It is convention that if we want to know why there is currently an international attack on transgender people, the first people we should ask are the attackers. While this assumption is questionable, it’s productive for fact-finding, so let’s go with it.
Here’s why anti-trans activists say they are attacking trans people.
Two headnotes
First, I deliberated whether to directly include verbatim statements by anti-trans activists in this post. In the end, I decided not to include them in the published post.
This is because, in maintaining this blog, I observe a policy of “no platform” — my blog must not serve as a vehicle to amplify reactionary rhetoric. Since republishing the words of people I consider reactionary always carries the risk of amplifying their rhetoric, I am morally obliged not to do so unless their specific words are central to the analysis, which in this case they are not — the content of their arguments is what matters, and I am perfectly capable of summarising that without platforming and quoting them. However, if you need citations, please let me know and I will provide them on request.
Second, this post is not intended to be read straight through. It can’t be — there is no single straight-through narrative uniting all the individuals and organisations who oppose trans liberation. There can’t be: many of the narratives they use to justify opposing it directly contradict each other. For instance, some organisations say that transness is actually a patriarchal plot to eliminate gay people. Other organisations, traditionally mainline conservative groups, say that transness is actually an extension of the homosexual agenda.
Consequently, this post is a catalogue. Instead of reading it straight through, you can scroll through it looking for subject headers recounting arguments you recognise. Unfortunately the territory of the anti-trans onslaught is only comprehensible if mapped out in the greatest possible detail.
Lines of attack
Ahistorical
This group of narratives holds that trans people, acceptance of transness, etc., are a new invention and that they did not exist at some point in the past.
The claim that transgender people did not exist in the past is false; see below. This makes the “ahistorical” narrative group inherently historically negationist — that is, it is false representation of the historical record. This is a tactic which has been used before by, among others, the Communist Party of the Soviet Union (CPSU), sympathisers of the National Socialist German Workers’ Party (NSDAP; Nazi Party), and sympathisers of the Confederate States of America.
A definable tendency within the “ahistorical” narrative group is the “memetic” narrative subgroup. “Ahistorical” narratives simply claim that trans people never used to exist, without giving a specific reason why; “memetic” narratives build on that by advancing the hypothesis that trans people exist now due to the creation of a meme of transness, a transmissible idea.
“Transgenderism is a new thing; there weren’t any trans people fifty years ago.”
Sources: Drescher (2016).
Transness is not, in fact, a new thing.
It is accurate to say that the words we currently use to describe transness are new. “Transsexual” was loaned into English from German in 1949 (Cauldwell, 1949/2001). “Transgender” was coined in 1965 (Oliven, 1965). “Cisgender” was coined in 1994 (Dame, 2017), and appears to have entered academic usage in 1998 (Sigusch, 1998).
However, transness has existed for as long as recorded history. To sparingly choose a few examples:
The galli were a Roman religious order dedicated to the goddess Cybele, who Romans called Magna Mater. They appear to have been trans women; they adopted feminine dress and behaviour, voluntarily castrated themselves, were referred to with feminine-gendered language, and were accepted as women by numerous ancient sources (Gabriel, 1994; Carla-Uhink, 2017, pp. 16 et seq.).
Elagabalus, Roman Emperor (r. 218–222), is said to have preferred to be referred to with feminine language (Varner, 2008), presented as a woman, and offered a substantial reward to any physician who could provide her1 with a vagina (Scott, 2018; Varner, op. cit.).
The Institute for Sex Research (Institut für Sexualwissenschaft), a private nonprofit sexology research institute and gender clinic, was operational in Tiergarten in Berlin, German Reich, from 1919 through 1933. The term “transsexual” was coined by the Institute’s founder and director, Magnus Hirschfeld, and the clinic issued what would now be referred to as gender recognition certificates (Gross & Beachy, 2014).
After the Nazi Party took control of the German government, militia under their direction destroyed the Institute’s archives and libraries (Diavolo, 2017). Some of the work which was attempted at the Institute, such as uterine transplantation for transgender women (“Lili Elbe,” 2015), is only starting to be discussed again now, a century later (Jones et al., 2021).
Dangerous
This category of attacks holds that the full social participation of trans people in their actual genders poses a danger to other people in some way. The most common groups alleged to be targeted are children, cis women, and “the vulnerable.”
“Dangerous to children”
“It’s inappropriate to discuss these topics in front of kids.”
