Transgender Issues

The idea of transgender identity is less perceived as a mental illness but as a sexual health condition in many parts of the Western world, while it is seen as an anomaly in most parts of Africa. Transgender identity is a gender expression that differs from the naturally assigned sex. The widely accepted reason behind transgender is unsatisfactory feelings toward assigned sex by the individual. This work sets out to explore transgender identity and family life in Africa. Several works have (...) explored the concept but with less emphasis on family life as it relates to the African setting. Furthermore, this work sets out to demonstrate some implications of transgender identity in an ideal African family. In this work, we shall argue that once transgender identity is normalized in Africa, it will be a threat to family life. The arguments to be used are historical, analytical, descriptive as well as evaluative. (shrink)

Beauvoir’s The Second Sex stands out as a master class in the accommodation of conceptual and inferential practices to real, objective gender kinds. Or so I will argue. To establish this framing, we will first need in hand the kind of scientific epistemology that correctly reconciles epistemic progress and error, particularly as pertains to the unruly social sciences. An important goal of the paper is to develop that epistemological framework and unlock its ontological implications for the domain of gender. As (...) we will see, the real gender kinds that contemporary social scientists successfully identify and track are very much the same kinds to which Beauvoir was coordinating reference in The Second Sex. The correct identification of those kinds endures as a moral and political priority, regardless of one’s other gender-related normative agenda. (shrink)

There is an emerging consensus within Natural Law that explains transgender identity as an “embodied misunderstanding.” The basic line of argument is that our sexual identity as male or female refers to our possible reproductive roles of begetting or conceiving. Since these two possibilities are determined early on by the presence or absence of a Y chromosome, our sexual identity cannot be changed or reassigned. I develop an argument from analogy, comparing gender and language, to show that this consensus is (...) premature. Language and gender imbue our body with further social meaning and so, I conclude, that just as we can learn multiple languages, so too can we learn multiple genders. Since language and gender each constitutively contribute to our wellbeing as a “second nature,” I argue against this consensus to show that the reason people who are transgender struggle to flourish is not because of a “troubled trans psyche,” but because there are conceptual, interpersonal, and institutional obstacles stacked against them. (shrink)

For individuals pursuing medically assisted gender transition, gender-affirming surgical treatments, such as oophorectomy (removal of the ovaries) and orchiectomy (removal of the testicles), cause sterility, and gender-affirming hormone treatment with medications (i.e., testosterone and estrogen) may negatively impact infertility. The major United States (US) medical associations already endorse fertility preservation (FP) through cryopreservation (i.e., “freezing” egg and sperm) for transgender individuals. Despite these endorsements from the relevant medical societies, medical insurance coverage for FP remains very limited in the US. Given (...) the high out-of-pocket costs for FP services, fertility preservation remains financially out of reach for many transgender individuals who may desire it. We present an ethical justification for universal FP coverage for all transgender and gender diverse (TGD) individuals who request this option during medically assisted gender transition. First, we argue that gender-affirming medical care is analogous to other medical interventions and treatment regimens that compromise fertility, such as cancer care, and that both types of interventions need to be afforded the same medical benefits and assistance in pursuing fertility goals. Second, we argue that the lack of FP for transgender individuals contributes to the ongoing and profound transphobia and anti-trans bias that has been exacerbated in the past several years across the healthcare landscape in the United States. We argue that the provision of FP coverage for transgender individuals is necessary for clinicians and third-party payers to state their unequivocal support for TGD patients and their healthcare needs. (shrink)

There are two aims of this paper: (1) to explore the affective dimensions of moral shock and how it relates to normative marginalization of those furthest from dominant society, but also, more specifically; (2) to articulate the trans experience of constantly being under moral attack because the dominant “world” normatively defines you out of existence. Toward these ends, I build on Katie Stockdale’s recent work on moral shock, arguing that moral shock needs to be contextualized to “worlds” of sense to (...) understand how marginalized people affectively experience shocking events. My focus is the trans experience of moral shock due to the way trans people are positioned outside of dominant society, creating the conditions to experience cyclical, chronic shock. These affective conditions point to a collective responsibility to ease the affective stress that the most marginalized experience. (shrink)

