The ‘Unbearable’ Prospect of Transition Being Paused

While delays in medical treatment for people undergoing transition may be painful, they present an opportunity to reflect on the realities of our human bodies.

“Her drama was a drama not of heaviness but of lightness. What fell to her lot was not the burden, but the unbearable lightness of being.”

Milan Kundera, p. 2

In the face of the COVID-19 lockdown, concerns are being raised over the compromised health and well-being of transitioners. Not because those taking hormones compromise their health – which they do – but because of alarm over delayed surgeries.

Leo writes: “Top surgery got cancelled because of coronavirus concerns : ( Give me mastectomy or give me death!”

Such posts read like Poe’s law in becoming indiscernible from self-parody.

While a ‘lighthearted’ sample of the current trans zeitgeist, the desperation of girls and young women to sever healthy breast tissue has earned widespread derision. Delaying surgeries not considered vital is key to managing the crisis, yet the media hypes trans surgery as lifesaving.

The media relies on gender-affirming professionals to make the case. Lobotomists – I mean “gender affirming” therapists and surgeons – line up now to mutilate on call, creating surgical demand by their ever-readiness to slice and dice female genitalia. 

Newsweek recently featured Dr. Alexis Chávez, the psychiatrist for The Trevor Project, whose mission is activism to prevent LGBTQ youth suicide. While an admirable goal, suicide by trans-identified individuals is not decreased by “gender-affirming” surgery.

In a Feb 2020 study that collected comprehensive Swedish data while avoiding both self-selection and self-report bias, distribution was flat across all stages of transition. In other words, there was no decrease in suicides with completion of ‘gender- affirming care‘.

Actually there may have been an increase in suicides. Those committing suicide would naturally be part of the study’s 36%  loss to study, and it is reasonable to conclude additional uncounted suicides as well as other poor mental health outcomes.  

Transitioning in the time of cholera, I mean COVID-19, is traumatic. Surprisingly, Dr. Chávez does not recommend youth maintain family contact through the crisis. Nor does he reasonably urge caution or suggest pausing hormones and surgical ambitions.

Instead, Chávez normalises estrangement from family by giving advice that parents accept emotional distancing from their kids. Sounding glib, Chavez recommends parents ask: ”Are you feeling green or red today?” At this precise historical moment – when trans-identifying youth most need caring family – Chavez virtue signals by calling up the absolute unbearable prospect of being misgendered as justification for withdrawal from family.

Newsweek also cites Molly Landgraff, who recently paused testosterone, and she unrealistically suggests the trans community will crowdfund estranged youth.

The mask is off transitioning, and the public is no longer willing to toe the trans- or- death line. Writing for Feminist Current, Meghan Murphy sums up the general response to such claims this way:

“the truth is that anyone who is so heavily reliant on a weave, surgeries, laser treatments, filler and botox, as well as on fashion, for their ‘survival,’ is not going to survive trying times like these. Claims that ‘misgendering literally kills’ or that one’s cosmetic surgeries are a matter of life and death are laughable at best, and contemptible at worst, considering our current circumstances.”

Meghan Murphy

In actuality, transitioning itself could be a risk factor for COVID-19. Particularly at risk would be women taking testosterone, which can suppress immunity. Emily Zanotti writes: “Since coronavirus seems to have an outsized impact on those with underlying conditions or those in a fragile medical state, that could make transgender individuals recovering from surgery particularly susceptible to complicated versions of the disease.”

Trans-identified youth seeking surgery need to understand, in other words, that a person’s own immune system plays a critical role in fighting the virus, and taking hormones suppresses their immunity. 

Catastrophising feeds transitioning-brain, so there is good reason the public is becoming impatient with the ongoing push for transitioning. A pattern emerges. Validation demand has continued despite the current shortened attention span diverted by the pandemic, producing distress.

A spiral of anxious rumination, validation seeking, and texting with dysphoric peers ensues, further escalating anxiety for which medical transition is the only answer on offer.

The whole effect of transitioning is dissociation from one’s body in favour of trans-messaging and attention seeking. Unable to tolerate their own nonconformity and understandably caught in the trans catch-22, trans-identified youth demand ongoing acknowledgement of their pain. 

Medical focus is now riveted on the health crisis, which does not cancel out the anguish these [mostly]women experience but lends it a grace period, a means for taking stock. Reflection can begin with the pandemic potential of hospitals becoming hotbeds of virus.

It might encompass choosing to pause testosterone for safety’s sake and using this as a time to assess its effects at the physiological level of basic well-being. Enduring through dysphoria means discomfort – sitting with one’s anguish – yet can also lead to discovering alternative coping mechanisms besides affirmation dependency. Listening to the body may be deepened by getting out in the sunlight, appreciating the fresh smells of spring, and experiencing gratitude for being alive.

Rather than ruminating over self-hatred and amplifying anguish, this pandemic can be an opportunity for online sharing with anyone experiencing distress. Especially now, when people are feeling isolated, reaching out can lend genuine help in finding ways through pain.

Tucked inside the trans experience is the basic frustration for each of us of being confined to a human body. Existing and even thriving in dysphoria finds parallels in our shared lockdown. There is a heightened sense of the body’s limitations and frailty just now; nevertheless, we are elevated by one another in ways that reveal our mutually-sustaining presentness to one another in the ephemeral reality of human embodied life. Its unbearable lightness might thereby become more liveable, more coherent.


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