A big reason why
there aren’t many resources for dysphoric people aside from transition
is how health care providers and trans activists have created the
treatment framework for dysphoria. They’ve chosen to privilege hormones
and surgery as the standard treatment above all else. This certainly
wasn’t inevitable. When clinics were setting up their procedures for
treating dysphoric people they could have chosen to provide more
treatments. Trans activists could’ve fought for a greater range of
treatments. There could’ve been greater support in trans subcultures for
finding ways to treat dysphoria that didn’t involve changing your body.
Both groups could’ve put the time, energy and money into making sure
transition was one option among many. They could have pushed for
research looking for other ways to relieve dysphoria. . And they
could’ve made sure there were exit plans and strategies in case
transitioning didn’t work out. But that’s not what they did.
Instead treatment for dysphoria is largely framed as treatment for trans and genderqueer people. Being dysphoric is equated with being trans. It’s assumed that if dysphoria is severe enough, the most viable treatment is transition and it’s assumed that once someone transitions they’re going to stay on that course.
The doctors, therapists and other health care providers are partially motivated by money. They are, after all, selling people goods and services. Therapists could still make some money providing counseling to dysphoric people who don’t transition or detransition but surgeons and those who provide hormones are only going to make money and stay in business if people decide to change their bodies. They have an financial incentive to convince as many people to transition as possible. If this is their specialty than their career depends on it.
Some of these people are purely in it for the money but others do really care about the people they’re treating and like to think of themselves as helping people. Once they get into providing these treatments, they also have an incentive to keep believing that what they’re doing is good and less incentive to question if the goods and service they’re providing are actually necessary or helpful or if they could in fact be doing harm.
I don’t think it was ever especially likely that mainstream health care providers were going to provide alternative treatments since the most effective treatments for dysphoria I’ve found involve working through trauma and other patriarchal damage. The medical establishment is largely conservative, still dominated by straight white men and historically has been more interested in controlling and making money off of female bodies rather than actually working for our health and well-being. It tends to treat bodies in ways that reinforce rather than challenge the dominant power structure.
And trauma is something our society is loath to touch or look at in general. If you look at the history of how our culture has “discovered” and dealt with trauma, you’ll see how some survivors and/or experts start speaking out and talking about living through heavy shit and what it does to people and inevitably there’s social backlash and denial. A lot of people, and especially people in power, don’t want to admit or believe that trauma is real because they don’t want to see how violent and oppressive this society is. It’s happened when people have tried to talk about rape, child sexual abuse and veterans suffering from PTSD. I’d say it’s happening now with detransitioned women talking about how trauma led us to transition and how transition itself was damaging.
Trans activists have also chosen to focus on transitioning as the main treatment for dysphoria. Now a lot of them will give lip service to how you don’t have to transition to really be trans and different things work for different people, yadda, yadda, but really, from what I’ve seen as someone who spent a long time in the trans community, transition and transitioned people hold a very privileged place. You get status by changing your body. It’s generally accepted that if you change your body, that means your dysphoria was more serious than someone who doesn’t transition and that often comes to mean you’re more trans than them. You have a special kind of suffering that could only be relieved by this extreme measure so you deserve more care and attention. Your suffering and well-being matter a whole lot in ways other people’s don’t, can’t compare to.
A whole lot of trans activism and rhetoric is reactionary, it’s on the defensive. I remember reading a lot of political writing by trans people in books and on blogs and, aside from describing what it felt like to be trans, be dysphoric, transition and so forth, a whole lot of that writing was about defending trans understandings of identity and defending transition as an effective and healthy treatment. A lot of trans activism is about getting access to transition and pushing this particular belief system. It’s not about about trying to understand all possible explanations for how someone could become dysphoric or come to have a trans identity, or find all possible ways of treating dysphoria. It’s about promoting this one particular explanation of trans identity/dysphoria and treatment over all others and then debunking and criticizing the other explanations and approaches.