Requests for assisted reproduction by transgender persons appear to be increasing. This chapter outlines relevant ethical considerations (autonomy, reproductive rights, child welfare, and non-discrimination) and provides guidance to clinicians regarding requests for medically assisted reproduction and fertility preservation for transgender persons. Those who advocate for inclusive access to fertility services note that transgender persons often express the desire to have children and should be afforded the human right of an opportunity to procreate. Cryopreservation of gametes or embryos is a viable (...) option for assisted reproduction in transgender patients, however, knowledge about both the impact of long-term hormone therapy on gametogenesis and the recovery of reproductive function after stopping pubertal blockers and cross-hormone therapy is limited. Professional autonomy in deciding whom to treat is also limited by an obligation to consider all patients equally regardless of gender identity (non-discrimination). Those who oppose access to ART by transgender people do so out of concern for well-being of future children (beneficence/non-maleficence), though this concern is not supported by research results (Freedman, Clin Child Psychol Psychiatry 7:42, 2002; White and Ettner, J Gay Lesbian Psychother 8:129–145, 2008; Green, Int J Transgenderism 2:4, 1998). There is no ethical basis to deny transgender people access to assisted reproduction. Resources should continue to be allocated towards creating culturally sensitive educational materials, training providers to provide competent care for transgender patients and continuing to research fertility preservation and long-term outcomes of hormone therapy. (shrink)

This thesis is an attempt to provide an account of gender. In particular, it is an attempt to develop an ameliorative approach to gender that satisfies a number of transfeminist political goals. That is, following Sally Haslanger, I ask what do we want gender to be? In order to answer the question, I develop a novel Neurathian methodology for conceptual engineering, and a distinctively ‘activist’ take on that project. From there I criticise a number of theories of gender and suggest (...) that we should instead adopt a position I call Ameliorative Semantic Pluralism. That is, a position that endorses multiple meanings for gender terms. I develop this position in conversation with those traditions that arose from the anti-essentialism debates of the 1990s – family resemblance theories, Butlerian performativity, deflationism, scepticism, and nihilism about gender. I provide novel critiques of each position but take seriously the concerns that each position had. I end the thesis by drawing on Audre Lorde to engineer one of the senses of the term ‘agender’ that speaks to my phenomenology, before using that account to critique some further recent attempts to theorise nonbinary gender identities. (shrink)

One of the most pressing and debated issues in contemporary sport is the inclusion of transgender athletes in competition. This is especially the case of transgender women who seek to compete in th...

Objective: Our report describes a case of nonpuerperal induced lactation in a transgender woman. Methods: We present the relevant clinical and laboratory findings, along with a review of the relevant literature. Results: A 30-year-old transgender woman who had been receiving feminizing hormone therapy for the past 6 years presented to our clinic with the goal of being able to breastfeed her adopted infant. After implementing a regimen of domperidone, estradiol, progesterone, and breast pumping, she was able to achieve sufficient breast (...) milk volume to be the sole source of nourishment for her child for 6 weeks. This case illustrates that, in some circumstances, modest but functional lactation can be induced in transgender women. (shrink)

Transgender and gender diverse individuals may seek gender-affirming medical care, such as hormone therapy or surgery, to produce primary and/or secondary sex characteristics that are more congruent with their gender. Gender-affirming medical care for transmasculine individuals can include testosterone therapy, which suppresses circulating estrogen and can lead to changes in the vaginal epithelium that are reminiscent of the post-menopausal period in cisgender females. Among transfeminine individuals, gender-affirming medical care can include vaginoplasty, which is the surgical creation of a vulva and (...) neovaginal canal, commonly using penile and scrotal skin. The effect of gender-affirming medical care on the vagina of transmasculine individuals and on the neovagina of transfeminine individuals is poorly characterized. This review summarizes what is known of the epithelium and local microbiota of the testosterone-exposed vagina and the neovagina. We focus on potential pathogens and determinants of gynecological health and identify key knowledge gaps for future research. (shrink)

