General Info #
My current (and ever expanding) list of things I wish cis people knew:
Medical stuff #
- Medical transition does not make someone a man or a woman. A trans woman is a woman, and a trans man is a man, regardless of what medical treatment they have or have not had. Medical treatment just makes life a hell of a lot easier for a lot of people.
- Being trans is not classified as a mental illness by either the American Psychological Association or the World Health Organization. Gender dysphoria or incongruence is recognized by both as a medical condition, and transition is the only treatment recognized as effective and appropriate medical response to this condition.
- Trans people who are able to transition young, with access to appropriate medical care, and who are spared abuse and discrimination, are as psychologically healthy as the general public.
- Transition-related medical treatment is not new or experimental; it has existed for over a century.
- Transition-related medical care is recognized as necessary, frequently life saving medical treatment by every major US and world medical authority.
- Transition is the only treatment for dysphoria that has proven to be effective. Attempts to “cure” trans people, alleviating dysphoria by changing the
patientvictims' gender identity to match their appearance at birth (aka “conversion therapy”), have proven to be such utterly worthless and actively destructive train wrecks that this “therapy” is now condemned as pseudo-scientific abuse by all major medical authorities.
- Transition is a very individual process. Not everyone needs or wants the same things.
- “Regret” rates among trans surgical patients are vanishingly rare, consistently found to be about 1% and falling. This 1% includes people who are very happy they transitioned, and often are still glad they got reconstructive surgery, but regret only that medical error or shitty luck led to sub-optimal surgical results. That’s a risk in any medical treatment, and a success rate of about 99% is astonishingly good.
- Hormone therapy is pretty damn cheap, is generally the first line of treatment most trans people get, and dramatically impacts one’s appearance.
- Most trans people socially transition long before they get reconstructive genital surgery, if they ever get it at all. Not all trans people need or want this surgery, and even those who desperately do need it are often unable to afford it. Genital surgery for trans women costs tens of thousands of dollars out of pocket. Surgery for trans men can cost between tens of thousands to over $100k, depending on the procedure one is getting.
- 20 US states have laws prohibiting health insurance companies from having “trans exclusion” policies, where they categorically refuse to cover medically necessary transition-related treatment. This means that a small but growing number of trans people are able to get treatment, including surgery, covered by insurance.
- When a child or adolescent transitions, that does not mean they are being rushed into irreversible surgery
- The first line of medical care for trans adolescence is puberty-delaying treatment. This treatment is extremely gentle, entirely reversible, and has been used for decades to delay puberty in kids who would otherwise have started it inappropriately young. It does nothing but buy time by delaying the onset of permanent physical changes.
- Transition-related hormone treatment does not cause serious long term health problems
- Reconstructive genital surgery for trans men can provide excellent results
Social/legal stuff I wish more cis people knew #
- It is entirely legal to update the gender on legal ID.
- Federal ID (passports, social security cards, etc) can be changed with a medical letter certifying that one has had “appropriate clinical treatment for transition to male/female”. The letter does not have to specify what treatment one has gotten, and surgery is not required. Many people get their letter from the doctor who prescribes their hormone therapy.
- Rules for changing drivers licenses and birth certificates vary by state; some are easy, some hard, some impossible. It is very common for trans people to have mixed ID - some identifying them as male, some as female, all equally legal.
- There is no federal prohibition against anti-trans discrimination. Employment, housing, business, medical, etc. discrimination are legal and common.
- In 30 US states it is entirely legal and the norm for health insurance companies to have “trans exclusion” policies, where they categorically refuse to cover medically necessary transition-related care, even when similar or identical treatment is routinely covered for cis patients
- Police targeting of trans women, particularly trans women of color, is very common. Just being a visibly trans woman in public can be treated as reasonable grounds to arrest them on suspicion of prostitution.
- Futile, medically condemned, abusive and destructive “ex-trans therapy”, is legal and not uncommon
- Most medical providers get no training whatsoever in how trans people’s bodies work, and refusing treatment to trans patients is legal in most of the US. Medical incompetence is the norm even when seeking routine care, and medical harassment, abuse, discrimination, and refusal of care are common. The average doctor knows as much about trans people as the average plumber, and when trans patients aren’t turned away entirely trans broken arm syndrome is damn near universal.
General stuff I wish more cis people knew #
- It is not true that 40% of trans people commit suicide. The infamous 40% statistic refers specifically to rates of suicide attempts which occur before transition. Most of these attempts fail and the person survives.
- Transition vastly reduces risk of suicide attempts from 40% down to around the national average, while dramatically improving mental health, social functionality, and quality of life for those who need it.
