This is a collection of personal stories and pictures of teens from the New York area who have been involved in the Callen-Lorde Community Health Center. They are young people who are questioning of the gender they were assigned when they were children and who use names and wear clothes often associated that create a new identity.  Some of them take hormone medication to change their physical appearance and change their bodies.  They call themselves transgender, although that’s a label that shifts and there are other related cases of people who also question their gender assignment are experiment with gender.  (There’s a useful fact sheet here about transgender, transsexualism, and intersex.) While it is clear that it is a good idea to be supportive of people who are unhappy because of their given gender assignment, and want to change, it is much less clear what should count as a disorder, what counts as a medical or psychological problem, and whether hormone treatment and surgery creating changes in the genitals should count as a treatment for a medical problem.  It does seem that many people who identify as transgender become much more comfortable in themselves when they start taking hormones to change their bodies and even to create major changes to their genitals.  This is an ongoing part of our changing attitudes towards sexuality and gender and our readiness to change their categorization.  These are ideas that are continuing to evolve, and there is a diversity of opinion in medicine and psychology about how best to help people who do not accept their given gender.  How much is it biology, how much psychology, and how much the social environment?  Life in the USA has changed a great deal in the last century, relations between men and women have changed, and we have different ideas of what it is to be a man or a woman.  But we are not moving towards any major erasure of gender difference; if anything, the enforcement of gender stereotypes for children seems more vigorous now than it was 30 years ago, and of course, there is much more obvious sexualization of children and young teens now in popular culture than there was in earlier decades.

This book provides plenty of food for thought and helps readers understand a certain perspective on transgender experience.  The young people here have their words (that seem to come from interviews) put into print.  There’s some contextualizing and explanation from the book’s author Susan Kuklin but she does not add much in the way of her own commentary.  There is a short section at the end of the book about resources available for people seeking help, and there is a brief interview with Manel Silva, who directs the “Health Outreach to Teens” program at the Callen-Lorde Center. 

Working out how to treat people who have same-sex sexual and romantic preferences is simple.  Let them do what they want to do, and be who they are.  It is more complicated with transsexuals because who they are is up for grabs.  It is not clear how much of their desire to be different is a result of a mental disorder.  Sometimes they say they are a man in a women’s body, or a woman in a man’s body, but what is there to verify those claims?  Often their sense of identity seems unstable.  That’s often apparent in these interviews.  For example, Jessy came out as a lesbian when she was a teenager, but she was attracted to straight women.  He was identified as a girl, but he was a tomboy when she was little.  Now he identifies as male, and he binds his breasts and takes estrogen.  He says “God made me transgender for a reason.” (25). So, maybe he identifies more as transgender than male or female.  Often the tempting conclusion from these narratives is that gender is fluid and contestable, and is not fixed.  That makes it confusing when people would want to take medications that have possibly serious side effects and can’t make profound changes to genitalia or genetic composition.  Why not take gender less seriously rather than take it so seriously that one engages in what is ultimately just a cosmetic change?  Wouldn’t we better off trying to change social attitudes so that we are more accepting of diversity rather than engaging in medical efforts to conform to old gender stereotypes?  Transgender can definitely be confusing, and even bewildering.  It would be helpful to know how much the people interviewed have explored other options with revolutionary sides to them rather than attempting to conform to conservative ideas of gender. 

So this book does not provide an ultimate answer to the “true nature” of transgender.  But it provides an interesting perspective and some memorable stories.  It is important to remember that it is just one perspective, and that these young people have been selected from a particular program.  In expanding the dialog on approaches to transgender, it would be good to have more information about other approaches.

© 2014 Christian Perring

Christian Perring, Professor of Philosophy, Dowling College, New York