February marked LGBTQIA+ History Month; a designated period to mark the progress made by our community. Each year the themes serve as an introspective reminder of what we can learn from the past and take forward in the present. This year, the theme was to recognise the queer contributions made in the field of medicine. While February is long over, the continuing politicisation of trans healthcare remains and we want to talk about it.
The trans and non-binary community’s relationship with the medical field and recognition within queer history is a complicated one. Often many of us are not taught about the pioneers that have contributed to the field of medicine and LGBTQIA+ healthcare like Sophia Jex-Blake, Harry Benjamin, and Magnus Hirschfeld – notable names we should all know about.
Instead, we see conversations on the lives of trans, non-binary and gender-diverse people take place without the community involved. We read sensationalised headlines honing in on the subject of trans healthcare and medicine, often defining them by that very subject. Aspects of trans identity tend to be negatively broached through the lens of medicine, whether this is discussing puberty blockers or gender-affirming surgery. However, many trans, non-binary and gender-diverse folk may choose to not opt for the medical route, while some will. Whatever choice is made by the individual, remains valid. Yet, the ongoing conversations towards the community, largely, remain tied to medicine.
So, Trans Day of Visibility, as the topic of medicine remains relevant, we asked five trans and non-binary folk to share their thoughts on the trans community’s relationship with medicine. Transitional author Munroe Bergdorf explores the importance of reiterating that trans and non-binary people are more than their identities. She also calls for combatting harmful and hateful media coverage with positive community stories. Meanwhile, Not A Phase charity founder and CEO Danielle St. James speaks to the complexities of the trans and non-binary experience, noting that you don’t have to medically transition to be part of the community.
Academic and writer Kim Heyam challenges the scaremongering used in relation to trans bodies using history and explores the conditions in which trans liberation can prevail. Elsewhere, Gendered Intelligence’s Cleo Madeleine reflects on the strained relationship the trans community has with the current state of healthcare in the UK. And, lastly, musician Jocelyn Sithey shares their opinions on sourcing accurate fact-checked information on the trans+ community and what we can learn from inner LGBTQIA+ community conversations.
Munroe Bergdorf
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The theme for this LGBTQIA+ History Month was medicine. Why is it important to positively spotlight the role medicine has played in trans+ stories?
We are living through an undeniably volatile time, the future of LGBTQIA+ rights haven’t felt so uncertain for quite some time. It’s that political, cultural and systemic uncertainty, teamed with a relentless negative and ultimately harmful media cycle that is creating a weight on all of our shoulders, especially as we head into a general election year, where trans rights will undoubtedly take centre stage, as they have for a good part of the past decade. We need the sharing of positive trans stories to be as loud, if not louder than the sensationalism, hysteria and misrepresentation being spewed by politicians, pundits and people in positions of power and influence, who have a vested interest in the demonisation and exclusion of our community.
Trans people, especially young trans people deserve to see positive examples of what is possible for them. That their hopes, talents and interests are worth investing in, a reminder we are more than just our transness, that our humanity runs deeper and is far more expansive, complex, exciting and precious than the moral panic being thrown in around the House of Commons.
What lessons can we learn, from trans+ people throughout history, that feel relevant today?
Surveys have shown that the vast majority of trans people are happier after medically transitioning, myself included. Yet still, the focus is sharply and disproportionately pulled on the 1% who regret transitioning. The UK transgender healthcare system is overwhelmed, under-resourced, outdated and oversubscribed.
People are dying whilst waiting for help, on a waitlist that currently exceeds a timespan of half a decade, just for a first appointment. We need the attention to be on that, not on a super minority of a minority who regret making a personal medical decision, that for thousands of others is lifesaving and joyous.
Danielle St. James – Not A Phase
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The theme for this LGBTQIA+ History Month was medicine. Why is it important that we positively spotlight the role medicine has played in trans+ stories?
I think that having medicine as this year’s theme has been really interesting, primarily for its prompt of resource-sharing from organisations of all different sizes. Trans people’s medical experiences in this country vary so greatly and this is overarchingly because of the system’s gatekeepers and the luck that the community members may or may not have in breaking through. Whilst it’s completely valid that you don’t have to medically transition to be trans, medicine and those that dispense it are a daily experience for trans people, so it’s great that this month we have been able to focus on that.
What lessons can we learn, from trans+ people throughout history, that feel relevant today?
That living authentically, out loud, can save the lives of others. Had it not been for the trans people I saw in my teen years that gave me hope of living a life of truth, I would have remained lost and confused.
Kit Heyam
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The theme for this LGBTQIA+ History Month was medicine. Why is it important that we positively spotlight the role medicine has played in trans+ stories?
Narratives around trans people and medicine can so quickly become toxic. Present-day discourse is characterised by gatekeeping (particularly for young trans people), excessive and dehumanising focus on the intimate details of trans bodies, and scaremongering talk of mutilation and regret, while the history of trans medicine is where we get our restrictive and harmful standards of what counts as a ‘real’ trans person today.
