medical gatekeeping

Algorithms of dysphoria

I am one of those fortunate trans people who don’t experience a lot of dysphoria around their gender. Really, for years now I’ve been in a place where I go long periods without thinking about my gender at all (which makes a certain kind of sense since I’m pretty much agender, to be honest. Why would I spend time thinking about something that doesn’t exist?*)

The dysphoria I do experience is mostly (maybe entirely?) social rather than physical/bodily – which is to say, I can and do experience discomfort related to my gender when I am misgendered (explicitly or implicitly), but my body itself isn’t a source of dysphoria for me. This makes me very lucky, because it means I can, and do, escape from sources of dysphoria on a regular basis. It’s a lot harder to run away from your own body.

But still, when you get right down to it, social and physical dysphoria aren’t as easily separable as all that. And this is an important point, because there are people who like to gatekeep non-dysphoric trans people, or solely socially dysphoric people from being considered Really Trans (TM). There’s a related misconception that direct physical dysphoria (that is, discomfort with one’s own body) is the only reason someone would pursue medical transition (hormones, surgery, etc.) – the true hallmark of being Really Trans.

Reality is, of course, far more complicated than that.

In fact, if I experience dysphoria because the shape of body causes people to misgender me, even though the *best* solution would be to teach people not to do that, the more expedient solution is still be medical intervention to my body (who wants to wait through the several generations it’s likely to take for the general population to get comfortable with trans people in general, let alone non-binary genders?) But in many cases, even if there are doctors near you that work with trans people in the first place, depending on the model of care they follow, simply being non-binary, being someone who experiences primarily social forms of dysphoria, could make you ineligible for their help.

So people who don’t experience the “right” kind of dysphoria can be stuck in a feedback loop of gatekeeping, they’re not Really Trans because we don’t seek medical intervention, but we often times *can’t* seek medical intervention, on the grounds of not being Really Trans


*this is mostly facetious. Being gendered all the time when you’re agender can be pretty uncomfortable.