- Being trans is a situation one is born into. No, trans children are not cis kids who are being manipulated or abused by parents because it’s “trendy”. That shit is just a modern reworking of the “gays are recruiting kids into homosexuality!" bullshit from the 70’s and 80’s.
- Trans women are not “biologically male” and trans men are not “biologically female”. Transition causes massive biological changes; trans men who are on testosterone and have had a hysterectomy have far more biologically in common with cis men than with cis women, and trans women who are on estrogen and have had reconstructive surgery have far more biologically in common with cis women than with cis men.
- The existence of trans people is not a recent phenomenon, and the number of trans people is not increasing. Trans people have always existed; there are just more out trans people now.
- Trans women are not gay men who attempt to become women in response to homophobia, trans men are not women who attempt to become men in response to sexism, and trans people would still exist and still need to transition even if both homophobia and sexism were eliminated.
- Many trans women are bi or lesbian; many trans men are bi or gay (attracted to other men)
- Allowing trans women and girls to use the same public facilities as other women (e.g., restrooms, locker rooms, etc) does not put cis women and girls at risk
- That there are not more trans women than there are trans men
- Most trans people are not visibly identifiable as trans
- Being trans and/or transition is not biblically condemned, and being trans/transitioning is not universally condemned by mainstream religious organizations
A few spelling and grammatical notes #
- It’s transgender, not “transgendered”
- Transgender is an adjective, not a noun. So there are transgender people, but nobody is “a transgender”.
- The word cis is a latin prefix, not an acronym, so there’s no need to capitalize it as CIS. Cis is short for cisgender, which is the opposite of transgender. The prefix trans- means “across/beyond/on the other side”, while cis- means “on this side/on the same side”. E.g., cislunar vs translunar orbits.
Social faux pas to avoid #
- Don’t ask about our genitals unless you’re our doctor or there’s mutual interest in sex. Don’t ask about “the surgery” either, which is still really just asking about our genitals.
- Same goes for the graphic details of our sex lives. Unless we’re already in the kind of relationship where we casually discuss these matters, it’s none of your business.
- When talking about something a trans person did before they transitioned, you should refer to them by the name and pronouns they use now unless they have specifically told you otherwise. It’s a bit like talking about someone who used to be married to an abusive asshole, but has since divorced him and stopped using his name. Even if talking about something she did while still married, I really hope you wouldn’t call her “Mrs. AbusiveEx”. That would be spectacularly tactless. That’s not her name now and not how she wants to be known.
- Never out someone unless they have explicitly given you permission to do so. Don’t assume that because they’re out as trans to some people, that they are comfortable having other people know that aspect of their medical history.
- If you accidentally refer to someone by the wrong pronouns, just correct yourself and move on. Don’t dwell on it, just make a serious effort to not make that mistake again.
The Sex Spectrum #
Medical Body Recommendations #
Here is an AMA resolution on the efficacy and necessity of transition as appropriate treatment for gender dysphoria, and call for an end to insurance companies categorically excluding transition-related care from coverage
A policy statement from the American College of Physicians
Here are the American Academy of Pediatrics guidelines
Here is a resolution from the American Academy of Family Physicians
Here is one from the National Association of Social Workers
- The Complex Relationships between Sex and the Brain
- Challenging the Cisgender/Transgender Binary - Nonbinary People and the Transgender Label
- Testosterone Effects on the Brain in Transgender Men
- Non-Binary and Genderqueer Genders
- Neurobiology of Gender Identity and Sexual Orientation
- Health of Non-binary and Genderqueer People: A Systematic Review
- Hormonal therapy and sex reassignment: a systematic review and meta‐analysis of quality of life and psychosocial outcomes.
- A Long-Term Follow-Up Study of Mortality in Transsexuals Receiving Treatment with Cross-Sex Hormones.
- Hormonal treatment reduces psychobiological distress in gender identity disorder, independently of the attachment style.
- Suicide Protective Factors Among Trans Adults.
- Effects of different steps in gender reassignment therapy on psychopathology: a prospective study of persons with a gender identity disorder.
- Young adult psychological outcome after puberty suppression and gender reassignment.
- Long-Term Follow-Up of Adults with Gender Identity Disorder.
- Intervenable factors associated with suicide risk in transgender persons.
- A Systematic Review of the Effects of Hormone Therapy on Psychological Functioning and Quality of Life in Transgender Individuals.
- Hormone therapy for transgender patients.
- Mental Health and Self-Worth in Socially Transitioned Transgender Youth.
- Hormone therapy, gender affirmation surgery, and their association with recent suicidal ideation and depression symptoms in transgender veterans.
- Sex Redefined
- Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes
- Long-term follow-up: psychosocial outcome of Belgian transsexuals after sex reassignment surgery