This argument assumes that we don’t already discuss gender with kids. In fact, we do. It is overwhelmingly conventional to refer to kids as “boys” or “girls” from the moment of their birth, long before we reach the age where we can be sure that is true — namely the age where current clinical consensus says transness and dysphoria can be clinically identified, shortly after the onset of puberty (Hembree et al., 2017).
We already discuss these topics in front of children — we assign gender to them, we make the expectations of gender clear to them, and we enforce it on them. We are perfectly happy to discuss gender with kids as long as the discussion embodies an exclusively cis analysis of gender. We already discuss these topics in front of kids — we just exclude the parts of them we consider inconvenient.
“It’s too easy for kids to access medical transition.”
It actually is not.
The first-line medical intervention for youth transition is puberty suppression, which, when used in accordance with protocol,2 halts the progress of puberty for the duration of treatment. Even though puberty suppression is fully reversible and carries virtually no risk, access to it is screened tightly enough that it has a dropout rate of less than 1%.
Since the Family Court of Australia’s 2020 decision in Re Imogen (No 6), it is now de facto necessary for any trans child in Australia who wants to access puberty suppression to have the full and unanimous support of their family. Less than a third of trans kids have this level of support (Baum et al., 2014).
Access to hormone replacement therapy, the first actual transition intervention, is not permitted in standard care until at least 16 (Hembree et al., 2016). Every trans child seeking access to HRT has had at least several years to reconsider.
No child in Australia is independently getting gender-affirming surgery of any sort, not least because they do not have the financial independence to do so. Gender-affirming surgical interventions have virtually no coverage on the Medicare Benefits Schedule (MBS).
The best-known gender-affirming medical intervention for female-assigned trans people, top surgery, costs up to $18,000 out of pocket (ACON, “Top surgery,” 2021). The two best-known gender-affirming medical interventions for male-assigned trans people, sex reassignment surgery (SRS) and facial feminisation surgery (FFS), cost up to $30,000 and up to $40,000 out of pocket respectively (ACON, 2021, “Genital reconfiguration surgery”; ACON, 2021, “Facial surgery”).
The assertion that it is too easy for children to access medical transition amounts to the assertion that even if a child, their doctors, and their family all agree to a specific transition intervention, and even if they are willing to pay for it themselves, that isn’t enough. At that point, it becomes clear that the idea that “it’s too easy for children to access transition” is less about children being rushed into transition and more about anti-trans activists wanting the power to unilaterally override families’ medical decisions for their own satisfaction.
“Dangerous to cis women”
“‘Cis’ makes women a subset in their own sex class.”
Literally any adjective placed before the name of a class identifies a subset of that class. Cis women are a subset of all women; so are trans women.
If the fact that a vast majority of a class is still a subset of that class is worthy of complaint, one might also complain that, in regards to Australian women, “Australian-born”, “Christian”, “European Australian”, “monolingual English-speaking”, and “under 45 years of age”, make women a subset in their own sex class.
However, if one were to insist on referring to “women and non-Australian women,” “women and non-Christian women,” “women and non-European Australian women,” “women and non-monolingual-English-speaking women,” or “women and over-45-women,” the inappropriateness might be slightly more apparent.
“Letting trans people use ‘single-sex spaces’ is dangerous.”
Sources: Lopez (“Myth #3,” 2018).
There is no evidence that letting trans people use gender-separated spaces in accordance with their correct gender is dangerous (Bianco, 2015; Percelay, 2015; Brady, 2016; Barnett et al., 2018). There is plenty of evidence that not letting trans people use gender-separated spaces in accordance with their correct gender is exceptionally dangerous (Sutton, 2016; Price-Feeney et al., 2020).
In any case, the assertion that it will be dangerous to let a minority use utilitarian, functional spaces that the majority people use will be dangerous is not a new one. It was part of the rhetoric used to justify racial segregation in the 19th and 20th centuries; some time later, it was used to justify forcing gay people to stay in the closet (Griffin, 1994).
“Letting trans people use ‘single-sex spaces’ is dangerous, and the existence of this trans predator proves it.”
This is an attempt to exploit the availability heuristic. A heuristic is a mental shortcut. The availability heuristic is the brain’s hardcoded assumption that if something is available for recall (i.e., can be remembered) then it must be important.
