‘Being trans is not something you put on and take off. It’s part of who you are’

Felix Moore Upon his death in 1989, retired jazz singer Billy Tipton, who lived as a man for more than 50 years, was discovered to be transgender. His story generated sensationalist press attention, but it also drew the notice of the trans community. “Men like Billy,” trans activist Lou Sullivan wrote at the time, “prove that we as FTMs [female to males] are not a bizarre recent phenomenon.”

Here I am as a trans man today, still having to explain and justify my identity. Growing up, I couldn’t have been less like the popular idea of a trans man. I played with Sylvanian Families, not monster trucks. I loved sparkly dresses and anything purple. I was a girly child who grew into a girly man. People sometimes expect trans people to embody a stereotypical image of their gender identity, but in my experience trans people are much more likely to be creative and unconventional in how we express gender. This is even more true among people I know who are both autistic and trans, myself included.

Being transgender is one of the great joys of my life. The trans community is the most loving and supportive I know, and no amount of outside hostility could make me regret joining it. None of the painful experiences I have had as a trans person were due to my trans identity. They were, and are, to do with the way trans people are treated by the wider world. And unfortunately, the treatment of trans people in the UK has gone from bad to worse.

As the trans journalist Freddy McConnell has said, many anti-trans groups pursue a strategy of “death by a thousand cuts”. They will pick any fight, no matter how pedantic, trivial or groundless. Anti-trans groups and individuals will turn something banal into a manufactured point of outrage, such as questions in the census or the use of the words “pregnant person” – the standard language since 2007 – in the new Maternity Act. Their attacks deprive us of the time and energy to talk about the devastating reality of being a trans person in the UK. I cannot tell you how fervently I wish that we had time to care one iota about what gendered prefix to use for a plastic potato. I am so tired. Every week there is another repetitive, infuriating debate, while I watch my friends plan to leave the country because they are afraid to keep living here.

The American writer Janice Raymond’s 1979 book, The Transsexual Empire, is in many respects a foundational text of the anti-trans movement. She argued that “all transsexuals rape women’s bodies by reducing the real female form to an artifact” (although she expressed regret, 35 years later, that “rape was not a proper metaphor because it minimised the distinct meaning of rape” this doesn’t to my mind remove the insult against trans people). She saw medical transition with surgery as a manifestation of “sexist, social conditions” that she called “transsexualism”, which, she said, “would be best served by morally mandating it out of existence”. Recognising that “the elimination of transsexualism is not best achieved by legislation prohibiting transsexual treatment and surgery”, Raymond advocated limiting it, for example by reducing the number of hospitals and clinics that performed gender-affirming surgeries.

Although not everyone who opposes trans rights shares her views, her writing remains a key influence on anti-trans activism. Anti-trans groups today don’t say that no trans person should be able to medically transition, but they lobby for restrictions on transition-related healthcare, or bombard services with so much hostile attention that they become impossible to run effectively.

Rowan Moore You experience many emotions when your child comes out as transgender. You want to support them but you also feel doubt: is this for real? Have they caught this off the internet? Will they make irrevocable choices that they will regret? You will discover that your child is not who you thought they were, which might shock you, although I’d say that this is something every parent should go through as their children become adults. You might have conflicts (we did) about the best courses of action.

So I understand the anxieties that cisgender people like myself sometimes have. But the parent also discovers more about what it is to be trans, how much seriousness and commitment it takes. It is not easy to start dressing to suit your chosen gender, to endure strange looks and possible hostility, to go into the relevant public toilets, to tell family and friends, to persuade people to use your name and pronouns, to undergo medical evaluations, to endure the increasing number of obstacles and delays that lie between you and medical attention.

All of which takes place over years (it’s been more than seven since Felix came out to his immediate family). And then, hopefully, parents see their trans children grow more comfortable in their skin, more confident about who they are. Neither parent nor child might ever know for certain if the “right” choice has been made, or if things might have been different in other circumstances, but such uncertainties are surely part of life in general.

To be the parent of a trans person now, in Britain, is also to witness a regular assault of distortions and half-truths. We hear that trans people can access medical treatment with dangerous ease, when they in fact face monstrous waiting times, or that there is a powerful trans lobby trampling on the rights of others when anti-trans groups are significantly better resourced. Hostility to trans rights runs across the political spectrum, from the Arkansas Republicans who have just banned treatment for young trans people, to George Soros-haters, to radical feminists and liberal opinion formers.