Cisgender men have increasingly come out with stories about their intimate relationships with transgender women. However, studies on relationships between cis and trans persons have argued that trans women are critical of trans-attracted cis men. This comes from the accusation that many cisgender men fetishize transgender women. Trans-fetishization is used in this study as the fetishizing of trans women by cis men who overvalue the trans women’s transness. The exploration of trans-fetishization is done in context of committed relationships between cis (...) men and trans women, and highlights the perspectives of cis men in the relationships. Through an analysis of the accounts shared by Filipino men in a voiced online interview, the author analyzes how fetishism may be explored in (1) the men’s motivations for entering a committed relationship, (2) their concept of an ideal woman, (3) the strategies they employ to maintain high-level of commitment, (4) and their compliance or resistance to hegemonic masculinity. The analysis reveals that men commit to relationships based on the reasons, sometimes overlapping, of material benefits, need for companionship, and the desire to move on from the dating phase by formalizing the relationship. Transness has not been a major factor and therefore, trans-fetishization cannot be accused in this context. Analysis also reveals that men were not attracted to their trans partners because of their transness, instead, their trans partners embody physical and non- physical traits similar to the men’s standard for an “ideal woman.” Using the investment model (Rusbult and Buunk 1993), the level of commitment of the relationships was assessed. It shows that there is a high level of commitment among the men based on satisfaction level, lack of quality alternatives, and investment of resources. Commitment in the relationships are also maintained by heteronormativity and transnormativity. Adherence to these normativities provides the author basis to assert that transness is not fetishized as an overvalued object of sexual desire. In the context of heteronormativity and cisnormativity, what may be argued as the fetish object is the adherence of the trans partners to the feminine norms. Finally, analysis shows that men, in diverse ways, comply with and resist hegemonic masculinity (Connell 1987, reformulated 2005) and thus undermines the accusation of trans-fetishization. At the most, the transness of their partners may only be negotiated against hegemonic masculinity. Future endeavors in this scope include an investigation of relationships between partners of different nationalities, as well as an exploration of non-monogamous and/or non-heterosexual cis-trans relationships. (shrink)

This essay discusses short-circuited trans care by focusing on failures of t4t as an ethos both interpersonally and within particular trans scenes. The author begins by recounting an experience working at a bar/restaurant that appealed to its identity as a caring trans community space as part of its exploitation of trans workers. This dynamic inspires the main argument, that t4t can become an ethos of scenes and institutions beyond the interpersonal while short-circuiting practices of trans care. Short-circuited trans care is (...) then traced to t4t by drawing from Hil Malatino's work on trans care and t4t, Kai Cheng Thom's work on community dynamics, and trans literature to argue that practices of t4t often include abuse, expulsion, and assumptive care. This short-circuited trans care is linked to trans scenes by discussing the ethos of t4t in the history of Topside Press and trans cultural production. The author does not condemn t4t and to this effect offers a critique of tethering trans cultural production to prestige instead of care. Rather, the goal of this essay is to openly discuss aspects of t4t and trans care that are often obscured through the projection of a highly questionable “we” or universalized “trans community.”. (shrink)

Preface: The following article is an adaptation of an open letter sent by the au- thor to the local U.S. Elementary School Administration on October 14, 2022, in response to the introduction of Transgender Literature in grades 2 and above (starting age 7) in the local US elementary school attended by the author’s children. More specifically, children have been introduced to three books: I Am Jazz, by Jessica Herthel and Jazz Jennings; Jacob’s New Dress, by Ian Hoffman and Sarah Hoffman; (...) and Born Ready. The True Story of a Boy Named Penelope, by Jodie Patterson. As part of this, children have been asked to join discussion in class to talk about the contents of each book and other related literature. Of note, several meetings with the administration and the school board have followed, but no changes have been made to the administration and content of the literature presented to children, with the exception of parents’ voluntary exclusion, per direct request, of their children from class time in which the books above and related new literature will be discussed in the future. Furthermore, these topics have also been discussed as part of a recent Lecture the author presented at the Academy of Sciences of Rome with the title “Science or Ideology?” in November 2022. (shrink)

