People Get to Do Things They Might Regret

The Guardian is apparently a font of anti-trans articles and articles that can be used that way, between the mom insisting that her kid is a tomboy and is not trans (despite a previous article where the kid states that he’s a boy), the really harsh letter to a trans ex, and this article detailing the experience of a woman who started a transition to male and regretted it. The article in and of itself wasn’t anti-trans, but it was thrown at me as a supposed example of “children being sterilized because they’re confused about their gender.” (It’s not—she was 18 when she had surgery and while testosterone can affect fertility, she still has a chance to get pregnant.)

Before sharing my take on this article, I want to give some background from actual trans organizations on the subject of detransition and amplify the voices of trans people who have been there*:
http://transadvocate.com/transitioning-back-to-ones-assigned-sex-at-birth_n_9946.htm – An explanation from Trans Advocate about reasons people detransition, as well as statistics
http://web.archive.org/web/20080409023914/http://www.joanneherman.com/Trans_101_regret.html – The author of Transgender Explained for Those Who Are Not, a trans woman, writes about why people regret sex-reassignment surgery
https://www.vice.com/en_us/article/dispelling-the-myths-around-detransitioning – An interview with two trans women who were widely reported as detransitioning. (One had only paused; the other had decided to detransition due to social pressures but changed her mind again.)

As far as the author’s experience itself, she was dealt a really crappy hand, and I have an awful lot of sympathy. She transitioned very quickly after being suicidal as a teenager. She had no counseling at all and started hormones and had chest surgery at the age of 18. Her chest surgery was botched, leaving her with major scarring. So, that’s two huge instances of extremely poor medical treatment. The usual standard of care involves not only counseling, but a whole year of Real-Life Experience (RLE) living openly as their gender prior to any surgery. (Some doctors even require it before hormones.)

She’s also completely right that oppressive sexism makes women and girls feel broken when it’s society, not us, that has something wrong with it. And it’s much easier to try to change yourself than to fight against the forces of society that try to force you into compliance.

I think hers is a story that’s worth telling, because it underscores the importance of good counselling before making a life-altering medical decision, as well as the damaging effects of misogyny. Also, it’s a true story, and everybody deserves to have their experience heard and respected.

But. (There’s always a but.) The way I’ve seen it used is really harmful. This author’s experience is *not* the norm for trans people who undergo surgical transition. There’s usually tons of counseling and a requirement that the person live as their gender prior to surgery. If you want to use this article to say, “Some counseling should exist,” great, most trans people would agree with you. But if you want to use it to expand gatekeeping that already makes trans people’s life more difficult, or to argue that we shouldn’t acknowledge people’s gender when they tell us they’re trans, then not so much.

The idea that adult people need to be protected, at all costs, from doing anything they might regret is pretty infantilizing. People particularly freak out about sterilization, whether directly through surgery or indirectly in the cases where hormones make someone infertile. (They also tend to assume that the second is an automatic guarantee, which it is not.) And yet, a lot of those people, certainly the ones who consider themselves feminists, wouldn’t question a cis woman’s right to have her tubes tied if she doesn’t want children or doesn’t want more children. To expect a trans person to undergo more strenuous gatekeeping than a cis woman for a similar choice indicates that you don’t view them as adults who can make their own decisions. (That’s not to diminish the amount of gatekeeping women who want permanent sterilization *do* face, especially if they haven’t had kids at all.)

Everyone will make dozens of choices in their lives that they might regret. Medical ones tend to have the most gatekeeping, with consent forms and counseling, but everything from your choice of a college major to your choice of a spouse can change your life. And that’s just the decisions that you know are life-altering at the time. It’s pretty obvious when you’re standing up in church or the courthouse to say “I do” that this is a life-altering moment, but asking that person for their number or sitting down next to them in chem lab probably didn’t seem like a turning point. It’s hard to imagine a life where you can never make a choice you regret. Your choices would have to be so constrained by other people as to be completely meaningless.

There’s no way to stop people from making decisions they may later regret, nor should we try. The best we can do is make sure they have good options available to them and have the time and information to make the choice that’s right for them. It may turn out that what they thought was right for them at the time wasn’t, but they’re still the only person who can make that choice.

With kids, of course the ideal is that they never have to face major decisions they aren’t ready for, because they have loving parents and a network of school and community to shield them from that. Reality, of course, is not that simple. A pregnant fourteen-year-old can either give birth or have an abortion. If she gives birth, she can raise the baby herself or put them up for adoption. All of those are life-altering choices, and there’s no neutral option.

