Gatekeeping Trans and Intersex Bodies
Trans and intersex bodies have been the battleground of gender essentialist gatekeeping. Our bodies have been questioned, scrutinized, examined, dissected, and cut while being met with skepticism, fear, and even hatred. The gatekeepers have assigned every sexed organ a gender and if it conflicts with the prevailing essentialist view of what a binary body should look, think, and act like, then the body in question will be corrected, whether socially or medically. The mythological gender “norm” in the human imagination has not just ignored the subjective experiences of trans and intersex bodies, but also numerous expressions of biology which create a broad spectrum of physiological diversity. In this paper, I will examine how gatekeepers examine trans and intersex bodies and highlight possible risks in the future of gatekeeping queer bodies.
In the rise of modern medicine, there has been considerable attention given to understanding gender and biological sex. However, even with modern advancements we cannot overlook that scientific inquiry into the trans phenomenon is not without its pitfalls and biases when the current social climate is steeped in cis-sexism, oppositional sexism, homophobia, misogyny, and transmisogyny. While I use the past tense to describe some historical examples of gatekeeping, keep in mind, many of these practices and attitudes still exist today. Gatekeepers like John Money, pioneer of nonconsensual genital surgery on intersex infants, was particularly interested in “curing” gender variant bodies. Even when seeking scientific understanding of the trans experience, it has also been done by those with explicit and implicit desires to eradicate or erase those who deviate from gender norms. According to Julia Serano, trans activist and author of Whipping Girl, “. . . sexologist have tried everything imaginable to ‘cure’ trans people of gender dissonance, including psychoanalysis, aversion and electro shock therapies, administering assigned-sex-consistent hormones and psychotropic drugs—all to no avail.” [i] Gatekeepers of the mythological gender norm have been influenced by their biases to the detriment of the trans community, when really it was belief in trans testimonial experiences coupled with allowing them to live their identified gender authentically that relieved much of their dissonance.
Trans people have been particularly susceptible to scientific gatekeeping when they have often been required to prove themselves to gain access to medical treatment. Advances in medicine have given people the opportunity to transition their bodies in unprecedented ways. However, who and how trans people might gain access to these advancements was often up to the discretion of psychotherapists. Serano describes in detail the many obstacles trans women face in order to gain access to medications or to be taken seriously as women. According to Serano, “. . . the gatekeepers’ job was to sort out the ‘true transsexual’ (who would be allowed to fully transition) from all the other trans people (who would be denied any medical intervention other psychotherapy).” [ii] This process of separating “true transsexuals” [iii] and “inauthentic transsexuals” included the evaluation of the client by a psychotherapist, followed by a 1 to 2 year testing period to see if they could “pass” as the opposite sex. For example, when a person was in transition the trans woman would often be encouraged to play into cissexual stereotypes of what femininity is by exaggerating their hair, make-up, face, and clothing as a surface level way to convince the psychotherapist the trans woman was “making progress” on her passing ability. Trans persons were not allowed to be ambiguous in anyway. Expressing any hesitation or doubt, even tension or anxiety, could be perceived by the gatekeeper as a “confused” person who doesn’t really know what they want. Gatekeepers didn’t take the time to consider that her stress and anxiety was a part of the transition process due to living in a society that was unwilling to accept her adaptations, not her desire to transition. Furthermore, even if trans women were to “pass” enough to gain the gatekeepers’ confidence, to make sure transsexuals fully transitioned, her past life and identity would be erased. Trans women with wives and children were encouraged to leave their families and told that it is better their children assumed their father abandoned them or died than transition to a woman. [iv] Gatekeepers argued it was for the good of the children. Trans women would be encouraged to lie about a past life and create a new backstory that would be consistent with what is to be expected with a cissexual woman. This harsh tactic of gatekeeping limited the amount of trans women who could or would transition at the expense of losing their families while simultaneously erasing the experience of the trans women who did. Gatekeepers often argued these methods were in line to protect trans persons from society, but really, they seemed to be in place to protect cissexuals from having to confront genders that varied from the mythological sex-binary. This also served to reinforce sexist ideals about what gender expression should look like. The motives of the gatekeepers were not to protect transsexuals, but to protect the fragility of cissexuals from confronting their own gender illusions.