Trans people often prioritize self-identification and self-determination when it comes to gender. We think people have a right to tell us who they are, rather than to be told who they are. But what does this really mean? And what should we do when someone self-identifies in bad faith--such as when the Club Q mass shooter (briefly) identified as nonbinary? I discuss these questions in a short blog post.

This introductory article presents some subtle and, perhaps, controversial aspects of providing care to adolescents who identify as transgender. I will describe (1) how praise from careproviders can benefit parents who have difficulty accepting the gender identity of their child that was not assigned at birth; (2) how adolescents who identify as transgender may follow the internet advice of peers on how to “con” careproviders; (3) how it may be difficult for careproviders to decide whether to further patients’ felt needs (...) and to protect them, paternalistically, from making an irreversible decision they may later regret; and (4) how careproviders can benefit adolescents by taking the initiative to discuss sex and how to say “no.” I emphasize how careproviders who see these patients, even when they have no special expertise in this area, may be able to enhance patients’ equality in every respect, even when they otherwise might not choose to do so. (shrink)

A 16-year-old adolescent who identifies as transgender wishes to consider fertility preservation prior to the use of gender-affirming hormones. The adolescent’s parents are divorced, and one parent supports fertility preservation while the other does not. This case explores the minor’s future reproductive autonomy and parental decision making in a field where there is limited evidence of known harms and benefits to the use of fertility preservation in the transgender population and about future potential regret from lack of consideration of fertility (...) preservation during the prime window of opportunity. This case is created from a composite of cases seen at multiple institutions. (shrink)

As of this writing, twenty‐one states have passed laws barring transgender youth‐athletes from competing on public‐school sports teams in accordance with their gender identity. Proponents of these regulations claim that transgender females in particular have inherent physiological advantages that threaten a “level playing field” for their cisgender competitors. Existing evidence is limited but does not support these restrictions. Gathering more robust data will require allowing transgender youth to compete (rather than preemptively barring them), but even if trans females are shown (...) to retain some advantage, this would not have greater moral significance than the many other “fair” physical and economic advantages found across sports. These regulations deprive transgender youth, an exceptionally vulnerable population, from the vast physical, mental, and social benefits of sports. While we advocate for transgender inclusion under our current, gender‐segregated model of sport, we propose changes to the overarching structure that would promote a more inclusive and fairer athletic environment. (shrink)

This paper employs a feminist model of scapegoating designed to capture the function that scapegoating plays in the justification and masking of oppression, and examines specific forms of legislation that target the rights of trans people to uncover their scapegoating patterns. Because scapegoating is experienced as a justified attribution of blame, it evades the understanding of those participating in its dynamics. My aim is to make apparent the transphobic rhetoric that convinces people of its necessity, such that we can determine (...) the best means to undermine its discriminatory consequences. I do this by examining the scapegoating logic behind bills that seek to impact various aspects of the lives of trans people, including education, sports, identification, and healthcare. (shrink)

As a still closeted and silenced trans woman, in chapter 15, Doel Rakshit (India) explains how speaking up for anymals prepared her to speak out against trans aggression. She writes of how compassion and empathy for anymals helped her to grow compassion and empathy for oppressed human beings, including compassion for self. Rakshit shares both positive and negative experiences in the anymal activist community, calling out mainstream privilege that blocks compassion and understanding. She also speaks against the narrow blinders of (...) single-issue activism (because this harms activists) and against heroization (because it protects perpetrators). (shrink)