There are millions of trans people worldwide, and most likely over one hundred thousand in Australia. For every conceivable law-breaking act, no matter how horrific or conversely how innocuous, some trans person, somewhere, at some time, has probably done it. This is also true for every other existing demographic group.
There is no evidence that trans people are more likely to commit any kind of crime (e.g. Price-Feeney et al., 2020). There is significant evidence that, as with many other marginalised groups (e.g. Sun, 2018), crime committed by trans people is over-prosecuted and over-reported, i.e., the same acts are more likely to be prosecuted and to be reported in media if they are committed by trans people than if they are committed by cis people (“Consistent respect,” n.d.; Jones, 2021).
Because of the availability heuristic, a person’s impression of the level of “inherent criminality” in a particular demographic group is determined roughly by the ratio of the number of criminals in that group of whom they have heard to the number of people in that group of whom they have heard. For the average cis person, that ratio is almost certainly higher for trans people than it is for cis people. Consequently, even well-intentioned people often subtly perceive trans people as more criminal.
The tactic of hyperfocusing on and hyperemphasising the individual crimes and criminals of a specific marginalised group is not new or particular to anti-trans activism. For example, during his administration, US President Donald Trump openly and explicitly deployed it against undocumented immigrants to the United States (Dreyfuss, 2017; Kentish, 2017), despite the fact that immigrants of any kind to the United States are statistically less criminal than people born there (Nowrasteh, 2015).
In every instance, it is intended to exploit majority-group citizens’ availability heuristic and bias it even further, to the point that they perceive a given marginalised group as so criminal that they begin to think it might legitimately be “in their blood”.
“Trans people shouldn’t participate in sports; they have unfair biological advantages.”
Sources: Human Rights Campaign Foundation (n.d.); Strangio & Arkles (2020).
In the first place, there is no evidence this is the case. While many arguments have been made that trans women should have a biological advantage, some of them quite superficially convincing, no individual trans athlete has demonstrated a commanding advantage (despite media coverage skating as close to suggesting the contrary as it can without violating defamation law), and no systematic analysis of trans women athletes has shown that trans women en bloc enjoy an athletic advantage over cis women.
In the second place, we actually do not ban people from sports for having unfair biological advantages — or, more accurately, the only people we ban from sports for having unfair biological advantages are the already marginalised.
For instance, Michael Phelps, the most decorated Olympian of all time, is rightly considered to have entirely earned his success. This is despite the fact that Phelps has a genetic variation which causes him to produce half the lactic acid of a typical athlete — he literally accumulates fatigue at only half the ordinary rate (Hesse, 2019). This, as well as his disproportionately long arms and hypermobile ankle joints, provides him with an advantage in his sport which other athletes cannot duplicate simply by putting in the same or more work.
However, Caster Semenya, a South African Olympic medalist who is a Black cis woman, has been excluded from competition under World Athletics rules since 2019 because she is intersex (Swarr et al., 2009). and has naturally elevated testosterone levels (Savage, 2020); therefore, she has been forbidden from competing unless she takes hormone-suppressing treatment (Agence France-Presse, 2020).
In the third place, while the vast majority of cases cited to justify the exclusion of trans people from sports have concerned high-level professional athletics, the vast majority of bills actually proposed and laws actually passed to effect that exclusion have targeted community and children’s athletics.
For instance, the Australian Senate is currently considering the Sex Discrimination and Other Legislation Amendment (Save Women’s Sport) Bill 2022 (Cth). Putting aside the Bill’s attempt at the broad, sweeping rolling back of anti-discrimination law, discussed in the previous part of this series, the Bill’s major legislative contribution to its alleged primary purpose is that, for the first time, it allows sporting organisations to discriminate against children under the age of 12 (Martin, 2022).
This is crucial because the purpose of school sport is not the rigorous comparison of athletic performance — it is to promote “physical fitness, health benefits, cognitive development, personal wellbeing, and social integration” (May, 2022). The purpose of excluding trans kids from sports isn’t to maintain fairness or protect anyone’s rights — it’s to stop them from getting fit and having friends.
“Dangerous to the vulnerable”
Narratives in this group, while often professing tolerance of the right of adults generally to transition, hold that members of specific groups do not have the full capacity to decide whether they wish to transition, and must therefore be prevented from doing so.
“‘Transitioning’ is dangerous to autistic people; they are black-and-white thinkers,” or “they are simply obsessed with gender transition.”