Space does not allow us to address all of these issues in detail, but Felix and I have picked out some of the more significant themes from recent debates, and address them below. We have tried to show how these questions look if you take into account the humanity of trans people. Being trans is not something you can take off and put on like clothes, or put on hold while others discuss the rights and wrongs of your situation. It is part of who you are. Many commentators on trans issues don’t seem to understand that.

How easy is it to obtain medical treatment?

FM The UK prides itself on being a country where medical care is free and accessible to all. But this is no longer true in any meaningful sense for trans people. None of England’s seven NHS gender clinics comes close to meeting the legal standard that patients should receive specialised care within 18 weeks – the average waiting time is 3.5 years. The trans charity Gendered Intelligence has calculated that “if the current intake of patients holds at its current rate, the waiting time for a first appointment at an NHS adults’ gender identity clinic in London will be 26 years.”

When I started transitioning, personal fundraising for healthcare was something that only happened in the US. Now my social media feed is an endless stream of fundraisers to privately fund hormones or surgery. Those who cannot afford a privately funded transition often turn to self-medicating with hormones bought online, from unregulated sources. In 2018 I helped write a survey on trans healthcare experiences: respondents described resorting to sex work, going into overdraft and living hand to mouth in order to fund their transition.

One-third of the 773 respondents reported that waiting for a gender clinic appointment had contributed to suicidal behaviour. One wrote: “If I hadn’t started self-medicating out of desperation, I’d have hanged myself by the end of 2018.” I cannot help but feel that every word wasted on manufactured debates could have been spent talking about the fact that trans people are being driven to a choice between self-medication and suicide.

Gender clinic patients undergo repeated psychologender clinical examinations where the sincerity of their desire to transition is scrutinised. 63% of respondents reported that they had been considering medical transition for more than a year before they even requested a referral to a gender clinic, and 43% had been considering it for more than two. They will then wait three, or in some cases five or six years, for a first appointment. These patients have had ample time to consider their decision.

Yet media coverage suggests that transitioning is too easy. It also claims that there is an epidemic of detransition among trans people, even though permanent detransition is rare. According to a 2015 study, 8% of transgender people have detransitioned at some point, but 62% of those who detransition later transition again. The majority of people who detransition cite external pressure, usually from family and friends, as their reason for doing so. They don’t detransition because they weren’t really trans, but because they are pushed back into the closet.

A study of more than 3,000 patients at a UK gender clinic found only three who had permanently detransitioned. According to research recently conducted in the Netherlands, regret rates for gender-affirming surgery are much lower than those for surgeries such as knee arthroplasty.

This chance of regret is treated as a problem unique to gender-affirming treatment, but it is inherent to many forms of medical care. Regret is a consequence of living. We still have the right to make decisions on our own behalf.

Is there a ‘social contagion’?

RM There has been, over the past decade or so, an increase in the number of people who identify as trans and a shift in the proportion of those who, assigned female at birth, are trans boys or men. Where once male-to-female transitions were in the majority, now it’s female-to-male. It’s reasonable to ask why.

What’s not reasonable is to assert, with partial evidence, that these changes must certainly be for negative reasons. In 2018 Lisa Littman, an assistant professor at Brown University School of Public Health, published a study of “rapid-onset gender dysphoria” (ROGD). Parents of young female-to-male trans people were, said Littman, reporting similar-sounding patterns of behaviour: they came out suddenly and often belonged to a peer group with other friends identifying as trans. The young people’s stated identity might, she said, be a “social coping mechanism” for other psychological issues.

The theory seemed authoritative, with its scientific-sounding name, except that Littman’s choice of sources tended towards people with particular viewpoints. The parents whom she surveyed were found through three forums that described themselves as “gender-sceptical” and “thinking critically about the youth transgender movement”. This was in Littman’s own words an “exploratory study”; the label of ROGD had “not yet been clinically validated”. She has defended her work, saying that it uses “established research methods that have been used in many studies”, but she also clearly states that further research is needed.

