The Medical University of South Carolina initially said it wouldn’t be affected by a law banning use of state funds for treatment “furthering the gender transition” of children under 16. Months later, it cut off that care to all trans minors.
One Saturday morning in September 2022, Terrence Steyer, the dean of the College of Medicine at the Medical University of South Carolina, placed an urgent call to a student. Just a year prior, the medical student, Thomas Agostini, had won first place at a university-sponsored event for his graduate research on transgender pediatric patients. He also had been featured in a video on MUSC’s website highlighting resources that support the LGBTQ+ community.
Now, Agostini and his once-lauded study had set off a political firestorm. Conservative activists seized on one line in particular in the study’s summary — a parenthetical noting the youngest transgender patient to visit MUSC’s pediatric endocrinology clinic was 4 years old — and inaccurately claimed that children that young were prescribed hormones as part of a gender transition. Elon Musk amplified the false claim, tweeting, “Is it really true that four-year-olds are receiving hormone treatment?” That led federal and state lawmakers to frantically ask top MUSC leaders whether the public hospital was in fact helping young children medically transition. The hospital was not; its pediatric transgender patients did not receive hormone therapy before puberty, nor does it offer surgical options to minors.
That is the thing though, we are not just tomboys and femboys. It is not on you to tell us what should and shouldn’t be nessisary. You are not us. That you believe in your heart that you are an authority is something you need to sit yourself down with and really think about because your experience does not represent the entirety of humanity here and you keep demonstrating to me that you have zero idea what it going on with people like me while trying to tell me what I am. You can’t change my position on what I am, I live it every day. When you tell me something that is conflicting directly with the experience I have and the experience of the community where I have a bunch of close friends to compare notes to it comes off as more than a little self centered. To you gender is just something you perform. It does not connect to anything deeper because for you it’s basically just clothes and affect. For you gender is superficial and that is part of the experience of being cis so that really doesn’t help. The majority of cisness could probably be best described as not as a strong conception of gender that aligns with your body but an absence of strong feelings about gender at all.
If I change my clothes people still treat me as my birth sex. Even the ones who are trying their damnedest to do right by me their brain is still coding me as the other sex and that is disappointing at a basic level. Being trans is not just about dress up. Gender is NOT just something we perform for your benefit. It is also not fully about pain. We do routinely have to tell cis people about our pain to try and break past the inertia to get people to help us we routinely have to prove to you that we are suffering an untolerable level of permanent unhappiness because otherwise you just prioritize your baseline of not having to do even a little mental work on our behalf. It’s easier for you to rebel against having to take on that cognitive load rarely when you meet one of us than it is to accept someone needs this.
But talking about pain doesn’t cover the joy when we actually get to catch glimpses of ourselves in the mirror because we get to see some glimmer of us in there. It doesn’t cover the deep connection we feel immediately with other human beings who react to us as though our gender is a given. It doesn’t account for the fact that so many of us literally dream we are not in the body we were born in so we wake up in the morning wanting something that feels so good and natural when we are asleep. A thing about transition is that so often trans people only find their very first actually fulfilling romantic relationships once they are on the other side of their transition. You can’t really love someone deeply when you don’t like the person you are and your partner doesn’t actually recognize what you want and need. It isn’t about reducing pain, it’s about being happy in a way that resonates with who we are.
And we understand gender expression. Ho boy do we. There are a lot of binary trans people who wish they didn’t have to conform to societies binary customs but if they don’t then people code them as their birth sex and treat them like their birth sex. There are plenty of trans femmes who desperately envy tomboys for their ability to wear comfortable clothes and still be recognized as their gender.
What makes a trans person feel trapped inside themselves and invisible to other people is the lack of recognition they are their gender. Not just that their body looks like it though we do have strong feelings about our bodies for the sake of them as well. Dysphoria and euphoria, the two halves of the experience of transness, are very good at telling you exactly what the heart wants. It screams it at you even when it doesn’t make a lot of sense. Longing is a killer. Because of my circumstances I basically just altered my clothes and style and it sucks. Every time I pass a reflective window or speak and hear the timbre of my voice it makes me lose confidence. I used to pass so effortlessly when I was a kid so I get that sense of loss of something that made me so happy that I just won’t experience again. Strangers still automatically gender me incorrectly about 90% of the time which makes me feel like I am a fucking human in a chimpanzee body trying to prove to them I’m human and everytime they treat me like a chimp I just don’t want to be around people just that little bit more.
Identify exists in two parts your conception of yourself and other’s conception of you. It’s basic Heigel. Transness is mostly dealing with the disconnect of these two halves of identity. The constant is our own identity. Gender is a primary key to how we conceptualize ourselves. From everything you have said I can tell that gender is not a component of how you conceptualize yourself… but that’s just comfort because of absence. If you are completely ambivalent about something you aren’t the best spokesperson for people who cannot live without that thing. Trans people work hard to express gender because if nobody recognizes that in us they do not see us and if we are not seen we are not understood and if no one understands us we are the truly alone.