I don’t want to equate being a trans teen with being a pregnant teen because they’re very different life experiences (and some teens experience both), but in both cases, there are no neutral options. There’s a cost for a kid to live as their assigned at birth gender, and a cost for them to transition. Current medical best practices include puberty blockers, giving the kid time to think about the decision and keep all their options open. Then, if they decide to transition, there’s more counseling at each step. The intent is already to protect kids from having to make life-altering decisions before they’re ready, and to make sure that they and their parents have the necessary information and fully consider all medical decisions.

The one place where I truly disagree with the author of the Guardian piece is where she says transitioning “should be seen as the last resort.” I think the idea of transition as a last resort is harmful because it adds onto the standard of informed consent. It’s not enough that the patient be aware of all their options and have thoroughly considered their choice. Instead, they have to somehow prove that they’ve suffered “enough” or are at “enough” risk to be allowed to transition. Considering that the author herself was suicidal when she transitioned, the bar for “last resort” would have to be extraordinarily high to have prevented the transition that she came to regret. So how many suicidal trans people would be denied care and would die as a result? Obviously, she didn’t get appropriate medical care. She had no counseling, and her surgery was botched. So of course she wants stricter standards. But “last resort” swings too far in the other direction, and it doesn’t treat trans people as adults who get to make their own life decisions.

*Referring to gender gets a little messy when people detransition, but the basic principle is to respect how someone refers to themselves. The author of the Guardian piece is “she” because she states that she’s a woman, not a trans man. Likewise, the two women interviewed in the Vice article paused their transitions but identify themselves as women. (This would be the case regardless of what surgeries they have or don’t have, or what meds they take or don’t take.)

The Little Black Yippy Dog Does Not Want a Hug

Let me add my voice to the “No! Don’t do that!” chorus, because that’s not just the opposite of help, but actively dangerous and skeevy as all hell.

First, let me introduce you to my imaginary dog Yippy, who is my metaphor for anxiety. The world is a terrifying place when you’re a nervous little black dog, so he barks at everything all the time.

This metaphor works particularly well for this trash advice, because dogs in general really don’t like hugs. A dog might accept a hug from a loved and trusted human, but a random acquaintance who picks Yippy up and gives him a hug is likely to get bitten. If he’s scared or agitated enough, and you ignore the warning signs, you might get bitten even if he knows and likes you.

Likewise, if you randomly grab me against my will while I’m having a panic attack, and continue to hang on while I’m struggling to get away, I make no promises that I won’t deck you. I’ll probably be with it enough to realize that this is a misguided attempt to help, and try to fake calm long enough to get your grabby hands off me, but that’s not a guarantee.  And if you try that with someone who has PTSD and is in the middle of a flashback? Bad call.

Panic attacks are different for everyone, but when I have one, I often feel trapped and warm, like the room is closing in on me and I can’t get enough air. Putting your warm body up against me and closing me in is going to make both of those things worse, and be the exact opposite of help.

One thing that strikes me about this advice is the many ways in which it’s dehumanizing. First and most obvious is the hostility to consent and the assumption that you can restrain someone “for their own good” as a random bystander. It also treats people having panic attacks as a problem with a single solution. Dude, if it was that easy, everybody with anxiety disorder or PTSD would pass this sheet out to everyone we know, and all our panic attacks would be instantly fixed. Humming or whispering might help some people in some situations, but I’d just find it irritating. And there are few things *less* helpful to say to me during panic or anxiety than “It’s going to be okay.” Especially since November, because it may very well not be.

I can picture a couple situations in which it would be reasonable to grab someone who’s having a panic attack. (This is as a friend, acquaintance, or other random bystander. If you’re an actual medical professional, I won’t presume to tell you how to do your job, but I certainly hope you have more training on the subject than a random Tumblr post.)

The first is if they’re in imminent physical danger that they seem to be ignoring or unaware of. If I’m too busy hyperventilating to leave a burning building, and don’t respond to “Hey, Kel, we need to get the hell out of here,” yes, please, drag me out physically.

The second is if they, specifically, have told you, specifically, that this is how they want you to help them handle their panic attacks. People vary wildly, so it’s entirely possible that this is helpful for some people, especially from someone they trust. I do find hugs helpful when Yippy is losing his shit, but offered, not forced, and from my husband, not anybody and everybody.