“I am only what I make myself to be”, Fichte tells us. In this paper, I outline Fichte’s views on sex, marriage and gender, with two aims. Firstly, to elucidate an aspect of his moral theory which has received little attention, and secondly to argue that Fichte’s distinctive stance on selfhood, freedom, and normativity lead to a revisionary account of gender expression and identity, where people can freely carve out their own identity, irrespective of “nature”. In this paper, I therefore (...) outline Fichte’s own views, highlighting what I see as a tension in the texts between essentialism and antiessentialism about gender, before reconstructing a neo-Fichtean view which foregrounds the anti-essentialist aspect. (shrink)

Social media plays an important role in forming, maintaining, and reproducing norms and practices (Flanagan et. al 2008). Content shared on social media has the power to reaffirm certain norms and practices merely by being shared (Caldeira et al., 2018; Burns, 2015; Krijnen & Van Bauwel, 2015). When it comes to questions of identity and questions surrounding representation of certain identity groups in the media, social media content is often taken to play a significant role in the constitution of certain (...) identities (Haimson, 2018, 2021; Frissen et al., 2015; Eickers & Rath, 2021). This chapter specifically explores the role social media plays in trans peoples’ transitioning processes. Transitioning, as understood here, can be social – e.g., performing gender differently via clothing or behavior, using a different name or pronouns – and legal – e.g., changing one’s gender category on formal identification documents, official name changes, and medical – e.g., undergoing hormone replacement therapy or other gender-affirming medical care like gender-reassignment surgeries. Transitioning can encompass all or any combination of these aspects (Bettcher, 2009, 2017). The chapter homes in on the impact that the representation of trans people on social media has on the transitioning processes. Here, questions around bodies and their representation through and with technologies and increasing digitization emerge. One might ask, for example, whether representation on social media platforms facilitates someone’s discovery of their gender identity and/or supports their coming to terms with it. This kind of representation may also provide people before or in transitioning processes with different ways to conceive of their future self. There are numerous social media accounts of trans people documenting their transitioning processes (Horak, 2014; Gauthier & Chaudoir, 2004). Displaying one’s own gender transition online may not only be important to some trans people because they feel like it makes a difference for the community, it may also become a vital part of the transitioning process itself, influencing and shaping the way the transition is taking place (Rawson, 2014; McInroy & Craig, 2015). Indeed, the representation of trans people on social media matters to trans communities and trans individuals because, by seeing images and perceiving narratives of trans people, one might, first, conceive of the possibility of one’s existence as a trans person, including the possibility of embodying another gender, and, second, think of the possibility of representing oneself (as a trans person) too (Cavalcante, 2016; Cannon et al., 2017). Accordingly, this chapter argues that social media can be viewed as a form of corporeal technology that is involved in transitioning processes. Social media can help the individual to reconceive their identity by means of representing themselves to themselves and others online. (shrink)

In recent years, an array of critical emotion theorists have emerged who call for change with respect to how emotion theory is done, how emotions are understood, and how we do emotion. In this chapter, I draw on the work that some of these authors have produced to analyze how emotional marginalization of trans and disabled identities is experienced, considering in particular how this emotional marginalization results from the long history of pathologization of trans and disabled people. The past and (...) current pathologization of trans and disabled people is produced through normative assumptions, values, and beliefs that uphold systems of normalcy, including assumptions, values, and beliefs about how we feel and express emotions. In order to examine these issues, I identify three different stages at which emotional marginalization may take place: emotion experience, emotional display, and emotion recognition. In other words, emotional marginalization of trans and disabled people can occur at any of these stages. The central concern of my chapter is thus to show how emotional marginalization, at each of these stages, affects trans and disabled people. (shrink)

Talk of gender identity is at the core of heated current philosophical and political debates. Yet, it is unclear what it means to have one. I examine several ways of understanding this concept in light of core aims of trans writers and activists. Most importantly, the concept should make good trans people’s understanding of their own gender identities and help understand why misgendering is a serious harm and why it is permissible to require information about people’s gender identities in public (...) life. I conclude that none of the available accounts meets these essential criteria, on the assumption that the gender norms of femininity and masculinity are unjustified. But we can, and should, pursue the feminist project without “gender identity”. Such feminism can include trans people because it is possible to account for the specific harm of misgendering without assuming a claim to the recognition of our gender identities. I conclude that we should eliminate the concept of “gender identity.” To understand the phenomena that are putatively captured by “gender identity,” we are better off employing other concepts, such as “sexual dysphoria,” (assigned or aspirational) “gender roles,” and (internalised or endorsed) “gender norms”. These concepts can usefully replace “gender identity” in an individual evaluation of each of the trans people’s claims to inclusion into particular spaces. (shrink)

