Dear Ms. Rowling,
I’ve seen your tweets expressing concerns around gender transition, and I’ve read your essay on your website. Twitter not being the place for nuance, I understand your frustrations. I do want to address some of what you’ve been saying–especially since you’re doubling down on this issue.
First, I want to address your concerns around trans women, in some sense stealing women’s bodies. This is a concern that has been popular in certain circles of feminism for decades. The rub though is that gender identity is established early in life–some research puts it as early as age 3, though others push it towards pre-adolesence. Regardless, the sense of the gender identity not matching biological sex is not a spur-of-the-moment decision. The societal pressures to conform to biological sex can make it seem that way but that’s all it is–appearance.
Second, I think it’s important to point out that a growing body of research is challenging the notion of a simple duality even within biological sex. Intersex births are not common, but not unheard of either. Chromosomes can come in combinations like XXY and XYY that further complicate things. Hormones can also come in weird combinations, and our genetic code has so many minor variations beyond the sex chromosomes that talking about biological sex can be quite difficult to do.
Gender identity too, is no longer considered dualistic. Many cultures the world over have different, and often contradictory conceptions of masculine and feminine; others have room for gender identities that don’t fit easily within either label (the Indigenous Peoples of North America attempt to capture this in the agreed upon term of Two-Spirit); and many people today are identifying as non-binary and rejecting gender identity altogether. Gender expression is becoming something that differs as widely as the individual–and given that gender expression is also ever-changing, historically inconsistent, and often contradictory, I’m skeptical of any claims that suggest that’s a bad thing.
Third, I do want to make sure your clear of the distinction between sexual orientation and gender identity. You’ve expressed some concern around transgender issues leading to homosexual and bisexual erasure. These are, in fact, not the same thing. Homosexuals and bisexuals may also find that their gender identity doesn’t match their biological sex–but that is not a given and many homosexuals and bisexuals don’t find that disconnect. There is also not a lot of incentive to transition in order to escape homophobia and biphobia. Transgender people are often ostracized even within the homosexual and bisexual communities–which isn’t that surprising because bisexuals are often ostracized within homosexual communities. The human inclination towards prejudices and biases over any detectable difference continues to plague us, it would seem.
Now to the meat of the issue. There are two basic points to address here: transgender affirmation, and body-alignment procedures. First, on the point of transgender affirmation, I’ve read your posts and your essay and I think that you’re doing better on this than many are portraying you as. You are not denying transgender people exist, and you are saying you support them fully. This is good–the research shows that affirming gender identity has strong positive correlations with better mental health and reduced levels of suicide attempts. The issue you seem to be especially concerned with is bodily transitions through hormones and sex re-assignment surgery. There IS some merit in this. Transitioning is not without risks and it’s something that needs to be decided on with fully informed consent.
Here’s where I think you cross a line: in presenting such transitions as an analogue to conversion therapy, or something that is decided far too arbitrarily. Conversion therapy was an immensely harmful process because it was trying to change something that could not be changed, and was thus only succeeded in repressing the authentic identity of countless people over the years–which is definitely a road to extremely negative mental and physical health outcomes. Hormones and sex re-assignment are exactly the opposite–they are changing the biological sex to reflect the gender identity of an individual thus allowing MORE authentic identity, which is a road to extremely positive mental and physical health outcomes.
In your most recent series of tweets you compared hormones to anti-depressants and said that both should be used only as a last resort. The issue with that is that SSRIs are actually quite effective for many and the idea of using them as a last resort is not always the most medically sound. The ideal, of course, is to use them to stabilize the situation, in conjunction with CBT and mindfulness therapies with the hopes of eventually taking the anti-depressants out of the equation–but in a number of folks, production of serotonin just doesn’t match the demand. I’m on the autism spectrum myself, and my dopamine, serotonin and norepinephrine levels are all naturally under-producing. I take SSRIs and NORIs daily and wouldn’t be able to function without them–despite years of CBT and mindfulness therapy. My dopamine levels are a function of my autistic neurochemistry and require careful self-monitoring to keep up. I was put on an anti-psychotic and a SSRI anti-depressant years ago, at low dosages with the hopes of eventually getting off of them. I never was able to, and the dosages had to, in fact, be increased. Eventually, we realized the anti-psychotic was probably not helping any longer so I was taken off of it and eventually put on an NORI because while there was some improvement there wasn’t enough. With the SRRI and NORI together, my life improved drastically. I was able to finally sleep a standard amount of hours rather than too many, and I was able to acquire and hold onto a job–admittedly, still at reduced hours. But if I wasn’t on initial medication at age 8, I wouldn’t be here today. I had already demonstrated suicidal ideation by that age, and even with the meds it was years before I overcame that particular struggle.
So here’s the takeaway: yes, transitioning has some risks associated with it, and yes, long-term effects aren’t fully understood. What we do have is plenty of psychological and sociological data that suggests a great deal of negative outcomes when gender identity is not affirmed, and if hormones and sex reassignment surgery can help with authentic expressions of identity, then they are worth pursuing. In the end, however, regardless of whatever you or I or anyone else may think, the decision comes down to the medical provider and the person seeking to transition. Similar to abortion, there are many factors that go into such decisions and no one legal standard can capture all of them–so the practical result is: their body, their choice. Advocating anything less runs the risk of sending a message of shame and rejection which, in this case, can lead to far greater harm than the possible risks of affirmation.
Guelph, Ontario, Canada