Yet it has been seized on as established fact, for example by advocates for the cruel Arkansas ban on treatment for young trans people. Littman’s work has been used to support the views that there is an internet-inspired “social contagion” of delusion among young people, and that the medical profession is making physical interventions to address purely psychological conditions. Voluntary and life-transforming medical transition – hormone treatment and surgery – has been likened to barbaric 20th-century practices such as involuntary sterilisation in the name of eugenics.

It’s possible, even likely, that the increases in people identifying as transgender, especially female-to-male, are due to the greater visibility of trans people in general and trans men in particular. The internet and social media will have played a part in this heightened awareness. But why jump to the conclusion that this is indoctrination? Information, you could call it, or support, or solidarity. And why be so much more perturbed that people assigned female at birth should make choices about their own bodies?

Being trans and being autistic

FM If trans and autistic people have one thing in common – and this has been my experience as someone who falls into both categories – it is that we are not taken at face value when we talk about our identities and desires. There is also evidence of a link beyond that. A 2020 study found that autistic people are six times more likely to not identify with their birth sex. Autistic people are more likely to be LGBT in general, not just trans, with one study finding that 69.7% of autistic adults were not heterosexual. It is telling that the focus is on why autistic people are more likely to be trans in particular. It’s less publicly acceptable to express concern about young people identifying as LGB.

Autistic differences are usually framed as negatives, so the inevitable assumption is that if autistic people are more likely to be transgender, they must be doing something wrong. However, it is worth considering the inverse. A 2018 study found that autistic resistance to social conditioning may play an important role in incidence of trans identity. One possibility, therefore, is that rates of trans incidence in autistic people may be closer to the true rates in the human population. Non-autistic people are more susceptible to social pressure to conform, so they may be more likely to suppress a potential trans identity.

But focusing on the “why” of this link is missing the point. To those asking this question, I would ask: Why do you want to know? What would you do with the answer? I am suspicious of this line of questioning for the same reason I am suspicious of attempts to identify a so-called “gay gene”. The next logical step, after the search for a cause, is the search for a cure.

People who are not autistic often imagine autism as a kind of shell covering up the “real” person. The truth is that the autistic me is the real me. Therefore, if I am trans “because” I am autistic, it is only true in the sense that everything about me is because I am autistic.

The focus on this question demonstrates the pathologising attitude to which both autistic and trans people are subjected. Even the most personal parts of our identities have to be run past a gauntlet of adjudicators. A worthier question would be: “What unique needs does this population have, and how can we best serve them?”

Trans rights and women’s rights

FM I am constantly frustrated by the idea that women’s rights and trans rights are in opposition. These are not two separate categories. Some trans people are women, and therefore the struggle for women’s rights is also theirs, even if they do not experience all of the same issues as cisgender women. Some trans people who are not women are affected by issues that have historically been part of the women’s rights movement; for example, some transgender men and non-binary people also need access to reproductive healthcare. Trans people of all genders are affected by issues like domestic and sexual violence.

Feminist scholars have recognised for decades the necessity of including trans people in the feminist movement. Andrea Dworkin wrote in 1974: “Every transsexual has the right to survival on his/her own terms. That means that every transsexual is entitled to a sex-change operation.” She was vehemently opposed to the idea of defining womanhood by biology, today referred to with the slogan “sex-based rights”, directly comparing the notion of biologically based female supremacy to Nazi doctrine.

The rhetoric Dworkin denounced continues today. Trans people, particularly trans women, continue to be portrayed by some as deceitful threats to cisgender women’s safety. Even among those who are not actively antagonistic to trans people, there is a tendency to treat this question as an unsolvable paradox – that trans rights and women’s rights are irrevocably opposed, and one must be sacrificed for the sake of the other.

The cruellest part of this is that trans people are painted as potential predators in situations where they are far more likely to be victimised. It is hard to find reported examples of transgender people attacking or harassing cisgender women in public bathrooms; however, a 2016 study found that 12% of transgender people had been harassed in a public bathroom within the previous year.

The bathroom issue is apparently so evergreen that it is dragged even into places where it has no relevance. It became, for example, a central talking point in the debate about reforming the Gender Recognition Act. But trans people with and without gender recognition certificates have always used public bathrooms for the same mundane reasons as everyone else. Reforming the Gender Recognition Act could not possibly have any bearing on this, because no public bathroom requires proof of legal gender as a condition of entry.