The gatekeepers of trans women were first and far most cissexist, but homophobia often influenced the gatekeeper’s motives, as well. Those trans women who expressed their sexual attraction toward men were often taken more seriously—assuming they also expressed their apprehension on acting on that attraction until they had “fully transitioned” to women, as to avoid any inclination toward homosexuality. Transsexuals, even more than cissexuals, were not allowed to be homosexual because it challenged the heteronormative model of what relationships ought to look like. Furthermore, trans women who were attracted to women were accused of being autogynephiliacs, fulfilling a perverse fetish. This sex-negative, homophobic view of sexual orientation influenced gatekeepers to only transition those that would uphold the heteronormative standard.
Even more disturbing is that gatekeepers often used their own sexual desires and feelings to determine if a trans woman was “convincing” enough in her gender expression. For example, in the 1970’s some gatekeepers were rather blatant in the attitudes of attraction being a factor in their decision making. “A clinician during a panel session on transsexualism at the 1974 meeting of the American Psychological Association said that he was more convinced of the femaleness of a male-to-female transsexual if she was particularly beautiful and was capable of evoking in him those feeling that beautiful women generally do.” Another clinician was cited as using “. . .his own sexual interest as a criterion for deciding whether a transsexual is really the gender she/he claims to be.” [v] While not all gatekeepers used their own sexual attractions to determine if a trans woman was “passible” or “credible in their impersonation,” [vi] it cannot be overlooked that such subjective value bias on the part of the gatekeeper played an oppressive role over the trans woman’s experience. Thus, sexual desirability in the opposite sex became a marker for whether the trans woman could transition.
Sadly, it wasn’t only psychotherapists and medical professionals who were gatekeepers of trans women’s bodies. Gender critical feminists also put pressure on the trans community to conform to cissexual ideals of “womanhood.” Even today gender critical feminists act as gatekeepers of women’s spaces which exclude both trans and intersex women from full participation. Even at a time feminism claims to be liberating women from oppression, gender critical feminists failed to acknowledge that trans women were even women at all. Thus, the gender critical feminist adopted the role of the oppressor over trans women’s bodies.
For example, in 1991 the organizers of Michigan Womyn’s Music Festival expelled a transsexual woman from the campground due to her gender. The festival was only open to “womyn-born womyn” [vii] which specifically excludes transwomen and implicitly some intersex women. The following year, some transsexual activists protested the festival policy excluding gender diverse women. The intended purpose of the protest was to persuade organizers allow postoperative, but not preoperative, transsexual women. [viii] According to a survey conducted in 1992, it was argued that most participants would support the policy change to admit postoperative trans women and not preoperative trans women. The protest escalated and became known as “Camp Trans” by 1994. [ix] The controversy was not simply between womyn-born womyn and trans women, but also among post-op and pre-op trans women.
The Michigan Womyn’s Music festival is a prime example of gatekeeping trans women’s bodies. First, trans women were being deliberately discriminated against due to their physiology and biology. If a woman wasn’t born according to the biologically essentialist ideal of “womyn-born womyn” she could not participate in the festival. However, rather than a collective force of trans women speaking out against the oppression of the trans community, trans women were divided into post-op and pre-op categories in a classic case of the oppressed becoming the oppressor. Proponents of pre-op trans exclusion justified their position by arguing that women would be able to convene in a safe space free of “male genitals,” because male genitals embody the symbol of sexual dominance over women’s bodies. The genital-centric view of what gender identity should be was the motivation behind the “no penis allowed” policy which divided trans women.