The social categories to which we belong—Latino, disabled, American, woman— causally influence our lives in deep and unavoidable ways. One might be pulled over by police because one is Latino, or one might receive a COVID vaccine sooner because one is American. Membership in these social categories most often falls outside of our control. This paper argues that membership in social categories constitutes a restriction on human agency, creating a situation of non-ideal agency for many human individuals. -/- However, there (...) are ways to resist the causal influence of social categories, and certain socially marginalized groups can be understood as attempting to do just this. I discuss two instances of social category resistance: gender pronouns and the rights of trans individuals. I suggest that the intentional declaration of gender pronouns (“she/her” or “they/them”) can be understood as an attempt to resist the causal powers of nonconsensual social categorization. Similarly, one among many reasons to support the rights of trans individuals is that their self-declarations of gender identity can be viewed as a reclamation of agency in the face of causal constraints imposed by socially defined and imposed gender categories. This lesson can be generalized to people belonging to a broad range of marginalized groups. (shrink)

Sex Matters addresses a cluster of related questions that arise from the conflict of interests between rights based on sex and rights based on gender identity. Some of these questions are theoretical, including: who has the more ambitious vision for women's liberation, gender-critical feminists or proponents of gender identity? How does each understand what gender is? What are the arguments for the refrain that 'trans women are women!', and do they succeed? Other questions taken up in the book are more (...) applied to specific issues in law and policy including: should there be a right to exclude people who are biologically male from women-only spaces? How do the interests of all stakeholders to bathrooms, in particular, trade off when it comes to moving from sex to gender identity as the basis for self-inclusion? If we think about types of transition, or gatekeeping requirements on transition, as providing assurance to women who are asked to accept the opening up of women-only spaces to transwomen, are any such assurances sufficient? Is 'TERF' a slur, as some radical and gender-critical feminists have claimed? And finally, is gender-critical speech 'hate speech', as it has been classified by some social media platforms, or at least harmful speech? -/- Holly Lawford-Smith discusses these issues in a series of essays, all but one of them previously unpublished. She takes an analytic philosophical approach to these issues, drawing on ideas from political philosophy, philosophy of biology, and philosophy of language, as well as second-wave feminist theory and empirical literature, to defend a gender-critical position in response to all of these questions. (shrink)

Drawing on the principle of subsidiarity, this article develops a framework for allocating medical decision-making authority in the absence of capacity to consent and argues that decisional authority in paediatric transgender healthcare should generally lie in the patient. Regardless of patients’ capacity, there is usually nobody better positioned to make medical decisions that go to the heart of a patient’s identity than the patients themselves. Under the principle of subsidiarity, decisional authority should only be held by a higher level decision-maker, (...) such as parents or judges, if lower level decision-makers are incapable of satisfactorily addressing the issue even with support and the higher level decision-maker is better positioned to satisfactorily address the issue than all lower level decision-makers. Because gender uniquely pertains to personal identity and self-realisation, parents and judges are rarely better positioned to make complex medical decisions. Instead of taking away trans youth’s authority over their healthcare decisions, we should focus on supporting their ability to take the best possible decision for themselves. (shrink)