There is evidence that autistic people are more likely to be trans, and that trans people are more likely to be autistic (Strang et al., 2014; Strang et al., 2016). There is no evidence that autistic people are more likely to be wrong about being trans (Jones, 2016 & 2017).
There is significant evidence that clinicians are likely to incorrectly under-treat autistic people based on the misperception that they may be more likely to incorrectly transition (Glidden et al., 2016). There is significant evidence that transness and dysphoria may give rise to intense and specific interests mistaken for autistic special interests by clinicians (VanderLaan et al., 2015).
Alienating
This group of narratives is called “alienating” because it holds that trans people will always be “aliens” in the historical sense — foreigners — to their correct gender.
A definable tendency in this narrative group is “essentialist”. Narratives in this subgroup hold that trans people will always be aliens to their correct gender because they are in some way fundamentally and unchangeably members of their assigned gender.
“Trans people are denying the biological reality of sex.”
This is obviously untrue. Trans people do not and cannot deny the biological reality of sex; that reality is what causes their dysphoria.
Moreover, there is no coherent “biological reality of sex” for trans people to deny. The “biological reality of sex” spoken of is supposed to cleanly divide two groups, one containing cis men and trans women, the other one containing cis women and trans men.
However, sex is not that predictable. Any biological characteristic or combination thereof which is used because it supposedly divides people as above, in reality, leaves several hundred thousand to several million of the “other,” “wrong” group on each side of the line. Sex is a bimodal distribution with two peaks, not a binary distribution with everyone perfectly divided into two bins.
Functional
This category of attacks holds that it is not necessary to provide medical transition services because they don’t or cannot work.
“‘Transitioning’ doesn’t work, because it doesn’t make trans people happier; they’re still unhappy afterward.”
Sources: Osborne (2021).
Anti-trans activists often quote Dhejne et al. (2011), stating that it shows that transition actually makes trans people more suicidal. However, Cecilia Dhejne-Helmy, the lead author of the study, emphatically rejected that interpretation as untrue when interviewed by The TransAdvocate, noting that what her team actually found was that “[m]edical transition alone won’t resolve the effects of crushing social oppression: social anxiety, depression and posttraumatic stress” (Williams & Dhejne-Helmy, 2015).
In short, anti-trans activists who argue that transition doesn’t work because trans people aren’t happier afterwards are intentionally ignoring the fact that they themselves are responsible for that — like saying “defending yourself clearly isn’t effective because you’re still developing massive bruises and bone fractures” while leaving out “because I’m hitting you with a cricket bat.”
“‘Transitioning’ is a lifetime subscription to medicalisation.”
Sources: Lopez (“Myth #5,” 2018).
Another thing which is a lifetime subscription to medicalisation is life. It is an extremely common and normal experience to develop a medical condition which requires you to undergo clinical monitoring and treatment for an indefinite amount of time.
If you are over 40 you should get your blood pressure checked yearly (Better Health Channel, 2015). If you have high blood pressure then you are expected to take antihypertensives indefinitely or until you don’t need them any more. If you don’t do this you are at elevated risk of cardiovascular disease (Law et al., 2003).
People are quite happy to take on a “lifetime subscription to medicalisation,” or encourage its taking-on, when they think the cause is worthwhile. The reason this argument appears when discussing transition is because most people don’t think transition is a worthwhile cause.
“Transitioning leads to regret and detransition.”
Sources: Osborne (2021); Zwickl et al. (2021).
This is incorrect.
The percentage of people who undergo gender-affirmation surgery who regret it later is 1% (Bustos et al., 2021). The percentage of people who undergo any gender-affirming intervention who regret it later is 1.4% (Smith et al., 2004). By comparison, the percentage of people who regret undergoing all surgeries, in aggregate, is 14.4% (Wilson et al., 2017).
There is absolutely no question that detransition occurs. The rate at which it occurs is unclear due to methodological differences and discursive controversies. Some older mainstream sources quote numbers as high as 5% (e.g. Goldberg, 2014); more recent methodologically rigorous investigation places the number at or below 0.5%, with the vast majority retransitioning later (Davies et al., 2019). Turban et al. (2021) found that, among people who had detransitioned, only 2.4% reported “uncertainty or doubt around gender” as their reason, or one of their reasons, for detransitioning.