It should not be overlooked that the segregation of transsexual women and transgender women is also a matter of intersectionality. Classism and racism both affect who fits into the transsexual and transgender category. For example, the expenses of medical and surgical transitions for trans women can be very costly. Not all trans women have access, nor the finances to shape their bodies into their ideal image or form. From this standpoint, the transsexual and transgender distinction in steeped in classism. Furthermore, economic disparity in this country cannot be looked at without also examining our country’s history of extreme racism. Race plays an intersectional component in which trans women will have the financial means to change their bodies. This means the post-op/pre-op distinction is a classist, racist approach in trans segregation where the title of “woman” can be purchased for the right price. It is also worth mentioning that there are transgender women who do not desire to be transsexual women. The terms “post-op” and “pre-op” assume that gender conformation surgery is a desirable or inevitable goal. To assume a trans woman to be “pre-op” is to assume there will be a time that she is “post-op.” So even the wording being used is a marginalization against trans women who do not desire medical and/or surgical changes and still reinforces cissexual standards of what women ought to be. This then assumes that to be transsexual is to be more in line with the mythical norm of what we call “woman.” Even in the language used to describe trans women is the same gender essentialist attitudes that are excluding gender variant women from the festival.
Trans women’s bodies have systemically and repeatedly been held ransom at the hand of gatekeepers. In the psychotherapist’s office, doctor’s office, courtroom, bathroom, and feminist spaces, gatekeepers await at every corner to scrutinize the trans woman’s body to examine her passing ability. If she were to play the role of woman too well, she was accused of being deceptive. If she exaggerated the role of woman, she was accused of being inauthentic. If she was too masculine, she was accused of being not convincing. If she had the means, she could transition, but if she were an economically disadvantaged woman of color, her likelihood of getting access to medical treatment was slim to non-existent. Even still, trans women’s bodies are not the only ones under the microscope awaiting to be examined and categorized. Intersex women, though not congruent with trans women, share some similarities in their experience.
The biological approach to gatekeeping has been particularly fraught with oppression and controversy in the intersex community. The genital-centric view of what a person’s gender ought to be is not just a problem in the trans community, but also the intersex community. When a child is born, and their genitals do not fit binary expectations of what genitals “ought” to look like, the child will likely be altered to fit into a surgically constructed sex binary. Gatekeepers of the sex binary are willing to surgically construct a genital sex binary on non-consenting intersex bodies to protect the illusion that bodies are or should be born either male or female. I should clarify, I do not advocate that all intersex persons should not surgically or hormonally modify their bodies, only that it should be their choice—not a choice made at the discretion of gatekeepers who are willing to diagnose anything that is atypical as a “mistake.”
An idea was codified into medical canon that gender variant bodies needed to be put in alignment to create congruency between a person’s psychology and their genitals. This became the primary justification for surgery, more so than matching gonads and genitals. [x] It seems benevolent to want to match people’s bodies to their gender identity, after all, isn’t this what many trans people have benefited from? However, matching a person’s body to their identity should not be done at birth, before the gender variant person has had a chance to articulate and express their gender identity. Gatekeepers, perhaps with well-meaning intentions, took the prerogative of assigning intersex bodies a gender identity without questioning if the assignment was what the person wanted. Imposed sex assignment surgeries on infant bodies cannot adequately consider the child’s psychological proclivities towards a particular gender. Furthermore, an intersex person may wish to identify as non-binary or agender. Gender identity is not so malleable that anybody could be assigned any gender and expect it to “work” with enough social impositions. The exclusively social constructivist model ignores biological inclinations.
Unfortunately, John Hopkins University psychologist John Money, with Joan G. and John Hampson, pioneered a series of articles which insisted intersex person’s mental health depended upon the parent’s ability to raise them as indisputably a boy or girl. Internal incongruencies and inconsistencies were considered secondary concerns to the social construction of the gender assignment and surgically altered body—meaning their genitals must match their gender-assigned identity. [xi] This hypothesis was called the “optimum gender of rearing” model. [xii] Under this model what mattered most was the consistency between genital assignment and gender assignment, and both could be surgically and socially constructed as if a human’s gender plasticity were nothing more than a ball of putty; see also the case of David Reimer. [xiii] Not only that, this model did not account for the other variances that composes a person’s biological sex and gender identity. Even with advancements in science and medicine, the genital-centric view of what gender identity must consist of still prevails in the modern imagination.
