BORN IN THE RIGHT BODY
Gender identity ideology from a medical and feminist perspective
Isidora Sanger
Copyright 2022 by Isidora Sanger
All rights reserved.
No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without written permission from the author, except for the use of brief quotations in a book review.
Cover design by Al Peters@2cheeseburgers
Contents
Foreword
The essays in this book are intended both as stand-alone pieces and as pieces of a puzzle that will form a clear picture of how we, as a society, came to engage in biological sex denialism and callous disregard for women's sex-based rights.
I hope this book serves as a record of an ignoble moment in history that should not be swept under the carpet and forgotten.
Chapter 1
About "Trans Women Are Women"
F or years, men who aspired to emulate women, whether by wearing stereotypically feminine make up and clothing or by undergoing medical gender reassignment, were referred to as "transwomen". More recently, however, the spelling was changed to "trans women". This enabled transactivists to argue that "trans women are women" and, because women are adult human females, "trans women" must be female too.
When challenged, they say: "Yes we know sex is immutable, this is why trans women were always female, their sex was just wrongly assigned at birth. 'Trans' is just another descriptor for a woman - like 'tall woman', 'Black woman' or 'disabled woman'. There is no one way to be a woman. Some women have blonde hair, other women have a penis. This penis, by the virtue of belonging to a certain kind of 'woman', automatically becomes a 'female penis'. If you refuse to accept any of this, you are a transmisogynistic bigot. "
On the surface, this novel interpretation of the word "woman" may seem progressive and kind.
"If people tell you who they are - believe them. Acceptance without exception. Trans rights are human rights!"
The problem is, not only does the claim "trans women are women" have no basis in science or logic - men and women, males and females, are immutable biological sexes and circular definitions are meaningless - it also erases men who identify as women. Only men can be "trans women". This is evident from the fact that undergoing a process of "male-to-female transition" is a fundamental defining quality of being a "trans woman". Therefore, if you were never male to begin with, you were never a "trans woman" either.
This creation of a special category of "man", and simultaneous erasure of it in language, has had a profound effect on women, and on the men who wish to emulate them.
Medical implications
Historically, medical gender reassignment (formerly known as "sex change" or "sex reassignment") was designed to convert homosexual males into straight members of the opposite sex. These males suffered homophobic abuse throughout their lives, but instead of increasing tolerance toward them, society and the medical profession declared them "abnormal" and punished same-sex attraction. "Feminine essence", "man trapped in a woman's body", "born in the wrong body", "wrongly assigned male at birth" were all linguistic sleights of hand designed to obscure homophobia, as well as the fact some men feel so uncomfortable with their bodies and masculine social roles, they seek to drastically modify their appearance in order to escape them. If only his facial features were more feminine, voice higher, breasts larger, hair longer, then society would recognise him for the woman he really is on the inside, and he would feel happier.
This projection of psychological discomfort onto the body is not dissimilar to how some women feel so uncomfortable with their appearance and social roles, they starve themselves into losing secondary sexual characteristics and body fat. However, society generally agrees that it is harmful to affirm an anorexic's irrational belief that they are overweight and to offer liposuction as treatment for their distress. Why, then, is extreme body modification considered appropriate treatment for psychological distress at being born one sex and not the other?
Gender dysphoria, body dysmorphic disorder (BDD) and eating disorders are separate entities but in practice they often co-exist. A seemingly exclusive focus on body alteration as the desired intervention for those who identify as the opposite sex (which is practically synonymous with a psychiatric diagnosis of "gender dysphoria") means that body dysmorphia is a significant, if not dominant, trait in the transgender phenomenon.
Although BDD is a contraindication to cosmetic interventions - or at least considered to be a clinical presentation that requires careful multi-disciplinary team assessment - in practice, patients with BDD are under-diagnosed and can usually find a surgeon who is willing to operate, as long as the patient signs a consent form. Therefore, the practice of treating psychological discomfort with surgery, despite the likelihood of unsatisfactory outcomes, is not without a precedent.
However, "medical gender reassignment" goes beyond cosmetic procedures such as lip fillers and rhinoplasty. It involves removal of healthy body parts, such as double mastectomies and hysterectomies for women and castration and vaginoplasties for men, as well as an administration of opposite-sex hormones in doses high enough to masculinise females and feminise males. These interventions carry a high risk of medical injury such as debilitating post-operative complications, loss of function and a significant increase in long-term morbidity, mortality and suicide.
Considering that evidence shows the long-term mental health outcomes worsen post medical gender reassignment (Dhejne, et al., 2011), it is not clear what the rationale is for these interventions, or why trans-identifying patients are encouraged to risk their own health in pursuit of a costly, yet unattainable, goal of sex change.
Whether or not these patients resort to medication and surgery in order to "pass" as the opposite sex, society's conflation of self-declared "gender identity" with biological sex can also result in their biology being neglected in a clinical context (Dahlen, 2020; Wilson, 2021).
In the NHS, it has become common practice to change the sex markers on medical records to bring them in line with a patient's self-identified gender identity. (PCSE 2020)
This has created such confusion, that the NHS now invites men who changed their sex marker to "female" for smears of cervices they do not have, while not inviting them for sex-appropriate screening such as an ultrasound scan to check for the presence of abdominal aortic aneurysm. On the other hand, women who change their sex markers to "male" stop being automatically invited for sex-appropriate breast and cervical screening. Clinicians are expected to mitigate the risks of this, even though they report finding it increasingly difficult to bring up trans-identifying patients' biological sex in discussions about their health, lest they be accused of "misgendering" and "transphobia".
A further consequence of the mantra "trans women are women" specifically, is that men only need to state their pronouns are "she/her" and they are automatically placed on women's hospital and psychiatric wards (Helyar, Hill & Griffin, 2021). This system is not only completely open to abuse by male predators, it has also deprived women of much needed single-sex spaces at times when they are at their most vulnerable to male violence.
