Your Bad Faith Questions About Gender Identity, Answered!
A letter to the editor for the St. Louis Post-Dispatch from an anti-trans crank posed what the writer seems to have thought were tough gotcha questions. We’re answering them!
by Evan Urquhart
One very frequent, but little discussed tactic of activists campaigning against the acceptance of trans people is posing pointed questions in a tone that presented them as if they are impossible for advocates of trans rights to answer. A man named Paul Rhodes wrote in to the St. Louis Post-Dispatch today explaining he was skeptical of the trans community, and then employed this tactic, peppering the Post-Dispatch with questions he never expected any answer to. Just for fun, we thought we’d give the answers to these supposedly devastating (but really very basic) questions.
Here’s the portion of Rhodes’ letter with most of his questions (one final question was below an ad, so we’ll just quote it without screenshotting):
screenshot from the St. Louis Post-Dispatch
Clearly, the letter writer intended these as points of argument, not as actual questions. But they’re also not difficult to answer. So, without further ado, let’s get to answering!
How is gender dysphoria diagnosed?
Gender dysphoria is a listed condition in the DSM V, described as “a marked incongruence between one’s experienced/expressed gender and natal gender.”
In adults, the DSM V states that the experience of incongruence must have gone on for at least 6 months in duration, and must manifest in at least two of these six ways:
A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics)
A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics)
A strong desire for the primary and/or secondary sex characteristics of the other gender
A strong desire to be of the other gender (or some alternative gender different from one’s designated gender)
A strong desire to be treated as the other gender (or some alternative gender different from one’s designated gender)
A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s designated gender)
The criteria further state that significant distress causing impaired functioning is necessary for the diagnosis.
Is gender dysphoria simply an unwillingness to conform to gender stereotypes?
Looking at the criteria above, notice that the sixth item could have to do with conforming or refusing to conform with gender stereotypes. “A strong conviction that one has the typical feelings and reactions of the other gender” could be imagined to mean a person who resisted that sort of conformity. However, it’s not enough for a diagnosis, and none of the other items deal in gender stereotypes so on that level gender dysphoria can’t be described as “simply an unwillingness to conform to gender stereotypes.”
Moving away from official diagnoses, trans people often defy the gender stereotypes of both their birth gender and their post-transition gender, if they identify as a member of any binary gender. The trans community has advocated against imposing rigid expectations of gender conformity on anyone, and many members of the community proudly flaunt the stereotypical expectations for either gender. Being a boy-ish girl or a girl-ish boy is not the same thing as being transgender, and unlike mainstream culture, which imposes rigid binary stereotypes, trans people tend towards celebrating gender-bending styles wherever they find them.
Why, if what goes under the rubric of “gender affirming care” (the use of puberty blockers and cross-sex hormones) is efficacious in the alleviation of “gender dysphoria,” as the editorial suggests, do health boards in England, Sweden, and Finland all state that the evidence for this claim is weak at best?
Let’s start with this: There’s no such thing as a “health board” for any of the listed countries that put out such a statement, and so on the strictest, most factual level this question is asking about something that never happened.
Across the world, different countries are at different places in both the provision of gender-affirming care, and in the political backlash against trans people that is pressuring governments and health authorities to restrict transition for ideological reasons. In England, a review that found multiple issues with the provision of gender-affirming care for youth, where patients on the waitlist received no mental health support for years while they waited for a first appointment. Unsurprisingly, this review also found their approach was ineffective.
In Sweden, the rise of the far-right in recent years has coincided with attacks on the transgender community, as in the US. However, Swedish healthcare is regionally administered, and the statement being referenced was for one region, not the entire country.
In Finland, Riittakerttu Kaltiala, who holds a key administrative role in adolescent psychiatric healthcare in that country, has always opposed allowing young people access to transition. Kaltiala sometimes portrays herself as having changed her mind on gender-affirming care, but this is misleading. Gender-affirming care has never been meaningfully available to youth in Finland due to Kaltiala’s opposition, and nothing has changed recently.
For more specifics on what’s happening with gender-affirming care in Europe, read Assigned Media’s full investigation into the topic, which was published last year.
Below an ad, Rhodes posed a final question:
What is gender identity?
This question seems to be gaining in popularity among people who make opposition to transgender rights the center of their online identity. They seem to believe that if they can poke holes in the common understanding of gender identity, trans people will disappear in a poof of logic.
Gender identity is generally conceived of as an inner sense of gender a person has, which can either be the same or different from their externally-assigned sex category.
Gender identity was developed to explain why trans people exist, and as an explanation it may turn out to be partial or insufficient. For example, some trans people don’t report experiencing a deep internal sense of their true gender, but rather a feeling of bodily discomfort that is eased by transitioning. Explaining exactly why some people feel that the only way they can live comfortably or authentically is to do so as a different gender is a work in progress. However, the existence of trans people is trivially easy to establish through objective observation and such observations do not rely on any one explanatory framework.
So those are our answers, to Paul, and other skeptics. Trans people are a natural human variation. Being trans has nothing to do with adhering to or rejecting gender stereotypes. Claims that certain European countries have shifted course on gender-affirming care for youth is a misleading talking point that relies on Americans not having access to more complete information, and gender identity is a way of explaining why people are trans that isn’t necessary to observe that some people are trans, objectively.