Beyond the genital-centric model of intersex bodies, there are intersex advocates such as the Intersex Society of North America that are contesting the theories of Money and the Hampsons. There is much deliberation over who counts as intersex and what features of the human body classify someone as intersex. It is commonly thought that intersex persons are only those with external genitalia that doesn’t fit the gender binary of what genitals are “supposed” to look like. However, this is a reductive and harmful view of what intersex conditions include. Hormones also play a significant role in development, so bodies with a wide range of hormonal variations can manifest some very diverse biological sex physiology and internal anatomy. It’s only been since about 1940 that genitalia, gonads, and hormones were not the only variables to consider in determining a person’s sex. [xiv] Others consider gender a product strictly tied to chromosomes—you’re either XX or XY. However, that is incomplete, as well. There are some bodies which are XXX, XYY, or XXY. Dorland’s Medical Dictionary defines biological sex as “the fundamental distinction based on the type of gametes produced by the individual.” Smaller gametes called sperm are assigned male, and larger gametes called ovum are assigned female. [xv] Many biological aspects should be considered in our categorizations, such as: chromosomes, genitals, internal reproductive anatomy, gonads, gametes, and hormones.
Take my biology for example. I’m a gender variant woman with multiple biological variations which are atypical of the average female. I was assigned female and identify as female, yet my biology is not of a typical female and produces some atypical sex characteristics. I have heightened levels of testosterone along with a retrovered, bicornate uterus that as been mutated. Like many intersex persons, I have encountered significant difficulties reproducing due to my atypical biology. Such hinderances include, but are not limited to, irregular menstruation and ovulation, polyhydramnios, hyperemesis gravidarum, transverse presentations, and non-elective c-sections. Though I don’t have gender variant genitals, my levels of testosterone may have been the leading cause of my secondary masculine characteristics, such as masculine bone-structure, broad shoulders, narrow hips, excessive body hair, facial hair, and androgenic alopecia. Just because I was assigned female and identify as female, doesn’t mean I don’t experience gender dysphoria caused by elevated testosterone levels. The characteristics I listed are typical of an assigned male biology, yet I was assigned female. While medical professionals and intersex activists may classify intersex conditions differently, both can act as gatekeepers of the intersex experience. While my specific variances are not clinically classified by the medical establishment as intersex at present, intersex categories are changing with advancements in science and medicine while listening to the subjective experiences of gender variant women.
I’ve seen more doctors than I can list. I’ve been examined, dissected, cut, poked, and photographed inside and out. I am tired of being "diagnosed" by medical professionals who are unwilling to listen to my experience. There is still no precise diagnosis or classification for my body’s sex abnormalities, but intersex or gender variant are the most accurate descriptor for my subjective experience. I, along with my trans peers, need to be trusted in our subjective gender experience—especially when medical knowledge is insufficient to adequately categorize gender variant bodies. But here in lies the problem, gender gatekeepers are still looking to classify, codify, and categorize bodies without looking at the full biological spectrum, or take into account the authentic subjective experience of gender variant persons. By all means, we should look into scientific explanations and applications of medical technologies, but not at the expense of dismissing gender variant subjective testimonies and experiences.
Consider biological sex as a color spectrum. Imagine a spectrum of warm hues on a horizontal bar graph. On the left end is red, and on the right end is yellow. We’ll call the red “female” and the yellow “male.” From the “truest red” to the “truest yellow” there will be a potentially infinite number of colors between the ends of the spectrum—most will look orange. Let’s call the orange “intersex.” A biology like mine will look more red-orange. Likewise, others that are not “true reds” and “true yellows” will likely be orange-red, orange-yellow, and yellow-orange. The question is, who is intersex and who is not? Who is to say and decide at exactly which point a body is to be classified as female, intersex, or male? Who gets to decide how much testosterone is too much testosterone for a woman too have? As stated above, biological sex cannot be completely determined by genitals or chromosomes alone. If all variables are considered, we may find that our categorizations are more ambiguous than previously assumed. It seems reasonable to trust the subjective experience of red-oranges, orange-reds, orange-yellows, and yellow-oranges of to classify themselves. After all, they know the subjective experience of their biology better than anyone else. Between a person who labels them self as red and one who labels them self as yellow, you will find orange, apricot, sunrise, pumpkin, carrot, ginger, paprika, gold, dijon, rust, sandstone, tangerine, amber, and marigold. No two intersex bodies will be the same. The spectrum of gender-diverse bodies, like mine, will not fit into the red, orange, or yellow category neatly. As a red-orange, I will appear more orange when I am standing next to a “true red.” However, when I stand next to a “true orange” I may appear more red. Yet, when I stand next to a “true yellow,” I may appear entirely red.
