Transgender issues and scientific evidence
Much of the 2020s conversation about gender identity and the medicalised processes associated with more trans folks gender journey stems from the desire for hard scientific evidence on both sides. Be this the medicalisation of trans youth, the percentage of detransitioners, the number of trans women in women’s prisons, those who oppose and support trans identities reach for statistics and biology to attempt to answer criticism. However, what is rarely considered is the very basis upon which those conversations happen in the first place. Why is it that we demand evidence from trans people, and what does it even mean when that evidence is presented in the first place?
Germany, 1851. Karl Ulrich made is first public appeal to reason and science in attempting to get the Prussian legal code changed so that gay men were no longer prosecuted by the State. Ulrich’s scientific method included trans identities under what would emerge as the homosexual discourse over the next eighty years until the Nazis destroyed the Institute for Sexology in 1933. Over that period biologists, doctors, psychiatrists, psychoanalysts, and sexologists, mostly white, male, and Christian, debated the inner workings of the mind and body, attempting to square away homosexual desires with the heteronormative society they lived in. Despite strong evidence suggesting that same sex desire and gender dissonance were a natural part of the human experience, Germany (and the wider world) refused to decriminalise homosexuality amongst men.
This refusal to liberalise the sex laws in Germany led directly to the Nazis rounding up thousands of gay men, lesbians, and trans folk between 1933 and 1945 and sending them to the death camps. The queer holocaust did not end in 1945, for the allies allowed West Germany to keep gay inmates locked up for perceived sexual offences, and it was only in the 1960s was this remedied. The evidence against these men was the societal prejudices against their desires and attraction, not based on any hard scientific verifiable evidence. Indeed, it was only in the early 1960s that the American psychiatric association removed homosexuality from its list of mental illnesses.
A rush to evidence, especially when it is trying to refute or reinforce a societal norm such as men are men and women are women based on biology alone, is always going to cast studies and research in what ever light you wish it to. Transgender issues in 2023 are comparable to the situation in 1920s German, with a liberalisation of societal norms not reflecting the legal or legislative approach. Biology will only ever get you so far, indeed as a science it has been weaponised against women, jews, ethnic minorities, Romanies, indeed any group that threatens those in power. Women throughout most of the enlightenment and industrial societies have been stepped upon by junk science, saying that they are too weak, too feeble minded, too nurturing to actually be in work, able to vote, resist their husband’s sexual advances. Science in the wrong hands and used for the wrong causes is just as deadly as pseudo-science.
Which is also why it is critical that trans folk understand this as well. Ever since scientists began to unlock the endocrine system, manufacture synthetic prosthetics, and ensure safe and reliable surgery, those wishing to medicalise their gender dysphoria have been served up quackery and junk science at every turn because being trans was historically taboo. Some of that junk science still percolates through trans communities precisely because we do not teach trans identities in schools. Indeed, much of the fear and resentment of trans folk can be traced back to both the lack of wider societal awareness and the prevalence of this historic junk science when these conversations are discussed.
Junk science runs the gamut of psychiatry, biology, psychotherapy, and early trans medicine. Jan Morris and April Ashley both had their surgery in Morocco, though only found out about the surgeon on the grapevine because he was relatively unknown outside a small circle in the 1950s and 1960s. To this day there is no clear yardstick to measure post-operative surgical outcomes for global gender confirmation surgery, just patient anecdotes and whispered conversation in forms and chat rooms. Finding a surgeon who will not butcher you, give you a health sex life (should you wish), and who provides great post-operative aftercare is like sifting sand in the Sahara. If you know the right post-operative trans person then they can be your key; otherwise, stick your finger in the air. None of this is scientific precisely because being trans, especially medicalised trans, is still a taboo subject.
All of this is doubly so when trans children are discussed. Any study or report is immediately weaponised both sides of the conversation, with the rates of regret and detransitioning especially being used to score points and people screaming over child welfare. That the same medication is given to cis children without comment never enters in the main discourse. Science is relegated to the sidelines, used to justify whatever sociology position the wielder holds. All medicine has a risk of harm, with no treatment being 100% safe, yet no-one is advocating we legislate to ban cosmetic surgery or hip replacements despite the regret rate and failure rate being in the double digits.
Evidence is never enough to win an argument, emotions always come into place. Societal understanding of any issue is based on education, personal experience, the community you live in, the media you consume, family, work place, and a myriad of other external factors that make evidence just one part of that. Not one of us relies solely on objectivity when we reach a conclusion, we draw on this background information before we plant our flag on a particular hill. This decision making process is where those who are opposed to trans rights, or who assert biological normativity, have attempted to harness. Why use evidence when emotion and historic narratives connect on a deeper level?
None of this is to say that scientific evidence is not required, nor is it to say that the evidence should not be used to back up the clear need to assert trans rights and create trans normativity. Yet, those who advocate for trans normativity need to also critically engage with the evidence at hand, question the historic assumptions underpinning the science, and ask what precisely is the science actually trying to tell us. Much of the current psychiatric assumptions are based on Ulrich’s attempts to overcome Prussian law, namely that being trans is disordered (albeit due to societal pressures on trans folks in the DSM 5 and ISD 11), and that gender identity incongruence’s wellspring is scientifically from homosexuality. Trans advocates cannot use evidence blindly, we need to interrogate and critically engage with the evidence to present a narrative that will overcome the strident objections to our very identities.
There is no use in simply waving a scientific paper at a doubter, especially when those who object to trans identities weaponise emotions, history, and biological essentialism. A woman was chattel until she was not. A Jew was labelled a wandered until they were not. Africans scientifically proven to be evolutionary lesser, until we junked the science. All required a critiquing and junking of dangerous scientific dead ends, and if we want normative trans legislation that ensures that trans folks can thrive and lead their best lives we need to set aside the junk science, the wretched media discourse, and create a new narrative based on both rigorous scientific analysis and reframing the societal narrative surrounding non-cisgender identities.
