Book contents
- Frontmatter
- Dedication
- Contents
- Introduction
- 1 The scope of sex/gender embodiment and self-determination
- 2 The desire for (political) self-determination
- 3 Medical governance and governing the healthcare assemblage
- 4 (Self-)determining trans, sex/gender expansive and intersex people
- 5 Self-determination in school cultures
- Concluding remarks
- Notes
- References
- Index
4 - (Self-)determining trans, sex/gender expansive and intersex people
Published online by Cambridge University Press: 04 January 2022
- Frontmatter
- Dedication
- Contents
- Introduction
- 1 The scope of sex/gender embodiment and self-determination
- 2 The desire for (political) self-determination
- 3 Medical governance and governing the healthcare assemblage
- 4 (Self-)determining trans, sex/gender expansive and intersex people
- 5 Self-determination in school cultures
- Concluding remarks
- Notes
- References
- Index
Summary
Introduction
In this introduction to the chapter, I would first like to contextualize some aspects of the diagnostic assemblage that trans, sex/gender expansive and intersex people are affected by in the UK. According to UK-based psychiatrists (Richards et al, 2015) working in a large gender identity clinic, the funding systems for sex/gender healthcare are arranged in such a way as to make it effectively impossible to assist trans people with hormones and surgeries if they do not have a psychiatric diagnosis which relates to their sex/gender. However, the clinicians accept that this should not necessarily be the case and write:
Is diagnosis a useful frame within which to conceptualise trans experience? We submit that it is not. Diagnosis is still necessary for funding and sundry bureaucratic matters, but it is a poor method of understanding the complex interplay of biology, psychology, personal and social influences which form this complex topic; and especially the complex interplay of such elements in any given trans person. Our clinical experience is that understanding and assisting with these elements and the interplay within them is of far more use than the rather procrustean approach of ‘fitting’ a given trans person within a diagnostic box and potentially dismissing the elements which do not comfortably fit … We will, of course use diagnosis for pragmatic ends to assist the trans people who see us, but, to help, not to label, and given the long history of pathologisation, and longer history of diversity, never as a de facto understanding that trans people are disordered. (Richards et al, 2015: 311)
The guest editorial from which this quotation comes has, potentially, a self-determination message and a patient-centring message, which would, if developed, produce new reconfigurations of trans, sex/gender expansive and intersex people's healthcare provision. The representation of this healthcare assemblage by these clinicians shifts from diagnosing trans as pathology to providing a facilitative process so that trans healthcare interventions can be supported. Richards et al (2015) suggest that diagnosing is strategic, and that they do not really think of trans and non-binary people as disordered.
- Type
- Chapter
- Information
- Sex/Gender and Self-DeterminationPolicy Developments in Law, Health and Pedagogical Contexts, pp. 111 - 140Publisher: Bristol University PressPrint publication year: 2021