Disproportionate focus on detransition by media outlets for the sake of sensationalism and engagement causes general audiences to feel that detransition is much more common than it is due to exploitation of the availability heuristic, discussed above (Knox, 2019).
Majoritarian
This category of attacks holds that the full social participation of trans people should not be allowed because, “in actual fact,” most people oppose it.
This is fundamentally the “silent majority” argument pioneered, in its modern form, by supporters of the Vietnam War, most prominently including US President Richard Nixon. The big problem with the silent majority is that they’re silent — they are defined by not expressing their position in any tangible way. What the silent majority allegedly believes is no more or less than what the speaker invoking them reckons they can get the audience to believe.
It is also not accurate. The well-developed UK theatre of the anti-trans culture war provides excellent evidence of how consent is being manufactured for majoritarian-type anti-trans narratives in the field.
Attempts have been made to give the impression that anti-trans sentiments enjoy widespread support in the UK by causing hashtags which indicate endorsement of transphobia to trend on Twitter. However, trans community intelligence and analysis group Trans Safety Network demonstrated that the hashtags were actually being boosted by a very small and determined crew of hardcore activists using weaknesses in Twitter’s algorithm (Allsopp, 2021; Moore, 2022).
By June 2020, attempts were being made by anti-trans sources to indicate that there were organised anti-trans groups in the Conservative Party, Labour Party, Liberal Democrats, Scottish National Party, and Women’s Equality Party. However, Scottish actor and trans ally activist David Paisley showed (Paisley, 2020a) that the groups in question had no significant links to the parties they claimed to be affiliated with, but did have strong links with multiple prominent anti-trans organisations, including in one case a “party group” using substantial copy from an anti-trans organisation verbatim and without attribution (Paisley, 2020c).
By November 2020, attempts were being made by anti-trans sources to indicate that UK anti-trans groups had sufficient grassroots popularity that they had gained international chapters. However, Paisley (2020b) again showed that the actual following and membership of these groups, including LGB Alliance Australia, was based overwhelmingly in the UK, and that every international chapter of LGB Alliance was registered using the same UK email address and phone number.
Pathological
This category of attacks holds that being trans is a sickness.
“Transgenderism is a mental illness.”
Sources: Lopez (“Myth #8,” 2018).
Transness is a normal human variation. It is not considered a disease because the distress it causes isn’t inherent to being trans; it’s inherent to being both trans and unable to transition. Access to transition care largely resolves dysphoria; the parts of it that are so far irresoluble can be resolved by future refinements in gender-affirming care.
“Transgenderism is the result of trauma.”
This hypothesis has been floated in research circles for at least 50 years, and, as Malone (2017) mentions, many clinical social workers treat it as if it were true. However, as Giovanardi et al. (2018) note, “to date, no solid empirical support has been produced” to suggest that this is the case.
Combination
This category of attacks combines aspects of other defined categories of attack.
“Kids aren’t old enough to know their gender identity.”
Sources: Lopez (“Myth #7,” 2018); “Some common myths about gender” (2019).
This combines elements from two other narrative groups,
- “ahistorical–memetic” (because transness is implied to be a transmissible idea that kids get infected with, rather than an inborn trait); and
- “dangerous” (for obvious reasons).
The narrative is not true. Gender identity appears to be durably formed and impossible to change by the age of 3 (Hine et al., 1983, p. 106); invariably, when kids are expressing their wish to transition, gender identity is a reality, not something a parent can wave or wheedle away.
“Transgenderism is a sexual fetish.”
This combines elements from two other narrative groups,
- “pathological” (because transness is implied to be a paraphilia, a sexual pathology); and
- “dangerous” (because the idea that transness is sexual means that trans people are dangerous sexual predators).
A keyword often used here is autogynephilia (“love of oneself as a woman,” from Greek autós “self” + gyné “woman” + philía “love”). The concept was developed by Ray Blanchard, a Canadian sexologist, who determined that some trans women were aroused by the thought of having sex as women.
However, Blanchard’s contention that trans women were often aroused by the thought of having sex as women, and that their womanhood was therefore in fact autogynephilia, a sexual fetish, did not account for the fact that based on the same questionnaire, 93% of cis women also qualified as autogynephilic (Davy, 2015). It also did not attempt to explain trans manhood, which obviously could not be explained by fetishising the idea of oneself as a woman (Ekins & King, 2006, pp. 86 et seq.).