However, this also raises the question, what is a “true red,” “true orange,” “true woman,” “true intersex,” or “true man.” We are still working within the frame work of gatekeeper’s biases to categorize bodies against their subjective experience with incomplete data about the human body. Like with trans persons who, rightful so, expect to be trusted in their subjective experience, so too should other gender variant bodies be trusted in their biological experience. If not, gender variant bodies like mine cannot be legitimized as a “true” anything. I have no “true sex,” but I identify as a gender variant woman.
It’s for reasons like these I use terms like gender variant and sometimes intersex to describe myself. There is a proliferation of naturally occurring gender-variant bodies and I don’t think gatekeeping people’s experiences, biology, bodies, and identity labels is nearly as important as respecting people’s experiences, biology, bodies, and identity labels. In the intersex community bodies are being “diagnosed” and cut as a way of gatekeeping the myth that a biological sex binary of female or male as the ideal of what all bodies should fit into or identify as. Likewise, experiences like mine are being brushed under the rug with the label “woman” as a way of ignoring the diversity of bodies that are standing under the umbrella of “woman.” Our bodies straddle multiple categories and sometimes there aren’t adequate words to describe the experience or phenomenon. However, words are necessary in the communities we are a part of because words have a way of legitimizing experiences and ideas. Even the words “woman,” “intersex,” and “man” don’t convey the physiological and biological diversity that exists within these subcategories.
The gatekeeping of trans bodies and intersex bodies should cause us to reconsider where the future of gatekeeping could lead us and how to mitigate for such risks. Let’s hypothesize for a moment that there is a “trans gene” that can conclusively prove a biological component to the trans experience. If that is the case, what if there are persons who claim to be trans, but lack the “trans gene” in her diagnostics? Is this trans person delegitimate? Is her subjective experience not worth trusting because our biological explanations are controversial or incomplete? If you think this is not relevant, consider the aforementioned examples of trans gatekeeping and how they intersect with economics, class, and race. What happens when the identity of “woman” can be purchased by the wealthy? I suspect the most vulnerable will be those at the bottom of the economic ladder. It is not surprising that the future of gatekeeping could include a quasi-Gattaca approach to gender discrimination. Anything from genital examinations, chromosomal tests, hormonal tests, and DNA samples could be used to exclude people from the expression and inclusion of their gender identity.
The examination of the trans and intersex gatekeeping should also cause us to pause and consider the future ramifications of “diagnosing” sexed bodies, gender identities, and by extension, sexual orientations. Transhumanists [xvi] should be particularly concerned with the gatekeeping of gender and sex variant bodies. If the medical establishment and parents have the authority to alter a child non-consensually on cosmetic grounds, it is not outside the realm of possibilities that children with the “gay gene” or “trans gene” or any atypical feature could be genetically altered before conception to create the “ideal” heterosexual, cisgender binary baby. According to the gatekeepers, this would be for the child’s own good. The “gay gene” or “trans gene,” like the intersex body could be deemed a “mistake” and be deleted from genetic code. In this dystopian scenario, it won’t be surgery, but eugenics which could make a perfectly constructed biological sex binary.
What some transhumanists fail to recognize is the future of “designer babies” is predicated on our current attitudes and policies. The queer community is a prime example of where our current attitudes are concerning atypical bodies and identities, and how to “fix” us. However, while I point out many of the risks of genetic alterations, I must make clear this is not an argument to abandon scientific inquiry or technological innovation. This is a call to reevaluate what a “designer baby” should be, and what scientific and technological progress is? Who gets to decide? Who is the most economically privileged? If the future of designer babies doesn’t include the invaluable perspectives of racial minorities, the economically disadvantaged, women, queer folks, or other minority categories we are doing the future of the human family a great disservice.