This makes sense when you’re inside of it. After all, a lot of people are threatened and weirded out by trans people and you get treated shitty when you’re trans. The community encourages you to lump all opposition and criticism together so that people who treat you bad because they think you’re an abomination against god are lumped in with people who question whether you could be transitioning due to social forces. Anything that goes against the community’s understanding of itself comes to be seen as an attack to be deflected. And interestingly enough, more time was spent going after people who say we transitioned due to rigid sex roles than those who think we’re going to hell and breaking god’s law even though there are way more transphobic christians than there are radical feminists, social scientists and queer theorists who critique transition and transsexualism. (Younger folks might not realize there used to be queer theorists who criticized transsexualism as reinforcing heteronormativity but indeed there were. There used to be a whole lot of tension and conflict between queer theorists and trans activists but that’s another story)
I think that’s because a lot of those critiques strike closer to home. Trans ideology doesn’t want to acknowledge how we’ve all been shaped by the society we live in and the people we interact with. Its adherents want to believe that their dysphoria and trans identities come from inside of them, that they’re innate, biological or, coming from a more genderfuck persuasion, freely chosen. And I think a lot of why this belief gets so adamant is because the social influences aren’t just sexist media images and being forced to wear uncomfortable clothes because of the shape of your body but because we’ve been abused and deeply hurt, often by people we trusted. It isn’t just about denying that we’ve been molded by our culture, it’s about denying some really fucked up shit happened to us. Because it is so much easier to believe that we’ve always been this way, we have some innate condition or we’re choosing this than to admit that people and society hurt us so bad it changed us on a really deep level. Hurt us so bad we can’t stand to be present in our bodies.
And looking for why someone could be dysphoric other than an innate condition is going to turn up this trauma and other damage from living in a patriarchal society. If other treatments are sought aside from transition, more people are going to trace back their dysphoria to fucked up shit happening to them, either what people have done to them and/or how this society has limited and hurt them. All this shit is out there waiting to be found, some of us have already found it and are healing from it.
But with few exceptions we’re not being sought out to help provide resources for other dysphoric people. Apparently it’s too threatening to admit that at least some dyshporic people aren’t helped and could be harmed by transitioning. There are a few sympathetic health care providers that I know of and some trans people react to us with compassion and support. But a whole lot of them want to write us off and minimize us. Reading some trans people’s reactions to us, I get the sense that it’s fine with them that our well-being and bodies got sacrificed for the greater good of providing transition to as many people as possible. We’re an insignificant number of exceptional cases. Whatever we suffer doesn’t matter as much as what people who supposedly need to transition suffer because again transitioning is valued over all else. It is so supremely good that a lot of its proponents can’t even seem to imagine that we could actually be damaged from having done it, that it could have made our lives significantly more difficult. That it could give us new problems we’re probably going to have to deal with for the rest of our lives. Underneath it all, they’re scared they’re not that different from us and could end up in the same situation. If they were really convinced we were different I don’t think they’d need to be so dismissive of our pain and experiences.
A lot of trans activists and their supporters have chosen not to listen to us or acknowledge us. It’s pretty clear when you read most articles by trans people about detransition or “regret” that they set out from the beginning to prove that it rarely happens and doesn’t matter and so shouldn’t be used to to question transition as a viable treatment. I’ve never read an article by a trans activist about detransition that mentioned trauma or patriarchy as a reason for why someone would initially transition but they will always list the difficulty of transitioning in a transphobic society as a reason why some people detransition. Their articles about detransition are basically more propaganda defending access to transition. We’re not even people to them, we’re statistics to be explained away.
I see this dismissal of detransitioned people as intimately linked with
a refusal to explore other ways to treat dysphoria. For whatever
reason, a lot of trans people are really invested in transition being
the way to treat dysphoria and they are reinforcing this idea whenever
they have the chance. And those with more power in the community make it
difficult to question this or look at this issue in different ways.
Like I said, a lot of trans culture and discourse is about defending and
promoting specific explanations that justify this one treatment. And
the ways detransitioned and reconciling women have found to treat
dysphoria defies these explanations and calls the need to transition
into question. The problem then is that large sectors of the trans
community care more about defending trans ideology and having access to
hormones and surgery than it does with helping people find the best way
to overcome their suffering.