bodies of transwomen can trigger rape survivors. To deny this and defund a shelter who refused to take in a transwoman in order to comply with gender affirmation ideology is beyond cruel. My compromise is that trans women are women and cis women (i.e. women with female bodies who identify as women) are women and we must all work for these identities to become inconsequential eventually. But recognizing that transwomen are different from cis women allows us to create safe spaces and psychological services  for cis and trans women which can be separate or mixed depending on preference, circumstance or need.

As this article is getting long, I will not elaborate on my point  that a different approach to the rights of trans people also be more fruitful in resolving other issues of women’s spaces such as bathrooms, prisons and lesbian bars.

As it is, gender affirmation ideology has caused harm to many young persons who struggled with gender identity. Those who regret having transitioned, called detransitioners, have increased as a result of the early use of puberty blockers, hormone therapy, surgeries. Only under gender affirmation ideology would these pathways be used for confused teens. Contining support and acceptance has always been my practice and I have no intention of changing. Let me be clear. I am not against making transition services available. I bewail the fact that gender affirmation ideology has allowed the misuse of such services.

I am upset however that the political correctness demanded by gender affirmation ideology has caused some writers to minimize and dismiss the misery of detransitioners. As I refuse to minimize the liberation trans people feel when they are able to transition, I will not minimize those who regret that transition as well. The minimization of the plight of detransitioners stems from the fact that their regret and recantation is a repudiation of gender affirmation. After all if one is born trans, one cannot regret transitioning.

Cancelled

I am aware that in other countries the question of gender critical feminists has become wrought. The hostility and violence against women expressing doubts about gender affirmation has caused the UN special rapporteur on violence against women to sound a note of caution not only on the policy implications of gender affirmation ideology but also the toxicity gender critical feminists and groups face.

I think that the rabidity by which those who question this ideology are canceled, derided and misrepresented as reactionaries and bigots is merely an expression that this ideology would not do well in a respectful and well-meaning debate. I am afraid to say from my own experience that this is true in the Philippines social movements as well. It is particularly sad to me because many of the issues and trends in the Philippine LGBTQ plus and women’s movements and the lives they wish to represent have nothing to do with the ongoing debates sparked by gender affirmation in the West. How often has our supposedly colonial movements nonetheless taken on the discourse of our previous colonizers to our detriment!

I am also against gender affirmation because it has caused the breakdown of solidarity between the LGBTQ movement and other social movements especially the women’s movement. In the western world it has caused a split within the LGBT movement as well.

I am hoping by writing this column that we can still perhaps have a meaningful debate and dialogue here in the Philippines. – Rappler.com

Sylvia Estrada Claudio is a doctor of medicine who also has a PhD in psychology. She is Professor Emerita of the University of the Philippines, Diliman.