Evolution gave us diversity for a reason: to mitigate risks. Total homogenization makes total annihilation that much easier. Joan Roughgarden, trans activist and biologist, warns in her book Evolution’s Rainbow, “Species need rainbows [genetic diversity] to survive [. . .] At times genetic engineering proposes to redecorate a whole rainbow, or it may target specific colors such as those for unusual expressions of gender and sexuality.” [xvii] To the extent that genetic engineering threatens genetic diversity in its arrogance to determine which anomalies are bugs and features, I agree with Roughgarden that we need to protect diversity. Not all difference needs to be seen as inherently threatening. She continues, “The most basic threat to our species’ future is the belief that our entire rainbow is somehow muddied with dirty colors and must be cleansed.” [xviii] Trans and intersex bodies know this better than most. The biggest gatekeeping threat of trans and intersex body’s is elimination from the human species. While technology and science have given unprecedented ability for trans and intersex bodies to adapt themselves to their gender identity through biological expressions—the same technologies could be used to oppress or eliminate these biological expressions.
As for me, I remain hopeful. Trans and intersex activism are intimately connected to transhumanist goals to allow persons to transcend unnecessary limitations—even oppressive gender assignment limitations—and allow them wide personal choice over how they enable their lives. [xiv] While our history is fraught with the gatekeeping of queer bodies, attitudes are changing—and though not as fast as I would like, they are changing. As we move into the future with more advanced technologies, it is imperative that our social structures and attitudes toward difference adapt too. The future could offer queer bodies possibilities to express themselves in ways we cannot currently imagine, and in order to get there we need to overcome the biases of gatekeepers and embrace the spectrum of diversity our species has to offer.
Notes and Citations
[i] Julia Serano, “Whipping Girl” Seal Press (Berkeley, 2007) pg.117
[ii] Julia Serano, “Whipping Girl” Seal Press (Berkeley, 2007) pg.119
[iii] Transsexual is a term used to describe a trans* person who has undergone medical transitioning. As opposed to being transgender which is a person who identifies with a gender other than the one they were assigned at birth. The term transsexual has been criticized for promoted a classist approach to trans* issues.
[iv] Julia Serano, “Whipping Girl” Seal Press (Berkeley, 2007) pg.119
[v]Kessler and McKenna, “Gender: An Ethnomethodological Approach” pg. 118
[vi] Randell, “Preoperative and Postoperative Status,” pg. 378
[vii] Womyn-born womyn is a term developed during second wave radical feminisms that describe women who were assigned women at birth, were raised as girls, and identify as women. The alternate spelling is to deter from the androcentric model of “men” being in the word “women.”
[viii] Davina Anne Gabriel, from an open letter to Lesbian Connection, (Jan. 27, 2000). accessed August 7, 2018 http://eminism.org/michigan/20000127-gabriel.txt
[ix] Emi Koyama, “Who’s Feminism is it Anyway?” The Transgender Studies Reader (2006, Routledge), ed. by Susan Stryker and Stephen Whittle
[x] Elizabeth Reis, “Bodies in Doubt” John Hopkins University Press (Baltimore, 2009) pg 116.
[xi] Elizabeth Reis, “Bodies in Doubt” John Hopkins University Press (Baltimore, 2009) pg 116.
[xii] Heino Meyer-Bahlburg, “Gender Assignment in intersexuality,” Journal of Psychology and Human Sexuality 10, no. 2 (1998) pg 1-21.
[xiii] David Reimer, Wikipedia, (accessed August 9, 2018) https://en.wikipedia.org/wiki/David_Reimer
[xiv] Elizabeth Reis, “Bodies in Doubt” John Hopkins University Press (Baltimore, 2009) pg 116.
[xv] Dorland’s Illustrated Medical Dictionary, s.v. “sex,” 32nd Edition. Philadelphia: Elsevier Saunders, 2012.
[xvi] Transhumanism is a philosophical movement that suggests we should use science and technology to radical transform and transcend the human condition and make such technologies widely available for the improvement of humanity.
[xvii] Joan Roughgarden, “Evolution’s Rainbow” University of California Press (Berkeley, 2004) pg. 306
[xviii] Joan Roughgarden, “Evolution’s Rainbow” University of California Press (Berkeley, 2004) pg. 306
[xiv] Transhumanist Declaration, 1998 "