Cis moves to innocence are rhetorical moves by which cisgender feminists falsely position their failure to engage with structures of transmisogyny as epistemically and morally virtuous. The notion derives from Tuck and Yang’s (2012) concept of settler moves to innocence and Mawhinney’s (1998) concept of white moves to innocence. This piece considers the case study of Manne’s (2017) work, in which she purports to offer a unified account of misogyny while explicitly refusing to consider transmisogyny. The justification she provides is (...) that she lacks the “requisite authority to do so.” I identify three functions of Manne’s cis move to innocence: i) to allow her to appear to be in solidarity with trans women and transfeminine people without taking on any of the obligations that requires, ii) to structurally reproduce the epistemic exploitation of trans women and transfeminine people, and iii) to reduce the obligations of allies to affect rather than action. (shrink)

Our gender identity is our sense of ourselves as a woman, a man, as genderqueer, or as another gender. Our gender is the property we have of being a woman, being a man, being non-binary, or being another gender. What is the relationship between our gender identity and our gender? Recently, much work has been done on ameliorative accounts of the gender concepts that we should accept and on the metaphysics of gender properties. From this work 4 views of the (...) relationship between having gender identity G (e.g. having a female gender identity) and being a gender G (e.g. being a woman) have emerged. A first, the no connection view, says that gender identity and gender are entirely distinct; Sally Haslanger’s ameliorative account of gender, as well as Theodore Bach’s account of gender properties, are instances of this view. A second, the gender-identity-first view, says that all there is to our gender is our gender identity; this view is at least similar to views that Talia Bettcher and R.A. Briggs and B.R. George have argued for. A third, contextualist view, says that in some contexts and relative to certain standards, our gender identity determines our gender, and that in others it does not; Ásta and Robin Dembroff have proposed and defended views along these lines. A fourth view, the two gender properties view, says that there are two properties that can make it the case that one is gender G (in any context), one’s having gender identity G and one’s being socially classed as a G; Katharine Jenkins and Elizabeth Barnes have proposed views along these lines. This article explains these 4 different views and spells out their prospects, and the problems they face, as both ameliorative and as metaphysical views. (shrink)

The exponential rise in transgender self-identification invites consideration of what constitutes an ethical response to transgender individuals’ claims about how best to promote their well-being. In this paper, we argue that ‘accepting’ a claim to medical transitioning in order to promote well-being would be in the person’s best interests iff at the point of request the individual is correct in their self-diagnosis as transgender (i.e., the distress felt to reside in the body does not result from another psychological and/or societal (...) problem) such that the medical interventions they are seeking will help them to realise their preferences. If we cannot assume this—and we suggest that we have reasonable grounds to question an unqualified acceptance in some cases—then ‘acceptance’ potentially works against best interests. We propose a distinction between ‘acceptance’ and respectful, in-depth exploration of an individual’s claims about what promotes their well-being. We discuss the ethical relevance of the unconscious mind to considerations of autonomy and consent in working with transgender individuals. An inquisitive stance, we suggest, supports autonomous choice about how to realise an embodied form that sustains well-being by allowing the individual to consider both conscious and unconscious factors shaping wishes and values, hence choices. (shrink)

This paper offers a discussion of the rationale for the creation of sports categorization criteria based on sporting genealogy and the gendered body, as proposed by Torres et al. in their article ‘Beyond Physiology: Embodied Experience, Embodied Advantage, and the Inclusion of Transgender Athletes in Competitive Sport’. The strength of their ‘phenomenological’ account lies in its complex account of human experience; but this is also what makes it impractical and difficult to operationalize. Categorization rather requires simplicity and practicability, if it (...) is to be applied to all athletes (and not exceptionally to transgender athletes). This discussion helps us to formulate three general principles for the process of categorization of athletes, relating to fairness, verifiability and practicability. (shrink)

BackgroundWhile fertility preservation is recommended practice for paediatric oncology patients, it is increasingly being considered for transgender children and young people in paediatric care. This raises ethical issues for clinicians, particularly around consent and shared decision-making in this new area of healthcare.MethodsA systematic review of normative literature was conducted across four databases in June 2020 to capture ethical considerations related to fertility counselling and preservation in paediatric transgender healthcare. The text of included publications was analysed inductively, guided by the Qualitative (...) Analysis Guide of Leuven.ResultsTwenty-four publications were identified for inclusion. Four key ethical considerations emerged from this literature: access to fertility preservation, conscientious objection, decision-making capacity of children and young people, and shared decision-making.ConclusionIn the identified literature, there is consensus that transgender children and young people should not be refused access to fertility preservation services solely due to their gender identity, and that clinicians with conscientious objections to fertility preservation for this group have an obligation to refer on to willing providers. Factors that create ethical complexity in this area of paediatric care include the child’s age, mental health, and parents’ views. (shrink)