If you want to help a friend or loved one who has panic attacks, *ask them* what would be helpful. If you want to be a generally useful good Samaritan to anyone who might have a panic attack or other mental health problem in your general vicinity, mental health first aid classes are a thing.

Love for the Real Person

Ragen Chastain has a fantastic post called Hate the Fat, Not the Fatty about how you can’t claim to like or respect someone while not treating them as a credible witness to their own experience.

While I appreciate someone treating me well, what I truly value is people respecting that I am the best witness to my experience. So when I say that my body is fine, that I’m happy with the path to health I’ve chosen, the proper response is “awesome”, not “Well, I don’t think you should be treated badly, but I do want to eradicate everyone who looks like you from the Earth and make sure that there are no more.”

When you try to separate people from parts of their identity, to love the fat person but not the body that they live in, or to love the gay person, but not their sexuality, you’re not really loving them. You’re loving a pretend version of them who only exists in your head. Actual, real love accepts the other person as they are. You don’t have to like or understand everything about them, but you can’t pretend that you know them better than they know themselves, and you can’t try to make them into something that they’re not.

Something I see a lot aimed at both fat and LGBTQ people is tolerance without acceptance. “Oh, I don’t think you should be bullied or discriminated against. I just think your lifestyle is sinful/unhealthy.” What irritates me is that the people spouting this always act like they’re doing us a favor. Oh, wow, you don’t actually want me to be thrown in jail for my sexuality or be mooed at on the street. You’re such a paragon of love and acceptance. Do you want a cookie?

I mean, yeah, sure, I’d rather have grudging, “But I still think you’re wrong,” acceptance than to have someone actively fighting against my right to exist. But it’s the bottom of the barrel baseline of being a decent person, not some extra special compassion for which you deserve an award. Especially not if you cry that you’re being branded as a bigot for telling people they’re going to hell and/or driving up insurance costs and going to die horribly.

But not actively harming people isn’t love. It isn’t even like. It’s just not actively being a jerk. It doesn’t merit any special praise.  Acting like it does just reinforces the idea that the people you disapprove of are broken—look what a good person you are, letting them exist in your space and breathe your air, how hard it is to accept their existence.

To really love someone is to see them and appreciate them exactly as they are.

Missiles and Futility

This week’s attack on Syria seems like the ultimate in futility.  We didn’t damage much of anything, except whatever tattered shreds of credibility we might have had left as a nation. We showed off that we have lots and lots of Tomahawk missiles, and the ability to blow shit up whenever we’re so inclined. We didn’t affect Assad’s ability to carry out chemical attacks in the future, beyond providing a deterrent.

But, then, I’m becoming jaded enough to think that none of that was the true purpose.  Doing something that Russia publicly disapproves of both provides an argument against Trump being Putin’s puppet and distracts from the ongoing investigation.  And the media lapped it up.  Oh, look how Presidential he is.  He’s leading with his heart.  Yeah, and he’s got ocean front property to sell you in Arizona.  Truly fabulous, great ocean views, right in Arizona. Really just the best.

It’s probably too uncharitable for me to say that I have not yet seen evidence that our President has a heart, much less that he leads with it. But it would do a lot more to convince me that this action was out of compassion for murdered Syrian children if he was willing to allow some of them to resettle here.

Nikki Haley’s justification for this blatant hypocrisy is that we just want *vetting.*:

What this president has done is said, ‘Prove to me that you are vetting these people properly. And if you are vetting them properly, then we will resume where we are. But until then, you have to prove to me that these people are being vetted in a way that we’re not putting American citizens at risk.

That would actually have some credibility if the administration had come out with any sort of plan for improved vetting, requirements for what “proper” vetting consists of, or specifics on what’s insufficient about the most extensive vetting of any means of getting into the country.

It would also be more credible if any refugee had at any point carried out a terrorist attack in the US, and if we weren’t currently in the midst of an epidemic of violence carried out by white, ostensibly Christian, native-born citizens.  If you check out the gun violence archive, we rarely go more than 2 or 3 *days* without someone shooting up a school, mall, or place of business. We’ve become so inured to these constant, near-daily acts of terrorism that they don’t even make the news unless there’s a body count in the double digits.

America is driving down the road doing 30 miles over the limit in a rainstorm, with bald tires and dodgy brakes, cell phone in one hand, cigarette in the other. But we refuse to stop for a terrified, desperate hitchhiker, because she might be dangerous.