I consider myself pretty thick-skinned to most of the ways in which trans people are criticised. I couldn’t care less what far-right Republican figures such as Rand Paul or Marjorie Taylor Greene think about me. But it causes me enormous pain to know that some women consider people like me a threat to their safety. I have been a feminist since my teens. I may no longer be a woman, but that doesn’t mean that I can’t lend my support to the feminist cause, just as I can support the cause of any marginalised group to which I do not belong. Trans people and cisgender women are natural allies, and it is detrimental to both groups to be pitted against each other.

What’s the issue with JK Rowling?

RM I imagine many readers won’t understand the problem that many trans people have with JK Rowling, who has become prominent in debates about trans rights. They see an admirable woman, subjected to vile attacks by toxic trolls, who only wants to defend “women’s and girls’ rights”, as she puts it in a long blog that has been on her website since last June, from the dangers posed by a “socio-political concept”. But as often in these debates, the devil is in the detail. Rowling misunderstands key issues in ways that might be inconspicuous to the general reader, but are crucial in their effect.

Related: Judge rules against researcher who lost job over transgender tweets

Take, for example, the case of Maya Forstater, who worked on a consultant’s contract for an NGO called the Centre for Global Development. She repeatedly proclaimed on social media the “truths” that “it is not possible for someone who is male to become female” and that “transwomen are men”. Forstater has strongly endorsed an article that compared transgender people’s use of pronouns to the date rape drug Rohypnol – relating, in other words, individuals’ desire to assert their identity to sexual violence. When her contract expired, and CGD chose not to renew it, she made a claim for employment discrimination.

The employment tribunal found against Forstater, although her case goes to appeal at the end of this month: “It is a core component of her belief”, says the judgment, “that she will refer to a person by the sex she considered appropriate even if it violates their dignity and/or creates an intimidating, hostile, degrading, humiliating or offensive environment.” Rowling took Forstater’s side. “Dress however you please,” she tweeted in December 2019, “… sleep with any consenting adult who’ll have you … But force women out of their jobs for stating that sex is real? #IStandWithMaya”.

But the basis of the tribunal’s ruling was that Forstater aggressively denied the identities of people with whom she might have to work, more than that she said that “sex is real”. Rowling gives similarly one-sided accounts of other controversies, for example defending Lisa Littman against “a tsunami of abuse”, without mentioning the valid grounds for questioning her study.

Rowling repeatedly refers to obnoxious people she calls “trans activists” without quite saying who they are, but who include unknown individuals who called her a “cunt” and a “bitch” on social media. She pays less attention to the fact that trans people also receive hateful abuse, or to the trans activists who have fair and well-founded disagreements with her. She describes some trans people, a touch patronisingly, as “adorable”, but seldom does she do them the honour of taking their points seriously.

Related: As the father of a trans man, I fear for the consequences of this cruel judgment | Rowan Moore

Her blog creates a loaded caricature: on the one side the vicious “trans activists,” on the other decent people like herself. There’s not the space here to point out all the times she does this, or all the times she seems to misrepresent contentious issues such as the Forstater case, but they are many. It’s hard to know what purpose these distortions serve, if not to bias the argument against trans people.

It should be obvious that it’s offensive to compare pronouns to Rohypnol. Or to call trans women “blackface actors,” as did the late Magdalen Berns, which Rowling didn’t mention in her blog when she praised Berns as “an immensely brave young feminist and lesbian”. This kind of language would rightly be condemned if applied to other minorities, but it seems to be acceptable in polite society to use it about trans people. To anyone who has nodded along to such statements, we ask: please stop and consider what all this feels like to trans people and their allies.

FM It should hardly need saying that trans people don’t want cisgender women and girls to be fearful in bathrooms. We don’t want people to undergo treatment they regret. But the terms on which these issues are discussed do little to help their understanding.

“Live your best life in peace and security,” tweeted Rowling about trans people. But it’s easy for opponents of trans rights to claim to back our right to be ourselves because it is the one thing that they cannot take away from us. Nothing can stop me being trans, so it’s pretty hollow to claim to support my right to do so.