Increasingly, transgender minors are seeking medical care such as puberty-suppressing or gender-affirming hormone therapies. Yet, whether these interventions should be performed at all is highly controversial. Some healthcare practitioners oppose irreversible interventions, considering it their duty to protect children from harm. Others view minors, like adults, as transgender individuals who must be protected from discrimination. The underlying ethical question is presented as a problem of priority. Is it primarily relevant that minors are involved? Or should decision makers focus on the (...) fact that they treat transgender individuals? The paper explores the relevance for medical practice. We provide results of an interview study with German healthcare professionals. We discuss the general question whether prioritization among different group memberships of the same person is ethically defensible. We conclude that priority conflicts between group memberships of the same person can be deceptive and should be addressed by an intersectional approach. Eventually, we discuss practical implications. (shrink)

The idea of gender is one of this century’s fiercest intellectual battlegrounds. In this paper, I seek to narrow down my focus towards one major debate surrounding gender: the debate between gender objectivism and gender constructivism. My contention is this: gender objectivism is a more reasonable view than gender constructivism. Moreover, gender constructivism has unjust and dangerous implications, especially towards biological women, a result to which gender objectivism is generally immune. I begin by noting how transgenderism as a product of (...) gender constructivism leads to absurd consequences, is viciously circular and lacks conceptual clarity in defining what a woman is. Then, I assessed the real-life consequences of transgenderism in three areas: women’s spheres for recognition such as women’s beauty pageants, women’s spaces, and women’s sports. I argue that evaluating the cogency or lack thereof of transgenderism while also seeing its harmful and dangerous consequences to women provide us with good reasons to prefer gender objectivism over gender constructivism. (shrink)

There is an emerging consensus within Natural Law that explains transgender identity as an “embodied misunderstanding.” The basic line of argument is that our sexual identity as male or female refers to our possible reproductive roles of begetting or conceiving. Since these two possibilities are determined early on by the presence or absence of a Y chromosome, our sexual identity cannot be changed or reassigned. I develop an argument from analogy, comparing gender and language, to show that this consensus is (...) premature. Language and gender imbue our body with further social meaning and so, I conclude, that just as we can learn multiple languages, so too can we learn multiple genders. Since language and gender each constitutively contribute to our wellbeing as a “second nature,” I argue against this consensus to show that the reason people who are transgender struggle to flourish is not because of a “troubled trans psyche,” but because there are conceptual, interpersonal, and institutional obstacles stacked against them. (shrink)

Trans theory is characterized in part by the apparent tension between discursive analyses of cisgender society and phenomenological descriptions of trans experiences. While traditional inquiry into the history of philosophy proposes an interminable opposition between phenomenology and discourse analysis, Rubin’s alternative suggestion is that within the domain of trans studies that they fulfill complimentary dimensions of investigation. Discourse analysis and phenomenology converge in trans studies because they are submitted to the same ethical and political imperative: the systematic development of the (...) trans archive. Both discourse analysis and phenomenology as methods in trans studies are directed toward the development of a genuinely trans history, perspective, and theory, with special methodological consideration toward the way that this perspective is misunderstood or obscured by dominant frameworks within cisgender society. In what follows, I provide a brief reconstruction of two major interventions in trans phenomenology, demonstrating that each is carefully concerned with distinctly archival considerations, but I further argue that each project remains incomplete because of an incomplete bracketing of medicalized cisgender concepts. I then propose a brief alternative program aimed at the full suspension of cisgender categories that I call transgender existentialism. (shrink)