In this context, I think it’s incredibly important to talk about the joy that can and has come from trans people being able to access the medical care we want and need, on our terms, and especially the pioneering trans people who fought to open up that care to groups who’d previously been denied it. Trans medicine is not mutilation, it’s not a heartbreaking denial of fertility, and it’s not even always a sombre decision taken to relieve urgent distress. It’s an expression of bodily autonomy, a triumph of informed consent, and something we can lean into joyfully.
What lessons can we learn, from trans+ people throughout history, that feel relevant today?
I think perhaps the most important lesson we can learn from the history of trans medicine – more important even than the fact that the relief of dysphoria and the option to exercise bodily autonomy can transform everyone’s lives (not just those of trans people) for the better – is that stringent, narrow diagnostic standards of ‘true’ or ‘real’ transness do so much more harm than good.
In the mid-twentieth century, gender identity clinicians were (as the historian Beans Velocci has shown us) almost obsessed with the idea that people would come to regret transitioning and would sue their clinicians, or even react with violence – so they responded by only allowing people to transition if they could conform to a narrow set of white, heterosexual, stereotypical gender norms.
Since then, trans people have had to fight at every turn to relax those standards – not just because they’ve prevented many people from being able to access the healthcare they need, but because they’ve created a mindset where no one is allowed to experiment, change their mind or be unsure about their gender (and, as I’ve written about elsewhere, because they limit our perspective on what counts as ‘real’ trans history, too).
Trans liberation will only come when we have the same access to informed consent in healthcare as every other group – and that includes the freedom to change our minds without fear or penalty.
Cleo Madeleine – Gendered Intelligence
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The theme for this LGBTQIA+ History Month was medicine. Why is it important to positively spotlight medicine’s role in trans+ stories?
Medicine, and healthcare in general, are huge topics for the trans community right now, both because waiting times are so high for specialist gender identity services, and for people to get access to medical transition for whom that’s the right pathway. There’s been a real collapse of trust between the trans community and the health service. [The issue] is not helped by the hostility towards trans people that comes from some areas of the media [and] from the government. [This leads] to things like trans people not getting cervical screenings, and trans people not seeking necessary trips to the hospital or their GP when they need them.
I’d love to see us get away from these conversations that reduce trans people to whether or not you can get access to medical transition, whether or not you can get access to puberty delaying treatments, or hormone therapy or surgeries, and look at the wider angle of trans experience of which medicine is an important part, but a very small part.
What lessons can we learn, from trans+ people throughout history, that feel relevant today?
Speaking to the medical context, one of the lessons we’ve learned the hard way is that we need to listen to trans people when it comes to issues of healthcare. Of course, you also need to listen to doctors and healthcare professionals, but it’s hard not to look at the fact that we, at one point, had a near-world-class system of gender identity services. A series of failures around funding supporting that, and a growing political stigma against trans people, is what has brought us to the failure of service delivery today and that [wasn’t always] going to happen as demand increased, rather it has come about be because of this pressure to exclude, to restrict to ignore the needs and the trans community.
We’ve seen it happen time and time again, elsewhere in the queer community, particularly around sexual health and reproductive justice, where the community doesn’t get heard and our health care needs get ignored. We have so many examples that we can draw on from history and there’s a lesson that needs to be learned about listening to queer communities about their healthcare needs. Unfortunately, that lesson isn’t being learned at the moment.
The lesson I have learned most from working with and within the trans community and the lesson that I hope other trans people might also learn it’s not as bad as it seems. When we talk about the conversation around medicine, it’s often carried out in a very doomy tone.
Jocelyn Sithey – Walt Disco
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The theme for this LGBTQIA+ History Month was medicine. Why do you think it’s important that we spotlight positive trans+ stories?
Because, unfortunately, so much of the news surrounding trans+ people is negative and distressing, it’s important to tell stories of trans+ joy. The trans+ community need it but I think the wider community need to hear it too, especially those that hate us. I want them to see us be happy so they know that they aren’t winning.
What lessons can we learn, from trans+ people throughout history, that feel relevant today?
Believing in medicine and science is so important. Believing in the advancement of medicine and technology is vital. Too often you will be on the wrong side of history if you blindly challenge it, especially if your arguments are based on Facebook conspiracy theories. A huge modern example of this is those that oppose the COVID-19 vaccines. These people aren’t going to be remembered fondly and a huge majority of these ill-informed people are likely to be the same folk that oppose transgender healthcare. I don’t think this is a coincidence, their sources are false and their arguments are baseless and full of hate.
Take Magnus Hirschfeld for example, a gay Jewish physician that was banished from Nazi Germany for his advancement in sexology and transgender healthcare. His ideas weren’t popular in his time but we look back on him as a visionary and a hero, but why just look back on people like this? Back them now while they’re alive so we can see and feel the differences they can make.
