Strange Bedfellows: Anachronisms,Identity Politics,and the Queer Case of Trans*

This article explores trans identities, as articulated within a few historical texts. From early literary depictions of gender difference, to medicalized conceptions of transsexualism, to a proliferation of trans and queer identities represented by an ever-expanding “alphabet soup” of identity labels, our understandings of identities, sexualities, and queer community-building continue to change. I use the notion of “kind-making,” as elaborated on in the work of Ian Hacking, to illustrate that some queer and trans identifications are affiliative, whereas others are contrastive or oppositional in nature, and these structural differences have important implications with respect to understanding identity and sexuality, and also trans inclusion within LGBT communities and activist efforts.     

From Otherness to Alliance

Abstract

The first part of this article presents the epistemological evolution of the therapeutic frameworks regarding the treatment of transgender individuals and their partners. It outlines a medical approach and two others-the developmental approach and the deconstructive approach, ones not based on the conception of transgender identity as pathological. Two case studies of couples presenting with gender identity-related issues illustrate their application with particular emphasis on the relational process of gender identity formation and on partners of transgender-identified persons.     

Listening to children imagining gender: observing the inflation of an idea

Using three of the clinical articles in this special issue of the Journal of Homosexuality as examples, the author attempts to show how their views of gender may influence clinicians' conceptualizations and treatment choices in response to children diagnosed with gender identity disorder (GID), or gender dysphoria. In particular the author argues that the belief that gender is a psychophysiological entity that is organismic and transhistorical, that is, the view known lately as essentialism, promotes more invasive interventions (e.g., endocrinological and surgical) and mistakenly deemphasizes psychological therapies as a clinical response to the suffering of trans children. He tries to show that the drawbacks of essentialism and its correlated treatment approaches are twofold, that a) they promote treatments with insufficient attention to our limited knowledge regarding their safety and efficacy, and b) they advance a reified differentiation of the genders that is politically problematic. The author suggests that a better response to trans children would be one that emphasizes the child's broadly subjective role in his or her construction of transgressive, gender-related psychological and interpersonal phenomena (both painful and not), thus, offering a deeper validation for trans children's challenges to our gender system.     

Commentary on the treatment of gender variant and gender dysphoric children and adolescents: common themes and ethical reflections

This commentary offers preliminary ethical reflections on the range of treatments for gender variant and gender dysphoric children, adolescents, and young adults described in the preceding five clinical articles. After clarifying the terminology used to discuss these issues, this commentary reviews several common themes of the clinical articles. Focusing on ethical values of informed consent, full disclosure, the minimization or avoidance of harm, and the maximization of life options, the commentary expresses concerns about various treatment options endorsed by some of the articles. In particular, this commentary focuses on how these practices problematically reproduce social prejudices and stereotypes and how they fail to acknowledge and embrace the multiple pathways for expressing one's gender. It also compares and contrasts the ethical issues related to gender variant and gender dysphoric youths and youths who identify as lesbian, gay, bisexual, or queer.     

Gender dysphoric/gender variant (GD/GV) children and adolescents: summarizing what we know and what we have yet to learn

The optimal approach to treating minors with gender dysphoria/gender variance (GD/GV) is much more controversial than treating these phenomena in adults. This is because children have limited capacity to participate in decision making regarding their own treatment, and even adolescents have no legal ability to provide informed consent. Minors must, therefore, depend on parents or other caregivers to make treatment decisions on their behalf, including those that will influence the course of their lives in the long term. Presently, the highest level of evidence available for selecting among the various approaches to treatment is best characterized as "expert opinion." Yet, opinions vary widely among experts and are influenced by theoretical orientation and assumptions and beliefs regarding the origins of gender identity, as well as its perceived malleability at particular stages of development. This article outlines some of the more salient points raised by the clinicians who treat GD/GV and their discussants. This article summarizes what the editors believe is known and what has yet to be learned about minors with GD/GV, their families, their treatment, and their surrounding cultures.     

A comprehensive program for children with gender variant behaviors and gender identity disorders

This article describes a clinical program designed to address broadly defined mental health needs of children who experience stress related to not fitting into normative gender types and argues for the need for integrated services that address the spectrum of gender variance. An array of services useful to children and their families is proposed. The article describes the clinical population served, common clinical and social problems, and a rationale for the interventions provided.     

Commentary

Abstract

The diagnosis of Gender Identity Disorder (GID) in the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 2000) continues to be controversial. Three papers by Hill et al. (2005), Lev (2005), and Winters (2005) each offer a critique of this diagnosis. Drawing from our clinical experience and research with transgender youth and adults as well as the scientific literature on gender dysphoria, we will comment on the main issues raised by these authors: the criteria reflect bias, who needs this diagnosis, and how can we lessen the associated stigma. Our discussion will clarify the rationale behind GID, and illustrate the dilemmas inherent in reform or removal of the diagnosis from the DSM.     

Beyond Risk Factors

SUMMARY

This article provides an overview of important themes in European research regarding sexual behavior and the risk for HIV infection. There is a growing critique of HIV prevention among European theorists which focuses on four themes: (1) That current models over-emphasize the role of rational decision-making in sexual behavior; (2) That the [individual is viewed as the unit of research and intervention; (3) That the person is assumed to be static, having qualities which remain unchanged over time; and, (4) That the social/ cultural context of human interaction is ignored in relation to sexual behavior. To counteract these perceived deficiencies, it is proposed that future research and practice incorporate the following elements: sexual behavior as being primarily an interaction between persons as opposed to a decision of individuals; the effects of time on sexual decision-making; the cultural context and its influence on sexuality; the subjective experience of love as relates to sex; the role of power in determining sexual interaction; and the symbolic meaning of sexual acts.     

变牲人的人权实现和法律保障——聚焦《变性手术技术管理规范（征求意见稿）》

卫生部发布的《变性手术技术管理规范（征求意见稿）》，在一定层面上肯定了变性手术的合法性。通过对三组名词的比较，进而分析变性手术成功的标准等问题，并对其术后性别更改等问题提出法律建议，具有一定的现实意义。     

Do Workplace Gender Transitions Make Gender Trouble?

This article examines what happens when an employee makes the transition from one recognized gender category to another and remains in the same job. Drawing on in‐depth interviews with transmen and transwomen in Texas and California, we illustrate how a new social gender identity is interactionally achieved in these open workplace transitions. While transgender people often are represented as purposefully adopting hyper‐feminine or masculine gender identities post‐transition, we find that our respondents strive to craft alternative femininities and masculinities. However, regardless of their personal gender ideologies, their men and women co‐workers often enlist their transitioning colleague into gender rituals designed to repatriate them into a rigid gender binary. This enlistment limits the political possibilities of making gender trouble in the workplace, as transgender people have little leeway for resistance if they wish to maintain job security and friendly workplace relationships.