“Transgenderism is a social contagion.”
This combines elements from two other narrative groups, “ahistorical–memetic” (because transness is alleged to be a transmissible idea) and “pathological” (because that idea is seen as a sickness, typically as a mass psychogenic illness or “mass hysteria”). This argument is also known as the “rapid-onset gender dysphoria” (ROGD) argument, because of the specific form of gender dysphoria that “socially-acquired” transness is alleged to cause.
There is no evidence that transness is socially acquired. The paper usually cited to support this argument is Littman (2018). There are fatal methodological flaws with Littman’s paper, the overriding one being the sampling methodology: she handpicked subjects who would support her predetermined hypothesis and made no attempt to acquire subjects who wouldn’t (Restar, 2019).
Bauer et al. (2021) investigated whether the “ROGD”/”social contagion” hypothesis stood up to empirical evaluation, and determined conclusively that it did not.
“Trans people are demanding change too fast for society to tolerate.”
This combines aspects of “ahistorical” (because it is asserted that change has never happened like this in the past), “dangerous” (because if trans people are given what they want it will cause damage to society), and “majoritarian” (because an assertion is made about the preferences of the majority of society).
This is basically just conservatism — the belief that cultural, social, and political institutions should be preserved in their present form. It is of an entirely political nature and doesn’t make a claim on reality that can be tested or verified.
Projective
This group of narratives is heterogeneous. Narratives in this category may have features of other categories, but what distinguishes them is that they accuse trans people and transness of doing something that anti-trans activists and transphobia are actually doing.
“Transgenderism is just anti-gay conversion therapy.”
Sources: Lopez (“Myth #2,” 2018).
The proposition here is that the intent of transition is to turn queer cis people into straight people by switching their genders. This is fundamentally based in the idea that trans people are simply Ultra Gay, which is not accurate.
If it were the case that transness was intended to reduce the number of queer people, it would not be very effective: in a 2015 survey of US trans people (James et al., 2015), of the 27,715 respondents, 89% reported being something other than heterosexual.
One popular variant of this argument is that “the patriarchy is trying to get rid of lesbians by transitioning them into men”. This, of course, simply ignores the existence of trans women; of the trans women who responded to James et al. (op. cit.), 27% reported being gay (i.e., attracted to women), lesbian, or same-gender-loving specifically.
“Transgenderism is just the sexist performance of stereotypical gender norms.”
This is inconsistent with trans people’s actual performance of gender.
Many trans people do not conform to presentations that are normative for their correct gender; for example, there are stone butch trans women and high femme trans men.
Many trans people have genders which simply have not been widely enough by convention to have stereotypical norms. It is difficult to accuse a nonbinary person of performing stereotypical norms of gender when for much of modern history society has avoided even acknowledging that their gender exists.
Inasmuch as trans people have historically performed gender norms it’s because they’ve been forced to; access to transition therapy has often been gated behind demands that trans people be conventionally attractive in their correct gender, or that they present themselves in a way the clinician considers “consistent” with their correct gender.3
As Amnesty International (“Stop trans pathologisation worldwide,” 2017) noted, the stereotypical performance of gender norms in trans people is forced by the conservatism and unquestioned prejudice of clinical staff — not the desires of trans people themselves.
Closing
This second installment explored why the architects of the war on trans people say it must happen.
The next installment will explore the much less chaotic, much more consistent reasons why the war is actually happening.
Footnotes
1 — The author chose to use feminine pronouns for Elagabalus because she felt that to do otherwise would be morally wrong. Readers are, of course, entitled to their own views.
2 — To clarify, this is a stronger condition than it sounds. On the face of it, the condition sounds weak because medicine is generally perceived as self-administered, and when medicine is self-administered it is possible easily to deviate from treatment protocol — for instance, the author has managed to frighten her GP in the past through overenthusiastic chronic use of paracetamol.
However, puberty suppression medications are invariably administered and monitored by the treating practitioner. This isn’t a case of “they should always be,” it’s a case of “they are”; puberty blocker supply is so tightly controlled that the price of a single blocker injection without PBS coverage is $951. Any deviation from protocol is thus wholly the responsibility of the practitioner.
3 — The author, a 27-year-old trans woman who began her transition in 2020, has on one occasion been questioned by a practitioner for wearing jeans to an appointments (women’s jeans with no unusual or distinct features).
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